Talking about the objective at the time of inception, Dr Prem Kumar Ganesan, who heads the department, informs, “Our goal was to set up a state-of-the-art diagnostic centre with all the latest imaging equipment so that we are able to provide accurate precision diagnostic facilities to the patients as well as the consultants.” He strongly believes that clinical support from radiology is rapidly changing the disease management process. “Diagnosis is making all the difference in today’s healthcare management,” he adds.
Despite being a relatively new set-up, efforts have been made to match it up with the best and catch up with its peers as far as advanced equipment is concerned. The department boasts of 1.5 Tesla MRI, 1.28 slice cardiac CT and digital fluroscopy or CINI fluroscopy. The latter in particular makes optimum use of special radiological equipments. “We also take pride in a state of the art ultrasound, in which we also have fusion imaging, a fusion of ultrasound and fluroscopy to target and perform intervention procedures and see lesions less than 1 cm which we can’t see on ultrasound,” Dr Ganesan says.
The aim of the department is to engage with other departments as well and work in conjunction with them across all modalities. The main focus is on neurology, neurosurgery, gastrointestinal surgery as well as providing support to gynaecology, medicine and paediatrics. The main thrust is on oncology, with a team that focusses on radiation oncology and surgical oncology. “Major support is for the oncology team since we regularly do triple phase CT angiography, wherein we are delineating the size and the extent of the tumour and its spread,” chips in Dr Ganesan. The department also does CT coronary angiography, a non-invasive screening method for identifying coronary artery disease along with whole body angiography like brain angiography, pulmonary angiography and peripheral angiography.
Apart from this, the team of radiologists also works with renal transplant donors and recipients and liver transplant donors and recipients to do a detailed evaluation of arteries, veins, segments of liver so as to better guide the surgeon on which part of the liver needs to be transplanted. “Diagnostic radiology is going to contribute a good amount of information on leukaemias 10 years from now but it needs to be used with sensitivity,” he exhorts.
Dr Ganesan himself is a MD in radiology from AIIMS with training in fusion imaging from Italy to perform ablation and various other procedures. He has 23 years of experience behind him and has been associated with the department since its inception for the last four years. He has a team of seven radiologists under him trained in MRI, CT, fusion imaging and ultrasound. What is unique about how the department works is that each consultant chooses a particular organ system, so there will be someone working on neurology and neurosurgery, one on gastroenterology and GI surgery and one on oncology. So, each consultant is responsible for a particular modality and they upgrade themselves on the latest in their particular areas from time to time.
Technology forms a crucial part of the radiology department, but that does not mean one can discount technical training and competence. So the staff needs to be regularly updated on the technology, while also being patient centric. “Radiology will always have the risk of radiation dosage, so the consultants and the staff have to be sensitive to the radiation dose that the patient is getting in a particular study. So, for instance a CT has been asked for in a particular study and we feel that MR will give the answer, we’d go ahead with the MR, because when we do the CT, there’ll be a certain amount of radiation dose. This applies for children and those who have earlier had a lot of radiation studies, X-rays, MR, CTs, PET etc.,” elaborates Dr Ganesan.
| The aim of the department is to engage with other departments as well and work in conjunction with them across all modalities. The main focus is on neurology, neurosurgery, gastrointestinal surgery as well as providing support to gynaecology, medicine and paediatrics. The main thrust is on oncology, with a team that focusses on radiation oncology and surgical oncology | |
The team also performs perfusion imaging in liver and stroke patients. Although the hospital still doesn’t have research trial permission from the Government of India it runs a DNB programme in radiology and research could be the next frontier.
Being an interdisciplinary field images don’t make any sense, unless they are of clinical use. And hence to train the staff in this area, there are regular weekly interactions with each department be it gastroenterology, neurology, gynaecology etc. All the cases in that particular department are taken up with the clinical team and analysed along with the reports to get critical feedback on their operating findings. Clearly, clinical outcome and clinical correlation is of topmost importance.
Touching on the trends in imaging Dr Ganesan says, “Imaging is going from anatomical imaging to functional imaging. In a stroke patient, in the first four hours, CT scan may not show anything but MR will still show something. But perfusion is going to say, how much of that tissue is salvageable. Fusion imaging has a great future too, you can target a 1 cm lesion which you can’t see in an ultrasound, do a biopsy and then do something to ablate it as well.”
Finally he boils down to the core of it, a patient centric approach, at the same time understanding the needs of the clinical team. “We need to interact more with the patient to understand his past problem and the present issue or medical condition,” he concludes.