The Health Services Authority has built a new X-ray facility at the Cayman Islands Hospital, refitting an examination room and installing the state-of-the-art $400,000 machine, streamlining the once-cumbersome diagnostic process.
Described by the hospital as “the first of its kind in the region,” the new machine was built by General Electric and installed earlier this month in the radiology department by a two-member team from the manufacturer’s Jamaican affiliate, Arel Ltd.
Following installation, physicists tested and approved the equipment for commercial operation on Aug. 10, ensuring radiation emissions were within international standards. General Electric and the hospital will launch an on-site training course – which takes four years – for the hospital’s 14 radiographers, although the machine’s essential functions are similar to an earlier generation of equipment, enabling ongoing use.
“[The] new X-ray machine was purchased as the old machine was obsolete and, as a result, finding replacement parts, had become challenging,” said Radiology Manager Pamela Vaughn-Duncan. “This created extended downtimes and affected patient care.”
The Ministry of Health, which paid for the machine, had planned the project for 18 months, Ms. Vaughn-Duncan said.
The Digital Discovery 656 is faster than its predecessor, she said. It “also produces images of greater quality with higher resolutions allowing for better diagnosis,” running on overhead tracks and rotating through three dimensions.
“This new equipment is far superior to the old machine as it produces images with greater quality and better resolution; it is also by far more efficient as it removes time taken to process images taken on a cassette in a processor.”
The new machine eliminates the need for film, chemicals for processing, processing equipment and two people to manage the processing.
It routes X-rays directly to a patient’s file, enabling easy access by radiologists.
“All of the … radiology equipment [is] now connected to our electronic medical record system, giving physicians access to view patients’ reports and images at the same time,” Ms. Vaughn-Duncan said.
The equipment includes a rebuilt examination room, designed by the hospital’s maintenance team.
Despite the four-year course for full training, she said, “we are still able to use the machine as patients’ positioning techniques have not changed.” She described the chief operating differences with the previous machine as “knobology.”
“Knobology,” she said, is “a technical term used when referring to buttons on a machine and their functions.”
The HSA is looking to other new equipment purchases, most immediately a mammography machine. The machine has been identified and procurement started, she said.
“We are hoping to upgrade our mammography machine to one that is more patient-friendly. The request, she said, “is in as a budget item, but is not yet approved,” meaning procurement may have to wait as long as 18 months.
She said the new mammography equipment is made by Massachusetts-based Hologic, which manufactures diagnostic and medical imaging systems for women’s health.
While Ms. Vaughn-Duncan declined to comment on prices, the company advertises its “Selenia” system for between $80,000 and $100,000.
A computer-aided detection component adds between $15,000 and $18,000 to the cost, while two 5-megapixel workstations cost between $15,000 and $40,000.
“At present, our machine produces two-dimensional images, whereas a machine that produces images using tomosynthesis produces three-dimensional images of the breast by using several low-dose X-rays obtained at different angles,” Ms. Vaughn-Duncan said.
According to the Massachusetts General Hospital website, tomosynthesis improves on conventional digital mammography, which produces only single images of overlapping tissue.
It enables “earlier detection, greater accuracy, fewer biopsies and tests, greater likelihood of detecting multiple breast tumors and clearer images.”
The nonprofit Virginia-based American College of Radiology, says tomosynthesis enables “higher cancer detection rates and fewer patient recalls for additional testing,” as “better sensitivity will likely translate into more lives saved.”
Ms. Vaughn-Duncan said the Hologic system means “the breast is positioned and compressed in the same way as for a mammogram, but the X-ray tube moves in a circular arc” to gain the 3-D images.