MEDICAL SPOTLIGHT: Health First’s CT Scanner Sets the Bar for Diagnostic Imaging

Health First's Holmes Regional Medical Center is a Center of Excellence in stroke care

CT TECHNOLOGIST MATT REHRER prepares a patient for a 256-slice CT scan at Health First’s Holmes Regional Medical Center. This particular CT scanner is the most advanced in Brevard County. (Health First image)

This 256-slice CT scanner at Holmes Regional Medical Center is a cut above in Brevard County – and one reason the hospital boasts incredible response times in cases of stroke, other emergencies.

BREVARD COUNTY, FLORIDA – On a recent afternoon, Misty Ritzel’s eyes got big. “Holy cow,” she said.

Ritzel is a CT Technologist candidate at Health First’s Holmes Regional Medical Center, and Lead CT Technologist Michael Wahne told her the 256-slice CT scanner just did a chest exam in 2.6 seconds.

Like an MRI, a computed tomography (CT) scan creates a three-dimensional image of tissues in the body. The diagnostic image is used to study the heart, brain perfusions in stroke patients, and physical trauma from, say, a car accident. Recently, because of complications from COVID-19, the CT scan has been put to great use examining pulmonary embolisms.

That’s where Holmes Regional’s 256-slice CT scanner shines. A “slice” is a credit card-thin cross-section of an anatomical image. Each is stacked atop the others to form a vivid, 3D image. This scanner does 256 slices covering a 50-centimeter field – of a chest, for instance – in seconds. For patients in a lot of pain who cannot lie still, or people who are short of breath, it’s a gem.

“Most times, when we finish, I say, ‘All right, we’re all done.’ The patient’s like, ‘Wow, we’re done? That was quick – you weren’t lying!’” Wahne said.

“We say, ‘Time is brain,’ ” said Lisa DeGoti, a Multi-Modality Radiology Supervisor at Holmes Regional. With this scanner, “the patient is in and out with clear results.” (Health First image)

Excellence in Stroke Care

Holmes Regional is a Center of Excellence in stroke care for reasons that include top surgeons and Health First’s First Flight air ambulance service. But in late 2020, the hospital pressed its case by adding this 256-slice CT scanner.

“We say, ‘Time is brain,’” said Supervisor Lisa DeGoti.

In most strokes, an artery feeding oxygen to the brain is stoppered by a blood clot. Before a team of neurologists and interventional specialists leap into action, the patient has a CT scan to create a perfect study for doctors to examine.

An older CT scanner will make several rotations in a brain perfusion study, “jogging” back and forth, stitching the images together. It creates small incongruities. For a brain scan, it hampers an already intricate diagnostic process.

With this scanner, “the patient is in and out with clear results,” she said.

Or, consider the heart, said Dr. Jose Ramos, chair of the Department of Radiology at Holmes Regional.

“When the 64-slice technology became available, we could scan a moving, beating heart, in four cycles. Now, we scan the whole heart in a single heartbeat. You think about a moving target, it’s significantly advantageous – in one heartbeat, you’re acquiring the whole image.”

HOLMES REGIONAL’S 256-SLICE CT SCANNER covers a 50-centimeter field – of a chest, for instance – in seconds. For patients in a lot of pain who cannot lie still, or people who are short of breath, scan time is critical. (Health First image)
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Kid-Friendly, Claustrophobia-Kind

An MRI is often thought the gold standard of diagnostic imaging, perhaps for its deftness around sports injuries, but a CT scanner has some advantages. For patients with renal insufficiency, it requires less iodinated contrast. For claustrophobes, it’s open on either end of the gantry (the “doughnut”).
For children, it can be a little less scary.

“With pediatric MRIs, frequently they have to use some anesthesia or sedation. A CT scan saves the need for that,” DeGoti said.
And because the scan doesn’t depend on powerful magnets, techs can distract children with entertainment shown on a tablet or small screen. Because of its speed, the distraction will be short, too.

“Especially really little ones, 2- and 3-year-olds, they’re hard to control, so if you get the perfect opportunity to scan them you’ve got to take it,” Wahne said.

More than 100 CT scans are conducted each day for patients arriving at Holmes Regional’s Emergency Department (others may be scheduled outpatient or hospital in-patients).

In November 2021, the 256-slice CT scanner at Holmes Regional received accreditation from the American College of Radiology, the highest standard for quality and patient safety in diagnostic imaging that entails a peer review by board-certified physicians and medical physicists.

Last month, the hospital celebrated the same accreditation for both new MRI scanners, including the Cardiac MRI recently featured in Space Coast Daily. It’s the only ACR-accredited Cardiac MRI between here and Orlando.

To read more news from Health First, visit HF.org/news_and_events.

This 256-slice CT scanner at Holmes Regional Medical Center is a cut above in Brevard County – and one reason the hospital boasts incredible response times in cases of stroke, other emergencies. (Health First image)
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