Outside, at Southlake Regional Health Centre (Southlake) in Newmarket, construction crews pour concrete for what will become the hospital’s Regional Cancer Centre – a modern, four-storey facility that will bring lifesaving cancer treatment closer to home for the over 1,000,000 residents of York Region and south Simcoe County. Inside, the hospital’s diagnostic imaging department has finalized the foundation to provide faster, more effective screening and disease detection through the implementation of 100 per cent fully digital diagnostic imaging and storage. As a regional cardiac and cancer centre, this milestone is crucial to ensuring that patients have access to more accurate and timely diagnosis, faster treatment, and reduced wait times.
During the summer of 2007, Southlake upgraded all areas within the hospital’s diagnostic imaging department to digital imaging and storage, including magnetic resonance imaging (MRI), CAT Scan (CT), mammography, X-ray, ultrasound, nuclear medicine, and bone mineral density.
“Digital imaging and storage allows our health-care providers to use advanced tools and functionalities not previously available on film,” says Dr. Yin-Hui Siow, Chief of Radiology at Southlake. “Having these advanced technologies available to aid our physicians can mean a more timely diagnosis, which can ultimately improve patient outcomes.”
Critical to providing advanced cancer services was the conversion of the hospital’s mammography department to include digital mammography capabilities. Today, the department is equipped with three full-field digital mammography units, including one unit with an add-on biopsy unit. Digital mammography can detect up to 28 per cent more cancer in women with dense breasts, which often could not be detected through traditional mammography alone. In addition to providing better screening, wait times for mammography exams have reduced significantly since the implementation of the digital machines. Southlake anticipates that the digital mammography units will double the capacity of exams to 20,000 annual mammograms by 2010.
For patients, digital mammography may not seem all that different from traditional analog tests, however, exam times are significantly reduced because the image becomes available on the acquisition monitor in less than a minute after exposure/data acquisition. Following the exam, advanced capabilities of the digital software allow for images to be manipulated, correcting for under or over exposure, magnification, orientation, brightness, and contrast, which can drastically reduce the amount of time spent performing repeat tests. The result in efficiency is significant – up to 30 per cent per technologist per day.
As an Ontario Breast Screening Program (OBSP) site, Southlake plans to open a Breast Diagnostic Assessment Unit in March 2008. The goal of the unit will be to streamline the process of breast cancer assessment and diagnosis by providing women with rapid access to mammogram, biopsy and diagnosis service in a comfortable and friendly environment.
Southlake also installed a Picture Archive Communications Systems (PACS) last year, which enables health-care providers to access digital images and reports 24 hours a day, 7 days a week.
“When a digital image is captured during a test, it becomes immediately available for viewing and storied in PACS,” says Dr. Siow. “Images can then be viewed in multiple locations simultaneously and easily shared, on a secure network, to allow consultations between physicians. This can result in a more timely review and discussion of patient needs and earlier access to treatment or intervention.”
In addition to PACS, Southlake has implemented a leading edge voice recognition system which dramatically improves report turnaround time. This technology is instrumental in reducing wait-times and the number of repeat exams required. Radiologists at Southlake can now provide same day final reports for over 80 per cent of all exams completed throughout the day.
Recent advancements in the hospital’s CT and MRI suites allow Southlake to provide specialized cardiac and cancer treatments only offered at a select number of Canadian hospitals. Advancements in the CT department include the installation of a second 64 slice volume CT scanner which enables new clinical procedures, such as multi-phase abdominal and CT angiography exams, to become clinically routine and can scan a total body in less than 10 seconds. An added application scans arteries and vessels, producing the most detailed images available of heart arteries without surgery.
In addition, the CT scanners have unique productivity features that have helped streamline workflow and reduce exams times, which in turn has had a positive effect on wait times. “Sadly, 50 per cent of CT exams we perform are cancer related,” says Dr. Siow. “By increasing our productivity, we can reach out to a higher volume of patients and ensure they get the help they need in a more timely, and possibly life-saving, way.”
In 2008, Southlake plans to further expand with the CT Colonography software, which will provide transparent 3-D reconstruction images of the colon and allow for a non-invasive and quick diagnosis of polyps and tumours. Southlake’s MRI department has obtained an improved application for vascular imaging, allowing patients to undergo a faster and less invasive MRI angiogram. In addition, the department now offers a specialized General Anaesthetic Program for children under six years of age who must undergo an MRI.
With the opening of the new breast diagnostic unit, MRI will become a valuable tool in support of the cancer centre. Often used in breast imaging as a problem-solving tool, advances in MRI imaging and the development of biopsy capabilities will open the door for even greater possibilities in the future.
Southlake is in the midst of developing its $110 million cancer program, which is already resulting in expanded diagnostic and assessment services. The centerpiece of the program is the Regional Cancer Centre, which is scheduled to open in 2009, and will include radiation treatment, a 23-bed chemotherapy unit, three large out-patient clinics. Upon completion of the Centre, Southlake will be the only non-teaching hospital in Ontario to specialize in both cardiac and cancer care.