The addition of a Computed tomography (CT) system in your practice increases your diagnostic capabilities dramatically. Pet owners today are increasingly willing to incur the higher costs of this advanced technology to ensure their pet receives optimal care. But they prefer to schedule their pet’s procedures with their trusted veterinarian rather than through a referral. Practices with a CT can ensure their patients don’t have to look elsewhere to get the care they need.
CT is a valuable tool in many aspects of veterinary medicine, including surgery, oncology, neurology, dentistry, and internal medicine. The most common clinical CT applications are sinus cavities, otic, dental, pulmonary, thoracic limbs, abdominal, and extradural spinal cases. Because of the multitude of use cases CT can replace certain procedures such as dental radiographs and sedated X-rays.
What Makes CT Different Now?
In the past apprehension to CT units was not only due to the financial investment, but the need for specific accommodations such as: space requirements, power consumption, radiation shielding, and cooling. However, there have been many new technologies that reduce or even eliminate these restrictions making CT a possible option for a much wider range of healthcare professionals.
Space requirements — Space tends to be the biggest limitation for most veterinary practices. Ideally, the CT system should have its own room outfitted with anesthetic and monitoring equipment, and possibly an adequate air conditioning system, depending on the CT scanner model. For practices short on room, there are newer CT units that require much less space to operate making them increasingly more popular.
Power consumption — X-ray generation and gantry rotation require significant electrical power. Many CT scanners require three-phase 480 V transformers, and you may have to coordinate with an electrician during the planning process. Newer CT models are equipped with technology, such as automated shut down and start up routines, to help save energy. An alternative option is mobile CT units that can be run from a normal 110 outlet but do not perform to the same standard as other traditional CT units.
Radiation shielding — Conventional CT systems require you to lead-line the scanning room walls to confine the radiation. Newer self-shielding CT scanners that have lead within their gantries to mitigate the scattered X-rays, which significantly reduces radiation levels, and the overall cost to prepare your space for a CT.
What CT system is right for your practice?
Beyond the advancements that make CT units more accessible, there have been many other improvements especially in the imaging technology. The quality of the images produced by CT scanners has improved tremendously over time. Yet, there are two types of CT scanners multi-slice CT (i.e., traditional CT) and cone beam scanners. Both must be considered when adding one to your practice as the technical differences may influence your choice of system. Characteristics include:
Multi-slice CT — Multi-slice CT uses a high output anode X-ray tube that rotates around the patient, and a fan beam transmits radiation. Specifics include:
-Rotates at 30 to 120 rpm, making motion artifacts virtually negligible. In addition, if motion does occur during a rotation, the artifact appears only in that slice of data, and the other images are unaffected.
-X-ray beam and detector array are collimated to a narrow slice of anatomy, ensuring the X-ray passes in a straight line from the generator through the anatomy to the detector.
-Exposes patients to higher radiation doses.
In general, multi-slice CT is better for soft tissue applications that require superior contrast, and for abdominal and thorax views where fast gantry rotation is important to avoid motion.
Cone beam CT — Cone beam CT uses a low power medical fluoroscopy tube, and a cone beam that radiates from an X-ray source, covering a large volume with a single rotation around the patient. Specifics include:
– Bigger and heavier X-ray tubes and detectors, so the rotation speed is much slower—typically about two to four rpm. If any motion occurs during the rotation, the entire image is affected, requiring a repeated scan.
-X-ray beam and flat panel detector array are not collimated, so the scan produces more scattered radiation and captures most of the scattered X-rays. These data points can reduce contrast resolution and interfere with accurate diagnosis.
-Scans a large area with a single rotation, reducing radiation exposure.
In general, cone beam CT is better for patients weighing less than 20 pounds, and for small structures, such as the head and feet, because the size of the scan volume decreases the scatter size. Cone beam CT also works well on bony structures because the tissue density decreases scatter.
Does CT Have a Place in my Practice?
Accessibility, lower costs, and advances in technology and expertise have led to a dramatic increase in CT use in veterinary medicine in the last 10 years. CTs are no longer only found in specialty practices, and they are a viable option for private veterinary practices who want to provide advanced imaging for their patients. Factors to consider include:
Lower cost — CT costs are rapidly declining, and the cost of a multi-slice unit is priced less than a single slice CT scanner was several years ago.
Fewer facility accommodations — Advances in CT systems allows for the need for fewer facility accommodations.
Wider applications — Applications for CT technology are constantly increasing, including imaging the brain, nasal cavity, spine, gastrointestinal, urinary, and vascular systems, evaluating musculoskeletal disorders, screening for metastasis, and evaluating tumors before surgical removal. Being able to use the CT in so many ways makes the unit a worthwhile investment.
Veterinary-specific workflow — Current CT machines provide veterinary-specific workflows to make finding the right settings easy and convenient.
Other options — Recertified and refurbished CT units are also an option that can benefit practices on a tighter budget.
Think long term — The more comfortable you become using CT, the more scans you will perform. For instance, you may currently see only one intervertebral disc disease (IVDD) case a month, but once you become skilled with the system, you can accept referrals from neighboring hospitals.
CT can be a valuable tool that will help your practice diagnose pathologies, employ interventional treatments, improve clinical outcomes, and generate more revenue. If you are considering CT for your veterinary practice, contact a product specialist at Universal Imaging, so we can help you determine which system fits your practice needs.