SPECT/CT Makes the Grade at the Community Hospital
Crouse Hospital in Syracuse, N.Y., is a 566-bed, acute-care community hospital committed to superior patient care. Its commitment to the community is paralleled by a strong collaborative relationship between its radiology and nuclear medicine departments.

Two years ago, Crouse’s radiology department began searching for a next-generation gamma camera. A careful analysis of the local market, current technology and its internal staffing and operational assets led the hospital to a more comprehensive choice — Siemens Medical Solutions TruePoint Symbia T2 SPECT•CT system.

The initial clinical plan was to deploy the hybrid scanner for tumor imaging and attenuation correction in cardiac studies; however, the scanner has exceeded the hospital’s expectations and is now the first choice for many SPECT studies and the only option for certain types of SPECT imaging, says Brad Hellwig, administrative director of radiology at Crouse Hospital. In addition to being a clinical winner, the scanner is an operational and financial success story at the community hospital.


The clinical mix

Crouse Hospital’s department of radiology automatically routes certain SPECT studies to the SPECT/CT camera. The system is used for all cardiac SPECT cases and tumor imaging. Its attenuation correction and localization capabilities also make it ideal for brain SPECT studies, says Hellwig. The new scanner has proven its clinical capabilities in other nuclear medicine applications as well. For example, referring physicians prefer the SPECT/CT camera over conventional SPECT for bone SPECT studies. “One of the local podiatrists has found that SPECT/CT is particularly helpful in localizing stress fractures of the foot,” Hellwig says. The hospital also successfully re-introduced ProstaScint imaging. “When we first offered ProstaScint SPECT, the procedure was not well-received among referring physicians. The SPECT/CT ProstaScint protocol is very successful because CT allows physicians to directly map nuclide accumulation to the anatomy, reducing false positives, so diagnostic confidence is much higher,” he says.


Economics and efficiency

It can be challenging for hospitals to locate solutions that meet the often-conflicting needs of economics, efficiency and patient care — but SPECT/CT has answered the call.

“Hospital-based nuclear medicine departments are facing a lot of marketplace erosion because of the rise of outpatient nuclear medicine facilities,” confirms Hellwig. Crouse Hospital’s acquisition of SPECT/CT has turned the tide. “At six to seven patients daily, we are coming out ahead on utilization. The hybrid camera provides differentiation in our local market. Plus, we’ve seen a certain amount of billable CT studies arise from the addition of diagnostic CT imaging,” notes Hellwig.

At the same time, the new business has not overly burdened radiology staff. The hospital relies on a pair of radiologists dual-trained in x-ray and nuclear medicine to read the studies, and access to in-house CT technologists makes it easy to tap into a CT tech when necessary. The SPECT/CT tech preps the patient and calls the CT tech to complete the study.

On the professional side, hybrid reading is manageable from a workflow perspective, says Hellwig. Although the studies require some additional interpretation time, the workflow impact is offset by other efficiencies and patient care gains.

“Prior to SPECT/CT, a number of our SPECT studies required multi-day imaging. Now, we can complete imaging in a single patient visit,” Hellwig says. For example, tumor localization might require three separate scans because it can be difficult to differentiate tumors from bowel or blood pooling in standard SPECT images. The addition of CT more clearly defines the anatomy, so physicians can answer all questions on the first visit.


Nuclear medicine optimized

“Deploying SPECT/CT was not a major leap for our department. We had all of the right ingredients in place,” Hellwig says. The essentials at Crouse Hospital included PACS, a solid history of collaboration between nuclear medicine and radiology, staff versatility and an open, uncrowded local market.

Consequently, the hospital and its patients continue to benefit from the investment in SPECT/CT. Crouse Hospital is maximizing its financial and staffing resources and, at the same time, providing patients with a high-quality hybrid imaging solution. Procedures and protocols are shorter; and new, more accurate studies like ProstaScint SPECT/CT are available. “Our experience demonstrates that SPECT/CT is a good fit for the mid-sized community hospital,” concludes Hellwig.


ADDITIONAL RESOURCES
View Community Hospital Webcast
Trimed Popup
Trimed Popup