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Radiology and Imaging Augmenting Patient Care

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Radiology

Technology has acted as a great enabler and improved the overall results in everyfield. In healthcare, it is proving to be a boon for people who used to be left out orutterly disappointed for want of being properly diagnosed. It used to happen due to absence of timely factual medical reports. The improved facilities of Radiology andImaging have come as a great relief for such people to some extent, writes Mukul Kumar Mishra of Elets News Network (ENN).

RadiologyToday, one can easily availmedical help what he or shecould only dream of about10-12 years ago. As case of chronic diseases like cancer, diabetes, heart related issues and strokes are on therise, radiology and imaging are makinga critical difference to determine themedical diagnosis.

To detect life-threatening diseasesat an initial stage so that radiologistscan guide patients about accuratetreatment, Diagnostic Imaging plays acrucial role.

One needs to understand that the Indian healthcare is presently at aninflection point with focus shifting fromprescriptive to preventive healthcare. Also, with the rise in the income ofneo-middle class and quest for qualitypatient care, healthcare ecosystem isgrowing by leaps and bounds.

Today, consumers are more aware oftheir healthcare and diagnostic needs.Digital technology has helped peopleto avail more customised solutions tomonitor their health in a better way.

Though latest advancements in Radiology and Imaging have enhancedpatient care, the sector is not devoid of challenges jeopardising healthcaredelivery in totality.

Disruptive technology andinnovative solutions cant be helpfuluntil we have required experts toanalyse huge amount of imagingvolume (Number of scans, images, andamount of data) the latest high-techequipments generate on the daily basis.

With a population of over onebillion people, India has radiologiststrength of only 10,000, meaning thedoctor and patient ratio being just1:100,000. This can make anyoneunderstand how difficult it is for the radiologists to diagnose diseases withprecision, which is first step in thedirection of providing right treatmentto a patient.

Tele-radiology has proved to be abig boon to fill the gap existing dueto mismatch between the availability of the radiologists and the number ofimages being generated.

Another obstacle is inept manpowerto handle these high-tech equipmentsit increases the risk of error during thecourse of the diagnosis.

Reduction of radiation doses isanother impediment which needs to betackled. It not only poses huge risk forpatients but also for radiologists. Bothneed to be protected against harmfulradiation which otherwise makes themprone to several deadly diseases.

Radiology gains relevance in thecontext of diagnosis, which decidesthe road ahead for treatment. Withthe rise in chronic diseases likecancer, diabetes, heart related issuesand strokes, the sector holds hugesignificance. These are all conditionsthat require imaging or scanning atsome point of time.

RadiologyThe modern-day advancement hasinfluenced radiology. About 20 yearsago, radiology was limited to X-rays.But over the years, conventionalprocedures have witnessed tremendouschange for the better, leading to enhanced experience of treatment formillions of people across the globe, says Dr Syed Akhter, Consultant &Incharge, Radiology and Imaging, Nayati Medicity, Mathura.

Diagnostic Imaging plays animportant role in giving insight aboutwhat is happening within human body.If a patient has an iota of doubt ofcancer or malignancy, he or she goesfor an imaging test to make the initialdiagnosis and then subsequent imagingtest for follow up treatment.

The utilisation of radiology acrossthe world is increasing to diagnosesuch life-threatening diseases at a rightpoint of time so that quick treatmentcould be provided.

With emerging trends andtechnology, it is interesting to see thetremendous scope that this sector hasto offer. The world of imaging andtechnology is constantly evolving, thusopening up to a vast new world of innovations.

Radiology has two parts one isdiagnostic and other is interventional radiology.

Diagnostic radiology helpshealthcare experts to see structuresinside your body. With diagnostictools like Computed Tomography(CT), Positron Emission Tomography(PET imaging), Magnetic ResonanceImaging (MRI), Nuclear Imaging, and Mammography, the radiologistsdiagnose the cause of underlyingdisease and direct patients what sort oftreatment is needed.

Interventional Radiology:

Interventional radiologists are thoseexperts who use imaging to insertcatheters, wires, and other smallinstruments and tools into your bodyto treat diseases like cancers or tumors,blockages in the arteries and veins,fibroids in the uterus, back pain, liverproblems, and kidney problems.

Doctors can use this technologyto diagnose or treat conditions inalmost any part of the body instead ofrequiring to directly look inside onesbody through a scope (camera) or withopen surgery. The doctors make noincision or only a very small one in this procedure.

Talking about interventional radiology, Dr M L Rokade, ConsultantRadiologist, Jupiter Hospital, says: Therole of interventional radiology hasexpanded. Radiologists do angioplasty,tumor embolisation and variousdiagnostic and therapeutic procedure.An embolectomy done in the GoldenHour can salvage the brain function ina stroke patient.

With the 128 and higher sliceMulislice CT scanners, diagnostic invasive angiograms are soon becoming past. Coronary CT scansnow reveal coronary anatomy inexquisite details. Small segmentalareas of narrowing and other vascularvariants can be assessed. Thesescanners also overall increase theoutput due to faster scan acquisitiontimes and recent advances help inreducing the patients radiation doses,Rokade further stated.

Imaging Market:

India has come a long way since thefirst X-ray machine was imported inIndia in 1902, only seven years after itwas discovered by a German ProfessorW.C. Roentgen. Today, we are at parwith other developed countries as far as latest technology and innovations inradiology are concerned.

The global medical imaging devicesmarket is expected to grow at a CAGRof 5.47% during the forecast period2018-23. According to Zion MarketResearch, the global market will reacharound $ 33.50 billion by 2021.

The emergence of innovativetechnology such as 7T MRI equipment,high-slice CT scanners, 4D and 5Dultrasound imaging, and innovationsin digital X-ray technologies is likelyto boost the demand for medicalimagining devices in the global market.

Innovations rule the roost:

Tele-radiologyThe Indian radiology market is alsowitnessing tectonic shifts with themajor players trying to explore andpenetrate the market in tier-II andtier-III cities. Tapping to this vast scopeof advanced-diagnostics-at-affordableprices,radiology industry is witnessingan overhaul with respect to launchingof cost-effective imaging equipments inthe secondary and tertiary healthcare segments.

The leading players like GE,Siemens, Philips and Fujifilm arelaunching next-generation medicalimaging devices that help inprevention, diagnosis and treatmentplanning, and disease management.

Ultrasound has maximum usagein any hospital setting. Ultrasoundshave become smaller to the size ofpalm top so that it is always availableto the critical care consultant. Todayultrasound has changed the way wesee the fetus with its 3D/4D capability,Rokade said.

Liver cirrhosis can be diagnosedearly with shear wave elastographyboth on ultrasound and MRI. Contrastenhanced ultrasound is now beingwidely used for assessment of tumorsand various lesions. Digital imageradiography and PACS (Picturearchival and communication system) isthe standard of a modern day radiology department.

Dr Rajeev Boudhankar, CEO, Bhatia Hospital, Mumbai, says thereare cutting-edge imaging techniquesthat may become popular in thenear future. He lists out some of theinnovations happening across world onthe front of diagnostics imaging.

Pocket-sized hand-held ultrasounddevices are predicted to replace the200-year-old stethoscopes in nearfuture. They can diagnose heart, lungand other problems more accuratelythan traditional stethoscopes.

Similarly, Hyperspectral imagingmay provide a non-invasive diagnosticmethod that allows determination ofpathological tissue with high reliability. This technology is in use in the defencesector and is now finding applicationsin the healthcare imaging Industry,Boudhankar adds.

A modality called ElectromagneticAcoustic Imaging has been makinguse of electro-magnetic and acousticwaves for diagnosis. It helps to identifyvarious types of solid Cancers at earlystages of development.

Another technology Wafer ScaleMega Microchip enhances medicalimaging techniques. It enables doctorsto detect accurately the effects ofradiation on cancerous tumours, thushelping early detection.

The University of California,Berkeley and the UniversidadAutonoma de Madrid of Spainhave claimed to have made the use of 3D Meta material to augmentultrasound images by a factor of 50X.If this technology becomes successfulcommercially, it would help currentultrasound investigations to capturehigh-resolution images for medicalimaging in both diagnosis andinterventional procedures.

Trends in Radiology andImaging:

Tele-radiology

It is one of the most useful discoveriesin the field healthcare IT whereradiologists, without being physicallyavailable on site, provide quality patient care.

It fills the gap of mismatch ofradiologists and the number of imagesthat are being generated on the dailybasis at various healthcare centresacross country. Using this IT-enabledsolution, the images can be transmittedto another location and reportedimmediately on real-time basis so thatthe emergency medical care can bedelivered on that very moment when itis actually required to patients.

Kenya with a population of 43million has only 200 radiologists. Inrural Nepal, there are places wherepeople travel almost two days forgetting X-Ray. In that part of theworld, machines are often outdatedmodels and are the ones that have been donated. Web-based systems allowphysicians to send and access imagesand reports from all over the world,Akhter said.

Hybrid Imaging Technology:

It is referred to as the fusion of two ormore imaging modalities to form anew technique. This not only improvesthe accuracy of a diagnostic test butalso reduces the radiation exposure for patients.

The most significant developmentin this regard has been the innovationof hybrid imaging systems like thePET/CT. This hybrid modality hasbeen so successful that major imagingsystem manufacturers do not providestandalone PET systems any longer.

Based on the success of hybrid PET/CT systems, hybrid PET/MRI and SPECT/CT systems havealso gained attention. These hybridsystems can provide precise imageswith better resolution compared tostandalone systems. They can providemorphological as well as physiologicalinformation in just one examination.

PET “ CT:

Positron Emission Tomographycontinued with CT scan imagesprovides easy detection of even smalltumors and metastatic informationand also provide metabolic statusof tumor as physicians get a betteridea of what is going on and howto properly treat it and also help inmonitoring chemotherapy.

Automated CT Scanners:

These devices offer high image qualitywith improved spatial resolution andlow radiation exposure to the patient aswell as surgeons.

These advanced CT devices havea simplified console, offer ease ofoperability, and provide affordableinstallation with minimal spacerequirements.

Digital Radiography and Digital Mammography:

“Pocket-sized handheldultrasounddevices arepredicted to replacethe 200-year-oldstethoscopes in nearfuture. They candiagnose heart, lungand other problemsmore accuratelythan traditionalstethoscopes.”

Digital radiography has tremendouslyimproved the x-ray quality, speed andreplaced all the boring Dark Roomprocedures, as these can be sharedimmediately for speedy diagnostic results.

The conventional X- Ray usedto take about half-an-hour forwhole procedure while the digitalradiograph can be acquired with justa click of a button while delivering afar better quality.

Our Full Field DigitalMammography “ Amulet Innovalityis the future of Mammography andcertainly has much scope consideringthe rapid increase in the number ofbreast cancer cases going undetectedin India. In order to provide timely diagnosis, Fujifilm has installed AmuletInnovality in several healthcare centersacross the country, says ChanderShekhar Sibal, Senior Vice President,Head of Medical Division, FujifilmIndia Private Limited.

CT Angiography:

Traditional angiography takes several hours, requires sedatives and caneven cause damage to vessels. ButCT- Angiography takes 10-15 minuteswithout such risks. It can be used toimage any artery in the body includingbrain, coronary, lung, kidney etc. withrecent advances in CT angiography.It gives a picture which is threedimensionaland is like actual arterialsystem in our body and is very friendlyfor clinicians to see the pathology.

Artificial Intelligence Can Be a Game Changer:

AI can play a pivotal role in intelligentworkflow and capacity management.It can help make radiologists moreefficient, properly prioritize care, andhelp distribute workloads for moreeffective use of resources.

The modern technology canassimilate large amount of patternrecognition data into their systemsand allow a computer algorithm todifferentiate the normal from anabnormal image; detect certain lesionsfor example lung nodules, early-stagebreast cancers or for instance theblockages in vessels such as embolismin the pulmonary arteries.

If AI picks up the way it isdestined, it will enhance Radiologyand will lead to better patient care,Sushant Kinra, Managing Director,Carestream Health India PrivateLimited said.

For Radiology and especiallymedical device companies like us, thebiggest advantage is that we are theones who are generating the data forAI. For example, our Digital X-ray orComputed Radiography equipmentconverts the analog information intodigital data, which is what AI uses toprocess information. This demand fordigital information will only increase,he further stated.

In essence, we can say Radiologyand Imaging field is replete withinnovations but that need to beleveraged with caution. Much needs tobe done to harness this potent tool toprovide holistic patient care.

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