Doctors, patients have 64 reasons to like new CT scanner

To the layperson, a 64-slice computerized tomography scanner may not sound like equipment with which they want to interact. Sixty-four slices of what, after all? Of you?

Indeed. When a physician orders a CT scan for a patient, it is to get a noninvasive, better look inside the patient. It is a special kind of X-ray machine that,
instead of sending out a single X-ray through the body, sends several rays simultaneously from different angles.

For the queasy, remember these are enhanced X-ray machines. Though 64-slice makes it sounds as if you may become a famous loaf of bread, such is not the case.

What has physicians so excited about 64-slice scanners is the same thing that thrilled them when 12-slice scanners were introduced. They get more information without a scalpel. 


PICTURE THIS

In late December, Affinity Medical Center in Massillon, Ohio, placed in operation its 64-slice scanner at its Doctors Hospital campus. The equipment cost in the neighborhood of $2 million, said Chief Operating Officer Beverly Bokovitz, and the purchase was made after a two-year study in concert with the new medical organization's strategic plan.

"It is another spoke in our heart-care program," Bokovitz, a registered nurse, explained, "and that planning has been ongoing. We currently have one other cardiologist and two of our radiologists who are trained to use it. This is Dr. (George 'Skip') Seese's baby and he is very well-versed in the device."

Indeed, Seese, a 17-year veteran of noninvasive cardiology, is Affinity's go-to source for 64-slice CT scan expertise as it applies to the heart. He anticipates the new scanner replacing up to a quarter of the heart catheterizations performed to detect blockages.

"The advantage (of the 64-slice scanner) is that you inject a little dye and that is as invasive as it gets. We can get an image with one single breath hold, maybe seven to 10 seconds," Seese explained. "I had one myself as one of the guinea pigs. I left my office at 12:30, walked across the street and I was back in the office at 1. If you are doing a catheterization, you have a day in the hospital, the procedure going in through the groin and lying still because you don't want a bleed to occur," he said.

Comparing the older CT scans to the 64-slice, Seese said the advantage is that the new scanner is so fast it can take clear pictures of the beating heart that then are assembled quickly into a three-dimensional image. And those images can identify soft plaque, the dangerous sticky substance that is unlikely to be seen during a catheterization.

WHAT YOU COULD NOT SEE

"Soft plaque is the killer. Hard plaques don't rupture like soft plaques. Sixty to 80 percent of all heart attacks occur with blockages of less than 50 percent because of the soft plaque. That's what causes blood products to clot off," Seese continued. "If we don't have bad blockages but have soft plaque, we can give aggressive treatment like statins for cholesterol."

And though the fast 64-slice units are a real boon to cardiologists, radiologist Sam Stuhlmiller of Radiology Associates of Canton, Ohio, sees them offering improved visualization of the entire body.

"Aneurysms, blood vessels in the legs, many things," Stuhlmiller said. "Technology is a moving target. It's really disruptive technology, changing the ways things have been done. Earlier, we used them more commonly for tumors, brain scans and abdominal pains or looking at the spine. So it's kind of new for the CT to be a tool used in cardiology.

"But it couldn't be done without the computer work station sitting behind the scanner. Its data sets are enormous, 1,500 to 2,000 pictures in one scan. We need the computer to build the three-dimensional model display in a way you can look at it. The computer crunches the data. That takes a good five to 10 minutes. So it's all really fast."