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Professional Association Collaborations Underwrite Education
March 1, 2010
For nearly 20 years, Toshiba America Medical Systems has been a vanguard-level sponsor of the RSNA’s Research and Education Foundation, which funds grants for young researchers in the imaging field. Since its inception 26 years ago, the foundation has provided more than $25 million in grants to 630 radiology investigators and educators. “These grants align with Toshiba’s focus on education and research,” Cathy Wolfe, director of marketing services for Toshiba, explains.
Toshiba’s education-focused collaboration with professional associations has expanded in the past few years to include the American College of Healthcare Executives (ACHE) and AHRA: The Association for Medical Imaging Management. The company sponsors the AHRA’s Putting Patients First Program, and has completed its second round of grant giving. The program seeks to improve the safety and quality of care in imaging both pediatric and adult patients. Putting Patients First provides six grants of up to $7,500 per year to hospitals and imaging centers to help fund programs, training, or seminars focused in this area.
In 2008, one such project involved developing a patient-handoff system to facilitate transferring patients from the hospital to the imaging department. Another looked at creating a bar-code system for identifying patients with allergies to contrast media. All grant recipients agree to share their results with others so that facilities around the country have the ability to implement similar systems, according to Ed Cronin, executive director of AHRA. Cronin notes that one of the 2008 recipients developed a seminar to present to other hospitals in the region; others wrote articles on their results for the AHRA’s journal, Radiology Management.
A similar partnership with ACHE gives a boost to midlevel managers who aspire to be leaders in the radiology field. Beginning this year, Toshiba will sponsor scholarships for 60 executives to attend a series of three leadership seminars throughout 2010, 2011 and 2012. “This is a program we developed several years ago to help middle managers move into roles in the C-suite,” Peggy Gordon, vice president of development at ACHE, explains. “It’s very intensive. The seminars happen three times a year, for three days at a time and are given by a very distinguished roster of faculty teaching management and leadership.”
The first 2010 seminar occurs in June and focuses on establishing leadership; the second takes place in August and looks at innovation and overcoming the financial challenges facing the health care industry; and the third, themed Manage for the Future, is slated for October. “Part of the reason for participating in the ACHE program is helping to strengthen health care leadership through quality education,” Wolfe says. “ACHE is an impressive organization in terms of its mission and vision, and of its focus on integrity, which we thought was a good fit with Toshiba.”
Through a fourth, emerging partnership with the Society for Pediatric Radiology, Toshiba has helped the organization develop a survey to address the concerns of pediatric radiologists. “We try to look at ways to collaborate that are more unique, that provide new benefits to the organization and an opportunity for differentiation,” Wolfe says. “We believe in investing in the industry in which we work, and one of the best ways to do that is to help ensure ongoing education of the membership.”
Finally, Toshiba is continuing its support of the Society of Cardiovascular Computed Tomography’s (SCCT) Young Investigator Awards. The SCCT is the leading international professional society dedicated to research, education and clinical excellence in cardiovascular computed tomography (CT), and is now accepting submissions for the fourth annual awards program. Sponsored by Toshiba, the unrestricted educational grants will be awarded to two residents or fellows in either radiology or cardiology for their patient care research in the categories of technical and clinical advancement of cardiovascular CT. The deadline for submissions is April 2, 2010. Abstracts are being accepted in two categories – Technology of Cardiovascular CT, or Clinical Applications of Cardiovascular CT. Applicants may enter by submitting an abstract through the SCCT Web site.
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Webinars Focus on High-tech Imaging Applications Education
Today’s economic environment makes it increasingly challenging for physicians and technologists to travel to educational events. Robb Young, senior manager in the CT Business Unit for Toshiba, explains that this obstacle inspired the company to begin sponsoring webinars on applications for its imaging technology. “Webinars are easier for people to access,” he says. “We can do them during the day, and we can make the expertise of a particular speaker available to a broader audience. A webinar can also be saved online, so if people missed it, they can easily access the information later.”
Toshiba’s first webinar in 2010 featured S. Bruce Greenberg, MD, professor of radiology and pediatrics at Arkansas Children’s Hospital, presenting on how radiology professionals and clinicians can leverage 320-detector row CT to reduce sedation needs and radiation exposure for patients while providing them with high-quality diagnostic images. This webinar was so well received, that Dr. Greenberg conducted a second session in late February. “We’re focusing on the needs in the market that drove the development of this technology,” Young says. “In pediatrics, obviously, that’s being able to image patients quickly at a low dose.” This CME-accredited webinar will be available online in April. At that time, please visit the following site to view the webinar and receive educational credits http://www.ceconcepts.net/CT/ .
Webinars planned for later in the year include sessions on using 320-detector row CT for cardiac care and stroke triage and diagnosis, as well as on applications and technology for non-contrast MRI. The webinars are each an hour long, are free to all attendees, and are accredited by the Accreditation Council for Continuing Medical Education. Each is worth one CME credit.
“We find these events are particularly beneficial for those who are looking at new applications of a technology, or who want to understand a technology better—especially because they get to hear about it from a user,” Young says. “The webinar format allows us to get the information out to those who need it more quickly and easily.”
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ACC Preview: Advances in Cardiac Imaging
At this year’s annual scientific meeting of the American College of Cardiology (ACC), which takes place on March 14–16 in Atlanta, Toshiba (booth #1944) will showcase a range of advances in and enhancements to its cardiac-imaging technology. Following is an overview of what Toshiba will showcase:
Infinix-i Hybrid Lab
When performing patient procedures in a hybrid setting, it is critical that the imaging system provides the flexibility to quickly and easily access both the patient and ancillary equipment. Toshiba will showcase its Infinix™ VF-i vascular X-ray system with 12” x 12” flat panel detectors and CAT-880B hybrid catheterization table, designed to create a best-in-class hybrid suite. The new mid-sized 12” x 12″ flat panel detector expands the versatility of the Infinix-i line that features a five-axis C-arm positioner and enables unprecedented patient access and coverage. Along with the new mid-sized detector, the Infinix-i five-axis systems are now available with the new CAT 880B tilt/cradle hybrid catheterization table. This table is designed to allow greater positioning flexibility and patient access during imaging and surgery. The table functionality, with side-to-side cradle and head-to-toe tilt, permits clinicians to angle the table in the optimal position to quickly and comfortably complete procedures. The system on display will also include ancillary equipment typically used in a hybrid suite.
Cardiac Ultrasound Capabilities
The cardiac capabilities of Toshiba’s ultrasound technology will also be featured. The Aplio Artida™ system is a dedicated cardiac system which provides unique 3D Wall Motion Tracking, allowing physicians to rapidly identify wall-motion defects and the timing of cardiac events, as well as real-time, multiplanar reformatting for assessing global and regional left ventricular function. Also on display is the new Aplio™ MX system, which is midsized and cart-based for better portability. Aplio MX is a multi-modality system which includes Differential Tissue Harmonic Imaging, for better results with bariatric patients; ApliPure, which enhances image clarity and detail definition; Advanced Dynamic Flow, which shows flow with directional information for even the smallest vessels.
Cardiac CT Software Enhancements
CT will highlight cardiac-software enhancements for the Aquilion® ONE and Aquilion Premium, including new ONE Beat Prospective Reconstruction, which shortens the interval window and reduces radiation exposure time, reducing dose by 21 percent; Real Time Beat Control, which calculates the running real-time average of the heart rate to predict the next beat more precisely (and thus, to time the scan more accurately); and optimizing timing for SUREStart, which accurately determines contrast uptake time for a better image. Wide Volume Cardiac Protocol on the Aquilion ONE, a work-in-progress enhancement, will enable clinicians to image the entire heart, lungs, and aorta in two rotations.
Cardiac MR
The wide range of cardiac MR capabilities on the Vantage Titan™ and Vantage Atlas® systems will be highlighted. The Vantage MRI product line offers a range of advanced cardiac capabilities, including a cardiac coil for the Vantage Titan and noncontrast imaging for patients with renal insufficiency.
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Clinical Case of the Month: Left Pulmonary Artery Stenosis
Congenital Heart Disease (CHD) is a birth defect or malformation of the heart which can impact the heart’s structure and function. According to the American Heart Association, nearly 36,000 babies are born with a heart defect each year. While CHD can affect both children and adults and can be life threatening, revolutionary advancements in diagnosis and surgery have made treatment and reparation of such defects possible. In 2008, over one million people with CHD had survived through adulthood.
Cardiac Catheterization is a non-surgical procedure that can be used for hemodynamic and angiographic evaluations of the structure and function of the heart, helpful in the diagnosis of CHD. Transcatheter interventions for treatment of CHD can also be performed using stents, coils, and other interventional devices.
Used in conjunction with the Toshiba Infinix-i cardiac systems, the Toshiba 3D-Digital Acquisition (3D-DA) software package allows physicians to view a three-dimensional perspective of a variety of vascular structures including the pulmonary arteries. 3D reconstruction is ideal for optimizing vessel-viewing angles prior to intervention, providing a better understanding of complex anatomy and helping to determine the proper size of interventional devices to be used for planning and treatment.
Case Study: 3D rotational angiography using 3D-DA software.
Technology: Toshiba Infinix CF-i Biplane cardiovascular cath lab using 3D-DA software.
Patient History: A 14 year old girl born with complex congenital heart disease (interrupted aortic arch, ventricular septal defect) required numerous surgical procedures beginning in early infancy which culminated in a Fontan procedure at age 4. Recently she began complaining of decreased exercise tolerance prompting a cardiac MRI which raised the possibility of a left pulmonary artery stenosis which had not been appreciated during previous cardiac catheterizations despite selective left pulmonary arteriography.
Diagnosis: During catheterization performed via a right femoral venous approach, selective 2D left pulmonary angiography failed to adequately demonstrate any stenosis. Due to the high degree of suspicion a 3D-DA was performed at 30f/s using a 206 degree rotation over a 5 second acquisition while holding respiration. Fifty milliliters of undiluted contrast were injected at a rate of 10 cc/sec to obtain the images shown in figure 1. Reconstruction took 35 seconds and post-processing took another 2 minutes to produce the images shown here. By rotating the reconstructed image 90% caudal (a view, not possible with standard angiography) physicians were able to clearly view the compression of the left pulmonary artery in a front to back orientation. Two overlapping Genesis XD stents were implanted across the area with 12 mm balloon and further dilated to 14 mm to obtain the image shown in figure 2.
In this particular case the use of 3D-DA greatly enhanced the ability to diagnose an important stenotic lesion which was undetected by 2D-DA despite multiple bi-plane acquisition imaging angles. Furthermore, using 3D-DA, post-intervention provided excellent imaging of the vessel stent interface and allowed for improved assessment of the result as well as any potential complication.
Figure 1: Pre-intervention 3D-DA of the branch pulmonary arteries in a child with a significant left pulmonary artery stenosis (arrow) after a Fontan operation. In a standard projection (LAO 21/caudal 7) the stenosis is difficult to appreciate (left), however, after rotating the image to a virtual angle (LAO 35/Cranial 71), the stenosis is clearly visible as shown by the arrow (right).
Figure 2: The same structure seen in the comparable views as above following implantation of two endovascular stents to enlarge the area. Note the excellent clarity and detail of the newly implanted stents and their relationship to the vessel wall.
Pre- (left) and post- (right) 3D-DA spins.
Images courtesy of Dr. Evan M. Zahn, M.D., Miami Children’s Hospital, Miami Florida