Heart on their sleeves | July 13, 2007 | Mountain View Voice | Mountain View Online |


Mountain View Voice

- July 13, 2007

Heart on their sleeves

Camino Medical Group's new facility features state-of-the-art medical scans

by Angela Hey

Camino Medical Group's new facility, located south of Route 85 on El Camino Real, is the place to go if you need a heart scan.

The medical group has invested heavily in digital imaging. Doctors can view and rotate colored heart images on workstations in 4-D (time being the fourth dimension) to look for abnormalities.

A virtual heart model is compiled from 1,800 to 5,000 image slices that are captured on the latest Siemens Somatom 64-slice, dual source CT (computed tomography) scanner. It has two X-ray sources at 90 degrees to each other, and two detectors. The advantage of dual source scanning is that it can scan faster and provide clearer pictures. The X-ray dosage can also be lower.

The heart of a sick patient often beats faster than normal, sometimes at more than 90 beats per minute, which blurs the image on single-source scanners. Sick people often have an irregular beat, which poses another scanning challenge. These scans can be taken when the heart is in its relaxed diastolic phase by synchronizing the image capture with the heartbeat.

CT scanners scan everything from the brain to the toes. A second 40-slice single source CT scanner is available for slower beating hearts and less detailed scans.

The clinic also features a Siemens Magnetom 3 Tesla MRI scanner. Most procedures take just a few minutes. The machine reduces the banging noise heard during a scan and is about 20 decibels quieter than older generation machines.

Vital Images Vitrea software assembles scanned images into a beating heart model (see www.vitalimages.com/products/adv-ct-cardiac.aspx). The software can show 2-D, 3-D or 4-D scans and can separate blood vessels from the surrounding tissue to show blockages and aneurysms in detail. The image processing software runs on workstations with 8 GB of memory using Microsoft's Vista 64-bit operating system.

Patients can swallow a barium meal and have their digestive tract scanned on a Siemens Axiom Luminos TF fluoroscopy system. It can be used to look for hiatus hernias, and generates moving images of their esophagus and stomach. It can also be used to analyze rotator cuff tears, bladder problems and infertility conditions.

For a digital X-ray, the clinic has an automatically operated Siemens Axiom X-ray machine. This sets up the equipment in exactly the right position for each patient — the patient can lie down or stand — saving the technician time. "Abdomen supine" means the patient lies on his back and the X-ray sensor automatically moves to the horizontal, parallel to the bed. (The bed is made of carbon fiber, which is very thin but can handle the weight of three adults.) For an upright chest X-ray, the detector lifts up and rotates to a vertical position away from the bed so that the patient can stand in front of it. The X-ray source aligns itself with the detector, at the precise distance from it for a clear image.

I asked Qumara Ahmadi, director of imaging services, why he selected Siemens from his short list of three major vendors. "Image quality, uniformity of applications, integrated workflow, patient comfort, fast scanning times and diagnostic accuracy," were his reasons. He also reminded me that demo images often look much better than those with abnormalities that he sees in real patients.

I hope you don't need to go to the clinic, but if you do, early, accurate diagnosis can save lives. We are privileged to have some of the world's best imaging equipment and medical staff right on our doorstep.

Angela Hey can be reached at amhey@techviser.com.


Posted by Robert Jackson, a resident of Old Mountain View
on Jul 17, 2007 at 11:44 pm

You can also get a heart scan at CVI Medical Group. See their website at Web Link for a detailed explanation of what it is like to have such a scan.

Posted by Mike Laursen, a resident of Monta Loma
on Jul 18, 2007 at 12:46 pm

Woohoo! Finally, after all these years, that prime chunk of real estate is being put to good use!

Posted by Janice Wright, a resident of Cuesta Park
on Jul 20, 2007 at 11:16 am

I would be very sceptical of any recommendation to get a heart scan from either Cardiovascular Institute (CVI) or Camino Medical Group (CMG), as they each have a huge financial incentive to have patients get the scans, whether they need it or not. Study after study shows that physicians with a financial interest in labs, MRI or CT Scanners, or Surgery Centers tend to over prescribe these services to their patients, and many are done for no medical reason whatsoever. There are laws to prevent this, but apparently both CMG and CVI have found ways around them. Chairman of the El Camino Hospital District Board David Reeder also questioned Board Member Ed Bough, MD over his conflict of interest with the hospital and his own heart scanner at CVI. In my opinion, David Reeder would never have a heart scan at CVI. I would recommend to all patients in the District to follow his lead, and at least get a second opinion if your physician at CVI or CMG recommends a heart scan. There is only one reason CVI and CMG got their own heart scanners to compete with the heart scanner at El Camino Hospital and that is GREED! Patients in the El Camino Hospital District do not need three heart scanners within blocks of each other.

Posted by John Esch, a resident of The Crossings
on Jul 21, 2007 at 9:12 am

The new CT Heart Scan is a test of questionable value, which is currently labeled "experimental" by many insurance companies. The only reason they are being promoted by the likes of CVI Medical Group is because of the huge profitability. If your doctor wants to do a CT Heart Scan "just to be sure nothing is wrong," I would ask if he would still recommend the procedure if you have it done at the El Camino Hospital scanner, where he doesn't have a financial interest. If he gets mad, then you know the answer! Find another cardiologist.

Posted by Judy Dosse, a resident of Old Mountain View
on Jul 22, 2007 at 3:08 pm

If you absolutely must have a CT Heart Scan, then I recommend going to El Camino Hospital and use their new scanner. As El Camino Hospital District Residents, we have already had our taxes increased by $300 million to pay for the updated hospital, and we are on the hook for hundreds of millions more with the bonds being sold by the hospital. It is appalling that Ed Bough, MD, former Chairperson of the El Camino Hospital District Board, has gone in to direct competition with the hospital by buying his own CT Scanner for his group, CVI. His actions display a profound lack of fiduciary responsibility to the Hospital District. Why the other Board members let him get away with it and allowed him to remain on the Board making financial decisions goes beyond the pale. They should all be ashamed of themselves.

Posted by Angus Dwyer, a resident of another community
on Jul 27, 2007 at 9:49 pm

Although El Camino Hospital has a CT scanner, they do not perform or schedule CT heart scans. I know because I have called them.

Posted by Eli Wisnom, a resident of Jackson Park
on Jul 28, 2007 at 9:54 am

From Mountain View Voice, March 10, 2006

" Tensions rose once again last week on the Board of Directors, when vice chair David Reeder suggested that board chair Edward Bough's purchase of a high-tech medical device amounted to conflict of interest.

The issue began when Reeder delivered a PowerPoint presentation on a potential conflict of interest involving the purchase of two new, advanced 64-slice CT scanners by both El Camino Hospital and board chair Edward Bough's cardiology group, CVI Medical Group -- the implication being that Bough is competing with the hospital he represents, and should have disclosed his purchase earlier.

Several hours and snipes later, it resolved itself with the board deciding to develop a clearer conflict-of-interest policy.

"I do believe that a physician board member should not compete with a hospital in a major way and I think the scanner was a major way," Reeder said after the meeting.

Since the issue involved the board chair, vice chair Reeder followed the board's conflict of interest policy and began researching the potential conflict last October, after Bough disclosed CVI's plans to buy a Siemens 64-slice CT scanner. At the November meeting, the board approved a $341,000 upgrade to El Camino's 16-slice CT scanner under the hospital's 10-year contract with Siemens. Bough had recused himself from this vote, but Reeder believed he didn't disclose the conflict early enough.

A 64-slice CT scanner is a new imaging technology that can scan patients faster and at higher resolutions. The advantages include better visualization of coronary arteries, which would improve diagnoses of heart disease and other ailments. "

Maybe the Hospital is giving all the business to Board Member Bough!