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Ultrafast CT Scans at Montefiore Medical Center Diagnose Heart Disease Without Uncomfortable Invasiv

Speed offers quick diagnosis in the emergency room, relieving wait times

New state-of-the-art CT scanners at Montefiore Medical Center are so fast they can image the beating heart in just five seconds, essentially freezing it in motion so that every detail of the coronary arteries is clear.

"The faster speed and finer resolution of these scanners will be useful in imaging any area of the body, but particularly the heart," said Stephen Amis, MD, chairman of radiology. "Because the heart is constantly in motion, older, slower machines couldn't give us the detailed views of the coronary arteries that we need to diagnose cardiac disease."

Called volume computed tomography, the technology can image stationary organs in just one second, and the full body in ten. Three-dimensional pictures are created by assembling 64 "slices" for every 40 millimeters of tissue. Each slice is as thin as a credit card, yielding superior resolution for a detailed view of any internal abnormalities or injuries.

Montefiore is installing four volume CT scanners: three in the Moses division and one in the Weiler division. One of the scanners in the Moses division will be placed in the emergency room, where it will help diagnose patients more quickly, relieving wait times. Montefiore's emergency department service has been ranked the seventh busiest in the nation, logging a record 180,000 patients in 2004.

"We're very excited about acquiring this technology for our patients," Dr. Amis said. "It opens up new possibilities for diagnosing heart disease without patients having to undergo an uncomfortable invasive procedure."

Physicians from the Montefiore departments of radiology and cardiology will be collaborating on a study to determine the best use of the scans in the emergency room. One question they will address is whether the tool can definitively diagnose, in all patients, a narrowing of the arteries that might be the cause of chest pain and could lead to a heart attack. At present, a coronary angiogram, or cardiac catheterization, is the gold standard for that diagnosis. The procedure, which involves threading a tiny tube up through an artery in the upper thigh into the coronary arteries, is uncomfortable and time-consuming for patients and usually requires hospital admission. A volume CT scan may provide enough information so that, at least in some cases, an angiogram is unnecessary.