PSMA PET-CT Medicare Rebate

As of 1 July 2022, Medicare rebates are available for patients suffering from prostate cancer. Medicare will now cover the cost of whole body PSMA PET-CT scans for initial staging of prostate cancer, as well as restaging for prostate cancer recurrence.

More specific information regarding these Medicare changes is available from Medicare.

Qscan is a leader in PET-CT, consistently delivering a comprehensive diagnostic and therapeutic service for over a decade. Qscan has also been involved in pioneering rural and regional access to PET-CT services, and has built a reputation of being on par with Australia’s leading tertiary academic institutions in terms of referrer demand and case complexity.

Qscan Group was the first in Australia to use Fluorine-18 (F-18) in PSMA PET-CT scans. This tracer developed by Professor Martin Pomper, director of nuclear medicine and imaging at the Johns Hopkins University School of Medicine. To learn more, click here.

PSMA PET-CT imaging is offered at all Qscan clinics with PET-CT services. Click here to find a clinic near you.

Dr Hal Rice named Gold Coast Australian of the Year

One of our excellent doctors, Hal Rice, has been named Gold Coast Australian of the Year from a very prestigious panel of finalists.

Hal is an incredible doctor, with achievements as a neurointerventionalist in the public and private systems. He is one of Qscan Queensland’s founding partners and established the renowned Neurointerventional Department at the Gold Coast Hospital.

He has been previously recognised by the City of Gold Coast for his work in promoting the city as an internationally acclaimed centre for innovations in stroke diagnosis, treatment, and research. His continued efforts to bring international medical conferences to the Gold Coast support the community at large and allow the city to uphold its credentials as a centre of medical excellence.

This award is a wonderful recognition of Hal’s contribution to neuroradiology, excellence in patient care, and his pivotal role in establishing the Gold Coast as a premier site for the endovascular treatment of life-threatening brain aneurysms and acute ischaemic stroke.

You can hear Hal speak at the awards night here.

Congratulations Hal, a wonderful recognition of your contribution to Neuroradiology, excellence in patient care and establishing your city as a premier site for endovascular treatment of life-threatening brain aneurysms and acute ischaemic stroke. 

Dr Hal Rice and Gold Coast Mayor Tom Tate at the Gold Coast Australian of the Year Awards night.

Fluorine-18 (F-18) PSMA PET-CT scans

PSMA PET-CT scans are important in the detection and staging of prostate cancer. In Australia, the most commonly used tracer for PSMA PET-CT scans is Gallium-68 (Ga-68).

However, Qscan Group uses Fluorine-18 (F-18), a tracer developed by Professor Martin Pomper, director of nuclear medicine and imaging at the Johns Hopkins University School of Medicine.  

Benefits of F-18

  • Improved image quality compared to scans using Ga-68
 
  • Intrinsic physical properties, which lends an improved spatial resolution of 5mm
 
  • Longer half-life, meaning increased reliability as a tracer
 
  • Lower urinary excretion
 
  • Improves detection of recurrences and additional lesions
 
  • Improved specificity in staging
 
  • Higher tumour uptake
 
  • High sensitivity, even in small tumours
Improved confidence for EPE and SVI

An 83-year-old male with a large basal PZ tumour. SVI is not clear in the Ga-68 PSMA images (note resolution and background noise), but with F-18, SVI is clearly resolved.
Reduced false positives for M staging

Scans of a 67-year-old male showing uptake in an L2 vertebral sclerotic lesion. Ga-68 PSMA (left) only showed background noise, while F-18 PSMA (right) allowed the patient to be cleared of metastatic disease.

Qscan Group has been using F-18 as our PSMA tracer of choice since 2017.

We are the most experienced in Australia when it comes to using F-18 for PSMA imaging, and will bring this leading expertise to all your prostate patients.

PSMA PET-CT is available at all Qscan clinics that offer PET-CT services. Click here to find a clinic near you.

References:

·        Brauchli D, Singh D, Chabert C, Somasundaram A, Collie L. Tumour-capsule interface measured on 18F-DCFPyL PSMA positron emission tomography/CT imaging comparable to multi-parametric MRI in predicting extra-prostatic extension of prostate cancer at initial staging. J Med Imaging Radiat Oncol. 2020 Dec;64(6):829-838.

·        Parathithasan N, Perry E, Taubman K, Hergarty J, Talway A, Wong L, Sutherland T. Combination of MRI prostate and 18F-DCFPyl PSMA PET/CT detects all clinically significant prostate cancers in treatment-naive patients: An international multicentre retrospective study. J Med Imaging Radiat Oncol 2022 Feb

New PET-CT using FET

FET PET-CT is a scan that can detect brain tumours – both primary and metastatic. FET PET-CT is indicated in the use of imaging of brain metastases as follows

  • Detection of viable tumour tissue; Radiolabelled amino acid imaging is superior to FDG PET, CT and MRI for differentiation of viable tumour tissue from treatment induced non-malignant changes such as post-operative change, oedema or radiation necrosis. FET PET is also superior to FDG PET for low grade recurrence.
  • Tumour Delineation; superior for estimation of true tumour extension in both low and high-grade gliomas.
  • Selection of biopsy site; FET is recommended to guide stereotactic biopsy for classification and grading of glioma.
  • Non-Invasive tumour grading; FET PET may aid in differentiating high grade gliomas from histologically benign brain tumours or non-neoplastic lesions. Oligodendroglioma and oligo-astrocytoma could have greater uptake than high grade gliomas.
  • Therapy Planning; FET PET used in conjunction with anatomical imaging may better define tumour volumes for resection of radiation therapy.
  • Tumour response; FET PET may predict the response to chemo and radiation therapy as it allows for earlier detection of residual tumour post-surgery.

Radiolabelled amino acids offer improvement over anatomical imaging (CT/MRI) as well as FDG PET-CT due to the low uptake of amino acids in normal brain tissue and therefore may be more tumour specific as uptake is less impacted by inflammation (1,2)

FET PET-CT imaging is offered at all Qscan clinics with PET-CT services. Click here to find a clinic near you. 

References

1.        EANM Procedure Guidelines for Brain Tumour Imaging using Radiolabelled Amino Acid Analogues, Vander Borght et al 2006

2.        Impact of F18-Fluoro-ethyl-tyrosine PET Imaging on target definition for radiation therapy of high-grade glioma, Rosenschold et al, Neuro-Oncology, Vol 17, Issue 5, May 2015.

Obstetric Scanning: The role of ultrasound in first trimester screening

Obstetric scanning plays an important role in first trimester screening. First trimester screening checks that a baby is developing as expected, determines the number of fetuses and estimates gestational time.

Obstetric ultrasound and Non-Invasive Perinatal Testing (NIPT)

Cell-free fetal DNA (cffDNA) is fetal DNA that circulates through the maternal blood. cffDNA testing is non-invasive and is used as a prenatal diagnosis tool for older pregnant women.

While cffDNA testing is valuable in detecting typical aneuploidy, first trimester fetal ultrasound is better at detecting non-genetic structural abnormalities including spina bifida and anencephaly.

The International Society of Ultrasound in Obstetrics and Gynaecology (ISUOG) guidelines state that all women should be offered a first-trimester ultrasound scan, regardless of their intention to undergo cffDNA testing. cffDNA testing should not replace first-trimester ultrasound.

Did you know:

  • Atypical aneuploidy can’t always be detected by NIPT therefore the nuchal thickness on ultrasound can be a key indicator regardless of a low risk NIPT result;
  • The incidence of spina bifida detected in the second trimester during routine ultrasound has increased since the advent of the NIPT. This points to the fact that more mothers are missing out on early detection of fetal central nervous system anomalies;
  • Routine first trimester ultrasound screening performed from 12 weeks and 5 days to 14 weeks is the best time to assess for the early signs of spina bifida.

In the first trimester highly trained sonographers can perform an age appropriate morphology scan and detect the absence of a nasal bone, bladder absence or exstrophy, oesophageal atresia, midgut herniation, limb anomalies, cystic hygroma, facial clefts, situs inversus, encephalocele, diaphragmatic hernia, and a range of placental anomalies.

Qscan Radiology Clinics provides a wide variety of specialised obstetric services, including both Nuchal Translucency Screening (combined with first trimester biochemistry) and First-Trimester Fetal Morphology studies.

Our highly qualified nuchal-accredited obstetric sonographers can provide you peace of mind by performing early screening for structural anomalies.

Ultrasound services are offered at every Qscan Radiology Clinic. Click here to find a clinic near you.

New International Trial Evidence supports Lutetium Radionuclide Therapy for Prostate Cancer, available at Qscan

Lutetium Radionuclide Therapy for Prostate Cancer is now supported by Randomized Multicentre Phase 3 Data. Qscan provides Lutetium Rx supported by RCT data and international trial protocols individualized to your patient.

Emerging current Rx indications:

  • Upfront Lu Rx at emergence of castrate resistance in combination with other agents prior to chemotherapy
  • Node positive patients with no or minimal skeletal/visceral metastases

The Qscan process:

  • Initial consultation with Dr Dalveer Singh or Dr Kevin Lee with patient and family
  • Evaluation of patient eligibility in conjunction with the treatment MDT
  • Individualised treatment plan based on PSMA/FDG PET Imaging
  • Therapy at Qscan Radiology Clinics
  • Follow-up by Dr Singh and Dr Lee in conjunction with MDT
  • Continued 6 weekly Rx cycles if appropriate


Case study above: 67 yr old. Metastatic castrate resistant prostate cancer, node predominant extensive disease on PET. Clinical and PSA progression. Two cycles Lutetium Rx at Qscan. Sustained CR on both PET and PSA.
VISION Trial Trial (October 2021) n= 831 men mCRPC*
Lutetium-PSMA Rx added to standard care, prolonged imaging-based progression free survival and overall survival as compared with standard care.
TheraP Trial (February 2021) n=200 men mCRPC*
Lutetium-PSMA Rx compared with cabazitaxel led to a higher PSA response and fewer grade 3 or 4 adverse events.

Lutetium therapy at Qscan is offered by Dr Dalveer Singh and Dr Kevin Lee. Dr Singh and Dr Lee provide compassionate and personalised care throughout the therapy journey in close collaboration with other specialists of the multi-disciplinary team.

Click here to find a Qscan location near you

*References:
Sartor O et al; VISION Investigators. Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer. N Engl J Med. 2021 Sep 16;385(12):1091-1103.
Hofman MS et al. 177Lu-PSMA-617 radionuclide treatment in patients with metastatic castration-resistant prostate cancer (LuPSMA trial): a single-centre, single-arm, phase 2 study. Lancet Oncol. 2018;19:825-833.
Violet J et al. Long-term follow-up and outcomes of retreatment in an expanded 50-patient single-center phase II prospective trial of 177Lu-PSMA-617 theranostics in metastatic castration-resistant prostate cancer. J Nucl Med 2020;61:857-865.
Hofman MS et al. Lu-PSMA-617 versus cabazitaxel in patients with metastatic castration-resistant prostate cancer (TheraP): a randomised, open-label, phase 2 trial. Lancet 2021;397:797-804.

FDG PET/CT is now MBS Rebated for work-up of Dementia/Mild Cognitive Impairment

Early diagnosis and characterization of dementia is a growing challenge in the clinical setting. FDG PET/CT is a highly useful tool for the diagnosis of neurodegenerative disorders. Distinct patterns of altered glucose metabolism seen on FDG PET/CT can improve the clinical diagnosis for differing types of dementia such as FTD, Alzheimer disease and Dementia with Lewy Body.


Case study above: FDG PET fused to MRI brain in patient referred for cognitive impairment work-up at Qscan showing classic findings of Dementia with Lewy Bodies (DLB).

Bilateral parietal and posterior temporal hypometabolism (yellow arrows) like Alzheimer disease (AD). However occipital hypometabolism (preserved in AD) with relative sparing of posterior cingulate cortex gives rise to “cingulate island sign”, highly specific for DLB (star). Also basal ganglia hypermetabolism and an occipital tunnel sign (relative preserved medial occipital metabolism but suppressed lateral occipital lobes) can be seen.

FDG PET for Dementia or Cognitive Impairment is available at all Qscan PET/CT clinics and led by our expert Nuclear Medicine Team.

Dr Peter Jackson

MBBS (UQ) FRANZCR, FAANMS

Special Interests: Nuclear Medicine, PET Imaging & Oncology Imaging

Dr Phillip Law

MBBS (UNSW) FRANZCR, FAANMS

Special Interests: Nuclear Medicine, PET Imaging & Oncology Imaging, Molecular Imaging, Novel Radiotracers & Body Imaging

Dr Gavin Mackle

MBBS, FRANZCR, FAANMS

Special Interests: Nuclear Medicine, PET Imaging & Oncology Imaging

Dr Zeyad Al-Ogaili

MBChB (UQ) FRANZCR, FRCR, FAANMS

Special Interests: Oncology Imaging, PET CT, Nuclear Medicine, Cardiac, Chest & Body Imaging

Dr Kevin Lee

BSc(Med), MBBS MHS (Clin Epi), FRACP

Special Interests: Endocrinology & Nuclear Medicine

Dr Dalveer Singh

BSc(Med), MBBS (Hon 1) FRANZCR, FAANMS

Special Interests: Nuclear Medicine, Molecular Imaging, Theranostic, Oncological Imaging & General Intervention

Click here to find a Qscan location near you

Platelet-Rich Plasma Regenerative Cellular Therapy

Platelet-Rich Plasma (PRP) is a non-surgical treatment that may help to repair degenerative tissue and injury by using the patient’s own blood to stimulate natural healing processes. PRP delivers a high concentration of the patient’s own Platelet-Rich Plasma directly to an injury site to promote healing.

Platelets are the healing component of blood, and the body will naturally send platelets to injured tissue to aid in the healing process. Platelets heal tissue by releasing growth factors and bioactive proteins. PRP has been observed to stimulate cellular repair, increase anti-inflammatory processes and grow blood vessels in damaged tissue.

PRP is often injected into areas that have a poor blood supply such as the foot, ankle, shoulder, elbow and knee. These areas generally have a poor blood supply and need assistance with healing damage. PRP may assist with tendon and ligament conditions, osteoarthritis and the stalled healing of muscle injuries.

PRP is suitable for the treatment of the following conditions:

  • Painful knee osteoarthritis
  • Tendon injury or chronic tendon pain in the shoulder, elbow, wrist, hips, knees, ankle and feet
  • Achilles tendinopathy
  • Plantar fasciitis
  • Partial rotator cuff tears
  • Partial tendon and muscle tears
  • Tendinopathies resistant to conservative therapy
  • Tennis or golfer’s elbow
  • Shoulder rotator cuff
  • Shoulder and trochanteric bursitis
  • Biceps and wrist tendinosis
  • Gluteal tendons
  • Patella tendon

The Procedure

PRP treatment begins with a blood extraction, which is taken in a similar manner to that of a blood test. This blood is then placed into a centrifuge, which spins the blood and separates the platelet, red blood cell, white blood cell and plasma components. Blood separation creates plasma with a platelet concentration that is at least three times higher than that of healthy blood. Once separated, the platelet rich plasma is then injected directly into the treatment site. The injection is often administered under guidance from an ultrasound to ensure precise placement.

  1. Blood is taken from the patient

  2. Separation of platelets in centrifuge

  3. Platelet Rich Plasma is then extracted and prepared for the procedure

  4. This will then be injected into the location of injury or pain to stimulate the body’s healing response

The PRP injection is administered by our expert radiologists. 

The treatment will take approximately one hour to complete.

The following clinics offer PRP treatment:

Annerley
Shop 7, 310 Ipswich Road, Annerley, Queensland
07 3357 0380

Parkwood
Parkwood Village, 76-122 Napper Rd, Parkwood QLD 4214
07 5631 7200

Red Hill
1/81 Fulcher Rd, Red Hill QLD 4059
07 3547 8080

Redcliffe
Silvyn St, Redcliffe QLD 4020
07 3357 0922

 

Robina
Yellow Carpark, Shop 4166, Robina Town Centre Access via, Scottsdale Dr, Robina QLD 4230
07 5587 6363

Southport
Pacific Private Clinic, 123 Nerang St, Southport QLD 4215
07 5503 3433

Windsor Gardens
Level 1, 480 Specialist Centre, 480 North East Road, Windsor Gardens SA 5087
08 8164 5600

We were awarded for Organisational Excellence!

This Certification may look like a bunch of letters and numbers that you’re not too familiar with, but we’re very excited about them!

Last month, QIP Certifications Certified our company; Qscan Group the ISO9001:2015 Quality Management System (QMS) certification. This Certification is the most established international standard of QMSs, recognising organisational excellence built around our patient care, continuous improvement, and risk management. The reason we’re so excited about it is because it’s a piece of paper that basically sums up that we are upholding our mission of Trusted Analysis, Excellence and Compassionate Care.

After undergoing rigorous assessment, we have been distinguished to have high-levels of service quality, giving us the opportunity to reach new markets and ensure that our patients receive the highest standard of service. We want to always be on the front foot in the industry and we are always looking at ways to improve, which is now supported by a Certification that ensures we do this as well. Yesterday, the CEO of AGPAL Group Stephen Clark; parent company to QIP Certifications, presented the certificate to our CEO Chris Munday.

On the Certificate being presented to Chris, he stated that “This accreditation is a landmark piece representative of Qscan Groups quality standards. Just saying we are a quality organisation is not enough for us, we measure ourselves against the highest standards – which we continuously strive to improve upon”.

Dylan Campher, our Executive of Quality, Innovation & Performance, and his team, have been putting all the steps in place over the past months to ensure we met all requirements for the Certification. “Qscan has a reputation of doing things differently, things that really matter to our patients and referrers. We are the first Radiology company to measure our quality standard against an international system. This is a huge step in the right direction.”

Stephen Clark remarked that “Qscan is ahead of the game, we’re proud to be presenting this accreditation to them today”.

This standard is based on a number of quality management principles including a strong customer focus, the motivation and implication of top management, a process approach and continual improvement. This Certification helps ensure that customers get consistent, good-quality products and services. ISO 9001:2015 QMS requires ongoing quality improvement initiatives to maintain the standard, so our next steps will be to systematically work through observations made during the assessment while continuing our quality improvement across the Group.

Adelaide community to benefit from the opening of new comprehensive Qscan radiology clinic with PET-CT service

Qscan Group welcomes the opening of its latest Qscan Radiology Clinics site at Windsor Gardens in Adelaide, which also marks the establishment of its initial presence in South Australia.

With modern, patient-centred facilities and equipped with leading-edge technology, the clinic offers a comprehensive array of specialist medical imaging services, including Digital X-ray, Ultrasound, CT, Interventional Procedures & PET-CT scans.

The new clinic opened on Monday 15th February 2021 and is located within the medical precinct of 480 Specialist Centre, 480 North East Road, Windsor Gardens in Adelaide.

Open Monday – Friday from 9:00am to 5:00pm. Plenty of free, dedicated on-site parking with disabled access is available. The clinic will offer Bulk Billing for most Medicare-eligible examinations. To make an appointment please call 1300 177 226 or book online at www.qscan.com.au/bookings/