CT

This is where we put the headlines from the daily business briefs

When Sir Godfrey Hounsfield introduced CT for brain imaging in 1973, my colleagues and I at the University of Pennsylvania were using a dedicated SPECT instrument, designed and assembled at our institution, to examine blood-brain barrier abnormalities in a variety of neurological disorders.

The ability to acquire functional and anatomic information in a single scheduled exam offers many clinical and workflow benefits. But making the most of a hybrid imaging system involves far more than simply pressing the "on" switch. With the advent of multislice SPECT/CT, radiologists and nuclear medicine physicians are taking a long, hard look at how these systems will fit into clinical practice.

A new generation of hybrid scanners has entered the clinical mainstream. Featuring high-performance PET detectors and 16-slice CTs, these systems have followed their predecessors' path into oncology, but they have also veered into new realms.

The marriage between PET and CT worked so well it made CT almost a standard component of any PET purchase. As installations of SPECT/CT begin, observers are waiting to see how this latest hybrid compares.

Nuclear medicine physicians would be the first to admit that the resolution of their color maps could be better. Despite the ability of radioisotope tracers to home in on likely areas of malignancy, poor spatial resolution can hinder precise localization of pathology.

One of the things a good newsmagazine should do is provide contrasting opinions on important issues. It is something we try to achieve with nearly every article we carry.

Combined SPECT/CT scanners are receiving a warm welcome in the nuclear cardiology community. Acquisition of CT data immediately before or after a myocardial perfusion SPECT exam is proving to be an effective means of minimizing attenuation artifacts. Multislice SPECT/CT units could also pave the way to comprehensive assessments of cardiac function.

Imaging of infection provides a classic example of nuclear medicine's strengths and weaknesses. Radiopharmaceutical tracers can locate infection sites with great accuracy. As with oncology imaging, however, the absence of anatomic landmarks makes it difficult to determine the location to which the hot spot on a color map corresponds. A better road map, capable of locating the position of signal more precisely, would make it easier to diagnose the cause of infection and plan the most appropriate treatment.

A new cardiovascular system designed to assist in the treatment of chronic heart and vascular conditions is headed for the global market. Its developer, GE Healthcare, expects Innova 2100IQ to improve patient outcomes by enabling clinicians in the cath lab to better visualize precise placement of interventional devices. The system, unveiled May 24 at the annual Paris Course on Revascularization, images fine vessels and anatomy in the heart. The 2100IQ is the latest addition to the Innova family. More than 1200 of this family have been installed worldwide.

The nuclear medicine market is in a state of flux. Sales were unremarkable last year -- flat for gamma cameras, slightly up for PET/CT scanners -- but new technological advances and product introductions are generating interest as well as new users.

Philips Medical Solutions will begin shipping a multislice CT simulator next month, carrying on a tradition in CT oncology begun by Picker International and carried on by Marconi Medical Systems, which Philips acquired 2001. Philips has been testing its latest 16-slice configuration at four beta sites.

The imaging community continued to drift in April on a flat sea of FDA clearances, as just 22 devices, one more than in March, managed to pass the agency’s review.

Varian, Inc. has developed an MR technologies platform that can be assembled into configurations supporting systems designed to research human, animal, and material applications. These different configurations, which range from MR scanners to nuclear MR spectrometers (NMR), operate at field strengths from 4.7T to 14.1T.

Given the high quality of FDG-PET imaging, the likelihood that other useful PET tracers will be approved for clinical applications, and the enthusiasm with which the larger radiology community has embraced PET/CT, the future of single-photon scintigraphy in diagnostic imaging is a relevant discussion for nuclear medicine and radiology departments. Decisions have to be made about the allocation of funds, space, and physician training.

Dr. Robert J. Lull, chief of nuclear medicine at the University of California, San Francisco and head of nuclear medicine at San Francisco General Hospital, was stabbed to death May 19.

Nearly half of all patients whose hearts are scanned with CT may get a shocking surprise: a diagnosis of a serious problem that has nothing to do with the heart, according to a study presented today at the American Roentgen Ray Society meeting.

Heart rate and CT density at the aortic root significantly affect image quality in coronary CT angiography, according to a study presented at the European Congress of Radiology.

The pace of FDA clearances slowed in March for the second consecutive month and the fourth in a row that the number has failed to break 30.

Over the past three weeks, Philips Medical Systems has been talking up its vision for the future of cardiac CT. In five cities -- Chicago, New York, Los Angeles, Dallas, and Ft. Lauderdale -- on dates ranging from April 19 to May 5, Philips has presented the clinical benefits of diagnostic cardiovascular CT. Feature presentations were made by clinicians from Wisconsin Heart, Washington Hospital Center, the Healthcare Clinic of Arkansas, and Lake Cardiology.

The quest for energy, homeland security, and soaring budget deficits are taking their toll on other federally funded programs, and one of the victims could be nuclear medicine research. As detailed in the article on page 13 by Senior Editor James Brice, the Bush administration's budget proposal calls for cuts of $43 million in clinical nuclear medicine research, reducing expenditures to $13.7 million. That's still a hefty amount of money, but several groups-the Society of Nuclear Medicine, the American College of Nuclear Physicians, and the American College of Radiology-are worried enough about the consequences that they have mounted a lobbying effort to stop the budget cuts.

I feel obligated to respond to the article in your March 2005 issue, "All clinical sides take hard look at PET and PET/CT" by Halliday et al (page 47). The article overlooks perhaps the most important team member needed to "ensure seamless integration of PET imaging within the hospital system." If the perspective of the nuclear medicine technologist is not taken into account, there will be no success for this venture.

A large multicenter trial of CT colonography has started collecting patients and some criticism among advocates who say it may undercut the procedure and produce not much more than is known already.

The nuclear medicine community is fighting proposed federal budget cuts that would end most Department of Energy support for basic nuclear medical research.

Radiologists should not only take their patients' history but perhaps also record their future travel plans. Apparently, individuals undergoing diagnostic or therapeutic nuclear medicine procedures can trip radiation detectors designed to catch terrorists smuggling radioactive material.