Quantum leap

Super scanner gives detailed view of beating heart

It can figuratively stop the beating heart - but it's a good thing.

It scans faster than the heart can beat or blood can flow and it's coming to HealthCenter Northwest and Kalispell Regional Medical Center in January.

Dr. Michael Henson, a radiologist, and Jana Rupp, director of imaging services, say the new General Electric volume CT scanner represents a quantum leap into the future of computed tomography scanning.

"In several beats, we can image the whole heart," Henson said.

The equipment, which cost more than a million dollars, promises to pay dividends in lives saved by earlier diagnoses of artery and heart disease. It also holds promise for reducing the cost of health care.

"It's cheaper when you find things earlier," Rupp said. "That's what new technology has to prove."

According to Henson, scientific studies need to catch up with this imaging technology before residents of the Flathead Valley will reap the full benefits of cutting-edge vascular imaging.

Henson compared these national medical studies to those performed for mammography. It took time to sort out its best application - which women, what ages and how often.

It's the same for the new high-speed, high-resolution scanner.

"In the next few months, the studies are due in," Henson said. "We'll start out with basic applications."

In the meantime, Henson, Rupp and others involved in imaging meet weekly with cardiologists to understand how the specialists will apply the new imaging.

"It's not a tool for a coronary emergency," Henson said. "It's for a patient who's clinically stable."

The emergency room will retain its existing CT for trauma. Rupp said it meets the hospital standard of moving patients from emergency-room to CT and back in 10 minutes.

"What we have in there is the LightSpeed Plus with four detectors," she said. "This one has 64."

The development and application across the country of this high-speed, high-resolution scanner has received widespread media attention, including a segment on "The Oprah Winfrey Show."

Time Magazine featured its potential in a cover story in early September. In that article, Time trumpeted the 64-slice CT scanner's potential for more accurate diagnoses of blocked arteries, tears in the aorta and blood clots in the pulmonary (lung) arteries.

Rupp said the hospital eventually will expand into this revolutionary vascular imaging.

"That's where it has big implications," she said.

Henson foresees a day when the scanner could detect a heart condition in a person who feels fine. But he emphasizes that science hasn't reached that point yet.

"Now if you suspect a heart problem, you get a test that's invasive and very expensive," he said. "Right now, that's the gold standard."

According to Henson, about 40 percent of the people who undergo an angiogram find they have no problem with their coronary arteries.

Conversely, he said 25 percent of the people who die each day have a heart-related fatality.

"Half of those suffering a fatality had no idea they had coronary disease," he said. "They had no chest pain."

This new technology holds promise for imaging those undetected heart problems at an early and treatable stage just as mammograms image breast cancer at early stages.

As a result, Henson said cardiologists will perform catheter procedures only on patients who need them.

"Studies will identify ages and risk factors that would suggest a follow-up CT," Henson said.

Patients referred for high-resolution CT would find the equipment looks no different than the square doughnut CT scanners in use for years. It also works in the same way.

The patient lies in the doughnut hole on a platform which the technician can move up, down, forward and backward to achieve the desired image.

Inside the doughnut, a rotating frame, with an X-ray tube on one side and banana-shaped detectors on the other, spins around the patient.

"It shoots a beam through the patient on to the detectors," Henson said.

Each rotation creates an image of a 4-centimeter section of a body part. The new super scanner divides that unit into 64 slices about the size of a credit card.

According to Henson, improvements in computer downloading technology led to the revved-up speed and resolution of CT imaging. A computer uses complex programs to convert the 64 slices into three-dimensional images of outstanding clarity.

The technology provided the first clear pictures of the beating heart and its major blood vessels. Scans can be timed to gather images between contractions to eliminate the blurring caused by motion.

Its future applications extend beyond the heart.

"We'll be able to generate pictures of the lung that looks more real to a patient," Henson said.

Some institutions now use the speedy, high-quality images to study how patients are responding to therapy.

Henson predicts that primary-care doctors will find applications for the new technology. But he cautioned that the image is still an X-ray and needs to be used wisely.

Rupp agreed.

"It's not voodoo or magic medicine," she said. "It's another diagnostic tool that needs to be managed."

Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com.