Ideas in Hospital-Based Imaging

More Radiation Therapists Enter Industry
Small Hospitals Welcome More Affordable MRI
Hospital Chooses Versatile, New X-ray System from Toshiba

More Radiation Therapists Enter Industry

The vacancy rate for radiation therapists has continued to decline in recent years, according to a survey recently conducted by the American Society of Radiologic Technologists (ASRT).

Down to 5.4%, the vacancy rate for radiation therapists is now slightly lower than that of other radiation oncology professionals, as indicated by the ASRT’s 2007 Radiation Therapy Staffing Survey. Half of those who responded indicated that their facilities were located within a community hospital, with 34% hailing from freestanding clinics and 9% from university medical centers.

“These results, along with findings of other surveys, suggest that radiation therapy is coming into a relative balance between supply and demand,” said Richard Harris, ASRT director of research.

Defined as “percent of budgeted full-time-equivalent positions currently vacant but being actively recruited,” the vacancy rate for radiation therapists fell by 2% since 2005. However, rates for the other specialties listed in the survey were higher than those reported for 2004-2005. The vacancy rate was 10.7% for medical physicists, 10.4% for radiation oncologists, 9% for medical dosimetrists, 7.2% for nurses, and 7% and 7.4%, respectively, for ancillary and administrative staff positions.

The survey found that the average facility reported a budget providing for slightly more than five full-time radiation therapists, 2.4 administrative staff members, 1.9 radiation oncologists, 1.9 nurses, 1.5 medical dosimetrists, and 1.1 medical physicists. Moreover, almost no physician assistants were accounted for in the budget, according to the survey.

Harris said the ASRT began administrating radiology staffing surveys back in 2004, picking up a task that the American Hospital Association had ceased. The organization felt it was to the benefit of the profession as a whole to have a feel for the radiological balance nationwide, Harris continued, adding that surveys provide “fairly frequent snapshots of what the supply and demand looks like.” These snapshots would enable program directors to tell their students about the job climate and allow managers to prepare for recruitment strategies, Harris said. Surveys also help prospective radiation therapists in determining whether to stay in the field, he said.

Along with surveys, the ASRT has worked hard to publicize and promote the profession. Among its many resources, the ASRT’s Web site provides high school counselors with informational materials on the industry and health care managers with a recruitment toolkit. Furthermore, the organization’s Education and Research Foundation provides scholarships to students with the help of sponsors.

With efforts from organizations like the ASRT, it looks like there is a growing trend of radiation therapists entering the field. Another factor to the influx of professionals may be higher pay, Harris said, pointing to a 7% climb in wages seen this year.

“It does seem to suggest that the profession is successful in reducing what was a severe shortage a few years ago,” Harris said, estimating that the increase could be 50% to 100% higher than rates calculated in 2000.

However, the survey yielded only an 11% return rate—Harris raised the issue that perhaps managers of radiation facilities aren’t feeling as much pressure from the severe shortage and therefore find it less important to contribute data to the study. All in all, he said, it is unclear whether the results are statistically significant or due to the broader population from which the sample was drawn, which this year included cancer centers and freestanding facilities. Nevertheless, results are consistent with feedback obtained from radiation therapy educational program directors, Harris said.

When asked about the level of difficulty in recruiting in various radiation oncology specialties, between 49% and 85% of the survey’s pool of participants indicated that it was the same as it had been in 2006. Of those who perceived a change in the level, more than 75% said recruiting radiation therapists had become less difficult.

—Elaine Sanchez

Small Hospitals Welcome More Affordable MRI

There’s encouraging news for smaller hospitals with limited budgets. It’s a new MRI with a focus on image quality, efficient patient setup, and faster throughput. It’s Siemens’ new Magnetom Essenza, a 1.5 Tesla MRI system. The Magnetom Essenza combines excellent system performance with a patient-friendly design at one of the lowest costs of ownership in the industry today—as much as $500,000 less than other 1.5T systems, according to the manufacturer.

The 1.5T MAGNETOM® Essenza from Siemens Medical Solutions combines excellent system performance with a patient-friendly design at one of the lowest total costs of ownership in the industry today. The magnet has simple siting requirements, is lightweight (approximately 3.5 tons), and has an ultrashort bore length of 145 cm.

“Magnetom Essenza addresses a real need in many small hospitals, where the cost of technology has prevented some facilities from investing in high-field systems,” said Jeffery Bundy, vice president, Siemens Medical Solutions, MR Division.

Thanks to its 1.5T field strength, the Magnetom Essenza system supports a complete range of clinical applications, including neurology, orthopedics, body imaging, angiography, cardiology, breast imaging, oncology, and pediatric imaging. The high field strength can improve diagnostic confidence, and the system’s powerful V-engine gradients technology boosts patient throughput.

In addition to the low initial investment, savings of up to 25% can also be attained on installation costs for space, power requirements, and construction. In part, this is due to the lightweight 3.5 ton magnet, which makes it possible to install the Magnetom Essenza on higher floors. If the system is replacing an existing MR system, it can reduce energy consumption up to 50%, thanks to its high-performance electronics. Since the state-of-the-art magnet has zero helium boil-off, there is no need to regularly refill this expensive substance, and the system is always ready for operation.

“Magnetom Essenza will make MR imaging attainable for hospitals and practices that up to this time simply could not afford to provide these services to their patients, at least not to the extent and the quality necessary. Our new system represents a paradigm shift. It will change the market permanently,” predicted Walter Märzendorfer, head of the Magnetic Resonance Division at Siemens Medical Solutions. “We have put a number of innovations together in this one system, including TIM (Total Imaging Matrix), which our customers have valued for years, and created a package optimized for low total cost of ownership. We know there is enormous cost pressure on health care providers, so we looked for and found ways to make MRI more affordable.”

Using TIM technology, the area of the patient to be examined can be covered with up to 25 seamlessly integrated coil elements that are read by eight independent radio-frequency channels. TIM allows for flexibly combining up to four different coils, which make patient and coil repositioning virtually unnecessary. TIM also enables Parallel Imaging for reduced acquisition times. All of these benefits translate into workflow improvements, increased patient throughput, and improved profitability. As an example, a complete examination of the entire central nervous system can be performed in less than 10 minutes.

Magnetom Essenza also features Siemens’ new coil innovation, the IsoCenter Matrix coil, which is placed in the isocenter of the magnet, meaning that it is always in position and ready to scan. This unique design offers high image quality, efficient patient setup, and faster throughput.

—James Markland

Hospital Chooses Versatile, New X-ray System from Toshiba

While capital budgets may be tight, hospitals continue to seek out new and better solutions for patient care. Arlington Memorial Hospital, an acute care full-service medical center in Arlington, Tex, recently installed the Infinix CF-i/SP x-ray system from Toshiba America Medical Systems Inc.

According to Robert Micer, director of Toshiba’s X-Ray Vascular Business Unit, the Infinix is a dedicated cardiac cath lab that features a floor-mounted C-arm with a unique five-axis positioner that allows head-to-toe and fingertip-to-fingertip coverage of multiple angles, making it possible to obtain images without repositioning patients.

Arlington Memorial Hospital recently installed Toshiba’s Infinix CF-i/SP x-ray system.

“Arlington Memorial’s mission to improve the health of the communities they serve aligns with Toshiba’s goal of advancing diagnostic imaging and improving overall patient care and comfort,” said Micer. “We look forward to working with the hospital to build upon its cardiac program for patients.”

Improving care with more efficient exams and procedures is what the new system is all about. The design concept allows the operator to approach and work in any desired relationship to the patient so that catheterization techniques can be freely executed, such as coronary studies as well as peripheral studies, as the system offers complete anatomical coverage from head to toe. The C-arm also delivers speedy, reliable, steep angulations such as those required for the spider view or complex proximal LCA lesions in cardiovascular angiography.

The five-axes C-arm design allows it to be used with great flexibility. All manner of interventional procedures are easily accommodated. The table-side operator is able to assume the most convenient location for full range of procedures, while the system produces images of superb clarity and resolution. The extensive right-left coverage of the C-arm and catheter table makes transradial approaches extremely simple.

A true multitasking platform, the Infinix is known for “interventional functionality.” Using sequential navigation, routine procedures such as PCI typically do not exceed 10 minutes with an average of only 1.5 minutes for fluoroscopy.

The system includes a sophisticated real-time digital image processing function. Real-time image processing is applied to both fluoroscopic and radiographic image data. A Dynamic Pattern Recognition Filter (DPRF) automatically detects different materials such as a stent, balloon marker, and others to enhance its contrast. In addition, a Dynamic Digital Compensation Filter (DDCF) is used simultaneously to enhance high definition of small devices and structures during the most demanding examinations.

High-definition Cardiac Flat Panel (C-panel) technology provides a fine balance of low noise and easy visualization of small detail whether displayed in dynamic or static mode. Excellent performance delivers the ability to display intricate blood vessels and small devices such as catheters and guide wires.

According to Micer, the Infinix CF-i/SP offers C-arm mobility and patient access like no other floor-mounted system in the industry. This advanced positioning and patient access allow physicians a better ergonomic working environment for optimized patient care.

The Infinix is equipped with a CD-R as a standard feature. The DVD is also available. The CD-R or DVD serves as a long-term storage medium for valuable image data, and both support DICOM 3.0. During reexaminations, images stored on CD-R or DVD can be reloaded into the Infinix as reference images for use during the examination.

—J. Markland