Healthcare Imaging & IT - July 2008 - (Page 29)

Innovation Confidence Life cant cost-savings can be realized by ruling out CAD with a test (i.e. CCTA) that typically runs at one-third of the cost of diagnostic coronary catheterization. “Thus, if patient management is based on CTA’s exceedingly high negative predictive value, this test can be beneficial on many levels,” Schoepf adds. CCTA offers a financial incentive for institutions operating a CT scanner and a cath lab to use the procedure to fill the schedules with patients who are reasonably expected to need an intervention, Schoepf says. He is among researchers at MUSC who have developed a dualsource CT scanner technique using the Somatom Definition from Siemens Medical Solutions, enabling a comprehensive diagnosis of heart disease based on a single CT scan. Normally, heart disease is difficult to diagnose because it not only requires a detailed view of structures like heart valves and blood vessels, but also blood flow to the heart muscle. By adding two x-ray spectrums with varying degrees of energy, researchers have gained a static image of the coronary arteries and the heart muscle, and thus the ability to map blood distribution and pinpoint areas of decreased blood supply. The technique, which requires only a single CT scan within a breath-hold of 15 seconds or less, brings better accuracy for detecting coronary stenosis, Schoepf says. “We have gained the ability to better see those lesions and grade them, differentiating between lesions that are non-obstructive versus those lesions that cause significant decrease in blood supply,” he says. “This is revolutionary because you historically needed a combination of tests—invasive coronary angiography and myocardial perfusion imaging—to determine the significance of the lesion and its affect on blood supply,” he notes. “Now, we bring them together into one single, non-invasive test, which bodes well for the work up of patients with suspected CAD.” By dropping the use of beta blockers, they also have seen improvements in workflow—now cardiac CT is like a regular CT scan. “It can be done in the same time slot without a radiology nurse on hand for IV protocols,” he adds. CCTA has reached the point where it should be the first test— instead of nuclear stress testing—for the initial evaluation of patients with suspected CAD, according to Harvey S. Hecht, MD, FACC, director of cardiovascular CT at Lenox Hill Hospital in New York City. “It is more sensitive, more specific and more accurate, plus you obtain information about the amount of calcified plaque—usually a strong prognosticator of coronary disease,” Hecht says. A second area where CCTA is beneficial is in guiding the practice of coronary stenting, which “tells you how long the stenosis is to size the stent appropriately, and tells you the size of the vessel to facilitate the procedure,” Hecht notes. Lenox Hill is using a Brilliance 64-slice CT scanner and a 256-slice Brilliance iCTscanner from Philips Healthcare. Despite the obvious benefits to CCTA, challenges remain. If CAD is found, CT is still somewhat limiting in grading the degree of stenosis and in determining the hemodynamic significance of the lesions on myocardial perfusion. Additionally, Hecht says contrast agents can be HealthImaging.com Powerful Tools at Your Fingertips At EDDA, w build advanced clinical applications A, A, we linical applications tio to bring a new generation of interactive g ge generation decision aid solutions f your needs in early id l i for d l detection, diagnosis and treatment. • • • • • Intuitive & efficient Lesion specific enhancement & analysis Advanced 3D/4D visualization Volumetric segmentation, editing & quantification Enterprise-wide solution for seamless workflow in PACS IQQA®-Chest CAD for DR/CR IQQA®-Liver for multi-phase contrast CT www.edda-tech.com • 609-919-9889 VISIT US AT AHRA 2008 • Booth #737 July 2008 | Health Imaging & IT 29 http://www.edda-tech.com http://www.edda-tech.com http://HealthImaging.com

Table of Contents Feed for the Digital Edition of Healthcare Imaging & IT - July 2008

Healthcare Imaging & IT - July 2008 On the Web The Enterprise News Update Convention Spotlight: AHRA 2008 Cover Story: Driving Metrics to Drive Business: Digital Dashboards Deliver Mammography CAD Comes of Age Breast MR CAD: Earlier Detection, Increased Efficiency Lung CAD Earning a Spot in Day-to-Day Practice Colon CAD: Breaking Down Barriers Modality Review: Cardiac CT Angiography: A Clear Pathway to Better Cardiac Patient Management Practice Management: RIS Rights Efficiency & Productivity Wrongs In Practice: Advanced Visualization Across the Enterprise Regulatory Update: Beware: Recovery Audit Contractors Poised for Permanent Status Technology Outlook: Compressing Images for Remote Transmission Reader's Resource Stat Sheet

Healthcare Imaging & IT - July 2008

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.