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Imaging Abroad: Part III

written by Matthew L. Hayes BSRS RT (R)(MR)(CT)
Adjunct Faculty | Radiologic Sciences| Online Learning
Adventist University of Health Sciences
mhayes@innovativeimaging.org
www.innovativeimaging.org

This blog is series contributed thanks to our very own Professor Matthew L. Hayes, an adjunct professor of CT and MRI at Adventist University of Health Sciences. Professor Hayes has spoken at events for the Radiological Society of North America (RSNA) and the American Society for Radiation Oncology (ASTRO) and brings more than 13 years experience in the field to ADU. He graduated from ADU with his associates and bachelors in radiologic sciences and has been fortunate to travel the world and learn from some of the brightest minds in the field. In this blog series, he will be contributing updates to his imaging work at ADU and abroad.

Plane-free, no frills edition of MRI abroad today, folks! Instead of flying to a distant city, it’s just my Volvo and I on the road. Today, I’m heading from my home in Orlando up to the Mayo Clinic in Jacksonville. It’s about a 2 ½ hour drive. I’d listen to music, but my daughter Penny put pennies in the CD player when I wasn’t looking. Needless to say, the CD player is dead. That’s just one instance of how my adorable children have broken all of the nice things I owned before they arrived. They’d better put me in a really nice nursing home later on. I deserve it.

The reason for my trip today is to see how Syngo.via, Siemens’ Advanced Visualization software, works in a hospital setting. My friend Heather Grousset has arranged for me to meet with Dallas Thorpe, the head of the CT department and see how they utilize the program. Since I come from an outpatient setting and will be speaking on the subject at Siemens’ imaging symposium, I always like to be as informed as possible.

Because I haven’t been wasting the opportunity to eat all the best food in the cities I’ve been visiting, I’ve paid the price. Therefore, I’m substituting lamb risotto with a protein bar. I’d describe its rich taste and creamy texture, but frankly, it’s horrible. I’ve got another one for the trip home. I can’t contain my excitement.

As you might expect, the Mayo Clinic Jacksonville is a beautiful hospital. The modern exterior seems to have more windows than concrete and the inside feels very open and friendly. The culture of pride in the establishment is immediately evident in the faces and behavior of the employees. I know I’m going to learn some things today.

I wait in the lobby and am greeted by Dallas and Dena. Dena is a product manager of CT within Siemens and extremely knowledgeable within the modality. After I introduce myself and thank them for having me, they give me a tour around their department. The environment is futuristic in design and in thinking. Managers do not have dedicated desks, rather desk time that they can schedule to have within the administration lounge. I really like this way of thinking. It keeps managers more connected to their teams and the teamwork is apparent.

I see how the department is using Syngo.via to process various types of CT examinations- most notably, dual energy with their Flash CT. Dual energy is the latest breakthrough in CT technology. Basically, it is a CT machine that has two x-ray tubes instead of one. The two tubes can either be used together (dual source) to reduce the scan time for moving body parts, or they can be used separately (duel energy) with each using different x-ray energies. By utilizing the dual energy capabilities, conspicuous lesions in the liver, kidneys and pancreas are seen clearly and are easily characterized. Dual Energy can also detect calcium (kidney stones), Iodine (found in the injectable CT contrast) and uric acid (seen in gout) based on how they react to the different energies. As a result, lower amounts of contrast dye can be used on patients and diagnosis like gout and kidney stones can be made with much more confidence.

I sit and watch Dena and another staff technologist work through the schedule. I scan CT on a 64 slice Siemens Definition AS, which I love, but this is on another level. I’m especially excited when I see them preparing a patient for a cardiac scan. When it comes to cardiac scanning, the time it takes to acquire each slice is key. We gate the patient with ECG to know what portion of the cardiac cycle they are on. Diastole is when the heart is at rest and is usually the time when the image will be generally free of motion. Systole is then the heart is the most contracted and generally more difficult to image free of motion. For this scan, since dual source scanning will be utilized, each x-ray tube will only have to make a half rotation around the heart to create a CT picture. Because of this, the scan time can be greatly reduced. My cardiac scans usually take 8-9 seconds, where their acquisition time was 4. Dena, clearly seeing my face says “pretty cool, huh?” I nod emphatically. I stayed around for another hour processing more examinations with Dallas. Not wanting to monopolize more of his day, I thank him for his hospitality and hit the road.

The thing that I am continually reminded of is how much there is to learn within imaging. With new technology always on the horizon, we are so lucky to practice within such a dynamic and ever-evolving field. I wasn’t counting on learning what I did, but it was a welcomed and pleasant surprise. I’ve got such a long way to go in my knowledge, but I relish the challenge. I do not, however, relish the idea of my protein bar and a 2 ½ hour drive home.

It’s ok. Maybe I’ll listen to some music to pass the time. Oh wait…