The demand for cardiac CT scans is on the rise, driven by increasing rates of cardiovascular diseases[1], changes in guidelines, and improved reimbursements. These factors emphasize the need for accurate diagnoses and early interventions. Heart disease is the leading cause of death in the United States, accounting for more than 700,000 deaths each year.[2] As health systems across the country face these challenges, many are investing in new CT technologies to meet the demand.
One example is St. Luke's University Health Network (SLUHN), a leading provider of care in Eastern Pennsylvania and Western New Jersey. A non-profit, fully integrated, nationally recognized network, SLUHN provides services at 15 campuses and more than 350 outpatient sites in Pennsylvania and New Jersey. As part of a strategic initiative, SLUHN is standardizing its CT fleet with several GE HealthCare's CT Scanners including the Revolution™ Apex Platform, installing 24 new scanners across its sites over a four-year period.
Building a Cardiac CT Program with fast, high-quality cardiac scans
Coronary Computed Tomography Angiography (CCTA) uses advanced CT technology to create detailed 3D images of the heart and its blood vessels, allowing clinicians to identify plaque, narrowing of the arteries, and other abnormalities. The Revolution Apex platform can complete high-quality CCTA exams in only one heartbeat at any heart rate, delivering motion-free images in one second through a prospectively ECG-gated whole heart axial acquisition that utilizes 160 mm coverage, 0.23 or 0.28 sec rotation speed, and SnapShot Freeze 2. Since SLUHN installed its first Revolution Apex scanner, they have experienced these benefits and can now bring CCTA to more of their patients than ever before.
“The fast acquisition speed diminishes motion artifacts in the chest, where respiratory motion artifact is frequently a problem. Patients who are short of breath can now be imaged with reduced motion because we can scan the entire chest in just a little over one second. We can now scan a whole range of patients that previously would have been more challenging prior to having these newer scanners,” said Dr. David Furman, Medical Director of Computed Tomography at SLUHN and Site Director at St. Luke’s Upper Bucks Campus.
Dr. Robert Fournier, Chairman, Department of Radiology at SLUHN, agreed that the Revolution Apex platform scanners have improved both speed and image quality. This increased accuracy has resolved previous challenges, such as distinguishing between calcium deposits and blood, which enables clinicians to accurately identify pathology.
“The Revolution Apex platform has improved overall patient care at our institution because detail in the images is significantly better,” he said.
Powered by AI and smart features
The Revolution Apex platform delivers new AI features that benefit providers, administrators, and patients throughout the facility.
It can deliver speed and clarity thanks to AI advancements that enhance image quality, reduce interpretation time, boost efficiency, and improve diagnostic confidence. For example, TrueFidelity uses advanced deep learning image reconstruction to deliver high-quality, true-to-life images for improved diagnostic confidence. In addition, HyperDrive leverages highspeed pitch to enable faster exams and high-quality images with minimized need for breath holds.
Dr. Furman credits SnapShot Freeze 2 with significantly improving image quality by leveraging an intelligent motion correction algorithm that automates whole heart motion correction. “It's incredible. It makes CCTA very easy to interpret,” he said.
These benefits extend to technologists, too. Previously, performing cardiac CT scans required time-consuming manual steps, like using a timing bolus to monitor how quickly contrast dye reached the heart. Now, smart features like SmartPrep, Smart Phase, and automatic gating streamline these tasks. “It takes a good three minutes off the timing of the study, so it's a lot quicker now,” said Amy Ortwein, CT Technologist at SLUHN.
This shift enables technologists to focus more on patient care. “You're not forced to follow a complicated decision tree on the fly. That decision has basically been automated, allowing you to focus more on the person on the table,” said Mark Kiser, CT Clinical Specialist at SLUHN.
Standardizing quality across the network and adding exam slots
With more than 130 radiology technologists in the St. Luke’s network, a standardized CT fleet of Revolution Apex scanners helps close the skill gap between technologists in performing diagnostic-quality cardiac studies. “Now all of our staff can do quality vascular and cardiac studies using the Revolution Apex platform scanners. A patient can expect a consistent image at any site,” said Matt Larson, CT Clinical Specialist at SLUHN.
They reduced their patient time slots from one hour to 30-minute exams. This enabled SLUHN to schedule more CCTA patients, while still serving inpatient and emergency department demand.
By offering cardiac CT across multiple campuses, SLUHN has successfully improved access to imaging by ensuring patients can stay within their communities for advanced imaging. It’s also helped reduce patient transfers to other facilities, which could impact the network’s bottom line. “We keep people in their environment, which is how we've gained market share from our competitors,” said Dr. Fournier.
The Revolution Apex platform system serves as both a staff retention and recruitment tool, helping attract top talent in a competitive market. “This has been a huge retention agent for us. Our turnover rate for technologists is extremely low and this is part of it,” said Dr. Fournier. “It's also been a recruitment tool in this market where finding technologists is really hard. We've been very successful in bringing in technologists from our competitors.”
Enabling dual-energy imaging
In addition to capturing growth in cardiac imaging, the staff at St. Luke’s were also tasked with scaling spectral imaging techniques across their health system. The Revolution Apex platform systems are equipped with dual-energy or spectral CT, which uses two different energies to acquire two image datasets of the same anatomic region. The difference in attenuation between images obtained with a high- and low-energy spectrum allows better characterization of tissues.[3]
“We're able to get dual-energy CT scans immediately on our PACS without any extra post-processing. It improves image quality and contrast resolution, as well as our ability to detect abnormalities,” said Dr. Furman.
Dual-energy CT also allowed SLUHN to reduce the contrast administered to patients by more than 50% in some studies, including from 75 mL to 35 mL for chest scans. “Image resolution is so much better that we’ve saved enormous volumes of IV contrast. We don't [have] to give as much to the patient, which is safer for them,” said Dr. Furman.*
Upgradeable technology for years to come
One of the key advantages of investing in the Revolution Apex platform is its upgradability. Like many health networks, SLUHN is challenged to maintain state-of-the-art imaging technology to serve their patient communities. With its ability to scale detector coverage from 4, 8, or 16 centimeters of coverage through upgrades, the Revolution Apex platform delivers all the technology SLUHN needs today and can grow when those needs change. “What I liked about our purchase of the Revolution Apex platform is that we have a consistent upgrade pathway,” said Dr. Fournier.
This ensures that SLUHN remains at the cutting edge of technology, continually enhancing patient care. “You don’t know what you don’t know until you see this equipment and what it can do for your patients,” Dr. Fournier said.
Learn more about GE HealthCare’s CT solutions.
DISCLAIMER
*This information is derived from a single customer experience, based on data from a small, single-center study with specific patient demographics and disease indications. Therefore, the results from this example may not be broadly applicable or easily reproducible.
Not all products or features discussed are available in all geographies. Check with your local GE HealthCare representative for availability in your country or region.
REFERENCES
[1] https://newsroom.heart.org/news/more-than-half-of-u-s-adults-dont-know-heart-disease-is-leading-cause-of-death-despite-100-year-reign#:~:text=The%20age%2Dadjusted%20death%20rate%20from%20cardiovascular%20disease%20increased%20to,rates%20seen%20in%20many%20years.
[2] https://www.cdc.gov/heart-disease/data-research/facts-stats/index.html#:~:text=In%20the%20United%20States%3A,people%20died%20from%20heart%20disease.
[3] Sanghavi PS, Jankharia BG. Applications of dual energy CT in clinical practice: A pictorial essay. Indian J Radiol Imaging. 2019 Jul-Sep;29(3):289-298. doi: 10.4103/ijri.IJRI_241_19. Epub 2019 Oct 30. PMID: 31741598; PMCID: PMC6857256.
