New CT Scanner at Cooper Clinic Reduces Radiation Dramatically on Arkansas Medical News Inc.

New CT Scanner at Cooper Clinic Reduces Radiation Dramatically

By: By BECKY GILLETTE

FORT SMITH—Someone who has a health problem doesn’t need an additional health risk from diagnostic tests—especially if numerous tests are needed. The National Cancer Institute (NCI) said modern diagnostic imaging has revolutionized medicine because computed tomography (CT) can produce extremely detailed images of any part of the body.

But CT tests expose patients to ionizing radiation from 50 to over 500 times that of a standard x-ray, and the increasing use of CT scans has raised concern about what NCI calls “a small, but significant” cancer risk in the general population. NCI said between 1980 and 2006, medical imaging increased by 600 percent, leading to doubling the annual per-capita radiation dose in the U.S.

Cooper Clinic Chief Medical Officer Rebecca Fleck, MD, said while she is not aware of any studies that prove radiation exposure from diagnostic testing has contributed to higher cancer rates, reducing radiation when possible makes sense.

“We do know that radiation can be an initiator for malignancy, and on that basis we want to ensure that our efforts to help patients don’t actually harm them,” Fleck said. “Our concern especially involves patients who must undergo repeated x-ray studies or studies that require higher radiation doses.”

Cooper Clinic has become the first medical institution in the Fort Smith area and one of the first in the state to invest in new equipment that significantly lowers radiation from their CT scanner. The GE LightSpeed® VCT XTe CT scanner averages 40 percent less radiation, and the heart scan radiation dosage may be reduced by as much as 80 percent.

Fleck said some patients have chosen Cooper Clinic for their CT scans specifically because of the lower radiation exposure.

“I think patients and people in general are increasingly aware of radiation exposures, and they do appreciate knowing that we are taking steps to decrease their exposure in medical testing,” Fleck said. “Of course, many patients who are undergoing treatments for life threatening diseases such as cancer are focused on the effectiveness of their treatments, so to them imaging studies are worth any potential risk. It is often their physicians who want to limit their exposures and potential long-term effects.”

Physicians are glad to have this option so they can get the diagnostic tools they need while better protecting their patients from potential side effects. Fleck said the technology is especially advantageous to children and young adults because it can decrease their lifetime risk of radiation exposure.

Radiologist Leo F. Drolshagen, MD, said typically lower radiation dose CT scans produce an image that may not be as clear as higher dose scans.

“But this new GE technology installed at Cooper Clinic uses special enhancement software to reconstruct data acquired while using a lower dose of radiation, to produce the same image quality as if done with the typical higher dose,” Drolshagen said.

CT is the diagnostic exam commonly ordered when a physician suspects a medical problem that is not easily detectable with a conventional physical examination or tests. Although the cost to upgrade the CT scanner was $250,000, Cooper Clinic did not increase charges for the tests.

Even with lower radiation, it is important to reserve the use of CT only for patients who really need it.

“We never want to perform testing when there are not proper indications for it,” Fleck said.

Other firsts for Cooper Clinic include being the first to offer cardiac CT, the first to offer a permanently installed PET/CT in the area, and the first and only clinic to offer bilateral breast magnetic resonance imaging (MRI) for early detection of breast cancer. MRI uses no radiation at all, but rather uses magnetic forces to provide visualization of tissue.

“We don’t typically use breast MRI for early detection of breast cancer, but sometimes we will in special circumstances,” Fleck said. “The reason it is not used as the first line in detection is because it is so sensitive that it can pick up a number of lesions that are not cancers, and this may cause women to undergo unnecessary biopsies. MRI is not meant to replace mammography, but rather to serve as an enhanced diagnostic tool. We use it to further evaluate an abnormality already detected.”

Circumstances where they would use MRI initially are women with very dense breasts or implants that are difficult to image with mammography, or women with a strong family history of breast cancer, especially occurring before menopause.

In terms of comfort, Fleck said that assessment probably varies with the patients. Bilateral breast MRI requires the patient to lie face down and some women do not like to lie upon their stomachs. On the other hand MRI does not require compression like mammography does.

Cooper Clinic is a physician-owned medical group with about 100 providers.

The Cooper Clinic CT department is staffed by three registered CT Technologists.