Randy Sprinkle, administrative director for radiology services, and Theresa Cook, director of outpatient imaging, in front of Piedmont Hospital's new state-of-the-art 64-slice CT scanner.
Forty years ago, hospitals considered it a major breakthrough to develop X-ray film in less than 10 minutes. Today, more hospitals have moved to filmless and paperless radiology departments with the digital Picture Archival and Communication System, which allows doctors to share test results almost immediately from a computer screen in an exam room.
"I continue to be amazed at how fast the technology is moving forward," said Roly Alvarez, RT, radiology manager at Piedmont Mountainside in Jasper. "Two years ago, the newest invention was the 16-slice CT scanner; now the 64-slice CT scanner is considered state of the art and we're able to find millimeter lesions that we missed before."
As a patient lies on a gurney, X-ray beams rotate 360 degrees around the body to take detailed "slices" or pictures. Capturing thousands of slices in seconds, the computer then generates final diagnostic images, which radiologists can study and manipulate in a 3-D computer work-station lab to diagnose conditions such as strokes, head injuries, aneurysms, fractures, cancers and heart disease - all without more invasive diagnostic testing.
"Thanks to new technologies, we can guide physicians to medical problems with greater accuracy, using lower doses of radiation, and we're seeing patients get healthier, faster," Alvarez said.
In his 20-year career, Alvarez has never stopped learning. He's had to stay abreast of the increasingly sophisticated and sensitive array of modalities used to report on the body's interior workings.
"As we've developed new ways to diagnose and treat the myriad of clinical conditions, radiology technologists have had to become more specialized," said Timothy J. Lacny, CRA, RT, R, CT, director of operations, radiology medical imaging services at Piedmont Hospital in Atlanta.
Widespread support "Imaging is a part of every medical specialty and supports every area of the hospital," said Randy Sprinkle, BSRT, MBA, CRA, administrative director for radiology services at Piedmont Hospital. "And since the equipment is only as good as the person who operates it, we require technologists who meet the highest standards in terms of education and clinical skills and who care about their patients."
In June, radiology services at Piedmont Hospital became the first site in Georgia to be awarded three-year accreditation by the American College of Radiology in all diagnostic modalities, including some of the newest, like positron emission tomography.
The PET/CT scanner creates images using small amounts of radioactive tracers to detect even tiny areas of abnormality within all the organ systems in the body and merges these images with a CT scan. This eliminates the need for two separate tests and allows the findings of both scans to be viewed simultaneously as a merged image.
Piedmont Hospital performs about 400,000 imaging procedures a year.
"Some modalities - like magnetic resonance imaging and computed tomography
scanning - can decrease a patient's hospital
stay or even decrease the need for surgery," Lacny said.
Radiology technologists also are assisting with medical inter-ventions. Uterine fibroid embolization is one beneficial procedure for women with fibroid tumors.
With the help of X-ray imaging, an interventional radiologist injects small particles into the capillaries that supply blood to the fibroids.
"The particles cut off the blood supply to the tumor so that it shrinks and dies. Patients are relieved of excess bleeding, pain and other symptoms that might have previously led to surgical removal of the fibroids or a hysterectomy and they're in the hospital less than 24 hours," Lacny said.
Theresa Cook, RT, CRA, director of outpatient imaging at Piedmont, noted that an MRI CAD (computer assisted diagnosis) system is being added to the Doris Shaheen Breast Health Center at the hospital.
"It will provide radiologists with an efficient, standardized method for analyzing and reporting breast MRI studies and interventional planning," she said.
According to a study published by the Radiology Society of North America in 2004, CAD significantly increases the rate of breast cancer detection. "We're also doing more MRI biopsies. When you catch things earlier, there are more opportunities for treatment," Cook said.
"Vertebroplasty is another image-guided, minimally invasive treatment for spinal compression fractures," said Dr. Louis Jacobs, an interventional neuroradiologist with Radiology Associates of Atlanta."MRI shows us the fracture and an imaging screen helps us to inject medical cement into the fracture to stabilize it.
"Most patients get relief from the pain that was keeping them bedridden and find their quality of life greatly improved."
High-tech rollout
This month, the department unveils its new $2 million biplane digital angiography
system suite, where neurointerventional radiologists, like Jacobs and Dr.
Steven J. Citron, chief of interventional radiology at Piedmont, will be
performing detachable
coil embolizations, a new approach to treating aneurysms.
About 50 percent of patients with a ruptured aneurysm die or are seriously disabled. Traditionally, brain aneurysms were removed through long and complicated brain surgery.
A fairly recent alternative is to place one or several miniscule coils
into the mouth of the aneurysm to promote clotting and
cut off the blood flow. The coil is inserted through conventional catheter
angiography through a major artery.
"We are on the precipice of using CT angiography instead, which is quicker and safer," Critron said.
CT angiography is much less invasive since it uses a smaller needle and peripheral vein."This technology is like having a Ferrari and learning how to shift the gears," Critron said.
The bi-plane imaging device will allow neurointerventional radiologists to simultaneously view real-time imaging of a bodily structure in two different planes.
"It's critical to place the aneurysm in space and know how it is directed,
because you have to place the coils directly into
the mouth, which may only be a couple of millimeters wide," Citron said.
"During the difficult procedure, the technologist serves as another pair of eyes, hands and brain to assist the physician," Lacny said.
The technologist manipulates the screens for clearer contrast, storing, saving and transferring images, and may be taking CT scans to monitor bleeding.
Citron calls CT angiography the wave of the future because it saves time, costs and decreases the risks of aneurysm coiling. "With any imaging procedure, the technologist has to know pathology, to be able to recognize what he is seeing and think outside of the box to achieve what's best for the patient. Every patient is a bit different, " Lacny said.
Sprinkle is proud that Piedmont's radiology services are operating on the medical frontier with the latest equipment and the highest-trained specialists to operate it.
Cook sees more applications for the 64-slice CT scanners in the future, as diagnostic radiology moves toward virtual colonoscopy, lung screenings and CT angiography for heart patients.
"Radiology technology is such a diverse field, and it's never boring," she said.