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The Catalyst

MUSC one of two sites featuring newest Siemens CT scanner

By Mikie Hayes
Public Relations

Callie Crawford, a biologist from the College of Charleston and an affiliate with MUSC’s Hollings Marine Lab, prepares to scan a 100– year–old shark specimen at MUSC. photos by Sarah Pack, Public Relations

Patients who must undergo computed tomography scanning now have a new option for care at MUSC: one that uses dramatically less radiation, is kidney–friendly and functions in a split–second.

On March 21, under the direction of Joseph Schoepf, M.D., professor of radiology, cardiology, and pediatric medicine, the first cardiac computed tomography scan in the U.S. was performed at MUSC using the Siemens SOMATOM Force CT scanner. This latest generation system, available for patient use only at MUSC and the Mayo Clinic in Rochester, Minnesota, can scan an entire body in literally less than one second.

CT scanning is a painless test that uses an advanced X–ray machine to take clear, detailed pictures of the body to look for problems. During a cardiac CT scan, for example, the machine will move around the patient’s body in a circle taking a picture of each part of the heart. A computer will then put the pictures together to make a three-dimensional picture of the entire heart.

The scanner is designed to function with the lowest possible radiation dose in viewing some of the more vulnerable and challenging patients, according to Schoepf. Children, patients with decreased kidney function, those who may be unable to hold their breath, and patients who must have frequent CTs to monitor their condition will all benefit greatly.

“Obviously a scanner that emits the lowest possible radiation dose is especially important in young patients, as well as when we image women as there is sensitive breast tissue in the field of view. It’s also important for patients who need frequent CT scans for ongoing surveillance of disease. Keeping the radiation dose to an absolute minimum is one of the true hallmarks of this scanner,” said Schoepf.

He added, “The scanner also may enable low–dose imaging in lung and colon exams as it significantly improves air and soft–tissue contrast.”

CT technicians prepare former U.S. Ambassador Philip Lader for the new dual-source scanner.

Former U.S. Ambassador to the United Kingdom Philip Lader recently underwent his scan with the new technology at MUSC. He said, “By increasing diagnostic accuracy and decreasing the amount of radiation, as a patient, it just gives me more confidence in the tools they are using to help monitor my heart and make sure that we are doing what we need to do, when we need to do it.”

The system is a dual–source CT scanner, using two X-ray sources and two detectors at the same time. This technology is a dramatic leap forward from conventional technology in terms of producing faster and better images and ultimately providing a safer and better patient experience. While he and his team continue to discover all the advantages this system offers, Schoepf is particularly excited by its unique features.

“It’s an evolving process as we learn how to fully use the machine, but my initial impression is that it’s better than I even hoped for. We can do amazing things that were not possible previously in the field of imaging. The noninvasiveness of this machine cannot be appreciated enough. What we’ve found is we are seeing drastic, drastic decreases in radiation exposure to patients — so the radiation we apply essentially amounts to that of a warm breeze. The ability to image patients noninvasively at a radiation dose that is many orders of magnitude lower than what other centers are using right now for the same exam is very rewarding indeed.”

The Force CT scanner also provides advantages in other applications. For instance, because the scanner is so fast, in an emergency situation when a patient is in critical condition, it allows for getting them in, scanned and out quickly. When patients are unable to hold their breath, clear diagnostic images can still be obtained as an entire adult chest, abdomen and pelvis study can be performed in less than one second. In cardiac imaging, for example, the Force CT scanner can obtain an entire study within a quarter of a heartbeat. The physician is therefore able to make faster, more confident decisions and better deliver timely interventions.

In addition to increased speed and lower radiation, another advantage is that the scanner is able to use lower amounts of contrast material — dye which is used to see body parts more clearly.  In patients with decreased kidney function, traditional contrast can place a burden on the kidneys, especially in older patients or those with chronic kidney disease. In the past, clinicians had two options: scan without contrast or avoid scanning entirely. This scanner provides another option.

Prior to FDA approval, Schoepf and his team utilized the machine for research studies. The studies they performed with patients were non–invasive yet still allowed for them to take images of the heart and explore early detection of liver cancer.

Christian Canstein, a Siemens collaborations manager, positions the shark for a scan of its anatomy.

Next they scanned and studied stingrays and 100–year–old shark specimens, partnering with the College of Charleston to conduct the very specialized research.

Gavin Naylor, Ph.D., Centers of Economic Excellence SmartState Endowed Chair in Marine Genomics Bioinformatics, MUSC professor of biochemistry and College of Charleston professor of biology, led College of Charleston’s team.

One of the goals of the research group was to create a database of evolutionary information for the Chondrichthyan fish species, which includes stingrays, sharks, skates, and chimeras.

Through this project, they sought to understand how these organisms addressed environmental challenges in the past. Anatomical data would provide important clues about the relationship between species, thereby expanding evolutionary knowledge.  Scanning the sharks and rays provided just that.

"Having access to MUSC's new Seimens Force dual source scanner, and the associated technical expertise in Professor Schoepf's research team, has allowed us to efficiently image rare preserved museum specimens that are fragile and not amenable to dissection," said Naylor.

This novel approach to using the scanner provided rich results, and the teams plan to continue working together in the future.

Schoepf added, “We have a good working relationship with the College of Charleston and the Hollings Marine Biology Center. The shark experiment was interesting. Studying non-traditional uses of the machine furthered our understanding of many things and allowed us to study the animals without destroying them. What we were after in imaging the sharks was to look at evolution to see what species have in common and how they have developed from each other. That obviously has implications in human evolution and we try to elucidate principles that govern biology. We walked away with a better understanding of how species are linked to each other in the developmental process.”

According to Schoepf, MUSC has built a national reputation for being at the forefront of new technologies, especially having the “latest and greatest” in CT equipment in particular.

“MUSC was one of first centers in the U.S. that installed a 64-slice scanner, first to install the first and second generation dual-source CT scanners, and now the new Siemens Force – the third and latest generation. With every single generation, MUSC was at least among the first five to have it. There is nothing on the horizon close to this. We will of course see a new quantum leap in the future, and we will be at the leading edge then too,” he said.

The third system will soon be installed at the National Institutes of Health in Bethesda, Maryland.

“Having this equipment is a big differentiator. Patients would rather come to you if you have it. It’s not just the advanced technology however, it’s also critical to have the greatest expertise in interpreting the results. We have the most specialized people to perform imaging studies, and we clearly do the most numbers. You want to have the person interpret your imaging study who does this every day, day in and day out. We are recognized as one of the premiere groups in cardiovascular imaging in the country and in the world,” he continued. “We are known for moving the field forward.”

August 1, 2014



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