Author: Catalina Imaging

CT vs. MRI: What to Use and Why

While CT and MRI are both medical imaging tools, they use different methods to produce pictures. A CT scan is ideal for larger areas, whereas MRI is better for tissue examination thanks to its more detailed images.

How CT Scan Works

CT scans work by taking multiple X-ray images at different angles to create a three-dimensional representation of an internal organ. With a computer, the X-rays are synthesized to form a 3D model of an organ system.

How MRI Scan Works

MRI uses radio waves and magnetic fields to form a detailed image of the bones and soft tissues, providing more thorough imaging than CT scans. 

Which Method Works Best? 

Multiple factors come into play to determine which imaging procedure is ideal and which one should be avoided due to the risk of complications. 

• Patients who are pregnant should avoid CT scans due to the risk of side effects to their unborn child. 
• Doctors who need more detailed images recommend MRI. 
• The type of disease the patient has determines which imaging tool is better. 
• The medical reason for the imaging determines whether MRI or CT is a better choice. For instance, gunshot and shrapnel victims are advised against having MRI due to the risk of injury, especially if their wound is near or at a sensitive area. 
• Patients who have claustrophobia may not tolerate the standard MRI scans that use a capsule-shape bed. A possible alternative is the open upright version, although its magnet is not as strong as the traditional MRIs.   
• Patients with some types of metal implants cannot have MRI scans due to the risk of injury. RF magnetic field can heat up pacemakers and long wires and cause magnetic metals such as intracranial aneurysm clips and some contraceptive devices to react. 

People with cochlear implants, implanted drug infusion pumps, bone-growth stimulators, and some types of prosthetic devices are advised against having MRI scans. However, common dental implants such as Titanium, titanium alloy, and zirconia are safe for MRIs. 

CT and MRI Scans: Detecting Diseases and Medical Conditions 

Both CT and MRI scans can see bones, bone structures, and soft tissues, making them useful in diagnosing a wide range of diseases and medical conditions. But in terms of accuracy, MRI provides more detailed imaging, especially of the soft tissue. 

“Minute” soft tissue injuries like a herniated disc–which CT scans may not be able to detect–are also best diagnosed with MRI scan thanks to its more detailed imaging capabilities. 

Assuming that the patient has no implant or condition that is contraindicated with RF magnetic field, both CT and MRI scans are useful in diagnosing the following diseases and medical conditions: 

• Head and facial trauma 
• Ischemic and hemorrhagic stroke
• Unexplained pain in a certain body area
• Internal organs such as the bladder, pancreas, stomach, colon, small intestine, uterus, ovary, etc. 
• Traumatic injuries to the bones 
• Lumps or tumors
• Cancer growth 

While CT and MRI scans are both used in cancer diagnosis because they can show tumors or “masses,” they are not a definitive tool. They are mainly used to detect which site is the best to collect a tissue sample for biopsy. 

Once the biopsy has determined that the tumors are cancerous, both imaging techniques remain useful in identifying where the malignant cells have spread or metastasized in the body.

Situations Where CT Scan Is Better 

In emergency situations like stroke, CT scans are a more helpful diagnostic tool than MRIs because they can rapidly scan the brain to identify the underlying cause of stroke (hemorrhagic vs. ischemic). 

MRI scans, meanwhile, are best reserved for non-emergency situations. 

Another issue with MRI is the cost barrier. In general, it costs twice as much as a CT scan, especially if it requires the use of a contrast dye (the average cost of CT is $1,200 versus $2,000 for MRIs). 

Final Words 

While MRI and CT scans are great diagnostic imaging tools, MRIs are better in terms of image accuracy and quality. However, people with certain metal implants, gunshot victims, and emergency situations are best diagnosed with CT. 

New advancements have been made in technology: Canon Medical further utilized Artificial Intelligence to improve image quality that can cater to more patients.

The company announced the further expansion of its Advanced intelligent Clear-IQ Engine (AiCE) Deep Learning Reconstruction (DLR). They used various amounts of high-quality image data to train AiCE, and it can now reduce noise and quickly deliver sharp, clear, and distinct images by boosting its signal. The company’s advancement in this technology features more modalities, clinical indications, and systems.

According to Imaging Technology News Online, this DLR imaging technology has the widest availability, providing advancements in multiple imaging exam types.

AiCE DLR will be showcased for the Cartesion Prime PET/CT system (pending 510(k) clearance) by Canon Medical at the RSNA annual meeting to bring advancements of Artificial Intelligence to molecular imaging. Possible benefits of this include faster scan times, lower dose, and improved image quality.

Canon Medical’s Vantage Orian 1.5T MRI system is now equipped with AiCE DLR for virtually all types of clinical exams that has expanded the capacity to scan clinical indications combined with technologies like Compressed SPEEDER that provides a boost of image quality for clinicians using MR.

Scanning has been expanded to cover a vastly larger number of clinical indications from the prostate to shoulder scans, including all joints, cardiac, pelvis, abdomen, and spine with better image quality. According to Mass Device, Vantage Orian can differentiate true signals from noise using an algorithm, and it can suppress the noise during image reconstruction.

Canon aims to cover the maximum amount of patients that can benefit from AI-based Image Reconstruction Technology. The Senior Vice President and Chief Sales and Marketing Officer of Canon Medical Systems USA, Satrajit Misra, has emphasized the importance of enhanced images for better and easier readability. Therefore, Canon’s efforts to bring accessible AI for technological advancements aim to help clinicians cater to patients better and create a big impact in terms of patient care. Misra also emphasized that the expanded availability of AiCE also aims to expand clinical capabilities as well as seamless integration.

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Cleaning and disinfecting procedures have become more important in several industries since the COVID-19 pandemic happened, particularly in the healthcare sector. Standard procedures and protocols have been revised to better adapt to the coronavirus situation, and scientists are continually looking into new ways to improve these procedures.

Medical experts at John Hopkins have been exploring the use of ultraviolet (UV) light in disinfecting medical equipment, particularly CT scan machines. The inner bore of CT scan machines is more exposed to exhaled particles from the different patients that use them, making them highly susceptible to contracting the virus. While the most common UV rays that hit the earth are classified ultraviolet-A, this light can cause skin cancer and other problems upon exposure, so Siewerdsen and Mahesh opted to test ultraviolet-C (UVC) rays instead since they’ve been known to eliminate a high proportion of SARS-CoV-2 virus from hard surfaces.

Biomedical engineer Jeff Siewerdsen and radiologist Mahadevappa MaheshIt utilized a lamp that emits UVC light to the bed inside the CT scanner to determine if it can successfully reduce virus particles. The experiment proved to be successful, as early results revealed that the UVC light coming from the $105 lamp project was able to eliminate 99.9999% of SARS-CoV-2 virus particles inside the bore in just three to five minutes. They published a summary of their study, accompanied by a video abstract, on November 18 in the Journal of Applied Clinical Medical Physics.

On a different note, researchers have been repeatedly testing for SARS-CoV-2 during the ongoing pandemic in order to isolate the COVID-19 patients and to lower the number of infected individuals. The tests are usually performed on people that are manifesting symptoms or to the ones that were exposed to COVID-19 positive individuals, even without any symptoms.

However, recent research has revealed that even though the genetic material of SARS-CoV-2 can be detected through molecular testing after a few weeks of symptoms, it does not mean that infectious virus particles are present. A study by researchers at Johns Hopkins Medicine and the Johns Hopkins Bloomberg School of Public Health has provided more understanding about the detection of the virus while also showing its contagiousness.

In their study, the researchers evaluated almost 30,000 nasopharyngeal swab results of repeated polymerase chain reaction (PCR) diagnostic tests. The number of times a PCR takes to get a positive signal is called the cycle threshold (Ct). A low Ct score indicates a large amount of SARS-CoV-2 RNA and a high one means a fewer amount of the genetic material.

The experiments’ results revealed that the average Ct value associated with cell culture growth of SARS-CoV-2 was 18.8. The researchers also detected viral growth from specimens collected up to 20 days after the first positive result. Sequencing of the entire genome from RNAs collected in the first and subsequent tests provided evidence that the same virus was seen throughout. Positive tests following negative ones had Ct values higher than 29.5, and were not associated with observed virus growth in culture.

According to Dr. Andrew Pekosz, professor of microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health and co-senior author of the study, additional studies need to be conducted to confirm if Ct values and cell cultures are accurate enough to make clinical decisions for diagnosis. “Defining the window of time in which a COVID-19 patient can transmit the virus can help drive more effective isolation practices,” Dr. Pekosz explains.

(Source: Science Codex)

Hospitals are currently experiencing a surge of COVID-19 patients. Because of this, hospitals are looking to expand their radiology imaging capabilities quickly. Various computed tomography systems vendors are now offering semi-permanent configurations to meet the demands. Some of these systems come packaged in shipping containers to allow mobility.

When COVID-19 increased the demand for imaging capability in Paris, France during the spring earlier this year, GE Healthcare designed a prefabricated structure that can house a CT system just outside of the Henri-Mondor Hospital in Créteil. This temporary structure contained what GE Healthcare engineers call “CT in a Box.”

The additional facility improved the hospital’s assessment of disease progression and complications in COVID-19 patients and enhanced patient flow in the hospital. The “CT in a box” was dedicated to COVID-19 patients, which allowed a specific flow for them.

GE Healthcare initially deployed the technology in China and the UAE at the beginning of the outbreak. Clinicians in China’s pop-up and remote hospitals needed CT scans to help them spot complications earlier. The situation gave rise to the idea of “CT in a Box,” an easy-to-install modular machine that can provide the same functions as traditional, building-installed CT scanners. They used their experiences to develop the idea further and adapted it to the specific needs of clinicians dealing with COVID-19 patients.

The challenging part of building the “CT in a Box” was not fitting the CT machine inside but replicating the safe and controlled environment of a hospital CT room. Traditional CT rooms in hospitals lead-shielded walls and thick windows so technicians and clinicians can safely observe the patient and operate the machine. While the small doses of radiation patients receive during the process of imaging, the prolonged exposure of clinicians and technicians puts them at risk.

Another real challenge is maintaining a constant temperature of 72 degrees Fahrenheit in the room. Hospital CT rooms have sophisticated HVAC systems that ensure the optimal temperature is achieved.

“CT in a Box” has proven to be an excellent addition to the hospital’s ability to treat its patients. There’s a clinical consensus that CT scans are vital for assessing disease progression and detect complications in COVID-19 patients.

The module is capable of accommodating one patient per hour, even though the actual scanning can be completed in a matter of seconds. Technicians need a lot of time to fully sanitize the exam room and prep the patients. But the additional number of patients examined is not the only benefit of these modular CT scanners. The improved patient flow across the hospital, as well as relieving the pressure on existing CT scanners, have a tremendous impact.

(Source: ITN Online.)

There has been a steady increase in demand for computerized tomography (CT) scan machines ever since the COVID-19 pandemic started. The machines have proven to be potent equipment in differentiating pneumonia that is caused by COVID-19 from other possible triggers. Additionally, CT scan machines can also be utilized to check how far the disease has progressed in the human body.

The ability of CT scans to differentiate COVID-induced cases of pneumonia from other types can considerably help the progress of treating patients (e.g. immediate isolation) even before their RT-PCR tests confirm that they are COVID-positive. However, this does not mean that CT scan results can be a complete substitute when it comes to identifying COVID-positive patients.

The pneumonia scores provided by CT scans can also help determine which patients need immediate help. This becomes more important during the pandemic, as more hospitals and medical facilities are experiencing shortages in ventilators and other equipment. Being able to determine which patients need to be prioritized can help medical professionals to make better clinical decisions, especially when there is a surge of incoming patients.

CT scan machines are more exposed to virus particles because of how the machine is used, which means that a couple of spare machines may be needed by some facilities in order to lower their backlog due to repetitive disinfection of each machine every time a patient uses it. For larger hospitals, buying more units makes sense because it would certainly be more efficient now that more patients need them.

Large manufacturing companies like Siemens Healthineers are used to selling over 200 CT scan machines annually. The coronavirus outbreak has prompted a significant rise in demand for CT scan equipment, as Siemens reported sales of 80-100 units in just 45 days. Vivek Kanade, executive vice-president of Siemens Healthineers-India, believes that this surge is caused by the fact that the machines can also calculate the medical score of patients with pneumonia, which could help in determining the type of treatment that the patient would need.

Wipro GE Healthcare has also seen a similar increase in demand for their CT scan machines. To make up for the surge, they have increased their production of mobile X-ray machines at their Bengaluru site, with 60-70 percent of the products targeted at sites where CT services did not exist before.

Shravan Subramanyam, managing director of Wipro GE Healthcare-South Asia, speculates that the increase in demand for CT scan machines may be related to a higher demand for treatment of other diseases, as many people have become more aware of the importance of their health during the pandemic. Additionally, a lot of people deferred on going to the hospital for treatment due to fear of the pandemic. As such, the increase in demand for CT scan machines may continue even after the pandemic, not just for patients who have been infected by the coronavirus, but also for individuals who wish to improve their general health.

(Source: Business Standard)