CRAIG T. KOJIMA / CKOJIMA@STARBULLETIN.COM Cardiologists can take sharp pictures of a beating heart for the first time with the 64-slice CT scanner. Lori DeCosta sits with scans on a screen from Pacific Cardiology's CT scanner, seen in the background.

New CT scan shows 64 slices of life

Some local doctors are using the fresh technology to better examine their patients

A revolutionary CT (Cat) scanner is changing the way some Honolulu cardiologists and radiologists are diagnosing patients.

Cardiologists for the first time are able to take sharp pictures of a beating heart with the 64-slice CT (computed tomography) scanner.

"It's so fast, it allows you to stop motions of the heart," said Dr. Gregg M. Yamada of Pacific Cardiology. "With this technology, we can actually look inside the blood vessel."

That's only one of the advantages of the 64-slice scanner, which is replacing older technology at Pacific Cardiology and some hospitals.

"We're changing the way we've done cardiology for 34 years," Yamada said. "It not only takes pictures of the heart rapidly but takes pictures of every organ that much faster."

Straub Clinic and Hospital was the first to acquire the state-of-the-art scanner in July, followed by Kapiolani Medical Center at Pali Momi.

The Queen's Medical Center also has ordered two 64-slice scanners and a 16-slice scanner to replace two four-slice and one two-slice scanner, said Kathy Sugai, manager of imaging services.

The new scanners will gradually be installed starting in January on the emergency department floor, accessible to all ER trauma patients, inpatients and outpatients, Sugai said.

"This will hopefully help expedite the diagnosis so patients' length of stay in ER will be decreased," she said. Queen's also plans to evaluate use of a portable eight-slice CT just for head injuries that it will take to patients in the intensive care unit, she said.

The Hawaii Medical Service Association is reviewing the American College of Cardiology's guidelines on appropriate use of the new technology for insurance coverage, said HMSA Senior Vice President Cliff Cisco.

HMSA is talking to doctors about a pilot project looking specifically at cardiac procedures, he said. "If it can provide information that would avoid an invasive surgical procedure, that would be of importance."

CT or "Cat" scans combine X-ray technology and computers so doctors can see thin cross-sections of structures within the body without invasive procedures. As the 64 camera heads rotate on an X-ray tube, they provide 64 slices of information representing thousands of measurements.

Traditionally, the best way to look at the beating heart and see clogged blood vessels was to go inside the body with a cardiac catheterization, Yamada said.

But with the 64-slice scanner, he said, the entire heart system can be imaged clearly in about five seconds, or five heartbeats.

The camera heads spin around the patient's body at 0.3 seconds per rotation.

Within seconds, the 64-slice scanner can exclude heart attack as the cause of chest pain and identify an often unrecognized torn blood vessel, such as actor John Ritter died of in 2003, Yamada noted.

Wong said an off-angle view recently exposed an abnormality in one of his patients after a false normal test and he immediately put in a stent.

The advanced scanner also is being used in hospitals for cancer diagnosis and treatment, enabling doctors to monitor changes in a tumor and the patient's response to treatment.

The whole body can be scanned from head to toe in about 10 seconds and some people want that done to look for cancers, Yamada said. But at Pacific Cardiology, he said, "We don't advocate full scans. We focus on heart and blood vessels."

Patients "respond fantastically" to the 64-slice scanner, said Lori DeCosta, Pacific Cardiology technical director. "It's only one IV poke, a warm flush (of contrast fluids) and 15 minutes in the chamber if their heart rate is regular."

Straub radiologist Ray Ballinger said a complete chest scan that used to require patients to hold their breath for 15 seconds can be done now in half the time. He said the technology "has changed what we can look for and how we look at it when we find it."