The world of mulitidetector computed tomography (CT) changed dramatically when systems leaped quickly from four to 16 slices and then to 64 slices just a few years ago. The call for more slices and better images was answered, providing diagnostic opportunities not previously available. Now the question being asked is — What’s next? Executives from GE Healthcare, Philips Medical Systems, Siemens Medical Solutions, and Toshiba America Medical Systems, as well as radiologists, offer their perspective on the future of CT.
Careful not to show their hands, vendors talk in generalities regarding the direction in which CT is headed. All agree there is more that can be done in terms of image quality and speed, and they want to be among the major players unlocking the door to earlier detection of disease. They believe that how disease is detected earlier could rest in multidetector CT scans. In short, with an eye on tomorrow, the CT scanner replaces the physical exam.
The backbone of CT
For facilities that got caught in the quick-paced revolution of multidetector CT and now wonder if they will be stuck with an outdated 64-slice scanner in just a few years, consensus says relax — 64-slice scanners are not going away anytime soon. Today, approximately a quarter of healthcare facilities across the country are using 64 slice. In 2006, the market saw a remarkable growth of 87 percent over the previous year.
Even with Toshiba’s 256-slice CT scanner in clinical trials and other 128- and 256-slice CTs being developed, the 64-slice scanner will continue to be the backbone of CT imaging. What will change are add-ons that make the scanner a more specific diagnostic tool along clinical pathways and improvements in workflow.
Currently, the most advanced 64-slice CTs on the market include: GE Healthcare’s LightSpeed VCT; Phillips Medical Systems’ Brilliance 64; Siemens Medical Solutions’ Somatom Sensation 64 and Somatom Definition dual-source CT scanner; and Toshiba America Medical Systems’ Aquilion 64. Each of the vendors has launched newer versions or upgrades since their initial introductions in 2004 and 2005.
What’s on the horizon
As much as has been done in the world of CT, what’s on the horizon promises to take this modality to the next level. And it’s not just about adding more slices, but rather addressing the larger issues of diagnosing disease earlier, adding clinical value, making scans safer for the patient, managing workflow, and increasing efficiency. Look for yearly introductions of software and other products from the vendors to answer the call.
- More slices. Though only Toshiba has been talking publicly about its 256-slice prototype (now having logged two installs worldwide, one in Tokyo at the National Cancer Center and the other for a three-month study at Johns Hopkins University School of Medicine in Baltimore, Md., that ended in April), other vendors say they also are exploring more slices, including a 128-slice scanner, though they would not confirm the exact nature of their testing. Doubling and quadrupling the number of slices mean thinner slices, more coverage, faster rotation, less radiation and a lower contrast dose — and of course, more stellar image quality.
- Clearer images. Distinguishing subtle differences or seeing new areas of anatomy will continue to improve with advanced visualization software upgrades. 4D images, moving 3D images, will be useful tools.
- Added diagnostic value. Scans of the future will provide more and better information before someone suffers a stroke, has a heart attack, or is in a later stage of cancer. The new information will be used in preventive medicine in addition to determining treatment of an existing condition.
- Adapting to body movement. Capturing the heart between beats and mid-beat — essentially freezing its motion — will provide a look at vital heart anatomy at its most vital, yet still point.
- Clinical pathways. Instead of thinking of the number of slices a CT scanner creates, scanners will be thought of more in terms of clinical pathways — cardiac, neuro, liver, colon and whole body. More software will be developed to address criteria specific to visualizing each of these areas.
- More automation. Preset criteria for scans and for image processing and post-processing will continue to be refined. The work of a technologist will be streamlined as data input will match predetermined criteria to provide the best position, dose and image quality. Automation will continue