Sliced out

June 26, 2006

Radiologists are getting tired of slices. It was fine when there were four, eight, and even 16. But then came the 32s and the 64s. It’s all gotten a bit much for them.

Radiologists are getting tired of slices. It was fine when there were four, eight, and even 16. But then came the 32s and the 64s. It's all gotten a bit much for them.

Wanting to help, I called my friend, Dimitri, a long-time veteran of the CT industry and the head of a maverick engineering group.

"What can we do about all these slices?" I asked him.

Dimitri gave me one of those looks journalists fear.

"We need a lot of slices," he said. "Slices are good."

Not wanting to take a position I couldn't defend, I agreed - grudgingly.

"Slices are getting to be too much," I said in a tone that reflected the seriousness of the situation.

"Slices," Dimitri retorted, "are not the problem. Radiation - that's the problem. Motion artifact - that's the problem. Calcification disrupting the image. These are the problems."

With each new "problem," Dimitri hiked the volume and pitch of his voice. Sensing that he had me back on my heels, Dimitri pressed further.

"Don't forget the really sick patients who can't hardly hold their breath. Speed and slices - these are the answers," he said. "I recommend dual source."

I was startled.

"It's been done, Dimitri," I said. "I thought you would come up with new ideas."

I had him. Dimitri was reeling from my last shot and he fumbled before speaking.

"Dual energy with a single source!" he mustered.

"Done."

I exaggerated. Dimitri caught me.

"In prototype," I said.

"Flat panel," Dimitri fired back.

This was too much for me.

"Good heavens, man! Aren't you listening?" I asked. "Slices are throttling radiology. Everything you come up with generates more data. Try postprocessing what's coming off today's scanners and see what happens!"

With that, we had returned to the beginning. But this time Dimitri was there with me. He saw what I was seeing and his expression changed. An eerie calm came over him, as if his personal neural net had been recalibrated, the problem reformulated, and the solution found.

"It is getting things done, is it not, my friend?" he said. "We can have all the slices we want, if we can process them quickly."

The radiology community, so long enamored with slices, now had to look at how to handle those slices. "Brilliant!" I thought. But before I could voice my approval, Dimitri barked:

"I know what we need."

"What?" I asked.

"Workstations that work," he said.

I was struck suddenly with deep admiration for this man who, having seen the price of CTs skyrocket over the last decade while the price of workstations plummeted, was willing to turn his back on such a lucrative business. But how, I wondered, would he ever convince customers to pay the high cost of making the workstations they so obviously needed.

Dimitri seemed to know what I was thinking. He dipped his chin, cocked his head to the side, and raised a single eyebrow. A chuckle escaped his thin, pursed lips. His head bobbed and he began to wag his finger slowly as he always did when he knew he was right.

"We'll make them part of the CT," he said.

And he was off to his lab.