Carestream has joined up with the State University of New York University at Buffalo to research and develop new cone-beam computerized tomography (CBCT) technology that could reduce the modality's footprint and allow its application beyond hospital walls. The collaboration is an extension of an agreement last year between Carestream and the Buffalo Bills with the goal of utilizing advanced medical imaging technology in early detection and monitoring of player injuries.

Diana L. Nole, president of digital media solutions at Carestream, spoke to DOTmed News about the research. She believes it could yield more cost efficient imaging for extremities, while also expediting treatment and issuing a lower dose of radiation to the patient.

"Traditional CT requires a lead-lined room, special power supply, quite a bit of real estate in a hospital setting, and the unit itself can cost between $500,000 and $1 million," said Nole, who estimates the cost of her research equipment, which is self-shielding, to be more in the range of $300,000. She says one of the core benefits of their research is in the ability to image weight-bearing legs, feet, and ankles.
"With weight bearing images you can more accurately diagnose the condition immediately," said Nole, "Joint space is very important as an indicator of whether or not healing is occurring, and can also be an early indication of arthritis."

The Carestream team is working with Dr. John Marzo, associate professor of clinical orthopaedics at the State University of New York at Buffalo and medical director of the Buffalo Bills, who emphasized the usefulness of taking 3-D images of weight-bearing extremities. "He says that without pressure a bone might lay fine but when you put pressure on it, it shifts and pushes things irregularly out to the side," said Nole, "and you can't see that unless you truly are putting weight on it."

Because CBCT systems are smaller and more affordable, they can be installed at urgent care facilities, athletic training facilities, and physicians' and specialists' offices. Nole says that unlike traditional CT scans, which a patient is horizontal for, their scanner resembles an inner-tube that the patient stands inside.

Nole walked us through the imaging of a typical knee injury, "It has an open door, you step into it, you're standing and there are bars you can hold on to for stability, and then the door closes behind the back of your knee, sweeps around and takes a scan of 600 images in about 20 seconds, then the software renders them into a 3-D image on the computer."

"The scanner goes up and down," said Nole, "so it can work with people of different heights."

One of the main perks of working alongside the NFL on this research has been the emphasis on portability. "We feel the uniqueness of doing at-event imaging will push the unit to being more mobile and give us a different flavor than just the office-based setting," said Nole. Moving forward she hopes to do more research on imaging head trauma at the point of care, "It's all about getting the cost down without sacrificing image quality."

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