Armed with linear accelerators, simulators, high dose rate remote after loading Brachytherapy system, dedicated treatment planning computers and mould room to fabricate lead shields and templates in house, it is intricately networked to CT scan and MRI with DICOM image transfer capability. Talking about the early days, Dr AK Chaturvedi, Director, Radiology says, “We acquired the first state-of-the-art stereotactic mammography machine from Siemens (Mammomat 3000) soon after our inception. It was a sophisticated breast diagnostic system which could do biopsy of lesions.” He added that even AIIMS did not have one that time. Today the digital version takes its place of pride, a newer more advanced system that integrates a small field digital mammography (SFDM) with digital breast tomosynthesis (DBT) and results in computer generated good quality images that are clearer and hence help in better diagnosis.
With more than 200 radiofrequency ablations (RFA) to its credit, the department is a pioneer in the treatment, which is ideal for patients with local tumours or those who have failed conventional therapies. Not only does it save the trauma associated with surgery, but also reduces hospital admission time to a day or so. RFA is performed under CT guidance and combined with chemotherapy for best results. The hospital’s reputation in image guided interventions is evident by the number of referrals coming in from multiple hospitals across the country, most of which are carried out on an outpatient basis. Another technique called Transarterial Chemo Embolisation (TACE) therapy involves administration of chemotherapy directly to the liver tumour via a catheter that reduces many side effects of traditional chemotherapy that is given to the whole body.
Touching upon the merits of functional imaging, he further elaborates how PET CT scans have changed the course of management of cancer. “So far in radiology, the focus was on studying the internal composition of the body, whether through CT scan, X-Ray. However, certain molecular changes also need to be mapped. A PET CT scan gives structural image with a superimposed functional image detailing the metabolic processes in the body which leads to better insights into the disease.” An 18 channel, high gradient 1.5T MRI performs dynamic studies and multiphase angiographic studies alongwith venography, MR spectroscopy, perfusion, diffusion imaging and mean curve analysis functions for evaluation of complex cases. Breast imaging is routinely performed with a high resolution breast coil with advanced software available for analysis of post contrast kinetics of mass lesions. The machine is equipped with a unique ‘total imaging matrix’ (TIM) technology making it possible to combine the elements for more than one coil for optimal imaging.
Currently, the department has 10 radiologists and five more in training. Almost 12 students have passed out so far as a part of its postgraduate DNB programme in radiology (three-year residency) accredited by the National Board of Examinations, New Delhi which started in January each year. Apart from this, it runs a one-year fellowship programme in oncological radiology for radiologists certified by IMA academy of medical specialities, a short-term training programme in radiology (two to four weeks) recognised by the Indian Radiological & Imaging Association (IRIA) and Indian College of Radiology, as well as diploma courses in X-ray and medical Imaging Technology for technicians (two-year programme recognised by Delhi Medical Association).
Dr Chaturvedi is currently working on a project for early detection of breast cancer under International Atomic Energy Agency (Vienna) and recently conducted a workshop in interventional procedures for radiologists in Malaysia. All in all, the department, with its cutting-edge technology supplemented with training and research, looks poised for growth.