April 2011 Vol. 24 No. 4 The Voice of Kitsap Business since 1988

InsideSpecial Reports:Healthcare Quarterly,pp 6-11Annual Auto Review,pp 28-35

Human Resources, pg 13

Financial, pp 14-16

Technology, pg 18

Real Estate, pp 23-25

Editorial, pp 36-38

Port Orchard Chamber,pg 26

Home Builders Newsletter,pp 19-22

BlazingA NewTrail

$1.50 Display until May 1st

Poulsbo radiologypractice uses cutting-edge technologyunique to Puget Sound

Cover Story, page 6

Dr. Manfred Henne, founder, InHealth Imaging

By Rodika TollefsonIt’s fairly common for Kitsap Peninsula

residents to drive across the TacomaNarrows Bridge or take the ferry across thewater for medical services — even thoughin many cases they are available locally —but one Kitsap practice is seeing the reversecommute. Poulsbo-based InHealth Imaging(www.inhealthimaging.com) has beenpopular with the Seattle crowd recently,thanks to its cutting-edge thyroid-cancerscreening.Dr. Manfred Henne, the founder and

managing member at the independentpractice, began offering a new type of fineneedle aspiration (FNA) analysis forthyroid nodule assessment about twomonths ago. Henne was the first radiologistin Western Washington to offer the Afirmathyroid FNA test, in partnership with SanFrancisco-based research companyVeracyte.Fine needle aspirations are performed

on thyroid nodules (lumps) in order toobtain biopsy samples. When the resultscome back as indeterminate, a second

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biopsy is usually performed. When finalresults are still indeterminate (which isabout 15 percent of the time), physiciansrecommend the thyroid to be removed —but only 15-20 percent of the removedtumors actually turn out malignant.Henne said the Afirma analysis has a 95

percent or better predictive rate. “The resultis, you have fewer repeat fine needleaspirations and eliminate repeat biopsies,” hesaid. The analysis also eliminates the need forunnecessary diagnostic surgery, he added.One of Henne’s patients had an FNA

performed three times, with the resultsindeterminate each time. The patientlearned about the new test after researchingoptions, and Henne felt it was something hewanted to offer. The FNA procedure is notmuch different from the traditional — hesimply has to assemble the specimen in twodifferent vials, one to be used for biopsy andthe other for molecular analysis. The DNAanalysis is looking for specific genesinvolved in thyroid malignancy — itmeasures the activity level of 142 genes —and classifies the tumor as either benign orsuspicious for cancer.Dr. Bryan Haugen, head of the Veracyte

trial at University of Colorado-Denver, toldthe International Thyroid Congress lastSeptember that the initial tests showed theanalysis had a false negative rate of fourpercent, the same rate of the false-negativeand false-positive from biopsy results. Inthe fall, about 50 medical sites throughoutthe country conducted further clinicaltrials, and results are expected to bepublished soon.

Staying on the Cutting EdgeKelle Kitchel-Cooper, director of

development at InHealth Imaging, said theAfirma test has been sought after bypatients from the Seattle area, includingsoftware company executives looking forthe most current options. But this is not thefirst time Henne has been on the cuttingedge, especially as a solo practitioner. Hisdiagnostic and preventative imagingservices range from MRIs, MRAs(including 3-D reconstruction MRA) andCTs to ultrasounds, nuclear medicine andosteoporosis screening, but he also offersspecial procedures such as CT-guided painmanagement, the only radiologist on theKitsap and Olympicpeninsulas to do so.In addition toupgrading a lot of itst e c h n o l o g y ,InHealth Imagingalso implemented aPicture ArchivingComputer System(PACS) that allowsall physicians to login remotely to seetheir cases instantly.In a couple of

months, Henne willbe at the forefrontagain. InHealthImaging is in theprocess of adding athree-dimensionalm amm o g r a p h ysystem. Thetechnology, calledSelenia Dimensionssystem and

manufactured by Hologic, was approved bythe Federal Drug Administration in February.It was pioneered at Massachusetts GeneralHospital, and Henne’s practice is the first oneto adopt the technology in Puget Sound andpossibly on the entire West Coast.Dr. Elizabeth Rafferty, who led the

implementation of the system at MGH, wasquoted as saying, “Like flipping through thepages of a book, the radiologist is able tolook at one page at a time instead of seeingthe whole breast reduced to a single frame,as is the case with standard mammography.”Three-dimensional mammography,

known as tomosynthesis, uses a proceduresimilar to the traditional mammogram and it

doesn’t cost extra. But the radiologist can seethe tissue in detail that wasn’t possiblebefore, in one-millimeter slices at a time; thisresults in less need to come for additionalviews as well as in more precise diagnosis.“It’s really devastating to miss a breast

cancer diagnosis as a radiologist. I learnedover the years it’s not benefitting the patientpopulation to wait on the technology to bewidespread,” Henne said. “I don’t want towait until they ask me to do it, I wanted tobring it to the community now.”

Growing PracticeBorn in Germany, Henne received a

doctorate degree in physics (and had severalpatents) prior to going to medical school.The change in careers was the result of hisdesire to work outside of a lab and connectphysics with medicine while helpingprevent illness. He moved to the UnitedStates for a radiology residency and latercompleted a fellowship in radiology as well.He founded his practice on the KitsapPeninsula 12 years ago.InHealth Imaging, which has a total of

about 25 staff, also has offices in Silverdaleand at North Kitsap Urgent Care and isopen seven days a week including afterhours to accommodate workingprofessionals. A new location will be addedon Bainbridge Island in April or May. In themeantime, the main office, at North KitsapMedical Center, is beginning a renovationto add more space along with a componentfocused on wellness and education. Henne said he wanted to have an

independent practice because he likesworking in a small setting. Thedisadvantage is that he has added risks —he has to sign a personal guarantee, forexample, when he invests into newequipment, some of which costs more than$1 million. But he compares his work tothat of a chef who has his own restaurantinstead of working for someone else —adding cutting-edge equipment being oneexample, because he doesn’t have to gothrough a board or other decision makers toimplement it.Kitchel-Cooper said the main advantage

is structuring the business so it’s patient-centric. Besides using the latest technology,Henne offers another unusual option: Anypatient is welcome to meet with him afterimaging to discuss the results instead ofwaiting to talk to his or her physician. She noted that many of the services are

less expensive at InHealth because there isno additional “facility fee” charged byimaging labs that are affiliated with ahospital. The office also has a dedicated linefor patients to call and find out thecomplete cost of a procedure (since the feescannot be publicized). “You really don’t have to take the ferry

anymore (for services),” she said. “…I thinkhealthcare here is as good as in Seattle, andthere’s more personalized care.”

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