Health Imaging & IT - September 2008 - (Page 22)

Point of Care Carts A Leg Up: DR Brings Orthopedic Details to Light with Speed, Accuracy Electronic height adjustment Work at your comfort level with our ergonomic workstations Pneumatic height adjustment Wall Mounts A more comfortable work environment improves productivity in Detroit is using the Sonialvision Safire II system from Shimadzu Medical specifically for orthopedic studies. The Sonialvision Safire II supports general radiography, fluoroscopy, tomography and, in particular, supports tomosynthesis. The clinic uses the system predominantly for musculoskeletal applications. The high resolution of the Selenium direct DR detector records fine bone details. For tomosynthesis, 75 precisely registered views are acquired over a 40 degree arc and reconstructed using specialized software. For a typical joint, this results in a stack of about 75 tomographic images with 1 mm spacing. “Our focus and utilization has been on musculoskeletal joint imaging where we find that it is superior for revealing occult fractures which tend to be subtle and not revealed on general radiographs,” he says. Why is it superior? The cross-sectional tomographic depiction of the anatomy is important for removing overlying structures that obscure small fractures and for demonstrating high contrast for fracture lines that are rarely aligned optimally for detection with conventional radiographs. “We have done comparisons of this particular tomosynthesis system to studies done with thin 64-slice CT and we do find that the tomosynthesis has about three times as better spatial resolution in plane than CT does,” he notes. Flynn says the orthopedic specialists routinely use DR with tomosynthesis in cases where the finding is particularly subtle or uncertain, such as suspected hip fractures that present in the ER. “What we are finding with tomosynthesis is it reveals more directly the fracture line and the extent to which the fracture line might be traversing the bone which will influence the way one manages that patient in terms of surgery or release,” Flynn says. with the purchase of the Stryker HD DR 3000 powered by Swissray for general orthopedic radiography procedures, according to Lead Technologist Laurie Corning. Last year, the practice provided almost 10,000 imaging studies. Certain specialized orthopedic views, such as Merchant or Sunrise views, have historically been more easily obtained using CR cassettes than by using DR. With the Swissray system, this is no longer the case. “Special angles or views like Merchant or axillary can be pre-programmed, which is a time-saver for our techs when they are really busy,” she notes. “This is the main reason we chose the system—because of the special auto-positioning settings.” Previously, for Merchant views, patients had to get up on the table and put their legs through a wooden stand. Now, patients can sit in a chair leaning slightly to the side, so that the x-ray comes across to show the patellas, as opposed to lying down. With the HD post-processing, physicians are given additional features like electronic preoperative planning tools such as implant templating and stitching. An auto-stitching feature creates long films by overlapping of separate images that are seamlessly fused for full leg and spine viewing—all in one exposure. Techs simply set the minimal and maximum height, then hold the button and the system takes over, angling itself to take three images from the plumb line to the crest of the hips. Prior to DR, a routine L-spine with five views took about 15 minutes. Now, it takes about six minutes. “We acquire images right away, minimizing the risk of patients moving or shifting and almost eliminating repeat imaging,” Corning says. maximizing patient throughput Strong Memorial Hospital Outpatient Orthopedic Clinic, an affiliate of the University of Rochester Medical Center in New York, sees more than 300 patients a day for a wide range of imaging exams from pelvis trauma series to cervical spines, shoulders, hips, knees and extremities. In 2005, the clinic installed the HealthImaging.com 1.800.663.3412 www.afcindustries.com 22 Health Imaging & IT | September 2008 specialty views in HD Orthopaedic Specialists of North County in Oceanside, Calif., a specialty orthopedic group, chose to make the jump from analog to digital x-ray three and a half months ago http://www.afcindustries.com http://HealthImaging.com

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Health Imaging & IT - September 2008

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