A new generation of CT scanners is revolutionizing the way
doctors diagnose and treat patients
n By Kelly Savio Staff Writer
The medical community has never seen anything like it; Oprah dedicated an entire show to it; and it’s saving lives.
It is the 64-slice Computed Tomography scanner, better known as the latest and greatest in CT scanners.
Traditionally, the scanners were used to take advanced X-ray pictures of patients’ internal organs when doctors suspected various conditions. The pictures were, however, two dimensional and often difficult to understand at a glance. But all that’s changed now.
“With the new 64-slice CT scanners, we have a wealth of options we never had before,” said Dr. Kenneth Hoffman, the section chief of musculoskeletal and diagnostic imaging at Kaiser Permanente San Jose/Santa Teresa Medical Center. “In the old days, every rotation of the machine gave us one slice of pictures. Then, we got a few more, but now every rotation of the machine gives us 64 slices. The overlap of information and data is absolutely perfect. We can make 3-D pictures of a patient’s body. We can capture the heart mid-beat with this machine. It’s truly amazing.”
The machine is shaped like a huge, square doughnut. A patient lays down on a table that slides into the “doughnut hole”, putting the patient in position.
An X-ray system then spins around the doughnut hole, taking 64 X-ray pictures with each rotation. The result, Hoffman said, is similar to slicing a person like a loaf of bread and separating the patient into minute individual layers.
“The resolution and the detail in the pictures are fantastic,” he said. “You look at the pictures, punch a few keys, and take out all of the soft tissues and just have a 3-dimensional picture of a person’s bones. We could never see the arteries before, and now we can take out everything and just look at the arteries. Surgeons can look at these pictures, see exactly where the problems are, and when they go into surgery they can go straight to the problem instead of having to find it with the patient on the table.”
A picture of a patient’s forearm and hand appears on one of Hoffman’s computer screens. With a click of a button, most of the picture disappears, leaving just the veins in the arm. Another click switches to just the muscles and tendons. Yet another click erases everything but the bones.
Another picture appears on the screen. It shows the upper arm and shoulder blade of a patient. With a click, the bones rotate 360 degrees. Another click gets rid of the shoulder blade, leaving only the upper arm. He clicks and zooms in, clicks again and zooms out.
“We’ve never seen anything like this,” Hoffman said. “We never had any of these capabilities before this machine.”
The 64-slice CT scanner is a relative new-comer to medicine, but Hoffman said more and more hospitals will transition to these new machines because they are so much better than the older technology. The main obstacle in securing the new scanners, he said, is the price tag: more than $2 million.
The Kaiser Permanente San Jose/Santa Teresa Medical Center has had its machine a little over a year. St. Louise Regional Hospital in Gilroy had a 64-slice CT scanner installed in the facility recently, but hospital administration and employees could not comment on how they have used the new technology or how they hope the machine will improve patient care.
Information posted on the St. Louise Regional Hospital Web site says the new scanner can detect strokes, head injuries and fractures as well as diagnose diseases and identify problems with various organs.
Despite the hefty cost of the new scanners, Hoffman said they pay for themselves quickly. For example, with the new technology, heart blockages that can lead to heart attacks are easily visible on the images the scans produce. Previously, doctors had to do a procedure that required them to insert catheters into the arteries to identify such blockages, Hoffman said.
“That machine basically saved my life,” said Karl Sonkin, the regional media relations specialist for Northern California Kaiser Permanente facilities. “They were just getting the machine set up, and they asked for volunteers to go through and have some scans done, so I volunteered. A few days after I did the scan, I got a call that said, ‘Karl, you better come back in here. We think there are some problems on your scan.'”
When Hoffman pulls up a picture of Sonkin’s heart, even the untrained eye can see exactly where the problem lies. The heart sits at the center of the computer screen, a multitude of slightly shaded veins and arteries fanning out from it. One of these arteries, resembling a slightly squiggly tube, is set apart from all the others by a bright white spot at a part of the tube that appears pinched.
“You can see that this plumbing is plugged up just looking at this picture,” said Hoffman, pointing at the white spot. “It’s shocking in a way. You see all the healthy vessels that are nice and fat, and you can see where this one thins out, and you know nothing is getting through that.”
In the future, Hoffman said the 64-slice CT scanner technology could lead to other breakthroughs. Currently, doctors are trying to perfect a procedure for a virtual colonoscopy. Though most patients having the scans done now have specific problems doctors want to get a better look at, the medical community should be able to scan anyone at high risk for heart disease, such as people with high cholesterol or a family history of heart attacks.
“It’s really about the patients,” Hoffman said. “We’re getting them a more accurate, quicker diagnosis, and therefore getting them faster treatments. These pictures are just beautiful, and we’re still learning all the things they can tell us. It’s just amazing.”
