Dr. Lal wanted a cardiovascular-radiography system that would enable the group to lower door-to-balloon time by reducing the time required for patient setup and loading, as well as by improving clinician efficiency and confidence. The unique C-arm design of Toshiba’s Infinix-i systems—which offers 270-degree positioning for improved access to the patient, ancillary equipment, and fellow clinicians—met these requirements.

“The ability to move the C-arm quickly in and out of the way facilitates quick loading of the patient,” Dr. Lal notes. “Once the patient is in place, the C-arm is immediately moved back into the desired position to begin the case. This system has saved time by enabling us to start catheterization sooner and reducing overall setup and procedure time.”

Toshiba’s Infinix-i systems boast a five-axis design. Allan Berthe, senior cardiology product manager for the company, explains that this enhances clinician workflow by allowing uninterrupted access to the patient. “If the operators are focused on the patient and don’t have to worry about working around the C-arm or pivoting the table, they can get through the required imaging much faster,” he says. “The system provides excellent access and coverage, and the design of the tableside controls allows clinicians to keep their focus on the patient, capture all the required images and control all key system functions while staying right at the patient’s side.”

Dr. Lal offers an example of the C-arm flexibility in some cases when it is necessary to switch rapidly from femoral to radial access while inserting the catheter. “Within minutes, we have reconfigured the system components to accommodate the transradial approach,” he says. “This flexibility permits more comfortable ergonomic positions for physicians, while also keeping the patient comfortable.”

The time-saving benefits of the Infinix-i systems go beyond design, Berthe explains. Toshiba’s Next Generation Advanced Imaging Processing (AIP) technology, a combination of proprietary hardware and software, supports interventionalists using fluoroscopic and fluorographic imaging by enhancing image quality, sharpness, and contrast during procedures. The technology also substantially reduces image lag time, enabling clinicians to perform fluoroscopic procedures with increased efficiency.

“Next Generation AIP greatly improves coronary-artery visualization and the ability to identify disease,” Dr. Lal says. “The great image detail on all patient types has improved diagnostic confidence and treatment planning, resulting in more accurate device selection and placement.” He adds that Next Generation AIP has improved his department’s efficiency by reducing room time, promoting increased patient throughput: “The reduced exam times have improved the utilization of our staff members and increased patient safety,” he says.

With PCI becoming increasingly prevalent as a treatment for STEMI patients, diagnostic speed and confidence are more important than ever before (as the new ACC/AHA 90-minute door-to-balloon requirement underscores). “If you have a door-to-balloon program, speed is of the essence,” Berthe notes. “Little things matter. The combination of the Infinix-i system’s design and its AIP technology creates an environment where everything is working in concert to produce a more uniform, high-resolution image with increased speed and efficiency.”

Berthe says that smaller flat-panel detectors are ideal for imaging the heart, but a larger detector is required to cover a larger anatomical area. Toshiba’s dual-plane Infinix DP-i system solves this problem by incorporating two C-arms and two flat-panel detectors on the same unit: a floor-mounted eight-inch panel and a ceiling-mounted 12×16-inch panel. “The two C-arms operate independently; one is dedicated to cardiac cases and the other is dedicated to vascular cases,” Berthe says. “You can quickly exchange those back and forth in less than 60 seconds—a capability no other system in the industry offers.”

Working with a shared system saves valuable hospital space and reduces both maintenance and staff costs, but the advantages don’t end there, Berthe notes. “The smaller flat-panel detector can easily image the heart, but it’s not uncommon for a patient with coronary-artery disease also to have problems elsewhere in the body,” he says. “If you want to perform two procedures on the same patient (looking at the heart and the legs, for example), the DP-i excels. You could use the small panel to look at the heart and then quickly change over to the large panel to look at both legs in one view.”

The Infinix-i DPi boasts multiple features aimed at bolstering its clinical flexibility, including a flexible C-arm for peripheral angiography, optional 3D angiography, a table that can accommodate patients weighing up to 484 pounds, and two liquid-metal–bearing X-ray tubes, one for cardiac work and one for full-body imaging. “The dual-plane systems allows you to do both types of imaging with a lot of freedom,” Berthe says. “The user will never have to compromise on the anatomy he or she wants to image.”

“By funding these grants, we are giving hospitals and imaging centers the ability to continue improving imaging quality and safety for children and adults through the development of diagnostic imaging best practices,” says Cathy Wolfe, director, Marketing Services, Toshiba. Applicants’ programs should seek to improve day-to-day practices centered around imaging and address reducing the need for radiation and/or contrast dose, reducing the need for anesthesia, improving patient communication and comfort, and/or improving the overall clinical pathway.

For the pediatric projects we are generally looking for the same types of projects as we are looking for in the area of adult imaging,” Ed Cronin, AHRA CEO, explains. “For instance, one of the awards last year went to a facility that was developing a patient-handoff system, so that patients were transferred from the floor to the imaging department via a formal system, cutting back on errors. With pediatrics, there may be some specific features that make programs different for children, but the emphasis on developing new and creative ideas remains the same.”

Cronin says that this year’s program also features an improved application process and more lead time for submissions. The program accepts applications from any hospital or imaging manager seeking to implement a new safety/quality program. “Recipients will share their processes with our members by writing an article for our Radiology Management journal or our newsletter,” Cronin explains. “One of the projects we’re funding this year even developed a seminar to present to other regional hospitals.”

Six $7,500 grants will be awarded in 2009: three focusing on improving patient care and safety in diagnostic imaging and three focused on pediatric imaging. To apply, visit AHRAonline.org or medical.toshiba.com. Entries are due October 31.

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In January 2009, AHRA: The Association for Medical Imaging Management, in conjunction with Toshiba, awarded three $7,500 grants to help fund innovative patient-safety and quality initiatives. St. Mary’s was a recipient, along with Washington Hospital Center, Washington, DC, and Jennie Edmundson Hospital, Council Bluffs, Iowa. “We have changed the way we engage patients. We now are more focused on being patient-centered and family-centered,” Knightly says. “It’s little things that make a big difference, like having a blanket warmer in the room. We just converted a warmer box that was used for contrast media, and we located this right in the scanner room so it’s easy to access for the technologist and they can keep the patient warm during the scan.”

Gayle Thompson-Smiley, director of Radiology at Washington Hospital Center, used her facility’s grant to initiate a patient-handoff program designed to refine the processes involved in transferring 300-350 patients a day from the hospital floor to the radiology department. “Washington Hospital Center is a very large institution and quite complex. In this type of environment, we’re also focused on how we can better improve the patient experience and the patient outcome,” she says. “This was a very unique opportunity for us.”

Meanwhile, Jim Lipcamon, director of Imaging Services at Jennie Edmundson Hospital, sought to leverage his hospital’s information systems to alert radiologic technologists to potential complications associated with contrast media for imaging. “People who take metformin [for type II diabetes] are contraindicated to receive iodinated contrast,” he explains. “We wanted to hardwire that process. Prior to the grant, that process was strictly on paper, relying on the patients to remember to tell their physician or tell the nurse on the floor. With the increase in obesity nationwide, we felt that this was a critical issue that needed to be addressed in our institution.”

Tom Kaiser, informatics pharmacist at Jennie Edmundson, is grateful for the interdepartmental collaboration fostered by the grant. “We’ve been able to use a multidisciplinary approach to our patient-safety enhancements,” he says. “It allowed me an opportunity to work with IT professionals, radiology professionals, and the pharmacy itself to come up with a program that generated rules based on patients’ medications.”

Washington Hospital Center is developing a CME course to train staff on successful handoff communications programs. “The CME event will help prepare physicians in our staff to really think about how best to keep patients safe in day-to-day care and in whatever handoff communication processes that they are involved with,” says Kathleen Srsic-Stroehr, senior nursing director for Evidence-based Practice and Quality. “It’s really important to think about those particular processes and those sender and receiver communication messages that are so important in a handoff communication situation.”

Knightly concurs: “This is a great opportunity for other departments in CT to tap into this knowledge and apply it to what they do every day out in the field. These best practices are very simple, very usable and make a difference in patient care and patient safety. It’s very exciting to be able to share what we’ve found and also to encourage people to use what’s out there.”

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This acquisition brings in-house critical core competencies — the development of 3D volume rendering and advanced visualization capabilities for all Toshiba modalities. In addition, Toshiba now is capable of conducting R&D twenty-four hours a day, seven days a week, ensuring that the medical community gets the most advanced technologies possible.

“The formation of TMVS establishes a significant multi-modality research and development center in Europe,” said Kenichi Komatsu Ph. D., president and CEO, Toshiba Medical, “ensuring Toshiba’s unfettered access to leading-edge technology in an area of the world widely acknowledged for its innovations in medicine. This also demonstrates Toshiba’s strong commitment to our customers in Europe as well as the healthcare industry worldwide.”

Toshiba is patterning this acquisition after the 2006 acquisition which resulted in the creation of Toshiba Medical Research Institute USA, Inc. (TMRU), a wholly–owned subsidiary. TMRU is a significant research and development center of advanced imaging technologies and clinical applications in the U.S. Combined with Toshiba’s R&D capabilities in Japan, the company undertakes development efforts worldwide on a 24-hour basis.

Toshiba’s global research entities support clinical programs in partnership with luminary academic institutions worldwide to accelerate research and development of clinical applications using Toshiba’s advanced imaging systems.

Every year, the RSNA Board of Directors modifies the annual meeting program to align with the needs of the radiological community. This year’s program features a number of expanded opportunities for dialogue and education, including a special ‘Japan Presents’ Integrated Science and Practice (ISP) Session in conjunction with the Japan Radiological Society.

The constantly evolving nature of the annual meeting helps keep healthcare professionals coming back to Chicago, and this year attendance is projected to expand again with pre-registration running 3% ahead of 2007.

In addition to more people, the 2008 RSNA also features more exhibit space than ever before with an expansion from two exhibit halls at McCormick to three, so there will be more to see, more to do, and more real-estate to cover. To make sure you know the room assignments for the sessions, floor plans for each building, as well as the shuttle bus schedule, the official RSNA 2008 Pocket Guide is available for download and review.

Technology to Expand Opportunity

While you’re at the RSNA, we invite you to stop by the Toshiba exhibit (#3429, Hall A) and discuss new technological enhancements to improve patient care. Last year, Toshiba launched the world’s first dynamic volume CT system — the Aquilion® ONE. This year in Toshiba’s exhibit, you can discover how the unique capabilities of the 320 detector row Aquilion ONE are bringing positive changes to patient care around the world.

Recent enhancements in Ultrasound and MR breast imaging techniques produce new opportunities to enhance women’s health. Although Mammography is still the gold standard for detecting micro-calcifications in the breast, Toshiba’s new, proprietary ultrasound technology called MicroPure™, can help identify and eventually characterize these micro-calcifications. MicroPure and new Elastography (works-in progress) techniques will be showcased in the ultrasound portion of Toshiba’s exhibit, as well as in a Monday evening non-RSNA Satellite Symposium.

Recent clinical experience with the Radiance Plus Breast Imaging Suite (works-in-progress) will also be highlighted during the Monday evening symposia. For a closer view of the Radiance Plus Suite, demonstrated on Toshiba’s Vantage™ Atlas and Vantage Titan™ MR systems, please stop by and see us in the South Building.

Radiographers in today’s healthcare systems are looking for help to streamline these critical radiological procedures. Toshiba’s exhibit at the 2008 RSNA will feature the RADREXTM-i, with high-resolution detectors to help ensure the best image quality at the lowest possible dose. RADREX-i includes a number of time saving features to assure you get the maximum productivity for your department.

While you are exploring the expanded exhibit floor at RSNA this year, please stop by Toshiba (#3429, Hall A). We look forward to discussing your challenges and exploring opportunities to help you enhance patient care in your community.