Preparing Your CT Workflow for the Multislice Data Deluge

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hiit040402.jpgMultislice CT scanners provide un-precedented imaging capabilities but unless you change your workflow to accommodate the exponential increase in data, you’ll drown in post-processing work.

So says Jay Cinnamon, MD, neuroradiologist and director of 3D imaging at Quantum Radiology Northwest in Marietta, Ga. The organization is equipped with more than a dozen CT scanners, with four Philips 64-slice scanners soon to be installed.

“In the early days of CT, it took a lot of time to generate a limited amount of data,” he says. “It wasn’t much of a challenge to blend technology with human resources workflow.” Multislice CT, however, puts facilities in a situation where the scanners are turning out huge amounts of data in a much shorter period of time. “We need to think innovatively about how to maximize human resources. Workflow and optimized human resource utilization are absolutely critical to handle the deluge of data coming out faster than we ever expected.”

Put PACS in place

A PACS is an essential first step on the road to multislice CT, says W. Daryle Heath, BS, RT(T)(CT), CT supervisor at St. Dominic Jackson Memorial Hospital in Jackson, Miss. “If you don’t have a PACS, you’re putting the cart in front of the mule,” he says. There’s no point in investing almost $2 million on a scanner just to produce films, he says. Hospitals need to develop an appropriate infrastructure before investing in a multislice CT scanner. “If you don’t have a profitable way of managing the data you’re collecting, there’s going to be a problem.”

Without a PACS, facilities are archiving data either on rewritable DVDs or magneto-optical disks (MODs) which is extremely expensive, Heath says. That might result in changing MODs four to six times a day. “At $60 or $70 a pop, that’s a lot of money a day.” And a lot of inefficency, too.

That’s the situation Duane Ronholm, administrator and director of imaging services at Passavant Area Hospital, Jacksonville, Ill., faced last year. The facility installed a Siemens SOMATOM Sensation 64 last June but, despite the best laid plans, its PACS wasn’t up and running for another six months. Although Ronholm tried to time the two installations better, his staff downloaded images onto a MOD and stored them until the PACS was installed.

The purchasing team at Passavant was originally considering a 16-slice scanner but decided that 64 slices would better help them tap into the market for cardiac work. Patients were going 30 miles away for procedures such as angiography. “We’re able to handle just about anything they can throw at us nowadays,” Ronholm says. “We still have room to add more volume.”

Tap tailor-made techs

One way Cinnamon has handled the new flow of information is by employing “super techs” — technologists who understand disease processes at a higher level than the typical technologist with a CT or MRI background. They also understand post-processing. “You need a fairly intimate understanding of how the software works to pull out as much information as possible from the studies as efficiently as possible,” he says.

Radiology educational programs are devoting some time to teaching advanced post-processing skills, Cinnamon says. But, “the jury is still out on what you need” for a good multislice CT technologist. He has found that, more important than experience in CT, MRI or vascular radiology, is someone who is very focused, meticulous about details and self-motivated to learn this new area including the disease processes, software, and working environment. An ultrasound tech with these skills could do as well in this arena as someone experienced in CT, Cinnamon says. But you need someone with the drive for this niche. “You can’t force somebody into this position who is used to working with patients,” he says. “This type of work has to be stimulating to them.”

The CT staff at Passavant has responded very well to the new 64-slice scanner, Ronholm says. He sent four technologists and a radiologist to Siemens’ training for the basics. Then, two techs learned post-processing through Siemens and the other two spent some time working one-on-one with technologists at another facility using the same equipment. “That worked out really well,” he says.

Since installing the 64-slice scanner last June, Ronholm has added a technologist to the day shift and expanded the department’s hours. The facility used to have 24-hour coverage five days a week and 16 hours on Saturdays and Sundays. Now, scanning staff is available