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Sensible Solutions for Refurbished Radiology

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CT Scanner Artifacts- How Do I Correct Streaks?

However, a number of image anomalies like streak artifacts can commonly occur.

What Is A Streak Artifact?

The name says it all: there’s a dark streak in the CT image and it usually appears between metal, bone, iodinated contrast, barium and other high-attenuation materials. But what causes it? It usually happens when the beam hardens and scatters. You’ll see bright streaks adjacent to dark ones.

Beam hardening is an interesting occurrence. Think of yourself as an X-ray beam and you are running a race in the part of the body that is being scanned. You are running against a strong head wind and you lose energy and slow down the longer the wind is in your face.  You expend more energy to maintain your pace as you run into the wind. Likewise, X-rays can lose their energy or “harden” more quickly when they pass through metal or bone rather than going through muscles or organs.

Compton Scatter can also cause streak artifacts. Scatter causes X-ray photons to change energy and direction. As they move, they can end up in a different detector than they are supposed to be. If scattered photons end up in a detector that would usually have very few photons, it can be an issue. For example, should a metal implant block all of the photons, the corresponding detector element could only detect the scattered photos.

By using newer reconstruction techniques or metal artifact reduction software, you can reduce streak artifacts. By scanning at a higher kV, a radiologist could also get a harder X-ray beam and fewer beam hardening artifacts. However, since the higher kV will reduce the tissue contract of the scan, it’s a tradeoff.

So what do you do if your reduction software and reconstruction techniques are current and the radiologist is scanning with the highest kV they feel comfortable with and you’re still experiencing streak artifacts? In all likelihood, you’ll need to get a service engineer to diagnose the underlying issues.

Talk to An Expert

Are you looking for a new CT Scanner? Having issues with your current one? The experts at Atlantis Worldwide are happy to help. We’ve been helping hospitals, clinics, practices and urgent care facilities with their medical imaging needs and issues for more than 27 years.  Contact Us Today!

However, a number of image anomalies like streak artifacts can commonly occur.

What Is A Streak Artifact?

The name says it all: there’s a dark streak in the CT image and it usually appears between metal, bone, iodinated contrast, barium and other high-attenuation materials. But what causes it? It usually happens when the beam hardens and scatters. You’ll see bright streaks adjacent to dark ones.

Beam hardening is an interesting occurrence. Think of yourself as an X-ray beam and you are running a race in the part of the body that is being scanned. You are running against a strong head wind and you lose energy and slow down the longer the wind is in your face.  You expend more energy to maintain your pace as you run into the wind. Likewise, X-rays can lose their energy or “harden” more quickly when they pass through metal or bone rather than going through muscles or organs.

Compton Scatter can also cause streak artifacts. Scatter causes X-ray photons to change energy and direction. As they move, they can end up in a different detector than they are supposed to be. If scattered photons end up in a detector that would usually have very few photons, it can be an issue. For example, should a metal implant block all of the photons, the corresponding detector element could only detect the scattered photos.

By using newer reconstruction techniques or metal artifact reduction software, you can reduce streak artifacts. By scanning at a higher kV, a radiologist could also get a harder X-ray beam and fewer beam hardening artifacts. However, since the higher kV will reduce the tissue contract of the scan, it’s a tradeoff.

So what do you do if your reduction software and reconstruction techniques are current and the radiologist is scanning with the highest kV they feel comfortable with and you’re still experiencing streak artifacts? In all likelihood, you’ll need to get a service engineer to diagnose the underlying issues.

Talk to An Expert

Are you looking for a new CT Scanner? Having issues with your current one? The experts at Atlantis Worldwide are happy to help. We’ve been helping hospitals, clinics, practices and urgent care facilities with their medical imaging needs and issues for more than 27 years.  Contact Us Today!

[atlantis-blog]

The Low Down on GE MRI 1.5T Systems

MRI

It’s no secret that you can often get the medical imaging performance you want without buying “new.” Andthe benefits are many: you still get a great service warranty, you don’t have to break the bank and your patients get the right medical imaging. Win, win, win!

There are so many great imaging devices available on the used and refurbished market—especially from GE. Here’s a breakdown of the choices that are currently available on the used/refurbished market that can deliver performance, peace of mind and savings. We’re going to look at them from new to old.

GE 1.5T Artist

Launched in 2016, patient comfort was key, thanks to a 70cm bore magnet. With up to 128 RF channels, The Artist introduced Direct Digital Interface, a direct analog to digital conversion that uses fiberoptic cables to transfer information quickly from the coils to the electronics cabinets. It provides noise reduction and enhances SNR by up to 27%. With this new technology, operators have the option of either enhanced SNR or increased speed.

GE 1.5T Voyager

The Voyager was introduced with the Artist in 2016. And while it doesn’t offer the same RF oompf, it’s ideal for practices, clinics and hospitals that require lower power consumption. It has a 70cm bore and DDI technology. If you can’t afford an Artist, the Voyager is a great alternative.

GE 1.5T Explorer

This beauty dates back to 2015. Powered by a 60 cm bore, it has the same CXK4 magnet that’s been used for 20+ years, with impressive stability and performance. It uses quiet technology, which is appreciated by patients and staff alike. It uses Optix technology which improves SNR. And since it uses the CXK4 magnet, it can be upgraded to an Explorer will little downtime and substantially less cost.

GE 1.5 T Creator

Introduced in 2015 with the GE 1.5T Explorer, The Creator is an 8 channel, lower cost version offering the same CXK4 magnet and OpTix RF technology. It also has 33 mT/m Amplitude and 120 Slew rate that’s offered by the Explorer and the LX and EXCITE line.

GE 1.5T Optima MR 360 Advance

Debuting in 2013, this 16-channel workhorse was engineered to address the demand for increased performance, a comfortable experience for the patient and reduced total cost of ownership. “Express coils” improve workflow by reducing the need to reposition coils between scans.

GE 1.5T Optima 450W MRI

This model isn’t as easy to find on the secondary market because it was launched in 2010. With a redesigned magnet and wide bore offering (70cm) that accommodates larger patients or those with claustrophobia, it’s perfect for cardiology and neurovascular studies. It features a zero boil-off magnet and OpTix, the optical RF system that delivers crisp, clear images. It also has the GEM Suite. It allows coils to be used together or individually to provide head-to-toe coverage without excessive patient movement. Yes, it’s expensive, but if it’s ideal for your hospital, practice or clinic, it might be worth the price.

GE 1.5T Optima MRI

This system has a 60cm bore, comes with 23.0x software and had a traditional CXK4 magnet of the LX and EXCITE series.

GE 1.5T HDXT MRI

This is a higher end MR that comes with a CXK4 magnet and either 15x or 16x software. It’s fairly easy to find on the secondary market and more affordable than the newer GE 1.5T Optima 450.  Many of these systems actually started out as GE 1.5 HDX systems and were upgraded. So, if you buy a five-year-old HDXT, the magnet may be a few years older than that.

GE 1.5T HDX MRI

This 16-channel system comes standard with 14x software and uses the CXK4 magnet. However, you can upgrade the electronics and the software to make it an HDXT. Pretty sweet, but the price point won’t be much lower than the newer GE 1.5T HDXT.

GE 1.5T HDe MRI

This is GE’s most compact system, but it’s rare to find it in the U.S. It has a 30% smaller footprint and is an economical choice, but there’s a trade-off. You get reduced channel capability and a lower slew rate.

GE 1.5T HD MRI

This was the first MRI to offer true HD imaging for GE. It also included a lot of software upgrades as well as the new HFD gradient cabinet. It delivers expandability at a lower price point. Plus, you can upgrade an HD to an HDXT or even the 23x “Optima Edition software and gradients.

GE 1.5T Excite II MRI

The Excite II can support 8-channel imaging, thanks to its newer Linux-based OS. If you don’t need a newer system, this can do the job for much lower upfront costs.

GE 1.5T LX MRI

The GE 1.5T LX uses 9x software and an older Octane computer system. It only supporta up to 4 channels and is equipped with HiSpeed or Echospeed gradients. However, it’s still on the secondary market. You’ll need to pay attention to which gradient cabinet has been installed, since it can house the newer ACGD or the older SGD.

GE 1.5T Horizon MRI

The Horizon is not just old, it’s ancient. No one is in the market for one of these anymore, but if you happen to have one, the secondary market is interested in your parts.

Talk To An Expert

If you’ve narrowed down your options or need guidance in determining what’s right for you, no worries! Talk to an expert at Atlantis Worldwide. We’re happy to help you evaluate your needs, market and options so you can make a decision with confidence.  Contact Us Today!

Follow Atlantis Worldwide on Twitter: @AtlantisLLC

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What to Consider Before Disposing Your Medical Imaging Equipment

So you’re ready to get rid of medical imaging equipment and make room for your new technology. Great! So, what do you do with that old equipment? Do you transition it to a different facility within your network? Do you sell it to an entity outside of your organization? Can you donate it? Is it so old that it needs to be scrapped? And what about all of that patient information? How do you protect non-public protected health information? How do you adhere to HIPPA regulations when you get rid of a piece of equipment? There are so many considerations to evaluate.

Before COVID-19, getting rid of outdated equipment was already complicated. Now it’s even more so. So what’s the best way to dispose of used medical equipment? How can you turn this equipment into a revenue stream during a time when it’s already financially challenging? How can you find the best revenue opportunity?

Oftentimes organizations don’t address this situation until it’s time to get rid of the equipment. The reality is, you should begin planning for this on the day you actually purchase the equipment. It’s the best way to protect your investment. However, if you didn’t plan for it in the past, it’s not too late to get it done. However, it will take an organized effort to achieve this. Ideally, you will assign a team leader who will be in charge of the process. This kind of leadership and accountability is essential for success.

There are four distinct ways to dispose of used medical imaging equipment: redeploy, donate, sell or scrap. And the first question to answer is: when will the piece of medical imaging equipment be disposed? Once you determine the “When”, then you can address the “How” and “Where".

Here is a list of questions that can help you determine the best course of action regarding medical imaging equipment you no longer need or use:

Is the device still functional? If not, can it be repaired?

How old is the item?

Is it still supported by the OEM?

Can it be used by another department or facility within the organization?

Is the system being used or not?

How much would it cost to ship the item?

If it’s defective, can the parts be stripped and used to refurbish equipment?

Do you have the complete records for servicing the medical imaging equipment?

If it no longer has value, where can it go to be recycled, scrapped or turned into e-waste?

Once these questions are answered, you’ll be able to move forward with disposing of your equipment.

There is real demand for used and refurbished medical imaging equipment. It can provide the performance healthcare organizations need at a price that helps their bottom line. In addition, used and refurbished medical imaging equipment comes with impressive service warranties. If you’re in the market for used or refurbished equipment, or need advice about finding a new home for your current medical imaging systems, talk to the experts at Atlantis Worldwide. The company has been helping healthcare organizations with refurbished and used medical imaging equipment for more than 27 years.

Contact Us Today!

[atlantis-blog]

PET/MRI Improves Lesion Detection

A study by a German research team has determined that PET/MRI exams improved lesion detection by more than 15% when compared with PET/CT in selected cancers. The study at the University of Duisburg-Essen in Essen, Germany consisted of more than 1,000 exams. The selected cancers were malignant bone disease and lung cancer. The study also showed that PET/MRI reduced ionizing radiation by almost 80% when compared with PET/CT. In 15.4% of all exams, additional lesions were identified on PET/MRI that weren’t detected on PET/CT, according to the article appearing in the August 2020 edition of the Journal of Nuclear Medicine.

The lead co-authors of the study, Dr. Ole Martin from the department of diagnostic and interventional radiology at University Dusseldorf, Medical Faculty and Dr. Benedikt Schaarschmidt from the University of Duisburg-Essen’s department of diagnostic and interventional radiology and neuroradiology, said, “PET/MRI improves lesion detection for selected cancers and potentially reduces the need for additional examinations in comparison with PET/CT."

For lung cancer and lymphoma, PET/CT had become the go-to method to improve cancer staging accuracy, optimize therapy strategies and improve patient outcome. But the modality has low soft-tissue contrast and emits radiation, unlike PET/MRI.

Several other studies have also shown PET/MRI’s effectiveness in imaging cancers, especially in prostate and the breast. However, the lack of high-quality data regarding other cancers has hindered PET/MRI’s widespread introduction into clinical practice, according to the study’s co-authors. They wanted to remedy this situation by comparing PET/MRI with PET/CT in different oncologic diseases at the German institution.

The patients at their institution underwent a whole-body PET/CT scan from skull to mid-thighs, as well as a whole-body PET/MRI. The patients presented with the following cancers:

Lung cancer (17.9%)

Gastrointestinal cancer or neuroendocrine tumors (17.2%)

Gynecologic or breast cancer (14.8%)

Prostate cancer (14.8%)

Lymphoma (12.0%)

Melanoma (8.7%)

Head and neck cancer (8.0%)

Cancer of unknown primary (4.3%)

Malignant bone disease (2.4%)

Following some exclusions, 1,003 PET/MRI scans of 918 patients were examined, with PET/MRI outperforming PET/CT in terms of providing more tumor information—26.3% more, in fact. These were detected in patients with malignant bone cancer, lung cancer, prostate cancer and gynecologic or breast cancer. PET/MRI identified additional malignant findings in 5.3% of cases, which lead to a change in tumor, node, and metastases (TNM) staging in 2.9% of cases. PET/MRI also clearly classified indeterminate PET/CT lesions in 115 of cases.

2.9% of lesions were detected on PET/CT versus PET/MRI, with 1.2% of those being malignant and resulted in a change in TNM staging in 0.5%.

The authors said that PET’MRI missed a negligibly small amount (.8%) of lung metastases, which contradicted previous beliefs that the chest required additional CT. New MRI sequences like ultrashort echo-time sequences are expected to improve lung nodule detection, which would also enhance the sensitivity of PET/MRI even more.

The estimated mean effective radiation dose between PET/CT and PET/MRI was an important difference: 17.6 ± 8.7 mSv for PET/CT and 3.6 ± 1.4 mSv for PET/MRI. That represents a reduction of 79.6%. This is significant for younger patients when considering the cumulative radiation dose required for staging, therapy monitoring and aftercare using CT.

The researchers said, “"Future studies addressing the technical and operational challenges of PET/MRI, as well as involving different vendors and even larger cohorts, will hopefully further pave the way toward a widespread introduction of PET/MRI into clinical patient care.”

Talk To An Expert

If you’re in the need for medical imaging equipment for your practice, hospital, urgent care facility or veterinary practice, be sure to talk to Atlantis Worldwide. Oftentimes a refurbished or used system can deliver the performance you need at a cost that is kinder to your bottom line. We’ve been helping companies with their medical imaging needs for more than 27 years, with thousands of happy customers.  Contact Us Today!

[atlantis-blog]

Comparing Digital Cath Labs-Peripheral & Cardiac

During the past decade, Digital Cath Lab Imaging has improved, offering better image quality and lower radiation exposure. These interventional Cath Labs are instrumental in diagnosing and treating many diseases. If you’re looking for the right fit for a Cath Lab for your facility, you have a lot of choices. However, because cardiac studies and peripheral studies are different in scope, it’s important to know that one size does not fit all. Some models are only good for cardiac studies, others only good for peripherals, and there are a very few that are flexible enough to handle a little bit of both. Let’s take a closer look at the field of view (FoV) of systems that are appropriate for cardiac and peripheral specialties.

Ideal For Peripheral Studies

Looking for the right Cath Lab for run offs, ablation techniques and tumor/vein embolization? You’ll need a larger FoV since these cases cover wider anatomical areas. The experts at Atlantis have three recommendations: The Philips Allura Xper FD20, the GE Innova 4100 and the Siemens Axiom Artis dFA/dTA.

The Perfect Choices For Cardiac Procedures

Cardiac procedures require a more concentrated area of focus for delicate work like directing catheters into the heart. A 20-27 cm FoV would be a perfect option  The experts at Atlantis Worldwide recommend the Siemens Axiom Artis dFC/ dTC, Philips FD10 and GE Innova 2100.

Your Best Options For a “Swing Lab”

A Digital Cath Lab that has a software and hardware configuration makes it flexible enough to accommodate a variety of studies in both cardiac studies, vascular and neurological applications is known as a “swing lab.” If your lab requires this level of flexibility, there are several choices to fit your needs: The GE Innova 3100, the Philips FD20 and the Siemens Axion Artis dFA/ dTA. Some of these also appear on the peripheral systems list because they have a 30 x 40cm detector that can be rotated to better match the FoV of the intended procedure.

New or Used?

If you’re looking for equipment for your Digital Cath Lab, you might want to consider looking at refurbished or used systems. Oftentimes a refurbished or used system can provide you with the performance you need, the warranties you want and a price that is kinder to your budget. To find out more, talk to Atlantis Worldwide to see what your best option might be. Atlantis Worldwide has been helping healthcare facilities with their medical imaging needs for more than 27 years.  Contact Us Today!

Some blogs you may have missed:

Top 10 Tips for the Operating Theater Radiographer

Single-Plane Or Bi-Plane Cath Labs: Which Is Right For You?

C-Arms & Vascular Health

Comparing The GE Innova Digital Cath Lab Family: 2100, 3100 & 4100

Top 7 C-Arms for Your Orthopedic Practice

[atlantis-blog]

Siemens Acquisition Creates Most Comprehensive Cancer Care Portfolio

Varian Medical Systems has been purchased by Siemens Healthineers, making Siemens a multidisciplinary company with the most comprehensive cancer care portfolio in the industry. The deal is valued at $16.4 billion or 18.8 billion euros. It’s considered the largest healthcare acquisition of the year.

Siemens has been ranked as the third largest medical imaging vendors worldwide but its activities in the treatment space has been limited.

Varian has dominated the radiation therapy segment with annual revenues in 2019 of $3.23 billion. It has a net income of $310.5 million. However, Varian did report third-quarter financial results with a decline in revenue of 16%, due to the COVID-19 pandemic.

Siemens returns to the radiation therapy delivery systems market with this acquisition. At one time, Siemens manufactured its own linear accelerators but left that business in 2011. That decision was due to the challenges involved with competing with Varian and other dedicated radiation therapy vendors. Siemens did stay involved with radiation oncology with a 2012 partnership with Varian, working together to provide advanced therapeutic and diagnostic devices and services for treating cancer.

The deal is expected to create a ripple effect across the global medical imaging space as competitors feel the need to pursue similar acquisitions or partnerships. This could put added pressure on multimodality OEMs to find a partner so as to not be shut out in the relatively small radiation oncology information segment.

Siemens announced that Varian would operate as an independent company once the acquisition is finalized because of its strong brand recognition.

At Atlantis Worldwide, we’re always interested in shifts in the medical imaging marketplace and the potential effects they will have. Having provided healthcare providers with used and refurbished medical imaging equipment for more than 27 years, we’re aware of how these changes can affect our customers. You can trust our experts to provide you with insights and information to help guide you to the right purchasing strategies for your clinic, hospital, practice, veterinary clinic or urgent care facility.

[atlantis-blog]

Cost of Delayed Elective Surgery During COVID-19

According to a study recently published in British Journal of Surgery, there was quite a cost when more than 28 million “time sensitive” elective surgeries were postponed globally during the peak 12 weeks of COVID-19. These delays caused worsened quality of life, deteriorations in health, increased disability and decreased work capacity for patients.

This translates to approximately 2 million postponed surgeries per week, with 300,000 procedures per week being in the United States. And while it’s true the delays were designed to decrease the chance of viral transmission and associated postoperative pulmonary complications, the study shows that the delayed procedures had a substantial impact on healthcare systems around the world as well as patients’ health. Excessive delays were shown to cause unnecessary deaths as well.

Because of the backlog of patients waiting for procedures when the elective surgeries resumed, it could take months for these procedures to take place. According to the study, even if countries could increase surgical volume by 20%, it would take an average of 45 weeks to clear the backlog caused by the COVID-19 pandemic. As such, there might be a need to prioritize patients by clinical urgency, which could result in even longer delays for patients with a less urgent medical condition.

These surgical delays also took a toll on patients’ mental health, with physicians finding a drastic increase in patient anxiety over the delayed procedures. This anxiety also resulted in patients believing they had more symptoms, which made is harder for physicians to tell which symptoms were real and which weren’t. Physicians also noted an increase in opioid use by patients, which could result in greater pain and a longer recovery time post-surgery. Other consequences of delaying procedures including an increase in emergency cases and unnecessary complications.

In a different article in The New England Journal of Medicine, healthcare delivery changed over the past few months. When patients were scheduled for surgery during COVID-19, many patients were reluctant to go through surgery. Also, it could be difficult to distinguish urgent from nonurgent surgeries, and when some surgeries were cancelled, it could result in more complex situations, especially for surgeries like hernia repair and knee replacements. The article supported using a case-by-case approach for each patient, rather than a broad moratorium on all elective procedures.

The medical community will continue to evaluate and learn from decisions made to cope with the COVID-19 pandemic.

At Atlantis Worldwide, we know that many healthcare facilities are reevaluating their procedures, equipment and staffing post COVID-19. If your practice, clinic, hospital or veterinary clinic is in need of medical imaging equipment, remember that a refurbished or used system can often deliver the performance you need with a much lower price tag—all while delivering exceptional warranties. Talk to an expert at Atlantis Worldwide to find out more.

Contact Us Today!

[atlantis-blog]

Uninterruptible Power Supply Essential For Medical Imaging

We’ve all had it happen to us. You’re working on a big presentation and suddenly the power goes out.  Poof! You’ve lost your unsaved document. While that situation is upsetting and disruptive, it’s even more serious if there’s a power outage while your radiology team is creating medical imaging with CT Scanner, MRIs , C-Arms and more. That’s why it’s wise (and essential) to have the proper UPS in place to protect you during power losses and surges.

When you hook up your medical imaging equipment to a UPS (Uninterruptible Power Supply) and a power surge or outage occurs, it will seamlessly kick in to keep your equipment from shutting down for a while. This gives you time to save what you were working on and then safety turn the system off.

As you know, if medical imaging equipment isn’t shut down properly, it can cause some serious issues. You could lose patient data, which is inconvenient for your patient and results in lost revenue for your practice. It also costs you and your patients time. After all, if you lose a patient’s data during an outage, they will need to reschedule an appointment, travel and wait. You will need to make time in your busy schedule to fit the patient in again. It’s a frustrating and time consuming situation for all involved.

Weather can be an even bigger problem. If you live in an area with tornadoes, hurricanes or big storms and wind, you definitely want your medical imaging equipment and data to be protected. By having a UPS, you won’t have to worry about whether your medical imaging equipment and data is protected. Basic surge and power loss protection can be provided with offline or standby UPS.

It’s also wise to provide a reliable source of “clean power” or power that is free of sudden dips or spikes in the overall sine wave. This is especially true if you live in an area where brownouts occur or in densely populated areas where the volume of electrical equipment used generates “noise” in the electrical current. If your equipment receives “dirty power,” it can cause the components to degrade at an accelerated rate, burn out completely or reduce the image quality output. These clean power capabilities are usually found in online UPS units. While an online UPS solution can cost more than a standby UPS, the protection can be worth it.

A back-up generator option is ideal if you need your systems to be protected longer than what a standard UPS can provide. It can provide the protection and peace of mind you need.

Which UPS Solution is Right For You?

The best way to determine which UPS solution is best, contact an expert like those at Atlantis Worldwide.  Refurbished or used medical imaging equipment might be ideal for you and cost you less than a brand new system. Regardless, it just makes fiscal sense to explore your imaging options.

Contact Us Today!

[atlantis-blog]

MRI Infection Control in the Time of COVID-19

Up until now, there haven’t been universal standards for cleaning procedures for MRIs. Usually, these cleaning standards vary from hospital to hospital. There simply aren’t clear recommendations for radiology departments. But with the COVID-19 pandemic, the world may become a cleaner, safer place.

The big questions about MRI are these: how should you handle the issue of airflow? How can you clean inside the bore? Should there be different cleaning protocols for confirmed infected patients versus non-infected? Or, should you assume that everyone is a potential infection risk?

Three MRI specialists recently weighed in on how they handle infection control in their hospitals.

Prof. Dr. Thomas J. Vogl, PhD, head of Department of Diagnostic and Interventional Radiology, Frankfurt University Hospital, Germany:

Dr. Vogl said that his department has conducted more than 100 CT scans, but only a few MRI exams on suspected/known COVID-19 patients. Their strict disinfection protocol for cleaning the MRI unit and the entire room is this: Everything is emptied, the airflow is stopped and then the inner bore of the scanner is cleaned with a special liquid disinfectant. The disinfection is done by special cleaners wearing full PPE. Three hours are scheduled between each patient.

Prof. Dr. Alexander Radbruch, chair of diagnostic and interventional neuroradiology, Rheinische Friedrich Wilhelms University Bonn, Germany:

There are standard operating procedures after each patient with suspected COVID-19, including thorough disinfection of all surfaces and the bore of the MRI. Once the cleaning is complete, the next patient can’t enter for an additional hour. They don’t stop the airflow in the MRI, assuming that a consistent airflow might help change the potentially contaminated air in the scanner.

There is a standard wipe disinfection within the bore, but they don’t believe additional spray disinfection or room nebulization are necessary. The standard operating procedures are identical for all contagious patients within the MRI Suite. He did say that the number of patients with COVID-19 is relatively low. That said, they are prepared.

Felicity Lacchin, MRI Superintendent Radiographer, University College London Hospital:

We don’t stop the airflow when we clean the MRI Scanner. The process takes about 20 minutes and the timing depends on the ventilation. Our radiographers reach into the bore to clean the machine. We are looking into suitable alternatives. As of now, now additional sprays are used.

For suspected or confirmed COVID-19 cases, all equipment that can’t be covered or removed from the environment is cleaned after a patient’s examination. For non-COVID-19 cases, only the scanner/coils are cleaned, as well as additional areas like cannulation chairs/lockers.

At the height of the pandemic, we treated all emergency room patients as suspected cases and the number was very high.

As a rule, we recommend:

Designating a scanner for all suspected/positive patients

Ensuring staff are kept informed of personal protective equipment (PPE) and cleaning guidelines

Establishing an inpatient and outpatient pathway for suspected/positive patients

Establishing a pathway to identify patients that may have been a clinical risk if they were not scanned during the height of the pandemic, i.e. two-week wait, cancer follow-ups.

Establishing a pathway for COVID-19 shielded patients (i.e., patients who are clinically extremely vulnerable)

Reviewing pathways regularly— there were numerous changes weekly when the pandemic was at its height

Reviewing protocols with radiologists. For example, University College London Hospital now includes arterial spin labelling (ASL) for all patients with suspected or confirmed COVID-19 because evidence suggests there is a vascular component to the disease.

The American College of Radiology Recommends:

60 minutes of downtime between patients after all surfaces have been thoroughly cleaned

Don’t bring powered air-purifying ventilators into Zone IV as there are potential adverse interaction risks with the MRI’s ferromagnetic components. If magnetic components are present, providers should remove them and temporarily replace the magnets with tape.

If inpatients have metal strips in their masks, fit them with MRI-safe alternatives before they enter the radiology department. If that’s not possible, remove the magnetic strip before bringing them into the medical imaging suite.

If you are in need of medical imaging equipment during this challenging time, talk to the experts at Atlantis Worldwide. A refurbished or used MRI or CT Scanner might deliver the performance you need at a price you can afford. Stay safe!

Contact Us Today!

[atlantis-blog]

Should You Buy New Or Used X-Ray and CT Tubes?

One of the biggest expenses for medical imaging equipment is the cost of X-ray tubes and CT tubes. As medical facilities continue to tighten budgets, administrators and purchasing agents are constantly on the lookout for ways to save money. How do you know if buying a used CT tube is the way to go? How can you be sure that buying used is the best way to save money?

The Beauty of Buying New Tubes

Besides the exorbitant cost, new X-ray or CT tubes provide a lot of peace of mind. A new tube will always come with a better warranty than a used one. As a rule, these warranties cover an extended use period and also offer a “full replacement” clause. Most warranties for new tubes last for 12 months. Some are full replacement and others are prorated. Be sure to read the fine print before you buy. Warranties tend to differ between liquid bearing tubes and conventional ball bearing tubes. Liquid bearing tubes usually have longer warranty over all.

New tubes are considered to be more reliable, of course. But a warranty is only as good as the company standing behind it. It’s important to choose a reputable seller because even brand new tubes can fail.

A word of warning: not all OEM parts are new. Sometimes OEMs bring in exchange parts, repair them and offer them alongside their new parts. You’ll want to ask your supplier about the age of the tube, as well as manufacturer, usage count and service life so you know what you’re really getting.

You can choose to buy non-OEM parts, but again, you need to get them from a trusted vendor. If a contract seller is buying parts from unregulated, uncertified suppliers, what you save in purchasing the tubes could be overshadowed by what you’ll spend with downtime, labor rework and other potential issues that arise from using unreliable parts.

Remember—just because you want to buy a new tube doesn’t mean you have to buy from an OEM supplier at their asking price. There are lots of options from Non-OEM replacement suppliers. As long as they are trusted, carry a warranty and have been system-tested, they can be a good option.

Buying a Used Tube

When you purchase a refurbished tube, you usually get a short warranty. These can last on average 30-90 days and the warranty itself is pro-rated. That means if your newly-installed X-ray tube fails on day 29 and you only have a 30 day warranty, you only get credit for 3% of the purchase price. If you do choose to buy a used or refurbished tube, it’s so important to buy from a reputable supplier. You don’t want to be stuck with a tube without a warranty with value and the reality is, there are people out there who will try to take advantage of you.

Be aware that there are many different kinds of tubes on the market: refurbished, remanufactured, repaired and tested. It’s important to understand the precise definition of what you are purchasing if you buy a used tube versus a new one. It really comes down to doing your homework.

Talk To An Expert

Not sure whether you should buy new, used, repaired or certified refurbished tubes? No worries! Talk to an expert at Atlantis Worldwide. We’ll listen to your needs and help you navigate the options so you get what you need within your budget!

Contact Us Today!

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New MRI Coil For Higher Quality Images

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The Lowdown on CT & X-Ray Replacement Tubes

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Does Your Veterinary Practice Need a MRI?

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AI Technology Cleared For Radiologists in Time for Covid-19

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What Radiographers Have To Say About COVID-19

The pandemic is far from over, and front line healthcare professionals continue to develop guidelines to keep patients and personnel safe. Aunt Minnie Europe recently interviewed several top European radiographers about their current standards.

David Guenther is a radiographer at Charite’, Universitytätsmedizin Berlin. He recommends:

Wearing a PPE for only one patient and then disposing it. These include a hair cover, goggles or face shield, mouth and nose protection, a virus-proof protective apron and gloves. They do not use shoe protection. A specific CT machine is used for patients with COVID-19 or with suspected COVID-19. The room contains only the necessary equipment and only 3-10 patients are examined daily. After each scan, the CT Scanner is disinfected, as well as all surfaces that may be contaminated. The floor is then cleaned, with the disinfectant requiring a 15-minute drying time. The whole procedure takes at least 30 minutes.

Kevin Barros Azevedo, PhD, lecturer with the medical imaging and radiotherapy department at the University of Algarve, Portugal shared these procedures:

Radiologists wear an apron, shoe protection, cap, FFP2 mask, two pairs of gloves and eye protection. While the ideal would be to change the PPE between each patient, they are keeping the mask, cap and eye protection and just changing the gloves and apron. They are cleaning surfaces between suspected COVID-19 cases and deep clean between suspected and confirmed cases. Patients are grouped by suspected patients, confirmed patients and regular patients. They also follow the hospitals’ infection control guidelines and guidelines published by the Spanish Society of Medical Radiology.

John McNulty, PhD and president of the European Federation of Radiographer Societies and associate dean for graduate studies at the University College Dublin School of Medicine shared these guidelines:

All radiographers and other CT staff should be required or directed to put themselves at unnecessary risk on the basis that PPE is not available to them. PPE should be used appropriately and when necessary, and changed between cases. He recommends hospitals utilize the project initiated by Professor Peter Hogg from the University of Salford UK and Ken Holmes, University of Cumbria UK, which provides teaching and support materials provided by a group of more than 40 authors from across the world. Using this single international resource can save a lot of time.

Chest radiography, chest x-ray, and CT have a significant role to play in the management of patients with COVID-19, but a range of approaches are being taken to manage the cleaning of scanners.

Nick Woznitza, PhD, clinical academic reporting radiographer, Homerton University Hospital in London had this to say:

That the role of the CT is not a screening tool or for primary diagnosis.  Where possible the departments are trying to stream into "hot" or "cold" scanners.  It is not practical as many patients are asymptomatic and the volume of non-urgent work has decreased significantly.

Like all professionals involved in healthcare and medical imaging, Atlantis Worldwide continues to monitor recommended best practices and guidelines for diagnosis and treatment of COVID-19. If your hospital, clinic, healthcare facility, veterinary practice or urgent care is in need of medical imaging equipment, remember that used or certified refurbished equipment can provide the performance and warranties you want and need, while protecting your bottom line

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COVID-19: Ultrasound, CT or X-Ray?

What did a nine-expert panel hosted by the American College of Emergency Physicians say about using Point-of-Care Ultrasound recently? The group of experts including emergency medicine experts from the U.S., Spain and Italy reported their findings in Academic Emergency Medicine in late April. The goal was to highlight the efficacy of POCUS and outline recommendations for its use with COVID-19 patients.

Lead report author and panel moderator Rachel Liu, M.D. said, “Ultrasound as a diagnostic test presents distinct advantages for imaging in COVID-19. It is a mobile technology that can be used in diverse environments, including in triage tents or makeshift hospitals that are now established for COVID-19 evaluation at many centers,” she said. “POCUS, in particular, where the clinician both performs and interprets the images immediately at the bedside, can minimize involvement of additional personnel in an infectious situation and provide immediate diagnostic information.”

The panel of experts provided five reasons why POCUS should be used more widely with patients suspected of COVID-19 infection than X-ray or CT scans.

It can rule out other pulmonary diseases like pneumothorax or pleural effusion. Being able to remove these conditions from your list of possibilities can be helpful, even if a patient is already sick.

POCUS can serve as a guide with venous access, particularly with critically ill patients who need peripheral or central venous access. Because some patients with respiratory distress can’t lie flat, ultrasound can facilitate central venous access. In addition, it can help diagnose venous thromboembolism.

Cardiac ultrasound can help pinpoint any new heart issues or ones that COVID-19 has made worse. The panel suggests that emergency departments integrate focused cardiac ultrasound into symptomatic COVID-19 patient workups and assessments.

Ultrasound can identify more severe illness prior to the development of severe symptoms. Abnormalities characteristic of COVID-19 can help you direct a patient to the appropriate hospital unit early, even before lab results return.

Performing bedside ultrasound can limit the number of healthcare workers that are put at risk. Of course, the sonographer needs to use all the recommended and appropriate personal protective equipment and disinfect the machine.

At Atlantis Worldwide, we provide used and certified refurbished medical imaging equipment that can provide needed performance at a reduced cost. If your clinic, hospital, practice, healthcare facility or urgent care center is looking for CT, MRI, C-Arm, Mammography, Bone Densitometer, X-Ray or any other medical imaging equipment talk to the experts at Atlantis Worldwide. Stay safe out there!

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Radiology After Covid-19

There was medical imaging before COVID-19. Then it radically changed during COVID-19. Now that COVID-19 appears to be receding a little, can we go back to business as usual before the virus? Experts say “not so fast.” There will need to be a balance between clinical assessment, ethical judgment and logistical planning.

During the COVID-19 crisis, adult and pediatric radiology departments curtailed imaging studies. As we move forward, the goal should be to avoid straining medical imaging departments, according to Irish and U.S. authors of an article that appeared in Journal of the American College of Radiology or JACR.

Dr. Aisling Snow of the radiology department at the University of Dublin Trinity College wrote, “Radiology departments worldwide have been severely affected by a period of COVID-19-induced imaging austerity that will reach beyond the peak of the pandemic.” George A. Taylor of Boston’s Harvard Medical School said,” Each department needs to rapidly take stock of the known and estimated future effects and begin to implement a strategy for returning to normal function."

Four-Pronged Approach Recommended

The authors recommended four steps to ramping up operations following the pandemic: forming a task force, reviewing system capabilities, designing a recovery process and creating a clear communication strategy.

There should be a unified approach to imaging workload realignments, which requires a relationship between the referrers and the radiology task force.  The task force should be comprised of radiologists, administrators and modality specialist radiologic technologists and radiographers.

Snow and Taylor wrote, “Documenting each referrer's preferred method of communication about patients has already proved helpful in one of our hospitals." They also recommended using available systems for documentation, including RIS, PACS and electronic health records to note decisions regarding the imaging of patients. The task force should also consider staffing and budget.

The task force should determine staff capabilities and match them with available facilities, the location of facilities and clinical need. Another factor is finances, especially in the U.S. since healthcare systems are struggling to pay employees on staff. It would be challenging to hire additional staff and purchase additional equipment.

As we move into a post COVID-19 process, there needs to be a prioritization of patients: those who have already been rescheduled and those who have been deferred. Some departments might be able to redistribute deferred cases without altering the scheduled appointments of other patients. For healthcare facilities with long waiting lists or limited capacity to return to high outputs, it may require a full reevaluation of all cases to allow equity of prioritization across all specialties and referrers. It’s important to consider urgent and emergent imaging, time-critical imaging, imaging of known versus potential disease and screening when reevaluating.

The authors wrote, “"Referrer and radiologist input will be necessary in order to determine if a study is still required, whether the correct study is ordered, and, if so and in the context of available resources, how quickly it should be and can be performed.”

For things to run smoothly, the task force must also communicate effectively with corporate management, radiology staff, referrers and patients.

Snow and Taylor concluded, “Proactive and careful management should allow departments to actively manage a recovery process that will last well beyond the immediate critical care crisis. Planning our own recovery will ultimately protect patients and staff and enable us to respond accordingly as the uncertainty of the coming months unfolds."

As you reevaluate your procedures and medical imaging equipment, remember that it can be financially wise to consider purchasing certified refurbished medical imaging equipment. The cost savings can be significant and you can still get the service warranty you want for peace of mind and protection. Talk to an expert at Atlantis Worldwide today.