Category: Work stuff

This will make my life very busy in the coming years.
Status of HR 6331
Full text of HR 6331
Section 135 covers provisions for imaging modalities.

(e) Accreditation Requirement for Advanced Diagnostic Imaging Services-
(1) IN GENERAL-
(A) IN GENERAL- Beginning with January 1, 2012, with respect to the technical component of advanced diagnostic imaging services for which payment is made under the fee schedule established under section 1848(b) and that are furnished by a supplier, payment may only be made if such supplier is accredited by an accreditation organization designated by the Secretary under paragraph (2)(B)(i).
(B) ADVANCED DIAGNOSTIC IMAGING SERVICES DEFINED- In this subsection, the term ‘advanced diagnostic imaging services’ includes–
(i) diagnostic magnetic resonance imaging, computed tomography, and nuclear medicine (including positron emission tomography); and
(ii) such other diagnostic imaging services, including services described in section 1848(b)(4)(B) (excluding X-ray, ultrasound, and fluoroscopy), as specified by the Secretary in consultation with physician specialty organizations and other stakeholders.

The last couple of weeks have had me busy working on a couple of lectures I have to give to a group of cardiology fellows at work. In the process of simplifying the lecture material (taking the “One picture is worth a thousand words approach”), I’ve been making up a new batch of graphics for my lectures using Inkscape, which I’m rapidly falling in love with.
A graphic artist I am most definitely not, so creating the graphics has been a lot of work: trying to imagine how to illustrate the concept I’m trying to get across, Googling info on how to make Inkscape do what I imagined up and tweaking the result.
By most standards, most of what I’ve created so far is pretty crude and simplistic, but it looks reasonably decent and (hopefully) gets the point across. I’m sure in the coming months, most of my other lectures will end up getting a similar treatment.
A short list of some of the Inkscape resources I’ve come across

• Inkscape
• Inkscape Tutorials
• Quick guide to Inkscape
• Inkscape: Guide to a Vector Drawing Program
• Inkscape FLOSSManual

A few years ago when I was at a weekend course at MD Anderson, I discovered that not all medical physicists have had the luxury of seeing the innards of the equipment we’re supposed to be experts on. This was something of a surprise to me. I’d been seeing the insides of equipment since my undergrad days and always made it a point to be around whenever I heard the service guys were working on a piece of equipment. I had assumed that most of the people at the course with me also had the same opportunities at some point in their career, most of them being much older than I was. Apparently I was wrong.
Since a big part of my job is keeping tabs on all the imaging equipment, I get to see most of it in various stages of undress at some point or another. This usually happens when the equipment is being installed or being serviced. Every now and then I also have my camera with me to take pictures, so I decided to make a Flickr stream of some of the naked imaging equipment I’ve taken pictures of.

I have a feeling this is going to mean that I’m going to be a lot busier in the near future.

UnitedHealthcare (UHc) will require all facilities performing diagnostic imaging to obtain appropriate accreditation by third quarter 2008, in order to continue receiving reimbursements for many imaging procedures. The deadline had previously been March 1.

UHc has recognized the ACR and the Intersocietal Accreditation Commission as acceptable accrediting organizations for medical imaging, and has designated the following modalities as falling under the mandate: CT, CT angiography, MRI, MR angiography, PET, nuclear medicine/cardiology and echocardiography.

With the new Siemens Symbia SPECT/CT cameras comes yet another programming language I need to learn.
Nuclear medicine, unlike other imaging modalities, generally requires a good deal of technologist intervention to process, analyze and present the images. In an academic hospital setting, a lot of customized analysis and processing usually needs to be done. In the past, to handle these tasks most companies have provided their own proprietary programming/macro facility which generally don’t look much like conventional programming languages. Guess who gets to learn all those programming/macro environments and develop all those custom programs.
The first one I learned was the PIXIE macro language used on Picker’s Odyssey platform. Completely proprietary and bearing absolutely no resemblance to any programming language I had encountered at that point. Probably based on something, but what I couldn’t say. Keywords were delimited using a strange .keyword. syntax. Not to hard to use, but cumbersome when it came to creating displays for the data.
GE’s Xeleris platform uses Visual Basic with a custom library to provide access to the image data and perform various operations. A little more standard, easier to use, but somewhat sparsely documented. Still somewhat cumbersome to use when creating displays for the data, but at least it’s BASIC.
The Syngo platform that runs the Symbia cameras uses IDL for programming, which means I have to learn IDL and how it integrates with Siemens’ Syngo platform.
The good thing is that companies have dumped the proprietary programming/macro facilities and deploying more common development environments. I just wish they would all go with one language. Create their own libraries to deal with the images, but stick with one language to make it easier on folks like me who have to work in multi-vendor environments.
I don’t really care what language they pick. Just use the same one. That way all I need to learn are the libraries and objects each company uses rather than having to learn completely separate languages for each gamma camera I have to work with. And I’d also be able to develop one program that would work on all the cameras instead of having to maintain 2 or 3 versions of the same program. Oh, wouldn’t that be just marvelous!
Now, while TPTB figure out how and when they’re going to get me a license for IDL, I guess I’ll start playing with GDL (good thing I’m using Linux now) and figuring out what books to add to my library to learn IDL from.