CHICAGO — Earlier this year, MedQuist (Mount Laurel, New Jersey), reported that it was ranked number one in front-end speech recognition for its SpeechQ for Radiology product in the KLAS Enterprise’s Speech Recognition Report.

And company execs were here in Chicago at the Radiological Society of North America (RSNA; Oak Brook, Illinois) annual meeting to continue telling the story of technology for which the time has come to hit the mainstream of radiologists’ workflow, they said.

MedQuist Senior Vice President of Sales and Marketing Scott Bennett told Medical Device Daily that front-end speech recognition has been discussed for at least a decade as being “just around the corner.” And he acknowledges that there is still “a lot of skepticism” from physicians regarding the technology.

Front-end speech recognition is designed to allow radiologists to dictate notes on an image that they are reading in such a way that the technology recognizes patterns of speech from a particular individual and basically respond to a particular person’s voice when dictating the notes to a screen — a screen that many radiologists keep hidden because they want their focus to be on the image in front of them.

“What I would say is that adoption of voice recognition on the front end — we’re now beyond what I’ll call the pioneers and early adopters, and judging from the show and the traffic we’ve seen, it’s now sort of for the mainstream,” Bennett said. “So, we’ve had a lot of folks that don’t think of themselves as technology avant garde come up and use and [become] educated on the speech recognition.”

Emmy Weber, vice president of product management, said that the difference from previous year’s shows is that those interested in the technology have gone from “amazement” that they can dictate so quickly and have their reports on patients documented in real-time, to the point that this year they are more interested in how such products as SpeechQ contribute to the overall workflow of a radiology unit and hospital ultimately leading to the electronic health record.

“I’m seeing a lot more discussion of not just the technology alone, but how it would fit into their environment,” Weber said.

The SpeechQ product is powered by Philips Speech Magic engine — MedQuist is a member of the Philips Group of Companies and partners with Philips Medical Systems (Andover, Massachusetts) in marketing and product development.

Since the product’s introduction two years ago, about 75 SpeechQ units have been sold, with the majority of them already installed, Bennett said.

MedQuist provides medical transcription technology and services, including digital dictation, electronic signature, medical coding systems and mobile dictation. The company services health systems, hospitals and group medical practices.

In 2005, MedQuist said it provided services to nine out of the 10 “Best Hospitals in the U.S. as ranked by U.S. News & World Report.

In other RSNA news:

Liquid silicone, which is often used for breast augmentation and other cosmetic procedures, can cause respiratory failure if not injected properly by a licensed physician. A study of individuals who underwent illegal silicone injections revealed a high fatality rate from pulmonary silicone embolism, or obstruction of the lungs.

“The illegal use of fluid silicone is a practice that carries life- threatening risks, and the community should be aware of the complications,” said Carlos Restrepo, MD, director of chest radiology at the University of Texas Health Science Center (San Antonio).

Restrepo and his colleagues compiled the imaging findings of 44 patients with pulmonary embolism that resulted from illegal silicone injection, constituting the largest case series to date.

Seven patients who presented to the hospital with respiratory distress due to illicit silicone injection were studied, along with an additional 37 cases from the literature. Patients’ demographic information, clinical presentation, imaging findings and outcome were analyzed.

“Twenty-five of the patients were transsexual males, and 19 were females,” Restrepo said. “The most common sites of injection were the breast, hips, buttocks, vagina, chest and arms.”

All 44 patients experienced respiratory difficulties after receiving the injections, and nearly half experienced fever. One-quarter of the patients died from resultant bleeding in the lungs.

Silicone that is injected improperly travels through the bloodstream and causes blood to coagulate in the lungs, creating circulatory obstructions that can be immediately life threatening if not identified and treated quickly. The imaging findings of pulmonary silicone embolism include dark, hazy patches in the lung tissue on X-rays or computed tomography (CT) scans.

“Transsexual males in particular should be checked closely for signs of pulmonary embolism when they show symptoms of respiratory distress and fever,” Restrepo emphasized. Male transsexuals often undergo cosmetic procedures of the breasts, genitalia and other areas to make them appear more feminine.

The FDA banned silicone injections in 1992, but people still seek them out because they are cheaper and easier to get than professional plastic surgery or hormone therapy and provide immediate results. In surgical clinics, transgender patients are often required to undergo psychological testing before receiving treatment.

Unfortunately, the illicit nature of the injections makes it hard to estimate how common they actually are. However, the increasing popularity of the “pumping party” — where a host will inject a number of people with silicone in the same sitting — indicates both the demand and the ready availability of the substance.

Restrepo expressed the difficulties of conducting long-term follow-up with patients who present with these complications, because of the underground nature of the practice. It is hoped, he said, that by making the public and the medical community aware of the symptoms and severe consequences of illegal silicone use, mortality risks and patient outcomes from this clandestine practice will improve.

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