Ideas in Hospital-Based Imaging

Making the Big Switch
Teaming Up on Electrophysiology

Making the Big Switch

Hospital Goes from Film to DR

When Saratoga Hospital was gearing up to transition from film to direct digital radiography, representatives from the hospital started visiting other medical facilities that had the technology in an effort to find the best fit for physicians and technologists.

Saratoga Hospital chose IDC’s X2200, X1590, and X1600 machines to replace conventional film x-ray in three radiography rooms.

That was a year before the hospital, which is based in Saratoga Springs, NY, made the switch. A team from the hospital made seven site visits to evaluate different computed radiography (CR), digital radiography (DR), and PACS systems.

In the end, the hospital chose Imaging Dynamics Co’s X2200, X1590, and X1600 machines to replace conventional film x-ray equipment in three radiography rooms. After putting in the work to find the right vendor, hospital officials say they expect to receive a number of benefits from transitioning to new technology in their imaging department.

“We’re transitioning the entire department,” said Mildred Aviles, director of medical imaging services at Saratoga Hospital. “It is a big undertaking, and we’ve been planning for this for quite some time.”

For the hospital’s physicians, the new DR technology provides better images, which is what they wanted out of it in the first place, Aviles said. For technologists, ease of use was key, and they have that in the new DR machines. “The steps that they have to take are reduced significantly on any patient, because they’re able to view their image within a matter of seconds after taking it, and they can decide if they need to do anything different,” Aviles said. “The patient is in and out of the room much, much quicker.”

As it started its transition to digital imaging, Saratoga Hospital considered seven different vendors for CR, DR, and PACS systems. Each vendor arranged for a team from the hospital to visit another medical facility to see its system in person.

For each site visit, Saratoga Hospital sent a team of four to eight staff members. Both technologists and physicians were included on the site visits.

The hospital also received literature from the vendors, but the site visits were essential, Aviles said. “In our field, kind of hands-on and seeing it and talking to current users, that’s the best information,” Aviles said.

After having seen all the vendors’ systems, technologists and physicians ranked which systems they liked best, and the imaging department’s leadership took those rankings into consideration in choosing a vendor.

The hospital opted to buy DR machines from Imaging Dynamics, Calgary, Canada, because of their ease of use and affordability, Aviles said.

Saratoga Hospital finished installing DR technology at one of its outpatient facilities in March. It was in the process of installing the X2200 machine at the hospital when Aviles spoke to Axis Imaging News. Each DR unit takes 7 to 10 days to install, Aviles said.

The hospital also bought a CR machine from Konica Minolta for use in its operating room and intensive care unit, so the hospital has both CR and DR technology, Aviles said. CR is portable technology, which is why the hospital opted to buy that technology along with the more efficient DR machines, she said.

In addition, Saratoga Hospital obtained a PACS, and it expects to go live with that system in September. With the PACS, the hospital will no longer have to store hard copies of images. And although the hospital has to store the images it has now for 7 years, in time it will be able to do away with its storage room, Aviles said.

“When we go digital and the images are digital, they are now transferable so we feel that our [physicians] will have increased access to them,” Aviles said. “You have some flexibility with the images. The quality is improved with digital imaging, and all of our images can now go on a CD.”

—Alex Dobuzinskis

Teaming Up on Electrophysiology

GE Healthcare, Waukesha, Wis, is expanding its relationship with Biosense Webster Inc, Diamond Bar, Calif. The two companies previously collaborated by integrating GE’s CardioLab IT system with the Biosense Carto Mapping System. Now they will work together to develop real-time ultrasound imaging for use in electrophysiology procedures.

“In electrophysiology, we’re dealing with the 3D space of the intracardiac chambers,” explained Mark Langer, general manager of the Interventional Cardiovascular Ultrasound business at GE. “The need for real-time anatomic visualization is obviously acute. The navigation of therapy catheters inside the heart is such a challenging proposition.”

The technology would be used to treat clinical conditions, including atrial fibrillation (AF), the most common arrhythmia in the world. “Ablation can be quite effective, 84% to 87%, in controlling this arrhythmia,” said Langer. “The only alternative today is drug therapy, which isn’t anywhere near that kind of effectiveness.”

But the procedure is extremely complex, and that’s where advanced ultrasound technology comes into play. “The ablation catheter needs to be navigated to various conditions in the left atrium,” said Langer. “It can take several hours to as long as 8 hours. There aren’t too many electrophysiologists who specialize in doing AF ablations, but there’s a tremendous demand for the therapy today. We think by bringing ultrasound to the procedure, we can help these physicians see better.”

Langer explains that GE will bring the imaging piece to the equation, while Biosense will develop the EP catheter technology. “Ultrasound is anatomical and can be real-time,” he said. “Our goal is to work on technologies that can apply ultrasound for EP. We want to be able to enable other intracardiac procedures that we see coming along. We enable the imaging, they enable the therapy—it’s a partnership between those two elements.”

Other emerging areas of clinical treatment in electrophysiology include ablation of arrhythmias in the ventricles and structural heart procedures like septal defect repair. “Further down the road, it’s still early for experimental therapies like cell therapy, but if they’re going to be successful, they’ll need as much visualization as we can bring,” said Langer. “All these procedures are intracardiac. They take place in the chambers of the heart, and that’s a particularly challenging area in which to work.”

And there are additional potential applications outside of EP to consider. “Numerous companies are working on new types of heart valves that could deliver via catheter rather than open-chest procedure,” Langer noted. “It’ll be critical to position those valves correctly to be able to really clearly see the anatomy in real time.”

Because the alliance is still in its nascent phase, it’s too early to know when the market could see the emergence of this new cardiac EP technology. But Langer notes that GE’s previous collaboration with Biosense has been very successful. “We have more than 300 customers using the interface between CardioLab and Carto Mapping today,” he said. “We’ve had a long-standing relationship with Biosense and we’ve always worked well together.”

—Cat Vasko