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Striking gold in radiation dose even below the
cardiac care low level it had been at before, so
in some patients by 20 to 30 per
How state-of-the-art twin CT scanners are revolutionizing cent,” says Dr. Paul.
the treatment and management of heart patients
He believes research and clinical
By Marlene Habib tools like the twin CT platform
also help empower patients. “The
A world-first project involving adjacent suite. The JDMI carries separate CT scanners. The CT old idea of the patient coming
twin state-of-the-art CT scanners out some 1,800 cardiac CT scans a scanners are not necessarily the into hospital and having their
has only been in gear at Toronto year, Dr. Paul says. same age or model, or from the treatment without any meaningful
General Hospital (TGH) since same manufacturer, and they interaction with the medical
April 2015, but this novel Researchers have conventionally are usually located in different team is gone. We very much
approach to conducting research used CT scans to evaluate the areas, with different imaging embrace patients being involved
that can be used immediately to anatomy or structure of organs protocols. In this scenario, in their management, so anything
help patients is already striking such as the heart, lungs and brain. once a CT research protocol that we can use to help them
cardiac care “gold,” according to But the focus has progressed is validated, it would require understand their disease more
TGH’s head of cardiothoracic to developing techniques that further modification to be used fully, particularly through use of
imaging. demonstrate how these organs on the clinical CT scanner. This CT images, is golden.”
function and, more recently, process could take days or weeks
This “research-to-clinical to investigating how they are to translate those protocols from For patients like Amy Shannon,
platform” using two special perfused. The aim of analyzing the research scanner to the clinical whose family has a history of
identical scanners – operated organ perfusion (blood flow) is scanner, Dr. Paul says. heart disease, waiting weeks for
from a single control room – has “to pick up disease before it would research and diagnostic results
proved to be “huge” in advancing otherwise be detected and to In the case of the twin CT can be stressful and, possibly, life-
the study and care of heart earlier detect the disease response scanners, if the new CT protocol threatening.
patients in the short time it has to various treatments,” Dr. Paul developed in the research scanner
been in place at the Peter Munk adds. does not need to be peer reviewed, Ms. Shannon, a 51-year-old
Cardiac Centre (PMCC) at TGH, then it can be transferred to the Lindsay, Ont., resident, has
says Dr. Narinder Paul, Division ‘These CT scanners allow us to clinical scanner and put to work benefited from other forms of
Chief, Cardiothoracic Radiology, look at disease in a different way on patients – almost instantly, he diagnostic and clinical care at
University Health Network to traditional methods, and the says. the centre since November 2012,
(UHN), and a world-renowned, partnership between the Peter when it was determined she has
British-educated radiologist. Munk Cardiac Centre and the Since April, when the project ALCAPA, a congenital heart
Joint Department of Medical got underway, “we’ve reduced the defect whereby the left coronary
The centre specializes in Imaging has ensured that the artery, which carries blood to
scientific research and innovative TGH is the only place in the world “These new the heart, is attached to the
patient care carried out by that has this particular set-up,” machines are pulmonary artery, instead of to
multidisciplinary teams. The joint, he says. the aorta. Since having open heart
multiyear project was unveiled able to give surgery in March 2013 at TGH
this spring within the Joint “Having these advanced CT much greater to repair the defect, Ms. Shannon
Department of Medical Imaging units side by side allows us to accuracy and has made frequent follow-up
(JDMI) at the University Health rapidly put cutting-edge research speed, so you visits to the adult congenital heart
Network (UHN). protocols into clinical care as soon clinic. Although she hasn’t needed
as they are validated – boom! can assess to get involved in the twin CT
Dr. Paul believes that, over time, And that’s huge. As we research, things now project , she sees it as an exciting
what’s being done through the evaluate and validate performing you absolutely development from a patient
project – a collaboration between cardiac CT scans at very low couldn’t do perspective.
the Peter Munk Cardiac Centre, radiation doses, the technique five years ago.”
JDMI at the UHN and Toshiba becomes more available for at-risk “I think it’s excellent,” says the
Medical Systems, Japan – will people. Imagine a person whose Dr. Lawrence White, former teacher. “With something
lead to a “fundamental change father and brothers died at a Radiologist-in-Chief, like my congenital heart defect,
in patient care and patient young age of a heart attack, and Joint Department of Medical Imaging, for instance, because it is so rare,
management.” every time they get a squeeze in University Health Network it would put the information out
their heart they are wondering, there more quickly and can be
The project involves using two ‘Am I next?’ Now we have a CT linked worldwide, which would
Aquilion ONE ViSION Edition scan-based test that can tell with be amazing because they [the
CT scanners, which Toshiba of a very high degree of accuracy researchers and clinicians] can
Canada Limited installed in a whether or not someone has compare their information,” she
single setting. One suite houses coronary artery disease.” notes.
a clinical CT scanner, the middle
area acts as a joint control room Traditionally, research and “Now they can check anybody
and the research scanner is in the clinical work is performed on with families with congenital
heart defects, see it right away and
fix it right away.”
Jens Dettmann, general manager
and vice-president of Toshiba
of Canada, Medical Systems
Division, says the total cost of the
two CT scanner project is about
$3.6-million. He says the project
is a continuation of a decade-long
18 Peter Munk Cardiac Centre
