Year : 2004 | Volume
: 14 | Issue : 3 | Page : 243--244
Multislice CT-CT coronary angiograms : Can we prevent getting sucked into the number game?
Joint Editor & Secretary, Indian Journal of Radiology and Imaging, India
Joint Editor & Secretary, Indian Journal of Radiology and Imaging
|How to cite this article:|
Kohli A. Multislice CT-CT coronary angiograms : Can we prevent getting sucked into the number game?.Indian J Radiol Imaging 2004;14:243-244
|How to cite this URL:|
Kohli A. Multislice CT-CT coronary angiograms : Can we prevent getting sucked into the number game?. Indian J Radiol Imaging [serial online] 2004 [cited 2019 Nov 20 ];14:243-244
Available from: http://www.ijri.org/text.asp?2004/14/3/243/28593
The last 18 months has seen the most phenomenal technological developments in multidetector CT. This pace of development possibly out stripes developments in any other field of science during this period. The singular aim off course is to make diagnostic noninvasive coronary artery imaging a reality. Starting off at 4 slice 18 months ago to now introduction of 64 slice scanners. In between the 4 and 64 came the 16 slice scanners, these scanners also had 3 generations within them, 500 msec, 420 msec, 370 msec. Evidently technological developments are not going to stop at 64 slice scanners. The technological progress is going to proceed at possibly a similar pace. We are also fortunate that the manufactures are willing to provide us these technological advancements as soon as they are available internationally and have passed out of beta sites.
This comes to the main question. When does a radiologist who would like to do coronary artery imaging enter the fray and purchase a multidetector CT. The technological advancements being so fast, soon after the purchase and installation a new technological advancement is available. This leads to problems. The radiologist wonders whether he is giving the best output. It also has marketing issues.
About a year and a half back an old friend was extremely excited. The cash strapped institution he worked at had finally agreed to upgrade his conventional CT Scanner to a Spiral. His excitement was more from the fact that he was getting a cardiac scanner and would do cardiac studies. Infact the cash strapped institution agreed as his projections showed a significant increase in income from the new cardiac applications, amongst other benefits.
His was a four slice scanner. But today all that it is good enough to do is calcium scoring. The 16 and 64 are far superior and robust in providing angiograms. He is frozen in the number game at 4 slices. For him to keep abreast in the cardiac imaging business he had to upgrade, but that meant additional investment with every hardware upgrade. Upgrades cost crores.
The initial CT scanners that were available for doing cardiac CT were technologically premature and not robust enough to perform diagnostic quality coronary angiograms. The consistency was not there. It is better with the newer scanners, and will get better as the scanners technologically innovate. The initial work that came out actually has had a negative impact on CT coronary angiograms. The lack of consistency resulted in poor co relations with coronary angiograms, providing fodder for cardiologists to punch this technology down. For these reasons as CT coronary angiograms are getting more consistent with technological improvements, it is in the interest of the manufacturers to see that radiologists upgrade. There will be a relatively uniform output and thus minimizing criticism. This will help this modality grow very fast to the mutual benefit of both industry and radiologists.
The best solution I feel is the manufactures should now sell and Radiologists buy Cardiac CT machines, which have hardware, upgrades for a horizon of 3-5 years. The upgrades must occur as simultaneous as possible for all machines, new and not so new. If this does not happen the number game will continue of 4, 8,16, 40, 64 and so on. Radiologists will be frozen at the time they entered the numbers game.
It is in the mutual interest of Radiologists and the Industry for Cardiac CT to thrive. The main driving factor for cardiac CT to thrive is technological advancements to improve spatial resolution and minimize inconsistencies thereby making it a robust technology. It is imperative therefore regular technological hardware upgrades to be part of an initial CT purchase package