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High-speed, low dose CT enhances care

Best Practice
Philips CT Clinical Science Philips Healthcare • USA

Philips iCT at Trinity Regional Medical Center

Who/where
Trinity Regional Medical Center is a licensed 200-bed non-profit hospital that serves Fort Dodge, IA, and surrounding communities. As a designated regional referral center, Trinity serves an eight-county area with a population of approximately 100,000. Offering a wide range of primary- and secondary-care services, Trinity employs more than 1,000 healthcare professionals, technicians, and other employees, and has a medical staff of 65 physicians. Trinity Regional Medical Center is accredited by DNV Healthcare Inc.

Challenge
Choosing a CT system that would help enhance patient care, expand the range of exams the facility is able to offer, and improve diagnostic confidence.

Response
The Philips iCT 256-slice scanner with iDose⁴ reconstruction technique is helping the clinical team bring high-speed, low-dose scanning to the region to enhance patient care through improved CT exams, including CTA.


Managing dose for the long term

Trinity Regional Medical Center performs approximately 20 to 30 CT exams a day. Troy Martens, COO of Trinity Regional Medical Center, says that when the facility went from a 16-slice CT scanner to a 256-slice iCT, the decision was a major one. “We have one CT scanner,” he states, “and so consequently our decision was very important to us. This 256-slice CT is the first in the state of Iowa.” Roseann Murray, Manager of Radiology Services at Trinity, agrees, pointing out that the Philips iCT and the iDose⁴ reconstruction technique have helped them manage dose without sacrificing image quality. “Dose is a major issue across the country, and we looked to Philips to help us address this,” she explains.
David Smith, M.D. Rosann Murray
David Smith, M.D.
Rosann Murray

Enhancing image quality across exams

David Smith, M.D., Medical Director of Radiology at Trinity, and a general and interventional radiologist, highlights the value that iCT with iDose⁴ is bringing to the facility, its patients, and referring physicians. “Because it’s our only CT and we’re seeing our purchases stretch out further and further, we thought we’d go with the most advanced technology to carry us that eight- to ten-year span,” he says, noting that image quality includes improvements in spatial resolution and reduction in noise.

“I think the images are just phenomenal,” he says. “I’ve never seen CTAs like this. The resolution is incredible. Before, CTA of the carotids was a major challenge in subtracting out the calcium, and CTA runoff of the lower extremities was impossible. CTA of the renal arteries prior to this scanner were questionable. And now, with this scanner, those studies are, without a doubt, of consistent high quality.”

“I’ve never seen CTAs like this. The resolution is incredible.” David Smith, M.D. - Medical Director of Radiology, Trinity Regional Medical Center

Low-dose scanning opening up new possibilities

“We have a very elderly population here so runoffs are a challenge because the flow rate can be slow from cardiac output and blockages. On our very first runoff, the techs just nailed it on the first run, and I thought maybe it was beginner’s luck, but we did it again on a different patient and sure enough: The timing was right on the money. “We went from very old technology to the latest and greatest, and it’s been a leap. And the dose modulation for different regions of the body just made good sense.”

Smith believes the system helps enhance his diagnostic confidence. “Prior to this scanner, MRAs were clearly better for us than CTAs. Now, I’m feeling more confident because the CTAs have improved so much,” he explains. “We found that we're actually getting better differentiation between contrast and calcified plaque.”

He is also pleased with the low IV contrast sensitivity of the iCT system. In general, with their iCT they have been able to use low contrast with high image quality. Smith states that, in comparing contrast studies, “a patient who was imaged on our old scanner and our new one, and so we could compare the difference.”

Smith continues, “I see our practice patterns changing. Our urologist has been asking for low-dose stone protocols. Some of these young people with stones who are in their 20s come in for multiple scans, and so we’re really trying to get a low-dose readable CT for them. It’s a work in progress.”

Fast scans changing care

Martens says that speed has been a factor in enhancing care for patients, as well. “One of the things we were looking for, because the scanner is fast, is the ability to scan pediatric patients without sedation, which we are doing,” he notes. “The whole patient experience has been improved because the scans are fast and we don’t have to use sedation in as many cases.”

Murray appreciates three major benefits of her new iCT system. First, “I think the techs were really impressed how easy it is to set up low-dose scans for the patient. They can personalize the dose.” Second, Murray is also pleased that, compared to her previous CT scanner, the low IV contrast sensitivity of the iCT has been “a significant economic benefit.” Last, Murray happily states, “Philips technical support as far as the applications and education has been superb.”


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May 7, 2012

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Best Practice
iCT
Body, calcified plaque, carotids, contrast, dose management, iDose4, image quality, kidney/renal CTA, low contrast volume, low dose, lower extremity, Neck, neck CTA, Neuro, Pediatric, peripheral runoff CTA, spatial resolution, Technologist, Vascular
 

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