Tampa VA Radiology Setting Trends in Imaging Technology Advancements
Being equipped with technology that can detect, diagnose and treat conditions to increase the number of successful health outcomes for patients isn’t a long way coming. It's here.
Dr. Narayan Viswanadhan, Chief of Tampa VA’s Radiology Service has been on a path to make the latest technology available to patients for half a decade.
“Over the last five years our focus has been growth. My mission is for Veteran patients to get cutting-edge radiology, diagnostic and interventional care,” said Viswanadhan.
To do that you start with people. “We’ve been growing at a rapid clip. There are thirty radiologists and 220 employees in Radiology,” he said.
“We’re probably the busiest and largest of the complex VA Medical Centers in the country,” said Viswanadhan.
The Service is staying busy by making screenings and treatments available at Community Based Outpatient Clinics for the convenience of Veteran patients.
“We’ve expanded to Riverview, New Port Richey with state-of-the-art imagery. We’re undergoing Lakeland expansion,” he said.
The Service also has a scheduling section dedicated to nuclear medicine and radiology.
“In Imaging, we have a number of modalities – Computed Tomography, Magnetic Resonance Imaging, ultrasound and general radiology,” Viswanadhan said.
The variety of modalities augment success rates, according to studies. Additionally, to increase accuracy during surgeries, Internal Radiology incorporates imaging to perform procedures.
Radiology services they offer also include women’s health breast imaging.
“Mammography is an excellent part of the department. We have fellowship-trained mammography specialists and a sub-expertise in breast imaging,” he said. “We follow American College of Radiology-appropriate criteria—recommend patients start exams at 40 years. We’re preparing for more women Veteran growth and have added more services to that end.”
Mammography is now offered at primary care and other outpatient clinics.
NEW SCREENING
Breast MRI incorporates SAVI SCOUT—a procedure that limits the amount of breast tissue removed to a precise area used to perform a lumpectomy when suspicious lesions are detected.
“This reduces patient anxiety and improves Veteran experience,” Viswanadhan said.
The Service also started using KUBTEC, state-of-the-art applications in imaging, for conducting an interoperative breast specimen radiogram reducing the operating room time.
“In a patient’s breast MRI, we found cancer and used the technology. These things matter. They make a difference. Using more finely-tuned technologies, we find more cancer and save more lives. If we find an abnormality, we diagnose and then treat it making care rendered more timely. What we offer is better than what I’ve seen in the community,” he said.
Radiology Service incorporates sophisticated heart imaging as a specialty to the advantage of patients.
“We have a Cardiac Imaging Fellowship and have trained fellows in cardiac thoracic imaging. Dr. Nikhil Goyal started working in Cardiology and started using the new technology for calcium scoring. We can determine the risk of cardiac disease using imaging for common heart procedures - tricuspid valve repair/tricuspid valve replacement,” Viswanadhan said.
“We screen for trans-catheter aortic valve replacements and recently started to implement cardiac MRI,” he said.
ARTIFICIAL INTELLIGENCE
Radiology Service is also focused on Artificial Intelligence and radiology. 75% of all commercial applications are in the AI space. Radiologists use clear-read AI for nodule defects and rapid AI for brain hemorrhage detection.
“We’re going to continue to do work in AI innovations to help clinicians. We’re enhancing scheduling operations with AI. Chatbot large language models support another area of growth,” Viswanadhan said.
INNOVATIONS
Another feature in the Service’s innovation efforts is in 3D printing.
They’re working on 3D printing of anatomic models for teaching and procedures, and can make prototypes of different inventions using the 3D printer.
The Service also focuses on virtual and augmented reality with image-guided overlays in inpatient procedures.
“We contracted with VHA’s Innovation Ecosystem. We’re improving the ability to do fundamental MRI of the brain. Patients who have traumatic brain injury and neurologic disease can receive imaging with advanced neurologic techniques,” Viswanadhan said.
Internal radiologists have also done more with newer techniques with oblations of spinal lesions.
“We’re embarking on endocrine assessments of adrenal lesions, advancing fibroid embolization for women with fibroids,” Viswanadhan said.
Advancing techniques to diagnose and target damaged cells for treatment, Nuclear Medicine started using prostate-specific membrane antigen (PSMA) prostate-specific membrane antigen (PET) to detect metastatic legions.
“We’ve seen significant growth in the use of the new technology for treatment in that area. We’re working to offer the service to more Veterans because this treats prostate cancer using radiopharmaceuticals,” he said.
With all the new diagnostic and treatment procedures to improve outcomes, the team is adding value to expertise, informed decision-making and investigation in health care.
“We also do research. We’re published,” said Viswanadhan.
Dr. Viswanadhan has been the chief of Radiology for two years and before that he was the assistant chief of the Radiology Service. He studied in New Jersey, did his fellowship in Harvard and was in private practice for five years in Lakeland before joining Tampa VA.
“The department is doing well. Of the VISN and the nation we’re leading in metrics that determine appointment completion, making sure exams are done timely. Our access measures are 93% total across all modalities,” said Viswanadhan.
“We’re providing cutting-edge diagnostic and interventional services to Tampa VA Veterans who’ve earned it from a Radiology staff that deserves credit for providing top-level care. It’s a team effort,” he said.