Features | Partner Sites | Information | LinkXpress
Sign In
Schiller
Ampronix
ElsMed

US Army Hospital Physicians Create Way to Detect Stress Fractures Faster

By Medimaging International staff writers
Posted on 03 Mar 2013
Image: Sgt. Christopher Funke, noncommissioned officer-in-charge of Nuclear Medicine at General Leonard Wood Army Community Hospital, injects Pfc. Sara Reagers, C Company, 84th Chemical Battalion, with a radiopharmaceutical agent (Photo courtesy of John Brooks).
Image: Sgt. Christopher Funke, noncommissioned officer-in-charge of Nuclear Medicine at General Leonard Wood Army Community Hospital, injects Pfc. Sara Reagers, C Company, 84th Chemical Battalion, with a radiopharmaceutical agent (Photo courtesy of John Brooks).
Image: Three to four hours later after the substance has worked its way through the body, the single photon emission computed tomography (SPECT) system can detect the low-level radiation absorbed by stress-injured bone (Photo courtesy of John Brooks).
Image: Three to four hours later after the substance has worked its way through the body, the single photon emission computed tomography (SPECT) system can detect the low-level radiation absorbed by stress-injured bone (Photo courtesy of John Brooks).
Image: Evaluating the scan (Photo courtesy of John Brooks).
Image: Evaluating the scan (Photo courtesy of John Brooks).
A new imaging protocol developed by the US Army radiologists can now find stress fractures in soldiers much earlier than traditional X-rays.

Single photon emission computed tomography (SPECT) is typically used for nonmusculoskeletal imaging studies, such as cardiac, parathyroid, and adrenal gland imaging. But this ground breaking use of SPECT imaging, in conjunction with a low-dose computed tomography scan, allows General Leonard Wood Army Community Hospital (GLWACH; Lenard Wood, MO, USA) radiologists to optimally rank stress injuries for severity.

With this information, providers return about two thirds more Soldiers back to training after rehabilitation, long before injuries would normally progress to career-ending injuries and incurring large training losses. “SPECT-CT fusion forms a more anatomically-precise image to allow radiologists to pinpoint the exact location of a stress change,” explained Maj. Mustafa Ali-Khan, GLWACH radiology chief. “SPECT-CT is typically not employed in the manner it is here at Fort Leonard Wood. The use of SPECT fusion imaging, although not unique to Army medicine, is unique to its application in its dedicated capacity in musculoskeletal imaging at a Training and Doctrine Command facility, in the manner employed here at Fort Leonard Wood.”

This innovative imaging process was developed in 2010 by the GLWACH radiology department as the result of needs identified through the combined effort of GLWACH staff members in the Musculoskeletal Athletic Team, Orthopedics, Podiatry, and Combined Troop Medical Clinic. “After looking at our training population and our basic training missions, we realized that we could use this technology to our advantage,” Maj. Ali-Khan said.

The technology worked effectively and the numbers are incredible, according to Maj. Ali-Khan. GLWACH’s radiology department used their SPECT-CT fusion imaging technique about 300 times in 2011. “We expect to top 500 studies this year,” Maj. Ali-Khan said.

Typically, injured soldiers in training are given an X-ray and sent back to continue training if an injury is not visible. Missed stress injuries then progress and are discovered at a later date as a more serious insufficiency fracture, or stress fracture. “We have seen a dramatic increase in identification of early stress injuries here at GLWACH, which has led to better outcomes for our Soldier population and less patients who have progressed to more advanced stress injuries and [Medical Evaluation Board] cases,” Maj. Ali-Khan said. “Fewer patients end up with serious stress fractures due to the early intervention. SPECT-CT fusion imaging has worked well in the training environment to mitigate the overall number of bad outcomes with respect to evolving stress injuries. We have every reason to believe that other installations with SPECT equipment, as well as other branches of the military with high training populations subject to bone stress injuries could use our SPECT-CT fusion imaging protocol with a high success rate as well.”

Dr. Ali-Khan reported that the GLWACH medical department activity is fortunate to have this technology, which is typically only available at the Medical Center level at facilities such as Madigan Army Medical Center at Joint Base Lewis-McChord (WA, USA), Walter Reed National Military Medical Center (Bethesda, MD, USA), or Brooke Army Medical Center (San Antonio, TX, USA). “We all feel great to be a part of something so big at such a comparatively small facility,” he said.

It is hard to determine how many training losses will be prevented at GLWACH with SPECT-CT fusion imaging this year, according to Dr. Ali-Khan said. “But we can determine how many stress injuries the technology allows radiologists to catch, and then treat early,” he concluded.

Related Links:

General Leonard Wood Army Community Hospital



Channels

Radiography

view channel

Healthcare Costs Could Be Cut by More Appropriate Use of Cardiac Stress Imaging

In new research, investigators concluded that overuse of cardiac stress testing using advanced imaging technology has led to increasing healthcare costs in the United States and unnecessary radiation exposure to patients. Researchers from the New York University Langone Medical Center (NYU; New York, NY, USA), in... Read more

Ultrasound

view channel
Image: Leading German anesthetists Drs. Wolf Armbruster, Rüdiger Eichholz, and Thomas Notheisen have collaborated to develop the Armbruster Eichholz Notheisen (AEN) training concept for ultrasound-guided regional anesthesia (Photo courtesy of Management and Krankenhaus).

Point-of-Care Ultrasound Training Program Established for Regional Anesthesiologists

Regional anesthesia specialists have developed an innovative ultrasound training program. Leading German anesthetists Drs. Wolf Armbruster, Rüdiger Eichholz, and Thomas Notheisen have collaborated to... Read more

Nuclear medicine

view channel
Image: The ProBeam system treatment room (Photo courtesy of Varian Medical Systems).

Five Proton Therapy Treatment Rooms Plus System Upgrade Deployed at Scripps Proton Therapy Center

An upgrade of a proton system will improve workflow at a US proton therapy center, enabling the use of the fixed-beam treatment rooms as well as more diverse patient-positioning devices.... Read more

General/Advanced Imaging

view channel
Image: A collaborative effort between EPFL, CNRS, ENS Lyon, CPE Lyon, and ETH Zürich has led to the development of a novel approach that can considerably improve the capabilities of medical imaging with safer procedures for the patient (Photo courtesy of EPFL - Ecole Polytechnique Fédérale de Lausanne).

Collaboration to Make Diagnostic Medical Imaging Less Hazardous Using Hyperpolarization Agents

A collaborative effort by scientists has led to the development of an innovative strategy that can considerably improve the capabilities of medical imaging with safer procedures for the patient.... Read more

Imaging IT

view channel

Tabbed Barcodes and Management System Software Designed to Help Apron Tracking to Improve Radiology Inventory Management

A web-based inventory management system has been designed to link each radiology apron with a distinct barcode ID. As a cloud-based, decision support system, staff can track, audit, and maintain aprons using data sorted by department, area, and garment type. Healthcare personnel can see details on individual inspections... Read more

Industry News

view channel

Global Partnership Provides Treatment Planning Support for Modulated Arc Radiotherapy

Varian Medical Systems (Palo Alto, CA, USA) Eclipse treatment planning software can now be used to plan modulated arc radiotherapy (mARC) treatments at sites using Siemens Healthcare (Erlangen, Germany) medical linear accelerators. Varian Medical Systems and Siemens Healthcare presented their range of solutions that... Read more
 
Copyright © 2000-2014 Globetech Media. All rights reserved.