Point-of-Care CT Scanning in Otolaryngology: Boon for Patients and Physicians: Part 1 of 2

For many solo and multispecialty practices in the private sector, it’s a different story. In addition to convenience and cost savings for the patient, an in-office CT scan offers treatment advantages, according to Dr. Sillers. Otolaryngologists may often begin a course of medical therapy for patients when waiting to review an off-site CT scan. With point-of-service scanning, noted Dr. Sillers, you do not have to delay treatment or subject your patients to unnecessary treatment.

Office-based CT scanners are not equivalent to facility-based CT scanners, which still offer better image quality in general. Also, offices will not perform CT scans with IV contrast, but IV contrast is required for certain types of scans, including neck CTs and any scan done for the evaluation of a neoplasm.
-Martin J. Citardi, MD

Another plus of the compact scanners is that the cone beam technology also delivers a low radiation dose. This is particularly important with pediatric patients, because it helps to reduce cumulative radiation dose over a patient’s lifetime. Dr. Citardi cautioned that even though office-based scanners provide images of sufficient quality for most indications in otolaryngology, they are not equivalent to facility-based CT scanners, which still offer better image quality in general. Also, offices will not perform CT scans with IV contrast, but IV contrast is required for certain types of scans, including neck CTs and any scan done for the evaluation of a neoplasm.

Susie Vestevich, Public Relations Manager for Xoran Technologies, a manufacturer of in-office CT scanners, countered that her company’s isotropic volume bone window scanner, the MiniCATTM, provides clear and defined images at extremely low radiation doses, perfect for imaging the sinuses, temporal bones and skull base.

Dr. Hopp pointed out that the value of in-office CT scans is compounded with the ability to preplan surgical procedures, by saving data on a CD for use with intraoperative CT-guided image systems. Similarly, Dr. Sillers said that if he suspects that a patient may need revision sinus surgery, he places the headset on the patient during the CT scan so that the surgical navigation points are captured. When it comes time for surgery, he simply takes the CD onto which the data has been burned, and inserts the CD into the navigation work station.

The ‘Reads’

Licensed physicians are qualified and authorized to perform scans in every state, according to Ms. Vestevich. The company offers radiation training and assistance from a medical physicist as part of the purchase package. GE Healthcare offers similar resources if needed.