Inland Imaging LLC, of Spokane, which bought a 64-slice computed-tomography (CT) scanner about a year ago, has begun to operate its coronary CT angiogram program at full capacity with the $1 million machine, located at Holy Family Hospital.

Ishwar Bhat, a body imaging-specialized radiologist at Inland Imaging, says, "This non-invasive procedure allows the doctors to visualize the internal characters of these arteries, such as non-calcified plaque formation, which will eventually block the arteries and could lead to angina or heart attacks."

Bhat is the radiologist who leads the program.

"This is the gold standard for imaging the heart," Bhat says. Still, he adds, "It is very underutilized. It will take time before it is used more."

Coronary CT angiogram is a non-invasive procedure to examine the walls of the coronary arteries and to help doctors evaluate the presence of hard and soft plaque, and the information gathered during the procedure can help doctors determine a patient's risk of a heart attack and develop a treatment plan.

Doctors may decide to recommend a coronary CT angiogram if a patient has experienced chest pain, or if the patient has a high-risk profile with no typical coronary symptoms, Inland Imaging says.

Physician education and awareness about the technology should lead to increased future use, Bhat says.

When Inland Imaging installed the 64-slice scanner last fall, it began to implement and train for the coronary CT angiogram program, says Inland Imaging spokesman Jason Miller.

"Though it has taken nearly a year to nail down all the (program) logistics, we as an organization plan to educate referrers and patients about the availability of the test and advantages over other heart studies," says Miller. Though Inland Imaging has been doing coronary CT angiograms for some time using the machine, he says, "We now have complete confidence in the program, and we're going full capacity."

The scanner, called the Toshiba Aquilion 64, is the only device that can be used for coronary CT angiography because of its high resolution and speed, though it also can be used for various other types of scans, Miller says. The machine provides caregivers and radiologists with clear, 3-D medical images that enhance diagnostic results, he says.

Bhat says, "It is an important tool (used) to evaluate the coronary arteries, the vessels which wrap around the heart to supply blood to the heart muscles."

With the scanner, doctors now are able to visualize blood flow in the coronary arteries with greater detail than more traditional studies such as nuclear or conventional angiography, Bhat says.

The speed at which the 64-slice CT scanner can process information is fast enough that it can synchronize with a patient's heart rhythm and capture images between beats, he says.

Patients hold their breath for a few seconds as they pass through the machine, while 64 cross-sectional images, referred to as slices, are taken every 400 milliseconds, Inland Imaging says. A computer processes them and generates thousands of slices that it transforms into 3-D images. Doctors can navigate a designated organ at any angle and isolate on an area of concern by zooming in on that spot, it says.

Bhat says the Aquilion 64 enables physicians to detect disease earlier, minimizing for patients the likelihood of invasive treatments and unnecessary tests.

Sacred Heart Medical Center, in Spokane, and Kootenai Medical Center, in Coeur d' Alene, also have 64-slice CT scanners, he says.