Patient Care

Technical Advancements and Equipment

In recent years, Yale-New Haven Hospital has invested substantially in technical improvements for the Department of Diagnostic Radiology.

Information Technology
The department has embraced electronic imaging and information systems as critical to our long term survival and success in a competitive marketplace. Beginning in the early 1990s, an IDXrad radiology information system was acquired permitting electronic report signature. By 1997, a Kodak PACS system for CT and MRI was installed, and web-based image distribution to referring physicians and radiologists alike was enabled via a web-based image server from Stentor. In 2003-2004, the department acquired a full scale PACS system from Fuji. Computed radiography, CT, and MRI are all connected electronically to Fuji PACS and distributed both within and beyond the radiology department. However, ultrasound, gastrointestinal/genitourinary radiology, and mammography are not yet fully integrated into the PACS system.

Angiography and Interventional Procedures
Five angiographic suites are devoted to non-cardiac angiography and interventional procedures. One suite contains the first Philips flat detector interventional system in the western hemisphere - compared to conventional equipment, this system can produce very finely detailed images with low radiation doses, allowing for reductions in the quantity of contrast agent as well. This can open new perspectives in the whole range of interventional and angiographic procedures.

Conventional radiography and fluoroscopy
Two new digital radiography rooms have been acquired in the past year from Fuji Medical Systems. These are housed in the South Pavilion and in the Yale Physicians Building. In addition, a Lorad digital mammography unit was acquired recently for the Breast Imaging section. A new single plate computer radiography reader was acquired recently for the Long Wharf Imaging Center which can accommodate both plain radiographs as well as mammograms. This digital conversion will permit greater flexibility in our staffing as coverage of the Long Wharf facility will now be possible by teleradiology.

Computed tomography
The department enjoys the use of four CT scanners deployed within the hospital and at an outpatient facility at Long Wharf. All scanners are manufactured by General Electric. A 16 slice scanner (Lightspeed) is present on the 2nd floor in the South Pavilion as is a single slice scanner for interventional and low-end diagnostic procedures. A four slice scanner is housed in our Emergency Radiology Department, and a second four slice scanner is housed at the Long Wharf outpatient facility. Two Vitrea 3D workstations (Vital Images, Inc.) and one Advantage Windows workstation (General Electric Corp) provide post processing and 3D support for the CT service. The 16 slice (Lightspeed) CT scanner has EKG-gating hardware and software to permit cardiac CT applications. CT fluoroscopy is housed on the single slice CT scanner in the South Pavilion permitting real time monitoring for interventional procedures.

MRI
MR equipment in the Division of Clinical Radiology is manufactured by the General Electric Corporation and has consisted of four 1.5 Tesla MR scanners for the past several years. One such scanner is housed in a mobile trailer which is docked adjacent to the Emergency Room. The other three magnets are housed in the clinical MR Center. Two new units have recently been installed - 3.0T and 1.5T MR units from General Electric. The MR service will be supported by a number of advanced imaging workstations from Vital Images, Inc and General Electric.

There are nine dedicated research magnets on campus (one Siemens 3T whole body, one Siemens 1.5T whole body, one 4T whole body for spectroscopy, three animal, three in vitro).

Nuclear Medicine
A new PET CT scanner was recently installed in the East Pavilion, effective September 1, 2004. This scanner is manufactured by General Electric Corporation and is supported by two Xeleris workstations positioned in Nuclear Medicine and Body CT. This approach permits simultaneous review of PET CT scans by both Nuclear Medicine physicians and CT radiologists. At the shoreline, there is currently only 1 gamma camera installed, which will serve general nuclear medicine studies.

Ultrasound
The Ultrasound service has undergone incremental upgrades to a host of imaging equipment over the past several years. At present, six ultrasound rooms support the department of Diagnostic Radiology and three support echocardiography. A machine suitable for transrectal sonography was acquired recently to support new applications related to the recruitment of a new colorectal surgeon. Two state of the art ultrasound machines are dedicated to the pediatric population.

Pediatrics
There are 2 fluoroscopy rooms, which utilize GE equipment, and 2 radiography rooms. This service also has 2 ultrasound machines, which are relatively state of the art.

North Tower Expansion
In 2008, Y-NHH is planning to open a 14-story addition to the hospital complex. Located in the north corner of the quadrangle, the new tower will house a comprehensive cancer center. For Diagnostic Radiology, this building project probably represents the single largest expansion of the department in recent history with substantial increases in imaging resources (MRI: 4 to 9 units; CT: 4 to 6 units; PET: 1 to 2 units; Ultrasound: 6 to 9 units).