Almost everywhere in the world, the effects of the economic crisis are clearly visible in reduced budgets for healthcare expenditure. Many clinical centers are, therefore, choosing for refurbished or used equipment. There is a difference, though, between refurbished and used. If we consider the example of CT or MRI scans, the vendors dismantle the used equipment, bring it to their facilities and old pieces are replaced, software updated and a fully quality check is done. In addition, these devices have a warranty. Used equipment, however, is normally sold by a retailer and it does not have anything done to it. Choosing one or another will depend a lot on the clinic’s requirements and budget.

Refurbished equipment can be a very good option, when you need to add capacity to your existing facilities, or if you are doing routine scans, which do not require the latest technology. One way or another, the choice is out there, but the decision is up to the buyers.

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Nanotechnology and cancer

January 26, 2011

In the last few years, nanotechnology has gained in popularity. Particularly, in cancer research, where it holds great promise for the development of targeted, localized delivery of anticancer drugs, in which only cancer cells are affected. Nowadays, anticancer drugs are distributed through the whole body, damaging healthy cells as well as cancerous ones.

Researchers at UCLA’s California NanoSystems Institute and Jonsson Comprehensive Cancer Center have carried out a study where they demonstrate that mesoporous silica nanoparticles (MSNs), tiny particles with thousands of pores, can store and deliver chemotherapeutic drugs in vivo and effectively suppress tumors in mice.

The study also showed that MSNs circulate in the bloodstream for extended periods of time and accumulate almost exclusively in tumors after administration and that the nanoparticles are excreted from the body after they have delivered their chemotherapeutic drugs.According to the researchers, the tumor accumulation could be further improved by attaching a targeting moiety to MSNs.

There is still a long way to go before this technology can be used in humans, with safety tests and many more studies to follow in different animal models, but so far, the results are very positive.

It is well known that doing exercise regularly can prevent cardiovascular diseases, but now researchers from the University of Pittsburg have shown that it can prevent Alzheimer’s. A study including 299 patients have shown that those who walked at least 6 miles/week regularly over a period of 9 years had a much lower Alzheimer’s incidence. According to the authors: “In short, walking greater distances was associated with greater [gray-matter] volume in specific regions, and greater [gray-matter] volume was associated with a lower risk for experiencing cognitive impairment in later years.” This research has been published at Neurology, Vol. 75:15, pp. 1415-1422.

Having your patients hold their breath properly during a MR or CT scan is always a challenge, especially when your patients are infants. Mueller et al. have come up with a simple volume-monitored (VM) method for performing reproducible, motion-free full inspiratory and end expiratory chest CT examinations in children. They tested the method on
fifty-two children with cystic fibrosis (mean age 8.8 ± 2.2 years). They underwent pulmonary function tests and inspiratory and expiratory VM-CT scans (1.25-mm slices, 80–120 kVp, 16–40 mAs) according to an IRB-approved protocol. The VM-CT technique utilizes instruction from a respiratory therapist, a portable spirometer and real-time documentation of lung volume on a computer. CT image quality was evaluated for achievement of targeted lung-volume levels and for respiratory motion. Overall, 94% of scans were performed at optimal volumes without respiratory motion. This method is applicable to children older than 4 years-old.
A drawback of the method, though, is the fact that the respiratory therapist has to stay in the room while the scan is being performed, with all the risks of radiation.

For more information you can read the whole article, published online in Pediatric Radiology (May 28, 2010): Volume-monitored chest CT: a simplified method for obtaining motion-free images near full inspiratory and end expiratory lung volumes

The past SIIM has presented some of the challenges and advances in Imaging Informatics in Medicine. The increasing costs in healthcare are driving the developments of more efficient ways of dealing with imaging data.
One of the fields that have experienced a tremendous development is 3D and the thin-client software, now performing almost as well as thick-clients. Thin clients are also available on on low-end hardware such as iPads and laptops, as well as work better on networks with low bandwidth and high latency. However, the workflow isn’t yet as efficient as it should be, especially in communication with RIS and PACS.
Another huge improvement comes from structured reporting format, although not yet fully integrated with RIS and PACS.
Storage is one of the challenges of digital imaging in Medicine. Cloud computing, which employs Internet-based servers for processing, storage, and secure transmission provides simple and secure cross-enterprise communication at low costs. Being internet-based, it supports multiple platforms, remote access, etc.
Digital Radiography has also experienced a lot of development in the recent years. Flat-panel digital detectors, digital tomosynthesis and CT conebeam acquisition used in interventional radiology, are just some examples. Point-of-service DR imaging is also possible, with image acquisition, processing, and display performed bedside or in the operating room. Hanging protocols will be the key to increase efficiency.

Nevertheless, a reporting-centric workflow is not yet available. Many pieces of the puzzle are already in place, but the multimedia imaging report, which uses all available data and media to create and distribute imaging information is not there yet.

On January, the 8th, an article appeared in Diagnostic Imaging, which analyzes the safety issues concerning whole-body airport scanners. Since the attempted attack inside an airplane flying from Amsterdam to Detroit last December, most airports are planning to install whole-body scanners to scan passengers. However, not much is really known about the health risks.
You can read more about the research conducted so far, in the following two articles:
http://abcnews.go.com/Health/CancerPreventionAndTreatment/experts-radiation-fears-full-body-scans-unfounded/story?id=9476542&page=1
http://arxiv.org/abs/0910.5294

MRI issues: pacemakers

January 12, 2010

A recent study by FDA researchers has shown the risks of MR scanning patients with pacemakers. This is normally contraindicated, but some physicians condone scanning certain patients. FDA researchers found that certain cardiac pacemakers may inadequately stimulate a patient’s heart while undergoing an MRI scan. For a full report, see:
http://www.biomedical-engineering-online.com/content/8/1/39