Dual scan doubles up on cancer
A facility in Kakaako merges PET and CT systems to cut disease
A facility combining two technologies to detect cancers and diagnose other physical problems has opened at Waterfront Plaza in Kakaako.
It is the first in the state with both a Positron Emission Tomograpy (PET) and computed tomography (CT) imaging system, said Eric Elizaga, Hawaii PET Imaging spokesman.
The combination of PET and CT capabilities allows doctors and patients to see both metabolic and structural changes in the body, he said. "We're more able to localize where the cancer is growing."
The Centers for Medicare and Medicare Services has named Hawaii PET Imaging as a participant in its reimbursement program, the National Oncologic PET Registry. This allows Medicare cancer patients who previously were denied PET coverage to obtain the imaging scans for all cancer-related diseases.
"Now, patients that were not able to afford or obtain this level of testing can access it more readily," said Bennie Andrews, HPI's chief radiation technologist, describing advantages of the noninvasive technology for early and accurate diagnosis of cancers.
The PET scan wasn't available when she felt something in her breast in a self-exam at age 34, said Jemellee Koki, a Wheeler Elementary first-grade teacher.
Koki, now 41, was told the lump was so small it was just part of her breast plate, but she began to get concerned and had a mammogram, ultrasound and biopsy, she said. She was diagnosed in 2001 with breast cancer, which she had treated.
Last March, "lo and behold, short of five years, here it came back again. You're just never ready for that kind of news," she said.
Her doctor recommended a PET scan that "traces cancer before you even know you have cancer," she said. "It's that precise, better than MRI (magnetic resonance imaging) or any kind of scan available before now."
After "a long and tedious approval process" through her insurance carrier, Koki had the first PET scan in April. At that time, Hawaii PET Imaging operated mobile PET scanning services (without CT capabilities) at St. Francis Medical Center.
"Results of the PET scan would determine my route of therapy," which began with weekly chemotherapy in May, Koki said.
She also had a cat scan, MRI and abdomen scan at Kapiolani Medical Center at Pali Momi in July. "Growth came back in my neck but not in my breast," she said.
"Those scans had shown that area was free and clear but a particular spot on my lung doctors were concerned about hadn't changed. What do you do? You keep plugging along. You have no choice. We continued chemotherapy and tried new things."
When the 2,000-square-foot Kakaako center opened with an advanced Philips GEMINI GXL PET/CT system in September, she had another scan and received good news.
"Apparently all the cancer is gone through my body. It's just a miracle. It really is. I'm just so blessed. I'm still processing everything," she said.
"This caught me by surprise. It's been this nightmare. ... Part of me wants to roar and yell to the mountain. The other part says 'wait.' I'm a little leery, very aware of how things can just change. ... I'm very hopeful and I believe in miracles."
Andrews said the PET/CT scan can show the size, shape and staging of tumors. At least 30 percent of patients change treatment after the exams because results are different than anticipated, he said.
About 99 percent of the imaging is done for breast, cancer and colorectal cancers, lymphoma, melanoma and other types of cancers, Andrews said.
But testing also is done for brain disorders and heart disease, bone, prostate, liver, stomach, spleen, adrenals and small intestine masses, he said.
The PET/CT is useful for evaluating "difficult to image" regions of the body, such as the head and neck, post-surgical abdomen and other areas, he said.
It's faster and more comfortable than the old PET system, Andrews said. "It helps with claustrophobia. I've been through this myself.
"We're the gold standard (for imaging)," he added. "But we're not going to replace anybody. We're just a difference piece of the puzzle doctors are putting together."