Friday, November 10, 2006
64 slice CT scanner
http://healthjournal.upmc.com/0306/CT64.htm
The earlier a coronary blockage is detected, the better the chance that life-threatening problems from CAD may be averted through appropriate treatment. However, CAD can be difficult to diagnose in a non-invasive way. According to Flordeliza Villanueva, MD, a cardiologist specializing in noninvasive cardiac imaging at UPMC, getting a clear image of the coronary arteries on CT scans wasn’t always easy. “The heart is a moving, beating organ, which causes the coronary arteries on standard CT images to appear blurry,” says Dr. Villanueva. In addition, the earliest signs of CAD often are very tiny changes in the blood vessel lining or wall, making them easy to miss on a traditional CT scan.
But a new imaging technology, called 64-slice CT, is helping overcome these and other barriers.Today, by using the ultrafast, 64-slice CT scanner and timing the scan to the patient’s heartbeat, physicians can image the heart and its blood vessels without blurring – and in record time. Using advanced computer technology, the information can be reconstructed into 3-D views of the heart and the coronary arteries, showing not only narrowed areas of the blood vessels but also early disease in the vessel walls that may not be narrowed.
Christopher Deible, MD, a radiologist at UPMC Presbyterian who performs CT scans along with Dr. Lacomis, describes the ease of the 64-slice procedure this way: “When a CT scan to look for heart disease is ordered by a patient’s doctor, a nurse calls the patient and explains the preparation, which includes a dose of beta-blockers the night before,” he says, explaining the process. “The beta-blockers are used to control the patient’s heart rate to help obtain the best possible images. If the patient can not receive a beta-blocker, an alternative is discussed with the physician.”
The patient arrives about an hour prior to the procedure, so the radiology nurses can assess his or her heart rate, start an IV for the CT contrast, explain the procedure, and answer any questions. The patient is in the scan room for only 10 to 15 minutes from start to finish, and the patient leaves as soon as the scan is done. The physicians use advanced workstations to generate the three-dimensional images and read the exam. The results usually are ready for the patient’s doctor the same day.
According to Dr. Villanueva, the 64-slice CT scan can look beyond the heart and into the blood vessel wall. “With this test, we may be able to get unique information on the biology of the vessel walls to see if disease is present. We even have the potential to see plaque inside the wall, something that coronary angiography can’t reveal, and which can help lead to earlier diagnosis.”
Dr. Deible describes another benefit. “Because the 64-slice CT scan takes only five seconds, even patients with an existing presence of heart disease can hold their breath long enough to complete the entire test, which helps obtain a clear image.”
The 64-slice CT scan still is being studied at UPMC and across the nation, but so far, the results have been positive. “We are still studying the data emerging from clinical trials and the literature on the ultimate value of this procedure is still being written, but thus far this technology does seem to hold great promise,” says Dr. Villanueva.
The earlier a coronary blockage is detected, the better the chance that life-threatening problems from CAD may be averted through appropriate treatment. However, CAD can be difficult to diagnose in a non-invasive way. According to Flordeliza Villanueva, MD, a cardiologist specializing in noninvasive cardiac imaging at UPMC, getting a clear image of the coronary arteries on CT scans wasn’t always easy. “The heart is a moving, beating organ, which causes the coronary arteries on standard CT images to appear blurry,” says Dr. Villanueva. In addition, the earliest signs of CAD often are very tiny changes in the blood vessel lining or wall, making them easy to miss on a traditional CT scan.
But a new imaging technology, called 64-slice CT, is helping overcome these and other barriers.Today, by using the ultrafast, 64-slice CT scanner and timing the scan to the patient’s heartbeat, physicians can image the heart and its blood vessels without blurring – and in record time. Using advanced computer technology, the information can be reconstructed into 3-D views of the heart and the coronary arteries, showing not only narrowed areas of the blood vessels but also early disease in the vessel walls that may not be narrowed.
Christopher Deible, MD, a radiologist at UPMC Presbyterian who performs CT scans along with Dr. Lacomis, describes the ease of the 64-slice procedure this way: “When a CT scan to look for heart disease is ordered by a patient’s doctor, a nurse calls the patient and explains the preparation, which includes a dose of beta-blockers the night before,” he says, explaining the process. “The beta-blockers are used to control the patient’s heart rate to help obtain the best possible images. If the patient can not receive a beta-blocker, an alternative is discussed with the physician.”
The patient arrives about an hour prior to the procedure, so the radiology nurses can assess his or her heart rate, start an IV for the CT contrast, explain the procedure, and answer any questions. The patient is in the scan room for only 10 to 15 minutes from start to finish, and the patient leaves as soon as the scan is done. The physicians use advanced workstations to generate the three-dimensional images and read the exam. The results usually are ready for the patient’s doctor the same day.
According to Dr. Villanueva, the 64-slice CT scan can look beyond the heart and into the blood vessel wall. “With this test, we may be able to get unique information on the biology of the vessel walls to see if disease is present. We even have the potential to see plaque inside the wall, something that coronary angiography can’t reveal, and which can help lead to earlier diagnosis.”
Dr. Deible describes another benefit. “Because the 64-slice CT scan takes only five seconds, even patients with an existing presence of heart disease can hold their breath long enough to complete the entire test, which helps obtain a clear image.”
The 64-slice CT scan still is being studied at UPMC and across the nation, but so far, the results have been positive. “We are still studying the data emerging from clinical trials and the literature on the ultimate value of this procedure is still being written, but thus far this technology does seem to hold great promise,” says Dr. Villanueva.
