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Rapport spécial : En dépit des reculs, fleurs du marché de CT

par Diana Bradley, Staff Writer | January 20, 2012
From the January 2012 issue of HealthCare Business News magazine

“It has been difficult to properly evaluate the effectiveness of these iterative reconstruction methods or affirm manufacturers’ claims of improved quality or reduced dose,” says Ehsan Samei, a medical physicist at Duke University. “New metrics of image quality are needed for that purpose.”

Another increasing trend involves the utilization of hybrid modalities such as positron emission tomography/CT and computed tomography laser mammography, to enhance CT systems’ applications. Hybrid modality systems are medical practitioners’ preference when diagnosing cardiovascular disease, cancer and Alzheimer’s disease. GlobalData’s report notes images of increased metabolic activity in diseased tissues obtained through other modalities, such as PET and SPECT systems, can be superimposed onto the anatomical images produced by a CT system through use of hybrid modality systems.

High-slice CT systems capable of producing high quality cross-sectional images or slices of a whole organ in a single rotation are another recent advancement. This reduces diagnosis times and radiation exposure. Perfusion CT scans and colonoscopy CT scans are also growing in popularity.

“Moving forward, I think we are going to see a greater proliferation of advanced tools that will provide radiologists with the capability to more consistently reduce exposure,” says Rubin. “The potential opportunity over the next several years is to perform CT scans with four to five times less dose than has routinely been applied.”

Monitoring and tracking
In November, the American Medical Association House of Delegates endorsed new policies aimed at reducing radiation exposure from diagnostic imaging for all patients. The policies call for raising standards for technicians who use CT devices, increasing radiation risk awareness and tracking a patient’s lifetime exposures.

A patient’s previous number of CT scans is relevant, but the cumulative impact of multiple CT scans remains unknown. Regardless, the decision to perform a CT scan should be informed by the medical need at the time, according to Rubin.

“It is important to remember that the latency of cancer development from a CT scan is on the order of 15 to 20 years,” he says. “If we are trying to give a patient with a chronic disease another two or three years of life, then the number of CT scans they have had is really not relevant to this goal.”

To help monitor how much radiation patients actually receive, in an effort to provide the optimal radiation dose to each patient, Samei and his colleague Olav Christianson created software that matches data from CT scanning devices with information about the age, gender and body part scanned for every single scan. The database currently contains information from roughly 10,000 CT scans.

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