Speed saves in healthcare.
Faster medical interventions spare lives, lighten clinical workloads and often reduce the cost of care.
A new batch of fleet and pricey computed tomography scanners is about to put speed to its latest test.
Manufacturers have improved X-ray tubes and detectors, software and computing hardware, and the mechanical guts that make the machines whir. In doing so, they've created a new generation of CT machines, one of which can snap as many as 7.5 images per second.
Like a deli meat slicer, old-fashioned CT scanners could capture pictures of the body only one slice at a time. State-of-the-art scanners spin their X-ray tube and detectors around the patient continuously as the exam table advances through the scanner's doughnut-hole opening. The technique, called spiral or helical CT scanning, paints the body with X-rays just as stripes are painted on a barber's pole. Sophisticated computer programs then reconstruct the spirally acquired data into the conventional slices read by clinicians.
But the next generation of multislice scanners go the spiral machines one better. They use the helical technique, combined with arrays of detectors, to capture swaths of data, which are transformed into many image slices simultaneously. The multislice approach makes these new CT scanners unrivaled speed demons. For instance, a patient's spine can be imaged in 15 seconds compared with the two minutes it takes for a slice-at-a-time scanner, according to General Electric Co., maker of the first multislice scanner to hit the market.
Besides speeding exams, multislice technology may expand the CT's uses in trauma, pediatric, vascular and cardiac scanning, even imaging the beating heart without blurring.
Leading the new imaging pack is GE's ultrafast CT machine, called the LightSpeed QX/i, which was approved by the Food and Drug Administration late this summer. Like the latest top-of-the-line computer or sports car, GE's CT scanner commands top dollar: $1.3 million to be exact. That's more than many magnetic resonance imagers and almost twice the price of middle-market CT systems.
But don't even think about asking GE for a discount any time soon, say industry analysts. This premium product will stay on the top shelf for quite a while, they predict.
GE is so high on the new scanner, developed over six years at a cost of $60 million, that Jack Welch, chairman and chief executive officer of the Fairfield, Conn.-based company, unveiled the system to the press and medical community in New York in September.
Even jaded radiologists are taking notice.
"I've seen this technology game played out before; I'm hard to impress," says Bruce McClennan, M.D., chairman of the radiology department at Yale University School of Medicine, New Haven, Conn. "But this is going to really be somewhat of a revolution; it's not just a new neat widget. This represents enough of a leap to seriously consider the $300,000 to $500,000 (premium in price). It's that different."
So far, GE has installed seven of the LightSpeed scanners, five in the U.S., one in Belgium and one in Germany.
Some market watchers are less sanguine than manufacturers, however, and question whether most hospitals need the CT equivalent of a race car to do a minivan's work.
"Even if the scanner goes that fast, it doesn't need to go that fast," says Scott Balsters, a clinical analyst with MDB Information Network, Dallas. "A lot of its (appeal is) sales and marketing."
For instance, some of the most exacting imaging work requires very thin slices-1 mm or less in thickness-which aren't possible at the highest speeds, Balsters says.
Moreover, for many hospitals and health systems, a CT's speed doesn't limit the number of patients imaged per day. Scheduling bottlenecks, short staffs and even imaging overcapacity mean many hospitals have trouble using the scanners they have efficiently.
Regardless of the technical hype, these multislice systems are evolutionary rather than revolutionary, adds Anthony Montagnolo, vice president for technology planning at ECRI, a not-for-profit technology assessment company in Plymouth Meeting, Pa.
"Over time, this will become the standard technology," he predicts. "I just don't think it will change clinical practice immediately."
Montagnolo says there's no need to replace perfectly good CT scanners with multislice technology now. The machines may warrant consideration, however, for hospitals already in the market for a high-end replacement scanner or that want to expand their CT services, he says.
Meanwhile, other manufacturers are trotting out their own multislice offerings or touting works in progress to keep the dam from bursting.
Siemens Medical Systems, Iselin, N.J., won approval for a multislice upgrade to its high-end Somatom M Plus 4 CT scanner last month.
Toshiba America Medical Systems, Tustin, Calif., got the nod for an ultrafast helical scanner and is promising multislice technology for that system soon.
For the curious, the new crop of scanners promises to take center stage at the Radiological Society of North America show in Chicago later this month. Stay tuned