Jumping on Board: Multidetector CT Grows & Flows

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Cardiac 3D volume rendering from a Toshiba America Medical Systems Aquilion 64 scanner.With devoted clinicians, post-processing image labs, thorough training and dedication to success, organizations are making multidetector CT hum. A few adjustments and the workflow is taking off too, so say end-users. So what’s a facility to do that needs to upgrade to 16- or 64-slice CT? Grab some advice from your peers and jump on board.

What can you expect?

When Hartsdale Imaging in Hartsdale, N.Y., installed a 16-slice Siemens Somatom Emotion scanner, staff had to make a mental adjustment, says Adam Davis, MD. “Some of it was people getting used to getting volumes of data in any dimension as opposed to always assuming axial.”

But once users become accustomed to the new data volumes, they can improve their diagnostic quality, according to Daniel Stricof, MD, a neuroradiologist at Radiology Ltd., a practice with 10 locations in the Tucson, Ariz., area. Stricof and his colleagues cover three hospitals in addition to their own office locations. They use everything from four to 64-slice scanners, owning Aquilion equipment from Toshiba America Medical Systems.

Ronald P. Karlsberg, MD, interventional cardiologist with Cardiovascular Medical Group of Southern California and director of the Advanced Imaging and the Cardiovascular Research Institute of Southern California, has been working with GE Healthcare to integrate coronary CTA into the office setting. He has been using the GE LightSpeed VCT 64-slice CT scanner since fall of 2005. “I think this represents a cardiac revolution,” he says. “The ability to perform essentially a form of cardiac catheterization in the office setting now allows one to see coronary arteries directly without entering the body. This is the only technology that has the ability to see the inside of a coronary artery non-invasively.”

Installing the scanner on the sixth floor was a major endeavor, Karlsberg says. The floor required extra support, a window was removed and the scanner needed integration into existing IT systems. He says it is easy to underestimate the challenges involved in bringing this technology into the office setting.

However, Karlsberg is “very excited about how this technology has changed the very face of cardiology.” Being able to provide his patients with a color-rendered image of their heart as well as evidence of the degree of their blockage has proven to be very motivating for changing bad habits and staying on proper medical treatment. “Treatment that has been proven to reduce cardiac events,” he says. “In many  situations there is no other non-invasive way to make the diagnosis of coronary artery disease.”

Summit Medical Center in Hermitage, Tenn., installed a Brilliance 64-channel CT from Philips Medical Systems in late 2005. It was “an opportunity to provide cutting-edge imaging for the specialists who needed the angiography product,” says Gregory Thon, director of medical imaging.

The hospital’s administrators had “no problem justifying a 64-slice,” he says. In fact, the facility’s CT angiography procedures increased by 74 percent from 2005 to 2006. The 188-bed community hospital planned for the scanner to help expand its oncology, radiology and growing cardiology product lines.

“It was very easy to use the capabilities of the 64-slice scanner to support the multiple specialties of the medical staff,” says Thon. He credits the physicians with the success of multidetector scanning. “They have taken ownership because they no longer have to send their patients to a bigger hospital for specialized studies. We have the technologists, equipment and radiologists who know how to read the studies as well. That’s a combination that’s pretty rare and sometimes difficult to get in a small hospital.”

Mastering efficiency

Most multidetector CT scanner users have found some common factors getting the most out of the equipment. Consider the following to find the same level of success:

Having a PACS is a prerequisite. Aside from assistance with the enormous jump in data, the connectivity offered via PACS is essential. “It’s extremely helpful to have a user-friendly PACS that can distribute images out to various radiologists interpreting the studies,” says Stricof.

Consider a centralized 3D lab. “The ability to obtain thinner slices rapidly can improve diagnostic quality largely by the ability to obtain outstanding 2D and 3D images,” Stricof says. “To really take the greatest advantage of multidetector technology in all areas, we have a centralized 3D lab.” Radiology Ltd. is big enough