USAMMA Fields Army's Most Advanced CT Scanner
General Leonard Wood Army Community Hospital (GLWACH) located at Fort Leonard Wood, Missouri, is now home to the Army's most advanced Computerized Tomography (CT) system, able to produce a 3D image of the entire heart in less than one heartbeat.
The new system is able to take such sophisticated images -- up to 640 image slices in a single scan -- because of its 8-inch detector, which is twice as wide as other comparable machines. The wider detector allows the system to capture complete images of organs, such as the heart, in one scan rather than multiple scans that have to be "stitched together" electronically.
The U.S. Army Medical Materiel Agency evaluated and acquired the system as part of the Medical Care Support Equipment (MEDCASE) program, which is an Army-funded program that validates all high dollar medical device requirements through Army Medicine. USAMMA is the execution agency for the MEDCASE Program, which is facilitated through the Technology Assessment Requirements Analysis (TARA) Team. The TARA team visits medical treatment facilities (MTF) and other medical environments to assess their medical equipment and clinical needs, and then makes recommendations regarding future acquisitions by providing the MTF a three-to-five year medical equipment acquisition plan.
More than a decade ago, USAMMA senior biomedical engineer Mack Moaveni first spotted the development of the new CT technology while he was conducting market surveillance, looking for new technology that would eventually flourish into advanced development and products that benefit patients and clinicians. Six years ago, USAMMA acquired an earlier version of the CT scanner and placed it at Fort Carson, Colorado, where researchers used it for a study. The demonstration helped determine the system's functionality to provide repeatable diagnostic results, said Moaveni, which was a critical step. Before USAMMA's team can field any technology, they have to be sure it is clinically acceptable, reliable, and that the location has the necessary logistical support infrastructure.
"We can only spend taxpayer dollars on a technology and field it when we have the confidence that the technology is ready, and that the location and infrastructure are prepared," said Moaveni.
A team from USAMMA deployed to GLWACH to help prepare the hospital to receive the CT scanning system. The system is now up and running at the hospital.
"This has tremendous positive implications for our patients," said Lt. Col. (Dr.) Shahin Nassirkhani, GLWACH's chief of Radiology. "It is like having four of our previous CT scanners in one machine."
Experts expect the new scanner will benefit most the older patient populations because it potentially reduces the number of invasive tests needed, such as cardiac catherizations, as well as trauma patients who need quick and accurate diagnostic results. The system uses a technique called Adaptive Iterative Dose Reduction, which also reduces patient dosage of radiation. The system also features a unique Single Energy Metal Artifact Reduction software algorithm that reduces image artifacts, or streaking, that can happen when a patient has metal in his body from items such as surgical screws or prosthetics.
The Army is looking to deploy additional advanced CT scanners at other major medical centers, according USAMMA's Product Manager for Clinical Technologies Jimmy Bisenieks. Because of the Army's modernization movement with all medical technology, Bisenieks did not rule out the idea of advanced CT scanning technology eventually making its way to the battlefield. Currently, 16-slice scanning capability is available at many combat field hospitals.
However, with a more sophisticated scanner come logistical support concerns may not be a concerns at a MTF but would be a concern on the battlefield. Devices have to be "hardened" before they can go into the field, able to contend with harsh environments and austere conditions. Most importantly, the decision has to be requirement-driven based on what best suits the needs of the mission.
"A surgeon on the battlefield has a very different mission than one in a MTF", said Bisenieks. Bisenieks explained that CT scanners provide an advantage over X-ray because they provide surgeons with a 3-dimensional image. For example, a CT scanner may be beneficial in a situation where a patient has shrapnel near his heart and the surgeon needs to know how deep and close the shrapnel is to the heart before operating. However, as Bisenieks clarified, very sensitive scanning technology may provide greater imaging yet may not be a great fit for the battlefield because it is too "sensitive" to things such as explosions and extreme temperature environments.
"A blurry image doesn't do anyone any good. That is why we look carefully at what is the best fit," added Bisenieks. "Sometimes more is not always better."
Editor's note: John Brooks, Marketing and Public Affairs Officer at General Leonard Wood Army Community Hospital, contributed to this article.