Nuclear medicine hits the road

Heads turn when Kalispell Regional Medical Center’s big black motorcoach rolls down the road, emblazoned Mobile Nuclear Medicine with an eye-catching atom graphic.

Andre Vanterpool, supervisor of nuclear medicine, has noticed the looks as he travels to St. John’s Hospital in Libby on Tuesdays and North Valley Hospital in Whitefish on Thursdays.

A man who knows his alpha, beta and gamma rays, Vanterpool said neither motorists nor patients have anything to fear from the equipment in the coach built on a truck chassis in Kalispell by Nomad Global Communication Solutions.

The radiopharmaceutical solutions on board come packaged in secure canisters with unit doses specific to each patient.

“It’s a small amount of radiation actually that we use to image the body and all its physiological wonderfulness,” Vanterpool said.

Nomad also lined with lead all cabinets for hazardous materials to prevent any danger to patients or medical staffers.

A veteran of 11 years as a technologist at Kalispell Regional, Vanterpool has boundless enthusiasm for his job. He was thrilled when he was tapped about a year ago to take the hospital’s nuclear medicine capabilities on the road.

“The really cool thing is that we’re taking the burden off the health-care system by providing access to people in critical access hospitals,” he said.

By finding a problem such as heart disease at an early stage, nuclear medicine imaging reduces treatment costs along with saving lives. The truck encourages patients to have these studies by eliminating the need to travel.

He hears this from patients he sees on rural trips with the mobile coach.

“Everybody I did last Tuesday in Libby was so grateful,” he said.

While most hospitals have state-of-the-art imaging, nuclear studies provide a unique perspective. Vanterpool said physiology differentiates nuclear medicine imaging from others such as X-rays, CT scans and MRIs.

While those provide valuable views of organs, nuclear imaging gives technologists and physicians a different perspective.

“We actually see how cells work on the molecular level,” he said. “With an X-ray, you see the bone. We can see how the cells are working within the bone.”

As an example, nuclear studies can show if prostate cancer has spread to the bones to help determine the appropriate treatment protocol.

Vanterpool said cardiologists use this equipment for heart studies called myocardial perfusion imaging. Results can confirm coronary artery disease and differentiate between cardiac-related chest pain and chest pain not related to the heart.

For surgery, nuclear medicine helps physicians assess cardiac risk before surgery and follow-up after surgery.

Bone scans with this equipment reveal fractures, cancer metastases, sources of bone pain, success of a bone graft and a chronic neurological syndrome called reflex sympathetic dystrophy. Physicians also use scans to follow up bone lesions seen on X-rays and to investigate possible child abuse.

Nuclear imaging also is used for studies called hepatobiliary scans in which a patient is injected with a radioactive tracer which goes to the liver, gall bladder and small bowel to reveal gall-bladder inflammation, bile duct obstructions or leaks.

“We’re pretty much 90 percent diagnosis,”  Vanterpool said.

Nuclear medicine does have treatment applications for thyroid conditions as well as a palliative for bone pain, he said.

As he began developing the mobile program, Vanterpool chose the Siemens Symbia-E nuclear camera. This technology had the latest software and latest generation of camera that gives physicians detailed information with increase clarity.

With the equipment specifications in hand, he got in touch with multiple vendors offering units to take it on road. Vanterpool was less than impressed with prepackaged units available on the market.

“We had the opportunity to buy one — it looked like the Oscar Mayer wiener van,” he said with a laugh.

 Vanterpool decided he needed a company that could custom-fit a coach to his needs.

“I picked Nomad in our own backyard,” he said. “I said, ‘Here’s the equipment— build a coach around it.’”

Jimmy Gladden, an account executive with Nomad in Kalispell, said most of the company’s competitors remain dead-set against changing anything on the packages they offer. Although Nomad had never built a mobile nuclear medicine unit before, the company was set up for innovation.

“We specialize in customizing vehicles based on the desires of the client,” he said. 

Founded in 2002, Nomad builds medical units as well as mobile command-and-control vehicles for all manner of emergency management agencies. Gladden said the company works nationwide and recently had begun some international projects.

“We’re already talking

to clients in other states about this identical platform,” he said. “It would be almost an identical design.”

According Gladden, the company working with Vanterpool had quite a few challenges to overcome in adapting this normally hospital-bound equipment, including very unique communications for a mobile application. 

“The challenge was to have it do everything it does in the hospital,” he said.

It had to meet very specific state and federal requirements for the hospital’s nuclear medicine licensing. Weight was another issue with the large cameras, generators, lead cabinets and heating, air conditioning and ventilation equipment adding up to 4,000 pounds.

Nomad engineers used modeling software to evolve the final design inside and out with Gladden seeking input from Vanterpool over four or five months. Because of Nomad’s location in Kalispell, he was also able to visit during the 200-day production of the final coach.

“It’s an International [truck] chassis with a custom aluminum body built to order,” Gladden said.

Vanterpool couldn’t be prouder of the results of his collaboration with Nomad and the new ability to take nuclear medicine to rural areas.

“It’s a vehicle from scratch,” he said. “You compare it to others — it’s in a class of its own.”

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