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Initial experience with a state-of-the-art mobile head CT scanner for use in neurointensive care units

Erste Erfahrungen mit einem modernen mobilen Kopf-CT-Scanner für den Einsatz auf der neurologischen Intensivstation

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Abstract

Objective

Mobile head computed tomography (CT) scanners can reduce transport-related complications in neurointensive care unit (NICU) patients and decrease the burden on NICU staff; however, the initial investment cost and reduced image quality of early mobile scanners have prevented their widespread clinical use. Here, we report our initial experience with a novel 32-row mobile CT scanner for use in NICUs.

Methods

Over a 2-year period, 107 patients received a mobile head CT scan. The technical characteristics of the scanner and the organizational procedures are described in detail. Patient characteristics were retrospectively collected and image quality was subjectively evaluated on a Likert scale ranging from 0 to 5 and compared with a stationary CT scanner.

Results

Mobile head CT was used for follow-up of intracranial hemorrhage in 51%, routine postoperative imaging in 28%, evaluation of neurological deterioration in 14%, bedside monitoring after external ventricular drain placement in 4%, and follow-up of ischemic stroke in 3% of cases. Diagnostic imaging quality was achieved in all cases, eliminating the need for stationary CT scanning. The overall image quality of mobile CT (median 4 points) was inferior to that of conventional stationary CT (median 5 points, p < 0.01), but was rated with 4 or 5 points in the majority of cases.

Conclusions

State-of-the-art mobile CT was found to be easy to use and maneuver and has the potential to expedite the diagnosis of NICU patients and reduce staff workload. Image quality was adequate for common NICU issues.

Zusammenfassung

Ziel

Durch mobile Kopf-Computertomographie(CT)-Scanner können transportbedingte Komplikationen bei Patienten auf neurologischen Intensivstationen (NICU) und die Belastung des Personals dort vermindert werden, jedoch haben die anfänglichen Investitionskosten und eine verminderte Bildqualität der frühen mobilen Scanner ihre Verbreitung im klinischen Einsatz verhindert. In der vorliegenden Arbeit berichten die Autoren über ihre ersten Erfahrungen mit einem neuartigen mobilen 32-Zeilen-CT-Scanner für den Einsatz auf NICU.

Methoden

In einem Zeitraum von 2 Jahren wurde bei 107 Patienten eine mobile Kopf-CT-Untersuchung durchgeführt. Technische Merkmale des Geräts und organisatorische Abläufe werden detailliert beschrieben. Die Patientenmerkmale wurden retrospektiv erhoben und die Bildqualität subjektiv auf einer Likert-Skala von 0 bis 5 bewertet und mit einem stationären CT-Scanner verglichen.

Ergebnisse

Die mobile Kopf-CT kam für Nachuntersuchungen bei intrakranialer Blutung in 51%, für postoperative Routinebildgebung in 28%, zur Beurteilung einer neurologischen Verschlechterung in 14%, zum Bedside-Monitoring nach externer Ventrikeldrainagenplatzierung in 4% und für Nachuntersuchungen bei ischämischem Schlaganfall in 3% der Fälle zum Einsatz. Dabei wurde in allen Fällen eine zu diagnostischen Zwecken ausreichende Bildqualität erzielt, wodurch keine Notwendigkeit einer Untersuchung mittels stationärem CT-Gerät mehr bestand. Die Bildqualität des mobilen CT-Geräts (Median: 4 Punkte) war insgesamt schlechter als die des herkömmlichen stationären CT-Geräts (Median: 5 Punkte; p < 0,01), allerdings in der Mehrzahl der Fälle mit 4 oder 5 Punkten bewertet worden.

Schlussfolgerung

Das mobile CT-Gerät auf dem neuesten Stand wurde als einfach zu bedienen und zu bewegen empfunden und hat das Potenzial, die Diagnosestellung bei NICU-Patienten zu beschleunigen sowie die Belastung des Personals zu reduzieren. Für die üblichen NICU-Fragestellungen war die Bildqualität ausreichend.

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Data availability statement

The data will be made available upon reasonable request.

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Authors and Affiliations

  1. Faculty of Medicine and University Hospital, Department of Radiology and Neuroradiology, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany

    Lukas Goertz MD, David Zopfs & Christoph Kabbasch

  2. Department of Interventional Radiology and Neuroradiology, Klinikum Hochsauerland, Arnsberg, Germany

    Yosef Al-Sewaidi, Mahmoud Habib, Benjamin Reichardt & Alexander Ranft

Authors
  1. Lukas Goertz MD
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  2. Yosef Al-Sewaidi
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  3. Mahmoud Habib
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  4. David Zopfs
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  5. Benjamin Reichardt
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  6. Alexander Ranft
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  7. Christoph Kabbasch
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Corresponding author

Correspondence to Lukas Goertz MD.

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Conflict of interest

C. Kabbasch serves as consultant for Acandis GmbH (Pforzheim, Germany) and as proctor for MicroVention Inc./Sequent Medical (Aliso Viejo, CA, USA). D. Zopfs is on the speaker’s bureau of Philips (Amsterdam, the Netherlands) and lecturer for Amboss GmbH (Cologne, Germany). L. Goertz, Y. Al-Sewaidi, M. Habib, B. Reichardt and A. Ranft declare that they have no competing interests.

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. The study was conducted in accordance with the STROBE guidelines in compliance with the national legislation and the Code of Ethical Principles for Medical Research Involving Human Subjects of the World Medical Association (Declaration of Helsinki). Informed consent was obtained from all individual participants included in the study.

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The authors Alexander Ranft and Christoph Kabbasch contributed equally to the manuscript as last authors.

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Goertz, L., Al-Sewaidi, Y., Habib, M. et al. Initial experience with a state-of-the-art mobile head CT scanner for use in neurointensive care units. Radiologie (2024). https://doi.org/10.1007/s00117-024-01304-1

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