From the November 2017 issue of HealthCare Business News magazine
Locally, we have altered our protocols at Phoenix Children’s to mitigate the effects of gadolinium. We have moved away from using Magnevist contrast, a linear agent with a high probability of creating free gadolium, in favor of Doterum, a macrocyclic agent with a much lower probability of deposition and untoward effects.
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Amide proton transfer: Kids who undergo brain tumor removal receive a traditional MR after the surgery to determine whether the entire mass was removed. However, traditional MR uses gadolinium, problematic in its own right, but the contrast also lights up the inflamed tissue surrounding the tumor site and makes it difficult to determine whether the surgery was a success.
To minimize gadolinium exposure and improve image quality, Phoenix Children’s is the first pediatric site in the world to utilize amide proton transfer (APT) MR in a clinical setting as a diagnostic tool.
APT assists in the initial diagnosis of a brain tumor and allows providers to determine whether the tumor has been removed. Moreover, APT MRs require no contrast and negate the continued need for gadolinium. Through our use of APT MR, we are amassing unique data that we believe will change imaging practice in pediatric populations.
Advanced imaging
We are committed to building a better future for children with chronic and complex illnesses. A large part of our work focuses on improving existing practice and pioneering new approaches, particularly for the most vulnerable patient populations.
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Drug-induced stress test: Cardiologist Tabitha Moe, M.D. collaborated with pediatric radiologist Dianna Bardo, M.D. to create a new procedure for assessing the coronary arteries in patients with congenital heart disease such as individuals with an arterial switch, Kawasaki disease and other congenital heart conditions, without invasive testing.
Understanding the potential of fractional flow reserve coronary artery computed tomography angiography (FFR CCTA), a procedure that was approved in 2011 for use in adult patients, the team adapted FFR CCTA for pediatric patients.
The test, designed for young adults with congenital conditions who cannot complete exercise-based EKGs, is a noninvasive procedure that allows us to determine whether surgery is required to correct coronary insufficiencies. The test has the potential to transform treatment of children with coronary artery disease worldwide, giving them hope for long-term survival – something that was not possible even a decade ago.
