News and Press Releases

August 2010 for Immediate Release: LDC Acquires New MRI Prostate Imaging Scan

September is Prostate Cancer Awareness Month

Lexington Diagnostic Center & OPEN MRI has acquired the capability of providing MRI of the prostate to demonstrate the presence and localization or the absence of cancer.  This test utilizes an MRI of the pelvis area with and without contrast enhancement using a surface coil.

Special MRI protocols and software (VividLook® by iCAD®) provides dynamic contrast enhanced (DCE-MRI) images that measure abnormal blood flow that is present in cancer.  Colorized maps indicate areas in the prostate that are suspicious or abnormal. The test takes about 40 minutes and does not require a rectal probe or difficult bowel preparations.

Prostate cancer is the second most common cancer in men after skin cancer. There is a one in two chance that a man will develop prostate cancer.  Most cases of prostate cancer are detected by elevation of a blood test, Prostate Specific Antigen (PSA) and/or Digital Rectal Exam (DRE).

Statistics show that when the PSA is abnormal, only 12 to 20% of men will have a biopsy positive for cancer. When the PSA is normal, 15% of men will still have cancer. At least 20% of cancers are missed when 10 to 30 random (blind) biopsies of the prostate are taken. 

Visualizing cancer within the prostate has been difficult because the prostate is small and deep in the body. Power Doppler Ultrasound using a rectal probe may be useful but random biopsies have been the main diagnostic tool.

Dynamic Contrast Enhanced (DCE-MRI) images have for the first time provided the ability to highlight and localize prostate cancer.  This allows urologists to target specific areas of the prostate for biopsy and increase the chances for finding cancer if is there.  In addition DCE-MRI can help in pre-treatment planning and in post-treatment follow up. DCE-MRI will also be useful in patients who are on blood thinners and who cannot have a biopsy.

Other diagnostic imaging tests used to evaluate prostate cancer at Lexington Diagnostic Center are Prostacint® nuclear scans, nuclear bone scans, PET scans and chest x-rays. 

Lexington Diagnostic Center and OPEN MRI is the exclusive provider in the Bluegrass of VividLook® DCE-MRI and Prostacint® nuclear medicine scans.

                

Blue Color on DCE-MRI indicates normal blood flow and no evidence of prostate cancer.

Red color on DCE-MRI indicates abnormal flow on the right indicating prostate cancer.

Red color on DCE-MRI indicates abnormal flow on the right indicating prostate cancer.

Prostascint testing for Prostate Cancer

Lexington Diagnostic Center and OPEN MRI has been selected by the Cytogen Company to provide Nuclear Medicine scanning of the prostate with ProstaScint® to determine if prostate cancer has recurred. This is procedure, when added with CT Fusion, has added new and valuable information to Urologists and Oncologists to assist in the diagnosis and treatment of recurrent prostate cancer.

Lexington Diagnostic Center and OPEN MRI is the only facility in the Bluegrass Area to provide this service and one of only four in Kentucky. For more information click on this link   CYTOGEN.COM

February 2010: Safety Notice For Immediate Release

Important New Safety Guidelines for MRI Scans of Patients with Implanted Medtronic Pumps

Many patients with chronic pain or spasticity have had pumps implanted to deliver constant doses of medication into the spinal canal for pain treatment, to control spasticity or to deliver cancer chemotherapy . Medtronic® is a major supplier of these pumps. Many of those patients also require MRI scans and in the past we have successfully performed many MRI scans in both our Open (0.6T) and High Field (1.5) MRI. It has long been known that the MRI magnet will temporarily stop the pump action for the duration of the scan, but the pump will restart on its own. Our past procedure has been to have the proper pump action checked by the pain management doctor after the scan.

Medtronic Corporation, has recently issued new safety notifications for the Synchromed EL® and Synchromed II® pumps relative to potential problems for MRI scanning in all 1.5 T and 3.0 T MRI conventional scanners if the Z axis of the static magnetic field is oriented 90 degrees to the flat side of the pump. In some cases, the pump motor has been permanently disabled requiring that a new pump be inserted.  For patients on Lioresal Intrathecal® (baclofen) for spasticity, the sudden stopping of baclofen can be dangerous and even life threatening. For patients on pain medications, this will result in resumption of pain.

These pumps are usually placed under the skin so that the flat side of the pump (access port side) is parallel to the surface of the torso. In conventional 1.5 T and 3.0 T scanners, the Z Axis travels through the center of the bore through the long axis of the patient from head to foot, therefore the Z axis is zero degrees to the flat side of the pump, and in this situation the MRI will stop the pump temporarily, but not permanently damage it.

Medtronics states that they have not tested the pumps in the open or standing MRIs they also indicate verbally that they have received no reported incidents of pump failure in the Open MRI.  We have performed MRIs on numerous patients with Medtronic pumps without any known incidence of permanent pump failure. In Open or (standing) MRIs, the Z axis goes from top to bottom (or side to side) in an anterior-posterior direction through the body so that the Z axis is, in fact, 90 degrees to the face of the pump.  However, most Open or standing MRIs have magnetic field strengths of 0.6T, which is considerably lower than the field strength of conventional MRI scanners.

Effective immediately, at Lexington Diagnostic Center & Open MRI, before performing MRI scans on pump patients with our 1.5 T conventional MRI we will have our technologist, nurse or doctor ascertain that the flat side (port access side) of the pump is in its normal position facing the outside of the body.  We will continue to perform OPEN MRI (0.6 T) scans on patients who have implanted Medtronic pumps (Synchromed®models EL and II).

For more information go to the MedtronicII® web site:

http://professional.medtronic.com/devices/synchromed-II-for-spasticity/mri-guidelines/#synchromedII

November 2009 Safety Notice..For Immediate Release

LDC Policies Reduce the Risk of Serious Side Effects from Gadolinium Contrast for MRI

Nephrogenic Systemic Fibrosis (NSF)

The contrast agent commonly used in MRI is a compound that contains and binds gadolinium.  (Unbound free gadolinium is very toxic.)  There are several of these compounds including Magnevist®, Omniscan®, OptiMark®, ProHance®, and Multihance®.  For years we thought that all of these agents were very safe and without serious side effects.

However, in 2006 there began to be reports of several cases of an unusual serious debilitating and usually lethal condition in which the patient developed thickening and stiffness of the skin and underlying connective tissue, joints, eyes and internal organs.  All of these patients had two things in common, all had renal failure and all had received one or more of the gadolinium compounds for MRI contrast. This condition is called Nephrogenic Systemic Fibrosis (NSF). There seemed to be higher rates of NSF associated with Omniscan®, Magnevist®, and OptiMark® and almost none with ProHance® and Multihance®. Fortunately, we were not aware of any cases of NSF in patients we had scanned.

In June 2007 Lexington Diagnostic Center instituted a two policies relating to the use of gadolinium contrast. The first policy was to use only half dose Multihance®. We did this for several reasons:

  • It is the only compound for which there were no reported cases of NSF when it was the only contrast agent that the patient had received.
  • It is a different type chemical compound when compared to the others and the gadolinium is more tightly bound. 
  • It is eliminated from the body by two routes, the liver and the kidneys rather than just the kidneys, as is the case in the other compounds.
  • It seems to be just as effective in half dose as in whole dose so less total gadolinium is used.

The second policy was to screen patients who were at risk for renal disease with a blood test to test kidney function (serum creatinine).  If the patient has some degree of renal failure, then we will only give Multihance® after consultation with the patient’s referring physician and weighing the risk vs. the benefit.

In October 2008, we revised our criteria based on new information and have eased the restrictions on mild kidney failure.  We continue to be fortunate to have experienced no known cases of NSF in our patient population. 

In October 2009, the results of a study at Emory Hospital in Atlanta and University of North Carolina, Chapel Hill were published in the Journal Radiology. In this study, these two institutions instituted similar changes and guide lines in the use of gadolinium for MRI contrast as we did and the study showed that no new cases of NSF have been diagnosed.

Based on this new study we believe that we have adopted a very safe strategy to best protect our patients from serious side effects from MRI contrast agents. We will continue to monitor the situation and adapt to any new recommendations.

July 2009.....For Immediate Release

Kentucky Insurance Companies now Required to Pay for Screening Virtual Colonoscopy

The 2008 Kentucky General Assembly has passed legislation requiring Kentucky commercial insurance companies to pay for Screening Virtual Colonoscopies just as they would for any colon cancer screening test approved by the American Cancer Society. Medicare and Medicaid do not yet do so, however strong pressure is being applied to do so.

Virtual Colonoscopy is recommended every 5 years for people 50 and older. For people at high risk, starting earlier and repeating more frequently may be appropriate.

Lexington Diagnostic Center and OPEN MRI was the first in Lexington to perform virtual CT colonoscopy and has been doing so since 2004. 

July 2009.....For Immediate Release

FDA Releases Silicone Breast Implants for Use.

Recommends Breast MRI to detect ruptures.

Silicone breast implants were removed from the market for several years due to concerns about the health implication of rupture. After much research, the suspected side effects of rupture were found to be very low and silicone implants have again been released for use.  However, because of concerns about local reactions or migration of the silicone from the chest wall to other organs, MRI has been recommended every 3 years to detect silent rupture.

Lexington Diagnostic Center has been on the forefront of providing Breast MRI for implant rupture determination as well as for Cancer detection in women with high risk for breast cancer, or who have very dense breasts or implants.  (See press release below)

September 2008.....For Immediate Release

Virtual Colonoscopy found to be as accurate as traditional optical colonoscopy.

The American College of Radiology (ACR) Imaging Network published results from their National CT colonography Trial that found that the accuracy of CT Colongraphy (virtual CT colonoscopy) was comparable to that of traditional optical colonoscopy for the detection of clinically significant colon polyps.  The report was published in the New England Journal of Medicine*in September.

The American Cancer Society has recommended that virtual CT Colonoscopy be included in the list of Recommended Screening tools for Colorectal Cancer in New Screening Guidelines. The ACR has supported this position by the American Cancer Society.

Lexington Diagnostic Center and OPEN MRI was the first in Lexington to perform virtual CT colonoscopy and has been doing so since 2004.  *Johnson CD, Chen MH, Toledano AY, et al.: Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med 359 (12): 1207-17, 20

Image Gently® Program for Children
Lexington Diagnostic Center is proud to be a part of the Image Gently® campaign.  We are committed to reducing the risks posed to children as a result of radiation received from medical imaging.  We pledge to “child-size” the scan by using the lowest amount of radiation possible, using a single phase scan when adequate, and scanning only the indicated area.

For additional information on the Image Gently program visit
www.imagegently.org

May 2007, Breast MRI now recommended annually by the American Cancer Society and the American College of Radiology in High Risk Patients

Women at high risk for Breast Cancer include:

  • Women who have BRCA1 or BRCA2 genetic defects or 1st degree relatives with those defects
  • Women who have a personal history of breast cancer or who have 1st degree relatives with breast cancer.
  • Women who have had radiation therapy to the chest between ages 10 and 30 for lymphoma or leukemia.
  • Women with a new diagnosis of breast cancer in one breast to determine if there is cancer in the other breast.
  • Women who have cancer in an axillary lymph gland with out obvious primary.
  • Women who have very dense breasts.
  • Women who have breast implants.

The recommendations for all other patients not at high risk is to continue to have annual mammograms and do self examinations.

Follow up: Lexington Diagnostic Center 2nd annual LEAP Competition installation complete.

In October 2006 Lexington Diagnostic Center hosted the 2nd annual Lexington Extraordinary Art Project. This competition was the idea of Dr. David Duboc and is designed to encourage local UK student sculptors by having a juried competition with the winner getting a commission to erect a large statue on the property of the host.

The winner was Luke Achterberg whose winning entry is entitled “Getting Back Up.”   Mr. Achterberg is a MFA student in the University of Kentucky School of Fine Arts and studies under Professor Garry Bibbs. The sculpture is 17 feet tall and was finished and erected in the Spring of 2008 in front of Lexington Diagnostic Center. Second place was awarded to James Kerr, Third place went to Michael Martinez and Patrick White received the Lexington Diagnostic Center Staff Pick award.

The Sculpture was installed in the spring of 2008. The sculpture competition was judged by a panel of five including Centre College Blown Glass Artist, Steven Rolfe Powell, Erica Strecker of Strecker Studio and her husband Tony Higdon of Iron Horse Forge in Lexington, Charles E. Barhhart, III Architect with Sherman Carter Barnhart in Lexington and Deborah Drury of Deborah Drury ASID Interior Design in Lexington.

Winner Luke Achterberg displays model of “Getting Back Up” with Sponsor Dr. George Privett

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Lexington, KY 40504
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