Hopkins Health

New CT Identifies Disease Earlier, Non-Invasively

Using the latest CT technology, radiologist Elliott Fishman picks up narrowing in arteries conventional imaging might miss.

Watching radiologist Elliot Fishman manipulate 3-D images of the human anatomy on a computer screen is a bit like looking at a 9-year-old navigate the latest Nintendo game. He’s into it, deeply. 

“Look at the detail, the resolution, the volume of the organ,” Fishman says as he points at the screen. “This is spectacular.”

Fishman’s apparatus is no video game, however.  It’s a $1.5 million 16-slice CT, the newest scanner in computed tomography, and it provides images of organ systems never before seen. Indeed, so sharp and illuminating are these images that Hopkins radiologists now are using them to make better decisions about treatment for every bodily organ.

 With cardiac patients, for instance, the images can provide a better diagnostic tool than conventional angiography in looking for plaque obstruction in the coronary arteries. The new multislice scanner proves superior for several key reasons: it’s faster, non-invasive, safer and less-expensive, and provides more views from which to detect the disease.

 “See how sharp the vessels are?” Fishman asks. “That’s due to two advantages: the thin sections and the infinite views. With conventional angiography you only get one or two different projections.”

Fishman uses a mouse to rotate, slice and travel through the three-dimensional images of vessels and organs, which allows him to detect the very earliest signs of disease. He can pick up narrowing in arteries around the heart, kidneys and other organs, and also stage malignant tumors and their spread more accurately. And that in turn helps surgeons make better decisions about treatment.

 “In every pancreas, every liver, the surgeon wants to know if there’s vessel invasion,” Fishman says. “So we do CT angiographic maps of all these kinds of patients. The maps are key in determining whether they should have surgery or not, what type of surgery, and whether they should have chemotherapy at the end.”