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Frontiers
High-Tech Systems Provide Health Care Savings
September 1996
An expensive and invasive medical technique commonly
used by doctors to screen for colon cancer may be replaced by a less costly
exam that uses a painless x-ray and computer visualization.
Virtual reality (VR) colonoscopy is one of seven Cost-Reducing Health
Care Technologies projects. Funded by NSF and the Whitaker Foundation,
the program focuses on new or improved technologies that can cut the cost
of existing procedures.
"Technology is often blamed for rising health care costs," says Whitaker
President Miles J. Gibbons, Jr. "But used wisely, technology can become
a powerful solution to the problem."
With the VR colonoscopy procedure, researchers are promising a significant
increase in patient comfort, as well as a cost savings.
A standard colonoscopy involves sedation and the insertion of a flexible,
100-centimeter fiberoptic scope into the rectum. Doctors then use the
scope to look for abnormalities that suggest cancer. After the procedure,
the patient spends several hours recovering from the sedation.
The new system uses three-dimensional, spiral computerized tomography
(CT) scans. The exam lasts less than a minute--as long as the x-ray takes.
When the pictures are fed into a computer, radiologist David Vining uses
a virtual reality program to look at the patient's bowels.
The computer screen shows an image of the colon that can be manipulated
electronically. Vining takes the image and splits it down the center,
laying it open like a hotdog bun.
The team then examines the internal tissue and the thickness of the walls.
Abnormalities are easy to spot, says Vining, a physician and assistant
professor at Bowman Gray School of Medicine.
For most patients, the VR images are adequate for complete diagnosis,
he says. When a potential lesion is found, the patient must return for
a colonoscopy.
In addition to developing computer programs for the VR colonoscopy and
setting up clinical trials, Vining and his colleagues are performing a
cost-analysis of the procedure. Since the new system cuts patient recovery
time down to practically zero, the researchers believe that the VR procedure
will save time and money for both hospitals and patients. Hospitals that
already own a spiral CT should be able to benefit from this technology
in the near future.
Other NSF/Whitaker Foundation projects include:
- Rapid closure of arterial puncture sites after angiography
and angioplasty. Savings from reduced bleeding may reach $500
million per year.
- Image-guided robotic-assisted therapy. A robotic system will
permit localized treatment of tumors, an approach that requires
less surgery.
- Biomedical sensors for detection of bacterial vaginosis (BV).
An at-home diagnostic tool for BV would reduce patients' time
at clinics.
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