PET/CT + MR Trimodality Imaging

PET/CT + MR Trimodality Imaging

The superb soft-tissue-contrast of MR. The exceptional metabolic insight of PET. The precise anatomical reference of CT. Fusing these three powerful modalities holds tremendous promise—by opening up exciting new possibilities in the management of cancer, neurodegenerative and cardiac diseases.

 

PET-CT-MR clinical image, spine.

 

You can utilize leading-edge PET, CT and MRI technologies — together or individually — providing unparalleled choice, flexibility and clinical value.  Researchers and clinicians can access new technology to potentially improve image quality. See fine vessel detail. Visualize cardiac anatomy and function. Detect small lesions. Monitor response to therapy.  And forge a smarter path from clinical research to patient care.

Combining mature, robust technologies with new breakthroughs, Trimodality imaging is intended to be one of the best investments available for researchers and multi-specialty hospitals. That’s why we celebrate it as another step toward helping you make the best decisions for your patients.

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The Optima* MR360 1.5T

 

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Economy causing more MRI accidents?

Insurers, the organizations that pay for the vast majority of MRI exams in the US, have been incrementally cutting the prices that they’ll pay hospitals and imaging centers for MRI studies. To a degree, this has been in response to ever-growing MRI scan volumes, which have lead to some economies of scale. A few years ago, Medicare / Medicaid switched from taking incremental nibbles off of the reimbursement rate, to lopping off a huge chunk with the budgetary equivalent of a machete, called the Deficit Reduction Act (DRA). Many commercial insurers followed suit.

The accumulated reimbursement cuts from the whole cadre of insurers has taken years following the initial enactment of the DRA to reach its full effect, just in time for the bottom to drop out of the broader economy. Now MRI providers are not only getting paid less for each exam, with many patients having to fork-over a 20% copay for the cost of their MRI exam, the number of patients walking in the door has also dropped.

A trend that began with the enactment of the DRA a few years ago may actually be building momentum, namely cutting staff, or cutting staff qualifications, to reduce the operating expenses of an MRI operation. Source

 

These reductions may be the worst thing for any hospital or outpatient center. Your greatest asset is The MRI technologist. The technologist understands MRI Safety at a level unparalleled to any one else in the diagnostic imaging environment. As the level of training decreases of staff the level of MRI safety accidents will continue to rise inversely proportionally. This is exactly why there has been a 277% rise in reported accidents.

This may seem a little over-simplified evaluation of a very complicated matter. However, the economy does correlate to the dramatic rise in MRI safety accidents. I can only put the pieces together. If cut backs are hurting health care at the patient level, where safety is concerned it is time to step in and make some drastic changes. Please let me know how you feel about this……

 

 

Please regulate MR safety practices

 

 

The knowledge base for safety in the MRI suite suffers from a number of profound disparities. The types of risks and potential accidents for persons in the MR suite are well known to clinical and technical MR personnel, but the rates at which these accidents occur on a national basis are obscured by profound under-reporting. And though many experienced MR staffers understand the risks, it is likely that the incidental personnel—such as housekeeping, engineering, transport—who may regularly serve the area know little of the breadth of risks to which they may be exposed (or to which they may be exposing others). 2007, however, has already seen the introduction of new tools and standards, which will help improve safety in the MR suite and also may work to narrow the dangerous gaps in our knowledge and promote enhanced standards of care.

Chief among these resources is the new American College of Radiology (ACR) Guidance Document for Safe MR Practices: 2007, which supersedes the two previous ACR safety documents published in 2002 and 2004 under the title of the White Paper on MR Safety. The new document was recently published in the American Journal of Roentgenology (AJR), though, through a special arrangement, the text has been circulating in electronic format since early this spring. Because of the importance of this document and the pressing safety issues it addressed, the ACR and AJRagreed to provide the document on both organizations’ web sites for free download as soon as the final manuscript was accepted for publication.

The arrival of this new document came not a moment too soon as the FDA’s Manufacturer and User Facility Device Experience (MAUDE) Database recorded a 140% increase in reported MRI accidents for the 12-month period ending in mid 2006. Though Emanuel Kanal, MD, chair of the ACR’s MR Safety Committee, and other MR safety experts believe that accidents reported to the FDA represent less than 10% of the actual number of incidents that occur (some, including John Gosbee, MD, formerly of the VA’s National Center for Patient Safety, have speculated that reporting of MRI accidents is near 1%), this recent dramatic increase is suspected to be the result of compounding increases in risk more than a significant shift in reporting.

Factors such as increasing magnet strength, greater utilization for emergent/trauma cases, wider patient dependence on medical devices or implants that may be contraindicated for MR exams, larger numbers of sedation/general anesthesia patients, and interventional applications from image-guided biopsies to intraoperative imaging are all perceived to ratchet up the opportunities for mishaps.

These increasing risk factors, perhaps statistically insignificant individually, compound in many facilities, and, when multiplied by the estimated 20,000,000 MRI exams performed annually in the United States alone, can be the source for dramatic increases in rates of accidents. If all of these factors combined to create only 1/100th of 1% likelihood of an MR accident resulting in a serious injury, statistics would suggest that we would see an increase of 2,000 serious MR injuries, some potentially even fatalities, in any given year. For a modality with an unparalleled safety record, this sort of accident frequency would be abhorrent, particularly given the fact that the vast majority of MR accidents are completely avoidable.

At the present time, there are no specific MR safety standards at the site level that are a part of payor credentialing, national provider accreditation programs, or even state or federal regulations. The absence of professional regulations, however, is on the brink of changing.

MR safety issues are currently under scrutiny by groups as varied as the American Society of Anesthesiologists, the committee that writes the building code for hospitals and health care facilities, the VA health care system, The Joint Commission, and the ACR’s Committee on MR Accreditation. These examples highlight the disconnects that have plagued concerted efforts to standardize MR safety issues, namely, the absence of unified professional standards. The ACR’s MR accreditation program, however, has worked to bridge this gap and references ACR’s MR safety guidance as a recommendation for those seeking accreditation. But soon sites seeking MR accreditation from the ACR may face new questions and scrutiny about safety provisions as a part of that process. Source

A six year old boy undergoing an MRI (Magnetic Resonance Imaging) scan was killed by a ferromagnetic oxygen tank that was pulled into the MR scanner. Although MRI can provide important diagnostic information, medical practitioners and patients should be aware that there are several hazards associated with MRI.

The references below give more information on safety in MR environments.

http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm135362.htm

The ACR created a multidisciplinary blue ribbon panel to address critical issues in MR safety. Initially published in in theAmerican Journal of Roentgenology in June 2002, updated in May 2004, and then markedly expanded and updated in March of 2007 (for June, 2007 publication in the AJR), the ACR Guidance Document for Safe MR Practices: 2007″ addresses numerous MR safety related topics, such as:

Read More

 

“There are increasing numbers of MR scans and an increasing demand to scan patients with implants or accessory medical devices and other equipment. With the increased use, we are also seeing a number of preventable incidents,” said Sunder Rajan, PhD, of the FDA’s Center for Devices and Radiological Health Division of Physics Biophysics Laboratory. “Given the new experience base, this is a good time for FDA to learn what MR practices are being used and what changes practitioners feel would improve safety to the MR environment.”

 

Is It Time For Regulation?

Industry leaders agree that you should have regular standards that provide for MRI safety. However, feelings around federal or state intervention are mixed.

“I’d love to see national guidelines, but I don’t know whether it needs to be federal regulation. Unequivocally, I’d like to see a set of objective standards applied to all MRI providers to ensure they offer a basic level of expertise and safety precautions in the MRI environment,” Gilk said. “Whether it’s federal regulation or an agreement between state licensing or accrediting agencies could help us take the needed steps toward preventing accidents.”
Kanal agreed that regulation is needed, but he said it needs to come from within the radiology community.

“We can either accept standards that we create and define, or we can wait for another terrible safety even to occur and be widely publicized throughout the world before pressure mounts on organized radiology to impose externally defined standards, guidelines, and practices upon us.”

 

 

Read more

 

MRI SAFETY.com

 

http://www.fda.gov/MedicalDevices/NewsEvents/WorkshopsConferences/ucm270720.htm

 

http://coolmristuff.blogspot.com/view/classic

GE reports The first X-rays to molecular medicine

 

This is a great article with some real history from GE. There are some Photographs below and more on there website. Be sure to follow up with Coolmristuff.com in a couple months when I speak with Mr. Michael Harsh about the future of GE’s medical division. Here at Coolmristuff.com we want to see what new technological advances GE is making in the medical field today. How will MRI, CT, &  PET make differences in the way routine diagnostic exams are done? What will be next? Will there ever be one scanner that does everything? hmm?………stay tuned.

http://www.gereports.com/fro m-the-first-x-rays-to-molecular-medicine/

 

 

Albert Einstein once noted that “imagination is more important than knowledge.” Yesterday on Capitol Hill, Michael Harsh, Vice President and Chief Technology Officer at GE Healthcare, quoted Einstein’s maxim in remarks at a U.S. Senate Special Committee on Aging forum on the future of healthcare called “Aging in America: Future Challenges, Promise and Potential.” Discussing healthcare innovation, Harsh said that knowledge was “limited to all we know while imagination embraces the entire world and all there ever will be to know.”

Yet knowledge and imagination are both the pillars of innovation. The record of Harsh’s business division, GE Healthcare, shows that the company stands firmly on both. In 1896 Willhelm Roentgen experimented with cathode-ray tubes and noticed that light was passing through solids. Referencing the mysterious light, he called the phenomenon X-rays and took a grainy picture of the bones in his wife’s hand. Just one year later, Thomas Edison and fellow GE engineer Elihu Thomson improved on Roentgen’s idea with insights from light bulb technology they had been developing and made the fluoroscope, the wFast forward to 1932, when GE’s Irving Langmuir won the Nobel Prize in Chemistry for his work that led to early coronary artery imaging. Forty years later, GE’s Ivar Giaever received the Nobel in1973 for research that made magnetic resonance imaging, or MRI, possible.

 

GE also employed Emile Gabby, who is known around the world as the father of mammography. Gabby developed a revolutionary x-ray tube design that made it possible to image soft tissue with unprecedented resolution. The positive impact on women’s healthcare is incalculable.

Irving Langmuir with Boy Scouts, 1950: General Electric Research Laboratory scientist Irving Langmuir gives a science demonstration to a group of Boy Scouts. Langmuir championed science education for children during his career at GE, and was honored by the Boy Scouts of America with their Silver Beaver and Silver Buffalo awards.

Used with permission from the GE Photographic Collection, at Schenectady Museum and Suits-Bueche Planetarium.

What innovations will change healthcare tomorrow? Most recently, GE’s scientists have been working on ways to combine the power of imaging technology with molecular biology and pathology. “We are moving from a healthcare paradigm where we ‘see and treat’ existing disease, to the ability to detect disease at the molecular level before physical symptoms emerge, and to treat that disease at a much earlier stage when it is much less costly to address and more advantageous to the patient’s quality of life,” said Harsh. Perhaps a breakthrough even Edison couldn’t have imagined.

orld’s first commercially available x-ray machine. For the first time, physicians could identify bone fractures and locate foreign objects in the body.

 

 

 

Testing the CT-Scanner, 1976: Dr. Arthur Bueche, Director of the General Electric Research and Development Center tests a computerized tomography scanner (CT-Scanner).

Used with permission from the GE Photographic Collection, at Schenectady Museum and Suits-Bueche Planetarium.

http://www.gereports.com/from-the-first-x-rays-to-molecular-medicine/

 

Toshiba 3T Vantage approved by FDA

Anyone using Toshiba magnets please comment about your experience. Good or bad. Thank you! I think this new magnet will be a nice one!!

Vantage Titan 3T

Titan 3T sets new standards in Comfort, Imaging and Productivity
Experience 3T like never before!
With Toshiba’s Titan series, you provide unsurpassed comfort to your patient, combining a short 1.6 meter magnet with a large 71 cm opening, reducing patient anxiety and allowing 80% of the body to be scanned feet first.

The widest…
What do 71 cm bring in practice?
More comfort for your patients
Helps against claustrophobia
More space to fit patients of all sizes
Reduce stress and anxienty
Easy check-on and access-to your patient
Ideal for pediatrics and geriatrics
Ideal for breast imaging
The quietest…
Acoustic noise is an important source of problems on conventional MR systems. It makes communication with the patient difficult and causes the patient discomfort. It can induce transient or permanent hearing disturbance and also poses a hazard for pediatric patients who need sedation.

Toshiba’s unique PianissimoTM technology has been further improved
and applied to provide the quietest 3T system available.
Read more about PianissimoTM

Magnetic Field Homogeneity: B0
While conventional MR systems offer a spherical homogeneous are centered at the iso-center of the scanner, a cylinder corresponds better to the form of the human body. With conform technology, Titan 3T offers a 50 x 50 x 45 cm cylindrical homogeneous Field Of View.

RF Field Homogeneity: B1
Titan 3T uses optimized amplitude and phase transmission called “Multi Phase Transmit”. It has the functionality of a Multi-channel Transmit Array, using multiple ports and multiple phases for optimal B1 homogeneity. It removes shading artifacts, improves SAR and reduces scan times by up to 40%.

Exceptional Contrast Resolution
With Conform and Multi-Phase Transmit technologies, abdominal and pelvic imaging are no challenge on Titan 3T. No more shading on your T2-weighted (fast) spin echo images. No more uneven fat suppression on your images. You can use SSFP from head to toe!

Image on the right:
T2-W FSE (0.5×0.5×2.5mm)

Atlas matrix coil system
In conventional MR systems, the organ specific coils require frequent coil exchange. The heavy weight of most coils makes the task tedious for the operators and the time devoted to this operation is wasted. With Atlas, coil exchange is dramaitically recuced and the few times it is required, the light weight of the coils makes it a fast and easy operation. This way, the workflow is significantly increased.
Read more about Atlas

Download
brochure!

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MRI suite is following LEED Platinum standards with new IMRI suite

Burt-Watts Constructs LEED-Certified MRI Suite

Austin-based Burt-Watts Industries, Inc. will provide general contracting and construction management services for the expansion of a new $10.8 million dollar intra-operative MRI suite at Dell Children’s Medical Center of Central Texas.

The IMRISneuro is a fully integrated operating room that includes a unique, movable MRI machine that allows surgeons to safely image patients in the operating room during brain surgery.

Dell Children’s Medical Center’s 6,000-sq-ft suite, scheduled to open this summer, is one of less than 20 medical facilities in the world to have the IMRISneuro. The suite, to be located 20 ft below ground-level, will have copper shielding. A room will be also specifically designed to house the IMRISneuro when not in use.

The new MRI suite is following LEED Platinum standards. Dell Children’s is the first hospital in the world to receive the designation.

Austin, Texas – (January 8, 2008) Dell Children’s Medical Center of Central Texas, a member of the Seton Family of Hospitals, has become the first hospital in the world to receive the LEED (Leadership in Energy & Environmental Design) Platinum designation, given by the U.S. Green Building Council.

“Even before the first plans were drawn up, we set our sights on creating a world-class children’s hospital, and becoming the first LEED Platinum hospital in the world was definitely part of that,” said Robert Bonar, president and CEO, Dell Children’s Medical Center of Central Texas. “Our motivation to pursue LEED Platinum was not just environmental. Being a ‘green’ hospital has a profound, measureable effect on healing. What’s good for the environment and good for our Mueller neighbors is also good for our patients.”

Dell Children’s, which occupies nearly one-half million square feet on 32 acres that were once part of Austin’s old Mueller Airport, opened in June 2007. Its environmentally-sensitive design not only conserves water and electricity, but positively impacts the hospital’s clinical environment by improving air quality, making natural sunlight more readily available, and reducing a wide range of pollutants.

Inside the facility, sunlight reaches 80 percent of the available space. Outside, sustainable and indigenous building materials were used throughout the façade. A 4.3 megawatt natural gas-fired power plant produces 100 percent of the hospital’s electricity, heating and cooling.

Dell Children’s routinely plays host to visiting clinical, environmental and architectural experts from around the world, and features six interior healing gardens, each representing a distinct ecosystem within Dell Children’s 46-county service area.

In order to achieve LEED certification, buildings are rated in five key areas: sustainable site development, water savings, energy efficiency, materials selection and indoor environmental quality. Listed below are some of the accomplishments in each LEED category:read more
here

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