Healthcare facilities often turn to a 64-slice scanner with one primary objective for the state-of-the-art system: to open the door to non-invasive coronary artery imaging. “The tremendous advantage of the 64-slice Aquilion [from Toshiba] is that it can be used to complete coronary studies and long segment CT angiographies,” explains Mark Winkler, MD, radiologist with Steinberg Diagnostic Medical Imaging Centers (SDMI) of Las Vegas, Nev.

Although its superior image resolution and scan speed make 64-slice CT ideal for coronary artery imaging, the Aquilion 64 has many applications beyond the cardiac realm. In fact, sites can optimize their investment in the Aquilion 64 by using it as the go-to solution for an array of studies. “Any CT study is appropriate for the 64-slice system. Aquilion 64 can do anything other CT scanners can do faster and with higher resolution,” opines Winkler. At the same time, other multidetector CT solutions like Toshiba’s Aquilion 16 remain vital diagnostic imaging tools. One reason the Aquilion 16 can function similar to an Aquilion 64 is that the detector technology is fundamentally the same — same slice thickness and same sensitivity. Many sites find that the two systems are a perfect complement and translate into enhanced flexibility and improved workflow.

Take for example St. Joseph Hospital in Denver. The hospital aims to become a cardiovascular center of excellence and views 64-slice CT as an integral component of its cardiac mission. In January 2005, the urban hospital deployed Aquilion 64; placing the new scanner next to the ER for smooth access for ER and cardiac cases. The hospital has found that the 64-slice solution can handle the bulk of its CT imaging volume, says Steven Gunberg, MD, chief of radiology. The urban trauma center, however, can not meet patient imaging needs with a single CT system. An Aquilion 16 housed in the radiology department is reserved for longer procedures like biopsies or drainage tube placement. The 16-slice system is used for routine imaging if the 64-slice scanner is tied up with a cardiac scan. The tandem arrangement enables the hospital to scan patients in the most appropriate and timely manner.

The dual scanner approach is suitable for all types of facilities including diagnostic imaging centers. SDMI, for example, employs a flexible approach to CT scanning.  The imaging center averages 20 coronary CT studies monthly and 25 to 30 non-coronary exams daily. The Aquilion 64 is the scanner of choice for coronary artery angiograms; other scans such as multi-segment CTAs are performed on either the 64-slice or the 16-slice scanner.

St. Elizabeth’s Medical Center in Edgewood, Ky., also relies on side-by-side 16- and 64-slice scanners for CT imaging. Techs always route cardiac CTAs to the 64-slice scanner, says Jeff Dardinger, MD, director, Cardiovascular Imaging Radiology Associates of Northern Kentucky and St. Elizabeth’s Medical Center. Technologists decide which scanner to use for other studies. Patients are scheduled by time slot — not scanner. With the exception of cardiac CTAs, patients are referred to which scanner is available, which keeps patient throughput moving. “Image quality is excellent on both Toshiba systems. There is no need to route studies [other than cardiac CTAs] to either scanner,” explains Dardinger.


Conclusion

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Many sites deploy Toshiba’s Aquilion 64 as the gateway to non-invasive cardiac imaging, but the scanner can be a multi-purpose solution that can be used for any CT scan appropriate for multidetector CT scanning and a host of other new applications such as virtual colonography and CT brain perfusion. Toshiba’s 16-slice solution remains a valuable diagnostic imaging tool and provides a secondary system for many studies, enabling sites to function efficiently at maximum capacity.

64-slice Scanning at a Glance

In many cases, facilities can realize significant advantages by using 64-slice instead of traditional imaging techniques. Marc Miller, MD, chief of radiology at New London Medical Center in New London, Wis., and founder of Advanced Medical Diagnostics in Mission Viejo, Calif., identifies three broad categories where 64-slice CT can enhance the practice of medicine. • Replacing multiple exams with a single study — Improved image quality and advanced protocols often allow multiple exams to be replaced with a single study. For example, a CT urography protocol, allowing visualization of the renal collecting system, kidney parenchyma and ureters can potentially replace an intravenous pyelogram (IVP) and retrograde pyelogram. Sixty-four slice CT scanners improve the ability to detect subtle abnormalities in the renal collecting system when compared to older CT models. • Replacing invasive examinations with a non-invasive study — For example, carotid CT angiography can be performed instead of a catheter-directed angiogram; the carotid CTA reduces risk of arterial injury, bleeding and stroke. And the 64-slice system provides tremendously improved visualization of atherosclerotic narrowing in these vessels. • Judicious use of advanced CT scanners can significantly reduce the cost to deliver high-quality medical care. Cardiac CT angiography, for example, can replace invasive diagnostic heart catheterizations at a savings of thousands of dollars per patient. At the same time, the exam can be performed faster and safer than a traditional catheter-directed coronary angiogram.

Top indications for Cardiac CTA

• Evaluating cardiac and coronary calcification, coronary calcification, and anomalous coronary arteries • Ruling out coronary stenoses • Evaluating bypass graft patency and location • Examining congenital heart disease and cardiac masses • Looking at pulmonary and cardiac veins