By Ron VandenBoom
As cameras go, this one is a humdinger!
While most cameras are small handheld imaging device for
taking family photographs, the people that work in the
Imaging Department at Northern Montana Hospital realize a
camera doesn't have to be small and can even have the
potential to save lives.
At least that's the goal the hospital had in mind when the
they recently purchased a $400,000 gamma, or nuclear, camera
to add to their arsenal of high tech medical devices. It was
a project the hospital started budgeting for three year ago.
The new two-headed, 2,500 pound, camera, required
additional support beams to be added to the floor before it
could be moved to the imaging department at the hospital.
But the extra work is expected to pay off because it will
cut in half the length of time patients spend horizontal on
the camera's scanning table and give physicians a clear,
high quality, picture.
"Physicians in communities such as Great Falls and Billings
will appreciate that," said John Rosenbaum, imaging manager
and vice president of Professional Services.
The new system also offers many useful tools that according
to Rosenbaum, far exceed, "anything we've had in the past."
The camera replaces an older G.E. Starcam the hospital
acquired in 1988 and is the fifth camera owned by the
hospital since nuclear medicine was first introduced to the
Hi-line in 1972.
"It (the Starcam) did a wonderful job and at the time it
was the unit to buy," Rosenbaum said. "but at 13 years of
age, it's well outlived its technology span."
Rosenbaum said it is not unusual for the hospital to try
and buy the very best technology they can, within their
budget limitations, and this piece of equipment was no
exception. It is probably the newest and most up-to-date
nuclear camera in the state, if not the region.
"We went through a lot of agonizing with this one to make
sure we made the best choice possible," Rosenbaum said,
adding that they could have bought a camera with more bells
and whistles, but as far as nuclear medicine capabilities in
general go, "it has virtually everything."
Nuclear cameras photograph maladies in organs by detecting
the amount of radioactive material that has gathered in
areas where a blood supply has increased or decreased.
The patient will inhale, ingest, or have injected a
harmless dose of radioactive material. The material is then
taken into the body where it congregates in a specific organ
and, depending on the patient's bodily functions, will
quickly target the organ to be photographed.
Cancer cells, for example, are fast-growing and require a
large supply of blood. When injected into the blood stream,
the nuclear material will pool in the area of the malignancy
and allow the nuclear camera to photograph details of the
growth.
"So it ends up in what we call, a hot spot' or active
area," Rosenbaum said.
A stress fracture is another example of an injury that may
not show up on a regular X-ray, but will on a gamma camera
because of an increase in blood supply to the injury.
"You use the body's own metabolic process in order to get
the material where you want it to be," he said.
A gall bladder too can malfunction for a number of
different reasons. A nuclear camera allows the physician to
scan the organ and determine whether the problem is due to
an obstruction of the bile duct or something else is causing
the ailment.
Nuclear cameras can be used to scan the lungs, liver, gall
bladder, bones, and even the heart.
"We do a lot of cardiac scans here and this is one area
where we will be able to offer quite a bit more, thanks to
the new camera," Rosenbaum said.
The camera is capable of detecting areas of the heart that
might be dying and can even be used to determine the amount
of blood the heart is pumping through the various ventricles
at any one time.
The patient is put through a procedure called a phallium
stress test where the heart-rate is increased. Then the
patient is scanned by the camera. The procedure takes about
15 minutes.
Three sets of photographs may be taken which collectively
will tell physicians whether the heart is getting too little
blood or some other problem exists.
The new camera can cut in half the length of time necessary
to perform the scans.
"We will now be able to send our images anywhere and the
professionals there will be able to understand what we're
showing them," Rosenbaum said.
Images can also be placed on an optical disk for archiving
and if need be, a 3-D image can be produced with computer
software that allows physicians to view an organ from all
sides or, with the use of computers, as a rotating image.
Knowing exactly where a malady is, its size and degree of
the damage might also reduce, or eliminate, the need for
physicians to conduct exploratory surgery. If, on the other
hand, it is determined surgery is necessary, physicians,
thanks to the cameras, will have a distinct advantage.
Budgeting for the camera started three years ago, Rosenbaum
said.
It is the kind of expense that would not normally be
considered at hospitals serving a population the size of
Havre and the surrounding area. In other parts of the
country, only larger facilities would invest in this kind of
a camera.
But distances in Montana offer a unique challenge to health
care providers.
Montana's larger communities, such as Great Falls or
Billings, are too distant for many people to travel when ill
or during emergencies. This requires Northern to provide
many services comparable hospitals would not.
"It's not fair to the community not to have the service,"
Rosenbaum said. "Because it would require people to travel
all of the time for their health care, even when they are
not well enough to travel."
Rosenbaum said these factors really do impact on how
Northern functions as a hospital and what their philosophy
has to be.
"We want to give the community everything we can (that is)
anywhere close to being affordable," he said. "We really do
feel compelled to provide these services."
Much work remains to be done before the new camera is ready
to be used and much of the responsibility for getting the
equipment ready for its first patient falls on the shoulders
of Christen Turner, a registered nuclear technologist at
Northern.
Turner, a former X-ray technician that studied for two
years to become a nuclear technologist, has just returned
from a week-long class where she received camera specific
training on how to operate this machine.
She is also responsible for writing the protocol on the
camera's use.
"These things don't come as a canned program," Rosenbaum
said. "So there's still a lot of work to be done."
It's a far cry from the days when patients would come in,
spend the night under observation, and have exploratory
surgery the next day. It was a time when even the surgery
would not always reveal
