Inland Imaging LLC, of Spokane, says it has bought a $2 million dual-technology scanner that will enable doctors to diagnose cancers and plan radiation and surgical treatments more accurately.


The scanner will be installed in the Sacred Heart Imaging Center on the first floor of the Sacred Heart Doctors Building, at 105 W. Eighth, says Dr. Edward Holmes, director of Inland Imagings nuclear medicine department. Its expected to be available for patient exams next month.


Holmes says the scanner is the most expensive imaging system ever bought by Inland Imaging, the Inland Northwests largest provider of radiology services, and is one of the first of its type in Washington state. It combines the technologies of positron emission tomography (PET) and computed tomography (CT), making it possible to collect both metabolic and anatomic information in a single exam, and includes newly enhanced high-resolution capabilities.


That integrated imaging will permit more accurate detection and location pinpointing of a variety of cancers, such as breast, esophageal, head and neck, lung, cervical, colorectal, and ovarian, than other technologies, Inland Imaging claims. Holmes says he also expects the new scanner to be approved for diagnosing early-stage Alzheimers disease, which opens up a whole different area where its capabilities can be put to use.


I believe it will become the standard, replacing separate PET and CT scans as the preferred method for dealing with such imaging needs, he says.


One other benefit of the new scanner is that scan times will be reduced dramatically, to an average of around 20 minutes, compared with 40 minutes or more combined for separate PET and CT scans on older equipment, reducing patient inconvenience, Holmes says.


Because it uses two technologies simultaneously, it also can shrink the typical time lapsesometimes weeks, or longerthat occurs as separate scans are scheduled and performed and the images are evaluated, thus accelerating crucial decision-making related to patient care, he says.


From the patients perspective, a lot of time goes by between steps. This speeds them up tremendously, he adds.


Traditionally, the diagnosis and staging, or progression assessment and categorization, of cancerplus the planning of cancer treatmenthave relied on anatomic imaging with CT or magnetic resonance imaging (MRI) scans. Those scans have been limited, though, in their ability to help identify masses as malignant or benign.


More recently, much attention has been focused on the molecular-imaging capabilities of PET technology, which captures images of miniscule changes in metabolism in various areas of the body caused by the growth of abnormal cells.


Holmes says cancer cells normally consume glucose at a higher rate than normal cells, and patients who are to be scanned are given a special glucose that accumulates quickly in the diseased cells rather than metabolizing. Its a marker that goes into cancer cells and stays there, he says. Thus, it shows up clearly in PET scans.


CT scans, meanwhile, provide precise internal organ visualization, allowing physicians to pinpoint the exact location, size, and shape of the diseased tissue or tumor. So, in essence, when the two technologies are used together, cancers are detected with PET scans and then located precisely with CT scans.


Illustrating the benefit of melding the two technologies, Holmes notes that lymph nodes can be cancerous without being enlarged, in which case a CT scan alone might not detect any abnormality. Conversely, though, he says, a CT scan might detect an enlarged lymph node that a PET scan then reveals not to be cancerous.


Analyzing separate PET and CT scans of the same patients has been error prone and tedious, however, due partly to different patient positioning when scans are performed at different times or dates, Holmes says. Doctors essentially have had to eyeball the separate images and make educated guesses as to the exact location of tumors.


Cancer staging and treatment planning can vary dramatically, though, depending on precisely where the diseased tissue is located, such as in the lung or nearby bone, Holmes says.


The dual-technology scanner eliminates that problem by fusing the images, as well as providing separate PET and CT scan images, he says.


That is said to help reduce biopsy sampling errors and improve therapy planning and assessment of response to treatments such as chemotherapy or radiation therapy. Holmes says studies have shown that PET and CT scans, when performed together, increase the accuracy of both tests.


He says he and three other Inland Imaging radiologistsDrs. Gary Bell, Phillip Curtis, and David Thorneall have received training in PET/CT technology. Scheduling of the new scanner will be fairly complicated and critical, so Inland Imaging is hiring a person to handle that task, but it has no plans for now to hire more technical people to support operation of the scanner, he says.


An engineer and a physicist first came up with the idea of combining the PET and CT technologies in one machine in 1992.


Later aided by a National Cancer Institute grant, they developed a prototype machine that was installed at the University of Pittsburgh medical center six years later.


The pair designed the scanner to be more patient friendly by giving it a 28-inch diameter imaging tunnel, far more spacious than the typical MRI tunnels, which trigger claustrophobic reactions among some patients.


Time Magazine honored the PET/CT scanner as the medical science invention of the year in 2000, noting that it had provided medicine with a powerful new diagnostic tool.


CTI Molecular Imaging Inc., of Knoxville, Tenn., which manufactured the scanner that Inland Imaging is installing, says PET/CT scanners now represent a large majority of its overall scanner sales.


Inland Imagings PET/CT scanner isnt the first combination imaging device to be installed here.


Sacred Heart Medical Center last year installed a new $500,000 unit that combines a nuclear gamma camera with a CT scanner. A gamma camera provides information about the bodys organs by tracking the movement and concentration of radioactive tracers injected into the body.


Like the PET/CT scanner, the gamma/CT imager is said not only to improve the diagnosis of certain health problems but also to help show whether cancer treatments are having any effect on tumors.


Inland Imaging employs about 320 people, and operates five outpatient imaging centers in the Spokane area and also one in Moses Lake, the latter through a joint venture.


It also provides services across the Inland Northwest through affiliations with more than a dozen hospitals. It now is performing and interpreting more than 500,000 patient studies a year, gathering internal body images using technologies such as PET, CT, MRI, ultrasound, nuclear medicine, and general X-ray and fluoroscopy.