Reid Hospital & Health Services (Richmond, Ind) is a progressive, nonprofit, 238-bed, regional, referral medical center serving east central Indiana and west central Ohio. Reid Hospital's service area is home to approximately 280,000 people, including five Indiana counties and two Ohio counties.

As part of Reid Hospital's expansion plan to add new heart services, which were critically important to the health of its community, the facility needed a state-of-the-art catheterization lab featuring the latest imaging technology available. Additionally, offering new heart services meant that local patients did not have to travel to neighboring Indianapolis and Dayton, Ohio, for interventional cardiac procedures.

After considering several imaging equipment vendors, Reid Hospital developed a relationship with Toshiba America Medical Systems (TAMS of Tustin, Calif) and selected its Infinix-i series vascular X-ray system for its new cardiac catheterization lab. As one of TAMS' most progressive sites, Reid Hospital was selected to perform clinical trials and measurements on the new cardiac flat-panel detector (FPD), a field-upgradable component to the vascular X-ray system that offers high image quality and dose safety benefits.

"With the latest imaging technology available at our facility, we are able to see firsthand the difference in the image quality of flat-panel detector technology compared to other imaging technology available today," says Jeanette Sullivan, program director of heart services at Reid Hospital. "We also took part in helping Toshiba define and refine the system with different protocols and with varying dose ranges and frames per second. This process was very beneficial for our doctors in determining their individual requirements for dose and image quality."

Further contributing to the dose efficiency is the system's true asynchronous platform, which enables variable frame rates for improved image quality at a lower dose and offers up to a 20% dose reduction than comparable systems. With these additional dose-management tools, such as variable dose-level selection and virtual collimation control, the cardiac FPD system provides a high level of safety and benefits for Reid Hospital's staff and patients.

Clinical Performance

Reid Hospital & Health Services in Indiana selected Toshiba's Infinix-i series vascular X-ray system for its new catheterization lab, shown here with Michael Cole, RN.

At Reid Hospital, the cardiac FPD is used to perform various heart-imaging services, including cardiac catheterization, angioplasty, and stenting. Additionally, it is used in advanced procedures, such as performing electrophysiology studies of the heart and implanting pacemakers and cardiac defibrillators.

"All of the cardiologists here at Reid Hospital are impressed with the image quality in that there is no degradation of the image around the edges, which, to us, is the foremost benefit of the flat-panel detector," says Allen Joseph, MD, medical director of cardiology at Reid Hospital. "We can visualize the periphery more clearly without having to focus on what's in the center of the screen, which is typically the case. We also found that thin wires, biventricular pacers, and coronary sinuses can be imaged in greater detail. As for stent placements, we are able to see our instruments and anatomical details more clearly, and deploying them is much easier."

The clinical advantages of using the cardiac FPD system are high-rate, high-resolution imaging as well as distortion-free radiographic images that allow more rapid and accurate measurement. Additionally, the FPD improves the range and image-processing capabilities for faster 3-D reconstructions with no need for distortion correction, as compared to traditional image intensifiers.

"Cardiologists here acquire images at 15 frames per second and occasionally adjust upward for our heavier patients, which provides us with a wide spectrum that most other [equipment] doesn't offer," Joseph adds. "We are comfortable with using just 15 frames per second for many of our procedures, which offers a great deal of dose savings; but when we require more, we're covered with the new system."

Economical Benefits

FPD technology also offers economic advantages with respect to its reliability and maintenance needs. As a solid-state component with no mechanical action, the FPD does not require calibration to maintain its imaging specifications, which, in turn, lowers equipment life-cycle costs.

The cardiac FPD also is a field-upgradable technology, which enables Reid Hospital to expand its imaging capabilities while reducing time and further costs associated with installing and testing new equipment.

"We had a great experience with the installation with no glitches," Sullivan says. "We communicated with our engineering department and coordinated the installation with our equipment vendor. The complete flat-panel detector installation on our vascular X-ray system took just three days."

Benefits: Seen and Unseen

The improvements from using the cardiac FPD system have led to many benefits at Reid Hospital. "We're pleased with the mechanics of the whole cath lab using the system's ceiling-mount C-Arm, which helps patients get in and out quickly," Joseph notes. "With the C-arms positioned appropriately, we have a larger field of view than we had previously so that we can do more peripheral imaging, which reduces time and increases the quality of studies without having to repeat exams."

The cardiac flat-panel detector technology provides high image quality and improves visualization for high-quality cardiac studies and complex interventional procedures.

Additionally, cardiologists and staff have experienced an increase in productivity and workflow with more expeditious diagnosis and shorter exam times. "The new FPD system has increased our productivity tremendously," Sullivan says. "Decreased panning during exams and increased speed of the direct imaging system of the flat-panel detector has reduced our patient turnaround time by 30 to 40 percent. The speed in which the system allows our staff to acquire images and then transfer to our archive also is superb."

With the installation of the FPD technology, Reid Hospital has been able to stay at the forefront of cardiac imaging and provide much-needed heart services to its surrounding communities. In doing so, Reid Hospital realized numerous benefits, such as improvements in the quality of cardiac studies with high-resolution images to aid complex interventional procedures, in dose safety to operators and patients, in long-term cost savings and productivity, and in the overall standard of care offered by the hospital.

Michael Cole, RN, is a clinician at Reid Hospital & Health Services (Richmond, Ind).