Reflecting on a handfulof recent studies, a few points jump out. One obvious observation is that healthcare is benefitting from incredible leaps in technical capabilities. The rapid dissemination of cardiac CT angiography has reinvented cardiac imaging, reducing the number of invasive diagnostic angiographies, accelerating diagnosis and decision-making and improving patient care and workflow. And tremendous leaps in computer-aided detection (CAD) technology nudge pulmonary embolism CAD from the realm of possible to the probable.
Yet, it isn’t the staggering technical developments or clinical improvements that strike me. What strikes me, and what we need to remember, is how utterly dependent technology is on the humans who operate these complex systems.
The prospectively gated step and shoot technique can achieve a remarkable 62 percent reduction in radiation dose and prospective helical acquisition technique mode may deliver additional dose reductions. However, these and the hundreds of other CT protocols that might slash or trim radiation dose are not automatic. They hinge on appropriating training of and implementation by CT technologists.
PE CAD provides another case in point. The ultimate success of the CAD algorithm hinges to some degree on image quality and other parameters in the technologist’s control. It may be possible to improve the algorithm to better distinguish arteries and veins, but it seems unlikely that such an improvement could completely compensate for mediocre image quality. What’s more, modifying the contrast injection protocol could partially provide the necessary enhancement. It’s another parameter under the tech’s jurisdiction.
The common denominator in both scenarios and thousands of others is the technologist. As we embrace new systems, (and we should), we need to remember that technology in and of itself is not the ultimate solution. The ideal end solution requires a delicate balance between robust and effective imaging and informatics systems and the people who operate them. By investing in technology and technologists, we are better situated to offer patients an optimal imaging experience that produces a high quality scan at the lowest possible radiation dose while minimizing the need for repeat imaging.
It’s a resolution worth considering. Happy New Year!
Editor of Health Imaging & IT