New Visions: Diagnostic Imaging

Thanks to a $20 million investment, El Camino Hospital's radiology department may well be the Bay Area's best-equipped imaging department.

Nowhere in El Camino Hospital's new $480 million facility is its name, "The Hospital of Silicon Valley," better illustrated than in its new, state-of-the-art diagnostic imaging department.

With a $20 million investment in advanced imaging equipment, such as a 3 tesla MRI, a 1.5 tesla Espree MRI, a 128-slice CT scanner, a dual-source CT with perfusion scanning capabilities, a PET-CT and a SPECT-CT, there is perhaps no diagnostic imaging department better equipped among Bay Area hospitals.

"We have truly leapfrogged into a new era," says Imtiaz Qureshi, MD, director of El Camino Hospital's Radiology Department. "Our vision is that we will be the best imaging department in Northern California, if not the entire state. The resources we have now in this new hospital are certainly befitting to that vision."

The terms "X-ray," "CT scan," "MRI" and to a lesser extent "PET scan" have increasingly become part of our vocabulary over the past 25 years. X-rays were discovered in the late 1800s, and since then there has been a steady progression of ways to capture images of the inside of the body to diagnose disease. These include fluorescent screens, contrast mediums, image intensifiers, radioactive chemicals, sonar, computed tomography (CT), magnetic resonance imaging (MRI) and molecular imaging through positron emission tomography (PET scan).

The top of the line of all of these diagnostic imaging tools is now available at El Camino Hospital's new diagnostic imaging department for the diagnosis and treatment of disease. In addition, the department, which occupies generous space on the first floor, has been designed not only for the comfort of patients but also to incorporate best practices in the care of the emergency or critically ill patient. The department is located immediately next to the emergency department, with access to the operating suites on the second floor via an express elevator.

"Great attention has been paid to the design and layout of the department," says Ramesh Gopi, vice chief of radiology. "We occupy a premier spot on the first floor, which means that some of our imaging room patients actually have a view of the outside. This is an example of the new hospital's healing environment--a pleasant room and natural light help reduce a patient's anxiety."

To get a more detailed view of the department's impressive improvements, take the following tour:

Magnetic Resonance Imaging

• 3 tesla MRI "trio": Doubles the power of the hospital's previous machine, allowing faster and more detailed scanning. This equipment is used to assess orthopedic problems, strokes, spinal abnormalities, liver cancer, heart disease and other conditions. Because of the exquisite detail it produces, the equipment can also be used for tumor staging and follow-up.
• 1.5 tesla Espree "open" MRI: Features a large hole and short bore to minimize claustrophobia or to allow imaging of larger patients.

Computed Tomography

• 128-slice scanner, the flagship of the Siemens line: Produces clearer images with lower radiation doses. 3-D imaging results in real-time animation. Provides guidance for procedures such as biopsies; performs stroke assessments.
• Dual-source, 64-slice perfusion CT: Allows expansion of services into cardiac imaging--for example, calcium scoring in coronary arteries for risk stratification and identifying high-risk patients for coronary artery disease. Coronary angiograph is a noninvasive method to look at vessels of the heart rather than angiography to diagnose heart conditions in low-risk patients. Future uses also include CT colonoscopy as an alternative to conventional colonoscopy.

Molecular Imaging

• PET-CT: Minimal dosage of radioactive substance is injected into the patient, which allows the physician to see metabolically active tissues, such as cancer. When PET images are combined with CT images, diagnostic accuracy is improved. Used to detect, pinpoint and stage tumors.
• SPECT-CT: A nuclear medicine procedure that with the addition of CT can more accurately discriminate healthy tissue from diseased tissue. Used mainly in oncology, specifically to study function of the organs, including the heart, lungs, kidneys, gallbladder, liver and thyroid.

Interventional Radiology

With the addition of a new interventional radiologist to its staff, the department will now be able to offer several endovascular interventional treatments not previously available at El Camino Hospital. These include treatment for DVT thrombolysis, chemoembolization, uterine artery embolization for fibroid treatment, tumor ablations and vein ablations.

Breast Imaging

A full range of breast imaging equipment is available at both the Mountain View and Los Gatos campuses (see "The Latest in Breast Cancer Screening," page 11). All diagnostic imaging capabilities have been upgraded with the move into the new hospital, according to Dr. Qureshi. The department uses all digital equipment and therefore is completely filmless. Results are sent over a secure connection to the physician's computer. "With the advent of digital equipment, we have moved entirely away from the view box to our large-screen computer monitors," says Dr. Qureshi. "These images, with their spectacular detail, have taken us several steps forward in our capability to more quickly and accurately diagnose and treat all kinds of diseases."