How has CT technology evolved and what is its effect on quality of patient care?

When a patient is hurt, sick or severely injured, a doctor can ask for an array of tests to be conducted in order to understand what is causing the problem. These tests include blood tests, X-rays, MRIs, CT scans, and so on. There are several kinds of diagnostic imaging exams performed by doctors but one of the most common and highly performed ones are the CT scan.

 

What is a CT Scan?

Computed Tomography (CT) imaging, also known as "CAT scanning" (Computed Axial Tomography) allows a doctor to see what is going on inside the body of a patient. A combination of a computer and X- rays are used to create pictures of the bones, organs, and other tissues. A CT scan is more detailed than any other regular scans.

CT-Scans are painless, quick, and an easy procedure that doesn't take too long, and it can be performed on any part of the body. A CT scan may be used to visualize the head, shoulders, spine, heart, abdomen, knee, and chest.

 

How does a CT-Scan work?

During a CT scan, the patient is expected to lie in a tunnel-like machine while the inside of the machine rotates and a narrow X-ray beam circles around one part of their body, thus providing a range of images from different angles. Later, these pictures are then sent to a computer, where they’re combined to create images of slices, or cross-sections, of the body. They could also be combined to produce a 3-D image of a particular area of the body.

A surgeon may use this type of scan to inspect all sides of a tumor to prepare for a medical procedure.

 

Why is a CT scan performed?

CT scans serve many purposes, but they are mainly deployed for diagnosing diseases and evaluating injuries. The imaging technique can help your healthcare provider with the following abilities.

A CT scan has the power to detect every kind of joint and bone-related problems. This includes tumors and complex bone fractures.

In case a patient is suffering from a serious condition like heart disease, cancer, liver masses, or emphysema, a CT scan can help a doctor spot it. They will be able to see any noticeable change very clearly.

If a patient has undergone a car accident, then the doctors will clearly see any signs of internal bleeding or injuries.

CT Scans can help a doctor locate a blood clot, tumor, infection, or excessive fluid inside the body.

Surgeons can proceed with other procedures and treatment plans such as radiation therapy, surgery, and biopsies after investigating CT Scan results.

The study of CT scan results can help to find out whether or not a treatment is working properly for a patient. A CT scan diagnosis of a tumor will show a doctor whether it is affected by treatment options like radiation or chemotherapy.

Blockages in a blood vessel or similar issues can be investigated through a CT Scan. With the help of CT scans, doctors can examine blood vessels without performing any serious exploratory surgery or surgical biopsy.

 

How did the first CT Scanner come about?

The word ‘Tomography’ is derived from the Greek word "tomos" meaning "slice" or "section" and "graphia" meaning "describing". Although the mathematical theory behind computed tomographic reconstruction dates back to 1917, the first clinical use of CT Scans was made in 1971 by British engineer Sir Godfrey Hounsfield.

 

The first commercially viable CT scan machine was invented by Sir Godfrey Hounsfield in Hayes, United Kingdom, at EMI Central Research Laboratories using X-rays. The first EMI-Scanner was set up in Atkinson Morley Hospital in Wimbledon, England, and the first patient brain scan was done on 1 October 1971.

 

The first patient to be scanned with a prototype scanner was a woman with a suspected frontal lobe tumour. The prototype scanner was developed by Hounsfield and his team at EMI Central Research Laboratories in Hayes, west London. The device produced an image with an 80 x 80 matrix, taking about 5 minutes for each scan, with a similar time required to process the image data. As technology has progressed over the years, current CT scanners can produce images with an 1024 x 1024 matrix, acquiring data for a slice in less than 0.3 seconds.

Hounsfield co-invented the technology with South Africa-born physicist Dr. Allan Cormack. Both researchers were later on jointly awarded the 1979 Nobel Prize in Physiology and Medicine.

The first clinical CT scanners, installed between 1974 and 1976, were dedicated to head imaging only, but whole-body systems with larger patient openings became available in 1976. CT became widely available by about 1980.

 

What is the scientific background of CT-Scans?

The concept of Computed Tomography was based on developments in two fields - X-ray imaging and computing. While X-rays were discovered in 1895, tomography was being developed by the 1930s. By the 1960s, many researchers had worked independently on cross-sectional imaging, resulting in Hounsfield's work at EMI developing computed tomography (CT) for the EMI Scanner.

This equipment relied on the reconstruction of image data by a computer, where data was acquired from multiple X-ray transmissions through the object under examination.

 

What were the early advancements made to CT Technology?

The successful experiment with CT lead to further demonstration systems being installed in London, Manchester, and Glasgow in the UK and at the Mayo Clinic and Massachusetts General Hospital in the USA. The first clinical scan in the USA was performed at the Mayo Clinic in 1973.

Within the next two years, by 1975, EMI were marketing a body scanner, the CT5000. With this, the scan time had already been reduced to 20 seconds, for a 320 x 320 image matrix.

 

There was a tremendous influx of development in CT technology, as by 1976, 17 companies started offering scanners, with scan times down to 5 seconds in some cases. By 1978, image matrix sizes were up to 512 x 512 and some models of scanner had the capability of ECG-triggered scans.

 

Towards the culmination of the 1970s, the significance of CT scans to medicine was established and Hounsfield and McCormack received the Nobel Prize for Medicine in 1979, for the independent work on developing the theory and technology of CT scanning, and in 1981 Hounsfield received a knighthood for his work.

 

What were the further advancements?

With an exponential rise in its use, by 1980, 3 million CT examinations had been performed. To keep up with the rapidly advancing usage of the technology, the 1980s saw incremental development of CT scanner technology. Until the late 1980s, scan times were down to only 3 seconds and matrix sizes were up to 1024 x 1024.

Improvements continued through the 1990s, with the advent of spiral (continuous) scanning to begin with, and then the development of multi-slice scanners, with 4-slice scanners and 0.5 second scan times. During the 1990’s, portable/mobile CT scanners also grew in popularity.

Advancements in CT scanner technology continued through the early years of the 21st century, leading to the popularity of multi-slice scanners.

 

How has CT technology transformed medical care?

With overall improvements in speed, slice count, radiation dose, and image quality, CT exam durations have come down from almost 30 minutes to less than 1-2 seconds.

Adaptive, statistical, model-based, and hybrid iterative image reconstruction techniques have reduced radiations by 70% - 80%.

The improvement in the CT detector materials has also made them more dose efficient and larger detector dimensions have also helped lower CT patient radiation dose while improving image quality at the same time.

With CT perfusion imaging, radiologists can view and quantify brain stroke and have a deeper and better understanding of changes in blood flow to the patient's brain. In coordination with CT angiography, this innovative approach can be revolutionary for the rapid evaluation of acute stroke.

 

Single-heartbeat CT coronary angiography has shown very high specificity and high sensitivity for coronary artery disease. In cases with low to moderate risk chest pain, the CT approach to triage saves time and money.

CT for congenital heart disease and for the planning of atrial ablation of fibrillation are other advanced applications. The field of CT evaluation of myocardial perfusion shows enormous potential.

The use of CT for Cancer Treatment Planning allows medical professionals to gather a better and accurate understanding of the extent of a patient’s disease. The technique of fusion imaging helps doctors to inspect metabolic and anatomical information at once.

CT is now the first line of swift and accurate diagnosis in emergency departments. Through the easy accessibility of CT exams in or around Emergency Rooms, the emergency evaluation of trauma, acute chest pain, or other urgent conditions has become more accessible too.

With the help of low radiation dose CT scans, medical professionals can now offer a higher quality of pediatric CT examinations, particularly for cervical spine procedures and chest CTs.

 

Conclusion:

CT scans offer numerous benefits to patients with internal injuries or other kinds of trauma and the technology also permits doctors to visualize pragmatically all parts of a patient’s body and helps diagnose diseases accurately.

CT technology can identify bone and joint diseases, fractures, tumors and also help patients with ailments like cancer, liver masses, and heart disease, by guiding the doctors into tracking the specific parts afflicted by the illness.

A CT scan is a critical tool in planning a patient’s treatment and to also gauge the results to determine which medications are working and what other treatments could be used. CT scans have come a long way since their invention and have evolved from a brain-scanning technology to one of the most crucial and valuable tools in modern medicine.

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