Body of Knowledge: New Machine Can See Bones, Organs in Stunning Detail
January 18, 2015 2:31 PM Subscribe
"Computed Tomography (CT) scanners ... use a narrow beam of X-rays processed by a computer to create slices of the body and assemble them into detailed 3D images." In 2013, GE introduced a line of fast CT scanners called Revolution CT. West Kendall Baptist Hospital in Florida recently concluded a six-month clinical trial using the new machines. Posted on a GE blog are incredibly detailed high-resolution images of blood vessels, soft tissue, organs, and bones obtained from the Revolution CT scanners.
One of the comments on the GE site says,
posted by XMLicious at 2:54 PM on January 18, 2015 [1 favorite]
There are already devices that can do this from other manufacturers, this is not that new.That would appear to refer to this entry (detail PDF.)
If it interests you, this particular one was approved by FDA last year, very quickly because as I mentioned, GE submitted it as substantially equivalent device as others already in the market.
Look it up, there is a summary of how it works in the FDA site, K133705.
posted by XMLicious at 2:54 PM on January 18, 2015 [1 favorite]
It may not be that new, but it's still pretty cool!
posted by jacquilynne at 2:58 PM on January 18, 2015 [1 favorite]
posted by jacquilynne at 2:58 PM on January 18, 2015 [1 favorite]
This is fascinating and now I want one! But I'd be interested in the radiation load. I had five chest CT scans this last year, most with contrast, and was sort of shocked that the radiation dose wasn't discussed with me beforehand as it is quite high--loads higher than just a chest x-ray (of which I had probably 20, also). So now I am very cautious.
posted by clone boulevard at 3:01 PM on January 18, 2015 [1 favorite]
posted by clone boulevard at 3:01 PM on January 18, 2015 [1 favorite]
I could watch those animations all day - amazing!
posted by 5_13_23_42_69_666 at 3:47 PM on January 18, 2015
posted by 5_13_23_42_69_666 at 3:47 PM on January 18, 2015
I was distracted by the animations too clone boulevard but on second glance a bit lower on the website they say, "Its combination of low-dose exposure, organ-wide coverage and motion correction technology allows doctors to reduce radiation and still obtain high-resolution images of blood vessels, soft tissue, organs and bones."
Up with this sort of thing.
posted by vapidave at 3:56 PM on January 18, 2015 [2 favorites]
Up with this sort of thing.
posted by vapidave at 3:56 PM on January 18, 2015 [2 favorites]
I work in a semi related thing to this, and though I don't really know anything about CT, I wanted to know what was going on without looking at GE's adverts (I sometimes look at CT images, and whilst these were good, they didn't strike me as amazing considering this is some flagship scanner system). I had a quick poke around, and found some more technical info here, it sounds like the big thing that's new about this is that it has 16cm detector plate, which means it can fit a lot more anatomy on a single slice. That means motion artefacts between slices aren't such a big deal, and it probably gives you more scope to apply clever motion correction algorithms to the data you get. It's also worth noting that all of the animated study sets on the GE website look smaller than 16cm, so they probably aren't playing completely fair, and are just taking a single slice.
The dose reduction claims that they make don't sound all that impressive, but they might be, I couldn't find any numbers on it, and I wouldn't know what's normal for a fancy new system. The website I linked to above talks about 'iterative reconstruction' algorithms, which I know about, so they can't be too state of the art, and whilst the dose monitoring software and kV / mAs optimisation is probably clever, it isn't a new thing. So yeah, it sounds like the bigger slices that it takes are cool, but as this is GE trying to push their product, I'd take the rest of it with a bit of a pinch of salt.
posted by Ned G at 4:41 PM on January 18, 2015 [6 favorites]
The dose reduction claims that they make don't sound all that impressive, but they might be, I couldn't find any numbers on it, and I wouldn't know what's normal for a fancy new system. The website I linked to above talks about 'iterative reconstruction' algorithms, which I know about, so they can't be too state of the art, and whilst the dose monitoring software and kV / mAs optimisation is probably clever, it isn't a new thing. So yeah, it sounds like the bigger slices that it takes are cool, but as this is GE trying to push their product, I'd take the rest of it with a bit of a pinch of salt.
posted by Ned G at 4:41 PM on January 18, 2015 [6 favorites]
I wonder if this level of imaging will allow us to develop robot surgeons? One obstacle has been the massive amount of learned anatomy knowledge that's necessary to perform many surgeries; if a robotic surgeon could "see" nerves and veins before making an incision I think it should be much easier to automate things.
posted by Joe in Australia at 5:48 PM on January 18, 2015 [1 favorite]
posted by Joe in Australia at 5:48 PM on January 18, 2015 [1 favorite]
But then you would be continuously x-raying the patient throughout the surgery, as clone boulevard points out.
Good news—we removed the tumor. Bad news—we created seven more tumors in the course of the surgery.
Though maybe it could take the CT once and thereafter guess where everything still is based on the visible surfaces?
Man, once we do have some kind of autodoc technology the consequences from situations where cost or circumstance will force you to rely on a buggy autodoc are unpleasant to think about.
posted by XMLicious at 6:10 PM on January 18, 2015
Good news—we removed the tumor. Bad news—we created seven more tumors in the course of the surgery.
Though maybe it could take the CT once and thereafter guess where everything still is based on the visible surfaces?
Man, once we do have some kind of autodoc technology the consequences from situations where cost or circumstance will force you to rely on a buggy autodoc are unpleasant to think about.
posted by XMLicious at 6:10 PM on January 18, 2015
Yes, you'd have to get the level of X-rays down. The processor, on the other hand, would be able to interpolate the expected position of things from earlier frames, so the scan wouldn't need to be continuous at all.
posted by Joe in Australia at 6:27 PM on January 18, 2015
posted by Joe in Australia at 6:27 PM on January 18, 2015
Alan Cormack won the Nobel Prize (along with Godfrey N. Hounsfield) in 1979 for his work on the math behind the CT scanner. He was teaching my freshman physics class at the time. We paid a lot more attention in class after that!
Non-ionizing imaging such as MRI and echo have largely replaced CT but it still is superior for certain things.
posted by cosmac at 6:33 PM on January 18, 2015 [2 favorites]
Non-ionizing imaging such as MRI and echo have largely replaced CT but it still is superior for certain things.
posted by cosmac at 6:33 PM on January 18, 2015 [2 favorites]
Stunning images.
second-to-last pic: is that screw supposed to be there or is this an injury? Ow.
posted by Klaxon Aoooogah at 7:33 PM on January 18, 2015
second-to-last pic: is that screw supposed to be there or is this an injury? Ow.
posted by Klaxon Aoooogah at 7:33 PM on January 18, 2015
I just hope we still manage to maintain the institutional knowledge of the core skillsets involved if medical practice becomes increasingly automated. Without any economic incentive for people to learn the skills, we won't maintain them, and we'll be less resiliant and poorer for it. We demand far too much economic efficiency these days to leave room for many people to learn and develop complex technical skills without being well-compensated for it, so if autodocs become too common, we could end up losing hard earned knowledge and skills over a longer term view. If the technical experts and engineers can't find enough SMEs to help them properly support, maintain, and enhance these kinds of systems in the future, they won't necessarily be able to satisfy our needs forever. But as tools for improving medical outcomes under the guidance and control of human doctors who understand the medical science, automated surgical systems have a lot of potential to help people. Can't wait for that FPP, but this really seems more like an incremental innovation being hyped as a revolutionary one to me. But I've been feeling a little cranky today so maybe it's just me.
posted by saulgoodman at 7:49 PM on January 18, 2015 [2 favorites]
posted by saulgoodman at 7:49 PM on January 18, 2015 [2 favorites]
Great, another giant tube to stick people in and irradiate them.
Hey GE, how about a low intensity scan with tuned LED's hitting an atomic 2 photon resonance and single photon re-emission, with separate frequency locked detectors and longer exposure times with, ya know, no serious radiation. You could even repurpose this CT software.
But of course, that couldn't be sold for jillions with those oh so lucrative support contracts. And no startup is going to look at the FDA approval process and say "Yes, we need to spend our money on that!" And even if one did, there's a J&J or Medtronic waiting to buy out their VC in a heartbeat... so they can sit on their ridiculous MRI investment for another decade.
/grumble
posted by underflow at 8:05 PM on January 18, 2015 [1 favorite]
Hey GE, how about a low intensity scan with tuned LED's hitting an atomic 2 photon resonance and single photon re-emission, with separate frequency locked detectors and longer exposure times with, ya know, no serious radiation. You could even repurpose this CT software.
But of course, that couldn't be sold for jillions with those oh so lucrative support contracts. And no startup is going to look at the FDA approval process and say "Yes, we need to spend our money on that!" And even if one did, there's a J&J or Medtronic waiting to buy out their VC in a heartbeat... so they can sit on their ridiculous MRI investment for another decade.
/grumble
posted by underflow at 8:05 PM on January 18, 2015 [1 favorite]
Non-ionizing imaging such as MRI and echo have largely replaced CT but it still is superior for certain things.
Volume-wise CT remains way ahead of MRI- it's faster, costs much less, and visualizes distinct things. After plain x-rays it's the most common imaging methodology. Echo is useful, but usually falls into a distinct task space.
Hey GE, how about a low intensity scan with tuned LED's hitting an atomic 2 photon resonance and single photon re-emission, with separate frequency locked detectors and longer exposure times with, ya know, no serious radiation. You could even repurpose this CT software.
Even with two-photon, tissue penetration would not be great, especially when you hit legit opaque features like bone. Diagnostically, I'm also not sure what useful info you'd get without a labeling process- you get various tissue resonances with 2p like the fat signal, but I'm not sure that they'd be valuable clinically.
posted by monocyte at 8:43 PM on January 18, 2015 [3 favorites]
Volume-wise CT remains way ahead of MRI- it's faster, costs much less, and visualizes distinct things. After plain x-rays it's the most common imaging methodology. Echo is useful, but usually falls into a distinct task space.
Hey GE, how about a low intensity scan with tuned LED's hitting an atomic 2 photon resonance and single photon re-emission, with separate frequency locked detectors and longer exposure times with, ya know, no serious radiation. You could even repurpose this CT software.
Even with two-photon, tissue penetration would not be great, especially when you hit legit opaque features like bone. Diagnostically, I'm also not sure what useful info you'd get without a labeling process- you get various tissue resonances with 2p like the fat signal, but I'm not sure that they'd be valuable clinically.
posted by monocyte at 8:43 PM on January 18, 2015 [3 favorites]
This is incredibly cool
posted by shesbenevolent at 9:20 PM on January 18, 2015 [1 favorite]
posted by shesbenevolent at 9:20 PM on January 18, 2015 [1 favorite]
I was in the ER last year after having passed a kidney stone and the doctor tried hard to sell me on CT scan of my kidneys "to find out if I had any more stones on the way"
Those stones will make their presence known if in fact they're present and isn't that a lot of ionizing radiation on my inner organs for non-critical info?" I asked.
She demurred. But it meant the CT scanner went idle isntead of billing my insurer a few thousand more.
What they often forget to mention and FYI: 1 CT scan=100+ chest XRays
posted by Fupped Duck at 11:08 PM on January 18, 2015 [1 favorite]
Those stones will make their presence known if in fact they're present and isn't that a lot of ionizing radiation on my inner organs for non-critical info?" I asked.
She demurred. But it meant the CT scanner went idle isntead of billing my insurer a few thousand more.
What they often forget to mention and FYI: 1 CT scan=100+ chest XRays
posted by Fupped Duck at 11:08 PM on January 18, 2015 [1 favorite]
monocyte: I'm a programmer these days, so my science needs to be taken with a big grain of salt...
The method would, sadly, rely on a magic photon arrangement to a potentially mythical concentration of a particular atom. So, the research question would be, is it possible to pick out, say, sodium from nerve junctions? Advances in detectors and low signal detection might make it a different problem today than it was 20 years ago.
Heck, you might as well try using second order reflections to capture internal surfaces and do a crazy deconvolution on the result... less worry about the frequency and random re-emission direction, but the absorption problem is the same.
Science is so much easier when you're not constrained by reality.
My small experience in medical devices has convinced me that, whatever replaces the MRI, it will be an even larger, more expensive tube to stick people in.
posted by underflow at 11:21 PM on January 18, 2015
The method would, sadly, rely on a magic photon arrangement to a potentially mythical concentration of a particular atom. So, the research question would be, is it possible to pick out, say, sodium from nerve junctions? Advances in detectors and low signal detection might make it a different problem today than it was 20 years ago.
Heck, you might as well try using second order reflections to capture internal surfaces and do a crazy deconvolution on the result... less worry about the frequency and random re-emission direction, but the absorption problem is the same.
Science is so much easier when you're not constrained by reality.
My small experience in medical devices has convinced me that, whatever replaces the MRI, it will be an even larger, more expensive tube to stick people in.
posted by underflow at 11:21 PM on January 18, 2015
Question for those in the know about this stuff: would this also be useful for scans of the GI tract? Could this sort of scan replace that awful thing called a colonoscopy? (at least for diagnostic non-intervention purposes?)
posted by bitteschoen at 4:17 AM on January 19, 2015
posted by bitteschoen at 4:17 AM on January 19, 2015
Obligatory "where will you be when the acid kicks in."
posted by digitalprimate at 5:51 AM on January 19, 2015
posted by digitalprimate at 5:51 AM on January 19, 2015
bittechoen: I don't think so. I'm not a radiologist, so I don't know, but the type of thing you're typically looking for with a colonoscopy (sources of bleeding as far as I know) wouldn't show up very well on a CT. Soft tissue stuff in general is best dealt with by another type of imaging, unless you can use a contrast medium. That does exist for GI tracts, in the form of barium meals / enemas (which I expect aren't particularly pleasant either), but I think they're used to diagnose slightly different stuff, and if I was doing one of those, I still wouldn't choose this system. Also, if you had a choice between a colonoscopy and a CT, and all other things are equal, you should go for the colonoscopy as there isn't a radiation dose.
posted by Ned G at 5:59 AM on January 19, 2015 [1 favorite]
posted by Ned G at 5:59 AM on January 19, 2015 [1 favorite]
You mean like this common procedure that's been around for years and years?
https://en.wikipedia.org/wiki/Virtual_colonoscopy
But, yeah, it's not as good a real colonoscopy.
posted by Hizonner at 6:14 AM on January 19, 2015 [1 favorite]
https://en.wikipedia.org/wiki/Virtual_colonoscopy
But, yeah, it's not as good a real colonoscopy.
posted by Hizonner at 6:14 AM on January 19, 2015 [1 favorite]
Ned G: thanks for the explanation, very clear.
Hizonner: I know, I'd already read about that, I know that no other diagnostic procedure so far can fully replace a traditional colonoscopy, but when I saw these "Super CT" images I wondered if perhaps, seen as they show other organs and veins so clearly, that could work for the GI tract too. Too bad.
posted by bitteschoen at 6:33 AM on January 19, 2015
Hizonner: I know, I'd already read about that, I know that no other diagnostic procedure so far can fully replace a traditional colonoscopy, but when I saw these "Super CT" images I wondered if perhaps, seen as they show other organs and veins so clearly, that could work for the GI tract too. Too bad.
posted by bitteschoen at 6:33 AM on January 19, 2015
I thought the choice of pictures was bizarre. Rather than showing healthy or altered tissue (stents, screws), they should have shown how it can be used for diagnosis. Show us exactly where that blood clot is that is causing the stroke. Quickly confirming a stroke is due to a blood clot can really save lives. Show us an otherwise hard to find tumor. Otherwise, you are just selling expensive pretty pictures.
posted by dances_with_sneetches at 6:47 AM on January 19, 2015
posted by dances_with_sneetches at 6:47 AM on January 19, 2015
And can I get one of these now so I can have a data reference for 3D printing replacement bones/organs later?
posted by plinth at 10:03 AM on January 20, 2015
posted by plinth at 10:03 AM on January 20, 2015
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