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At Dearborn County Hospital, we keep abreast of new technology so that we can offer our family, friends and neighbors the latest in healthcare advances. Listed below you will find information on some of our advanced procedures and services. Endoscopic Ultrasonography (EUS) - a minimally invasive gastroenterology procedure used to diagnose possible abnormalities in the digestive tract and certain adjacent or nearby organs. Capsule Endoscopy – a noninvasive imaging procedure used primarily for viewing the small intestine. Endovascular Repair – a procedure used to treat life threatening abdominal aortic aneurysms. Picture Archiving and Communications System (PACS) - a system that consolidates the results of imaging/radiology and selected other healthcare modalities into an integrated online patient file. CheckMate for Mammography – utilizing Computed Aided Detection (CAD), CheckMate provides Radiologists with a “second set of eyes” when viewing images. Hawkeye PET/CT Imaging – the combining of CT and PET imaging allows for a more complete series of diagnostic images. Lung Cancer Screenings – a 20 second, low-dose helical CT scan used to help detect lung cancer before it is visible on a standard X-ray and usually before there are noticeable symptoms. |
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ENDOSCOPIC ULTRASONOGRAPHY (EUS) Endoscopic Ultrasonography (EUS) is a new, minimally invasive gastroenterology procedure used to diagnose possible abnormalities in the digestive tract and certain adjacent or nearby organs. EUS can be used to gain ultrasound images of the digestive tract including the esophagus, stomach and intestines (intestinal wall, gastric folds and colon). In addition, EUS can obtain internal ultrasound images of nearby organs and anatomic structures such as the liver, gallbladder, bile ducts and pancreas. While EUS has multiple applications, it is most commonly used to diagnose or stage lung, esophageal, pancreatic, bile duct, gastric and rectal cancers. It is also used to diagnose and biopsy bile duct lesions and cystic masses in the pancreas. In many cases, EUS can be combined with fine needle aspiration to determine if a questionable mass or lymph node is malignant. By using this low risk procedure, patients may be able to avoid more invasive exploratory surgery. This in turn, decreases the risk from infection and other complications and greatly reduces recuperation time. Endoscopic ultrasonography is the result of combining two technologies, ultrasound and endoscopy. In EUS, an endoscope which contains a very small camera, much like those used for an EGD or colonoscopy, is enhanced by adding an extremely small embedded ultrasound transducer. This procedure results in ultrasound images gathered through the embedded transducer. Because the transducer is utilized inside the body, it is able to provide a much higher quality image of certain organs and structures than traditional ultrasound used on the body’s exterior. This advanced technology provides valuable information regarding the density and size of the mass, in addition to a higher quality visual image. The more data and imagery a physician has available, the better that physician is able to develop a targeted plan of care for their patient.Only a limited number of hospitals in the Greater Cincinnati area have this technology. The M2A Capsule Endoscopy Given Diagnostic System utilizes a camera so small it fits inside a capsule. After swallowing the capsule the device travels throughout the patient's digestive tract while transmitting full color video images to a receiver for future examination by their physician. This noninvasive imaging device is primarily used for viewing the small intestine. Traditional endoscopic procedures do not reach the small intestine. Esophagogastroduodenoscopy (EGD) examines the esophagus, the stomach and the upper tip of the small intestine. Colonoscopies examine the rectum, the large intestine/colon and only the very lower portion of the small intestine. Without the use of capsule endoscopy, the majority of the small intestine is left unexamined by endoscopic means. Before capsule endoscopy, the most common nonsurgical ways to examine the small intestine were through CT or through radiography or fluoroscopy in which the patient consumed a barium sulfate solution. These types of procedures provide information regarding the size, contour and position of the bowel. While valuable, they do not provide the high quality full color images of the interior of the intestine that are available through capsule endoscopy. In some instances, abnormalities of the small intestine went undiagnosed because a surgical procedure was needed to make a definitive diagnosis. In many cases, the risks posed by exploratory surgery outweighed the perceived benefit to the patient. Because capsule endoscopy is noninvasive, it is easily tolerated by most individuals and involves no radiation. More importantly, it requires very little effort on the part of the patient. The capsule endoscopy procedure, which is performed on an outpatient basis, begins at home with the patient fasting for a specific period of time. Upon arriving at the hospital, the patient is asked to swallow the M2A capsule with a small drink of water. Next, small sensors with an adhesive backing are secured to the patient’s abdomen. These sensors are connected to a DataRecorder stored in an adjustable belt. The belt is then worn around the patient’s waist, on top of clothing, much like a fanny pack. Once the capsule has been taken and the belt is fitted, the patient is free to return home. Approximately eight hours later, the individual returns to the hospital for a very brief time to have the sensors and belt removed. At this point the video data is retrieved for the physician’s review and the procedure for the patient is concluded. The encapsulated camera passes naturally out of the patient’s body. Capsule endoscopy isn’t for everyone. It is not for routine screenings or for examining areas readily available through other means of endoscopy or radiography. It is, however, an excellent tool in helping physicians diagnose undetermined abdominal pain, obscure bleeding, Crohn’s disease, celiac disease, multiple polyps, intestinal tumors or other abnormalities of the small bowel. Depending upon the outcome of the procedure, surgery may still be required to treat the abnormality. Life threatening abdominal aortic aneurysms, in many cases, can now be treated using a new procedure known as endovascular repair. The procedure utilizes the Zenith AAA Endovascular Graft System by Cook Incorporated. Aneurysms occur when the walls of a blood vessel become weakened allowing a pocket of blood to build up in the affected area. As this pocket expands, the walls of the vessel become thinner, much like a balloon that is being blown up. Over time, the walls of the vessel may become unable to support the blood flow causing the aneurysm to leak or rupture. This may result in severe internal bleeding. Traditionally, abdominal aortic aneurysms or AAA were repaired using an open surgical procedure where an incision was made the full length of the patient’s torso. After reaching the aneurysm site, the surgeon would then open the aorta and sew a graft in place to prevent rupture. This major surgical procedure usually resulted in a six to 10 day hospital stay for the patient and an overall recovery period lasting up to three months. Now, by utilizing an endovascular repair technique, most patients will stay in the hospital less than 48 hours following the surgery with an overall recovery time of several weeks. The endovascular repair procedure is performed by Dr. Michael McAndrew and Dr. Mark McAndrew. This procedure requires two small incisions in the patient’s groin. This allows the physicians to insert a catheter into each femoral artery. The catheters are then guided through the arteries to the weakened area of the aorta. At the proper location, interlocking fabric-covered metal stents are opened to secure the artery wall and adjacent vessels, thus relieving pressure on the aneurysm. Because the procedure is new, the surgeons must submit specific medical criteria to Cook Incorporated for their analysis. Their panel of experts reviews the case to determine if the patient is medically appropriate for the procedure. Patients may be deemed ineligible for the procedure for a number of reasons including the specific shape or location of the aneurysm or because of blockages in the femoral arteries. Not all AAA patients are candidates for aneurysm repair. Surgery is usually not performed unless the aneurysm is four centimeters or larger in size and the patient meets the criteria for the endovascular graft. Zenith AAA Endovascular Graft patients must have routine follow-up appointments with their surgeon. The schedule usually includes check-ups at one, six and 12 months following surgery with annual exams thereafter. Most appointments include routine blood tests, a CT scan, X-rays and a physical examination. At this time the surgeon will look for signs of leakage or movement of the graft or for growth or change in the aneurysm. PICTURE ARCHIVING AND COMMUNICATIONS SYSTEM (PACS) In late 2004, Dearborn County Hospital implemented a Picture Archiving and Communications System or PACS. The system consolidates the results of imaging/radiology and selected other healthcare modalities into an integrated online patient file. Images derived from traditional X-rays, CT, MRI, PET/nuclear medicine, ultrasound, DEXA and cardiovascular procedures, such as cardiac catheterizations, are formatted and stored digitally. With the exception of mammography, film is no longer needed. PACS allows physicians and other healthcare professionals to access patient information in a faster and more organized manner. Physicians no longer need to have physical possession of an X-ray to view it. By using PACS, physicians are able to request and view patient images and the corresponding interpretation digitally. PACS work stations featuring computer monitors with extra large high-density screen resolution are located in key areas of the hospital including the Emergency Department, ICU, Surgery and Radiology. Physicians can also access PACS at the nurses stations and at their individual offices through the hospital's Meditech system.While PACS was developed primarily to facilitate the viewing and storing of imaging files, it can also interface with other programs. The PACS program acquired by DCH is compatible with the hospital's Meditech computer network so it was able to be integrated into the main hospital system. This allows physicians to not only access imaging files but also by using Meditech; lab results, pathology reports and other pertinent patient information...all without leaving the PACS work station. PACS makes a great amount of current and past patient information available to the physician on demand. For example, a physician utilizing a PACS work station in the ICU can view a patient's current MRI scan, read the Radiologist's interpretation and review previous scans or imaging procedures. Also, by utilizing PACS, numerous physicians can obtain the same image on their monitors simultaneously. Referring physicians, Radiologists, Surgeons and other specialists can review images and patient findings during a joint consultation without ever leaving their individual PACS station. In the future, it is anticipated that PACS programs between various hospitals and systems will interface. This will allow pertinent health information to be available to a patient's physician, regardless of when or where the patient is in need of care, such as following an auto accident or while vacationing. R2 IMAGECHECKER® CHECKMATE™ SYSTEM FOR MAMMOGRAPHY CheckMate uses Computer Aided Detection (CAD) technology to provide a comprehensive review of images. CheckMate is not part of the actual mammography examination equipment, but instead is two pieces of computer hardware installed in the mammography and X-ray reading rooms. The equipment consists of a digitizer which reads the films digitally and a viewing station with video screens. The ImageChecker® M1000 CheckMate system by R2 Technology, Inc., offers an additional format for Radiologists to examine breast X-rays for possible lesions. The software program digitizes the images of the right and left breasts and highlights area with certain characteristics, called ROIs (regions of interest). These regions might be clusters of bright spots (suggestive of microcalcification clusters), dense regions, or dense regions with radiating lines (indicating a mass). ImageChecker then displays its search results on small video monitors. The final interpretation is then made by the Radiologist after comparing the ROIs on the ImageChecker with their findings on the original mammogram. HAWKEYE PET/CT IMAGING The Hawkeye combines both CT and PET imaging into a single diagnostic tool. It produces a hybrid image by utilizing data from both the CT and PET scans. The Hawkeye adds image definition, helping to pinpoint the location of the abnormality. By uniting PET and CT, Hawkeye is able to reveal a more complete series of diagnostic images. Although Hawkeye is designed to locate cancer, it can also be used in cardiac studies, neurological examinations, bone scans and other procedures. A 20 second, low-dose helical CT scan can help detect lung cancer before it is visible on a standard X-ray and usually before there are noticeable symptoms. This noninvasive screening requires a physician’s order and is recommended for smokers and former smokers with a history of 10 pack-years or greater or those who have been exposed to significant secondhand smoke. Ten pack-years translates to someone who has smoked one-half pack a day for 20 years, one pack a day for 10 years, two packs a day for five years and so forth. The CT screening requires no advance preparation. |