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Eu quero-o abaixar o dose!

por Lisa Chamoff, Contributing Reporter | October 22, 2014
From the September 2014 issue of HealthCare Business News magazine


Since the law only applies to diagnostic CT done in a Medicare outpatient setting, Denison says facilities can look at what machines are in use and possibly swap them.

“Maybe I can upgrade one of them,” Denison says. “What we’re doing is helping healthcare providers.”

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Aharon says that the big OEMs won’t retrofit the lower-level systems. One customer in New Jersey has one 64-slice and four 16-slice CT scanners. The OEM offered to retrofit the 64-slice scanner, but said the facility would have to replace the others, Aharon says. Instead, Medic Vision installed the SafeCT system in the data center, supporting all five existing scanners.

“Most of the CTs in the U.S. are 16 slices or less,” Aharon says. “They are working fine. They do what they need to do, especially for the private sector and smaller hospitals. There’s no need to replace them.”

Studies have compared different iterative reconstruction techniques, including those offered by OEMs. A recent University of Pittsburgh study compared the diagnostic quality of low-dose CT exams for pulmonary embolism post-processed with SafeCT and GE’s ASIR. Four experienced radiologists evaluated the processed exams and provided rankings for image quality and diagnostic value, with 48 percent of the ratings favoring SafeCT, 48 percent indicating no difference and 4 percent favoring ASIR. A clinical study performed by Massachusetts General Hospital that compared Siemens SAFIRE and SafeCT found both to be comparable, with each having slight advantages and disadvantages.

Denison, of GE, says that the comparison between SafeCT and ASiR didn’t go into enough detail, looking at lower doses and thinner slices. He notes that the company’s newer technologies, Veo and ASiR-V, expand the dose reduction capabilities, and that clinical comparisons should be in within the next few months.

“In a point in time, these kinds of filters [such as SafeCT] looked good, but we’ve already moved on to the next thing,” Denison says.

When asked about the comparison, Siemens spokesman Jeffrey Bell noted that internal studies with a phantom identified a 54 to 60 percent dose reduction using a test method that assessed noise, CT numbers, homogeneity, low-contrast resolution, and high contrast resolution, and that low dose data reconstructed with SAFIRE showed the same image quality compared to full dose data based on this test.

Sapheneia is also a big independent player in the post-processing space with its Clarity platform. Greg Mason, product applications and support specialist, says that aside from only working with newer scanners, OEM scan only reduce noise in the raw data state. If the OEM software pulls out too much noise, it’s more difficult to sharpen the edges of the organs being examined.

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