Extraordinary Machine

The machine is more understated than is fitting of something poised to make such an impact on oncology. It just sits in the corner, its muted white shell slightly aglow under the fake skylight — a feature installed in every Cancer Treatment Centers of America radiology department after a patient made a comment about how nice it would be to stare at something other than ceiling tiles.
As anyone in internal medicine knows, however, it’s what’s on the inside that counts, and while it may not look revolutionary, this machine may change the way cancer is treated.
Cancer Treatment Centers of America’s Southwest campus, at 81st Street and Hwy 169, recently became the first U.S. hospital to install GE Healthcare’s Discovery PET/CT 600, a distinction CTCA radiologist Dr. Timothy McCay said was based on mutual trust.
“This is a new technology, and being willing to put money on the line for a new technology [the cost of which was not disclosed] is not easy, especially in this economic climate,” McCay said. “But we trusted that GE had the technology and had done their homework enough to perfect the technology.
“On GE’s side, they wanted to put it in a place that would really utilize it and would really make it sing, and a cancer hospital is a perfect place for that.”
Their Powers Combined
CT, or Computed Tomography, uses multiple x-ray images to create a detailed, three-dimensional model of the patient’s anatomy.
Positron Emission Tomography, PET, uses a radioactive glucose analog called fluorine-FDG to find areas of abnormal metabolic activity in the body. Cancerous cells are stuck in replication, which will use more glucose, and therefore store more fluorine-FDG than healthy tissue.
By combining these technologies, doctors gain more accurate data.
“When these technologies were developed, they would do a PET study, then the patient would walk across the hall to get the CT study, and they would try to match them up,” McCay said. “The problem, though, was that the patient wouldn’t lay the same for both studies. This allows us to get the patient in the exact same position, guaranteed, allowing us to accurately locate the tumor and localize the treatment.
Less is More
The joining of PET and CT technologies isn’t what makes the Discovery PET/CT 600 exceptional, however.
“PET and CT scanners have been married for a while,” said Jim Mitchell, GM of GE Healthcare’s PET/CT Division. “We have made substantial improvements to the machine’s sensitivity and how it handles motion.”
In medicine, increased accuracy can literally be a matter of life and death.
“If motion gets in the way of detecting a lesion, that is more time for the cancer to do harm to the body,” Mitchell said. Which is why GE came up with MotionMatch, a camera mounted on the end of the camera that tracks a sensor on the patient’s abdomen to correct for breathing and other motion.
The result, McCay said, is unmatched accuracy.
“We had GE here earlier today, and I showed them a lesion that was four millimeters on the very top of the liver,” he said. “That is absolutely the hardest area to image because it moves with the diaphragm.
“Three years ago, we wouldn’t have seen the lesion until it was larger, and it would have had all of that time to metastasize.”
The increased accuracy also means a smaller dose of radiopharmaceutical is needed to appear on the scan, decreasing the possibility of long-term effects.
McCay cited studies in which children who survive cancer, develop a second neoplasm later in life from the treatment.
“We know that if you give a person a high enough dose of radiation, they’re going to develop a neoplasm,” he said. “Now, I can get increased accuracy, and with a third less dose than before.”
Computing Power
GE has also improved the software used to process scan data.
The software, called PET VCAR, organizes data to provide quantitative analysis across exams.
“When I scan a patient, I can bookmark lesions in the body, and it will store all of the information in a databank,” McCay said. “When that patient comes back post-chemotherapy, I can recall all of those bookmarks, and it gives you a sort of progress report.”
That report can allow doctors to change the course of ineffective treatments quickly.
“We can take patients three weeks into therapy and determine if treatment is working,” McCay said. “We used to have to wait until the end of treatment to determine if it worked. If it hadn’t, that cancer had time to progress and metastasize in the meantime.”
The Human Element
The final, but certainly not least important advantage of the Discovery PET/CT 600 is efficiency.
“Patients get to spend less time on the bed,” McCay said. “You really have to enter the psyche of a sick person to understand how big that advantage is.”
McCay spoke from personal experience.
“I was a sick kid growing up,” he said. “The less time you have to spend being sick or being treated, the better it is.
“Before, it was about a 30-minute process. Now, you spend 15 minutes on the bed and then be back out with your family, living your life.”

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