December 27, 2013 | As one of the first hospitals in the region, SKS Hospital in Salem, India, provides access to high-quality CT scans. Dr. Vijay Sadasivam explains why both physicians and patients benefit from this advanced CT technology.
Text: Swati Prasad
Photos: Arush Mayank
A doctor in Salem’s Appusamy Hospital diagnosed 34-year-old Mallika with metastases on her liver. She was referred to neighboring SKS Hospital for an abdominal CT. During Mallika’s scan on the 128-slice CT SOMATOM Definition AS, the radiologist at SKS Hospital noticed a mass on her chest and extended the study to cover both: chest and abdomen. This only takes a few more seconds in addition to the total scan time. The diagnosis was breast cancer that had spread to her abdomen.
A Quantum Leap for the Radiology Department
On a less advanced CT scanner, the results might have been inconclusive. Precision, excellent imaging, and maneuverability to cover a wider area of the body in the minimum possible time are the hallmarks of the 128-slice CT. It is rare for hospitals in India’s tier-II cities (those with a population of less than 5 million) to own such a high-end machine. If Salem hadn’t had one, Mallika would have had to travel 200 kilometers, to Bengaluru, or 170 kilometers to Coimbatore for her scan.
“Radiology as a practice has changed because of machines like the 128-slice CT,” says Dr. Vijay Sadasivam, 40, who is head of radiology at SKS Hospital. “Most small hospitals in the region are constantly referring their patients to us,” he says. The role of the radiologist has changed, as well. “Our opinions matter. There are very few occasions when my inputs are not sought for diagnosis of a disease or before a surgery,” he adds.
Good Reasons to Aim for More
Since its beginnings in 1987, SKS Hospital has had a strong focus on quality. For example, it was the first hospital in its region to acquire a 4-slice CT machine. At that time, only hospitals in Chennai had such advanced imaging technology. Salem was considered a market for single-slice spiral CTs. The acquisition of the 4-slice scanner also coincided with SKS Hospital’s managing director, Dr. V. Suresh Kumaran inviting Vijay to join his team in Salem. The job profile – combined with access to a 4-slice CT machine – seemed irresistible and Vijay left his old job to become a full-time radiologist at SKS Hospital.
But technology was evolving, and within a few years, other hospitals in the region had bought more advanced CT scanners. This was what prompted SKS Hospital to consider upgrading to a 64-slice CT machine, back in 2009.
Investments in Advanced CT Technology Paid Off
Following a demonstration of the 128-slice CT, in Mumbai, Suresh found himself more inclined to go for the higher specification. “Technically, the 128-slice CT was far superior to the 64-slice machine. But it was a lot costlier, too,” says Vijay. There was skepticism over whether such an expensive machine would be financially viable in Salem. The credit for choosing the 128-slice CT machine for Salem goes to Suresh. “He had a firm belief that this machine would benefit Salem,” Vijay adds.
Technically, the advantages of 128-slice CT were numerous. The machine gave excellent images in much less time. “Diagnostically, we made a huge leap,” Vijay recalls, adding that it saved not only time, but costs, as well. “The machine is energy-efficient. Since the scans happen much faster, we expose the patient to far less radiation. Moreover, we don’t need as much contrast medium,” Vijay said.
Healthcare in the South Indian State of Tamil Nadu
Tamil Nadu is India’s most urbanized state, and the fifth-largest contributor to its GDP. The state’s healthcare facilities are among the best in the country. Several medical colleges, medical education, and research institutes, as well as numerous healthcare centers have contributed to this success in the healthcare industry. In fact, South India produces the greatest number of doctors in India, followed by West India.
Numerous Insurance Schemes for Higher Healthcare Standards
Both the private sector as well as government hospitals have played a role in increasing the standards of healthcare in Tamil Nadu. The state offers several health insurance schemes, such as the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) and the State Employee Health Insurance. CMCHIS is an ambitious insurance scheme launched by the state government through a public sector insurer – United India Insurance Company. It provides free medical and surgical treatment at government and private hospitals to members of any family whose annual income is lower than INR 72,000 (US$ 1,277).
Center of Medical Tourism
It is not just the capital of Tamil Nadu – Chennai – that dominates the healthcare landscape of the state. Medical tourism is booming, with patients coming from neighboring states in East and Northeastern India, and even from abroad. Coimbatore, the second largest city in Tamil Nadu, is transforming into a “medi-city”, with four multispecialty high-tech hospitals and more than five specialty hospitals. Estimates suggest that in 2008, around 500,000 people from other parts of India, along with 40,000 foreigners, visited Tamil Nadu for medical treatment.
A Responsible Role in the Healthcare Market
Besides its numerous primary health centers equipped with facilities for providing Cesarean sections, the state has the best record in full child immunization coverage and the provision of antenatal and postnatal care. Tamil Nadu responded swiftly to the 2004 tsunami disaster by organizing care for survivors and putting measures in place to minimize the risk of epidemics.
CTs Beyond the Brain
The 128-slice CT also scores medically, providing multiple benefits across a number of specialist fields. One such example is cardiology. With this advanced CT scanner, cardiac CTs are both painless and noninvasive: “The machine does away with the need for interventional screening – especially in patients who have just been through a coronary artery bypass graft (CABG) or stenting, or those who are too frail for an interventional study in a cath lab,” says Vijay.
Consultant cardiologist at SKS Hospital, Dr. P. Kannan, MD, adds that the machine “is particularly useful for diagnosing peripheral arterial disease, pulmonary stenosis, and pulmonary arteriovenous fistula.”
For surgical oncologist, Dr. G. M. Chandrashekharan, the CT scanner has almost eliminated surprises at the operating table. The surgical approach in oncology has been transformed because of CT technology. “The CT reports are more reliable. We can see even small lesions,” he says.
A New Hub for Multidisciplinary Imaging
The machine has also helped neurologists, thanks to its Neuro DSAs facility. Neuro DSA (digital subtraction angiography) is a postprocessing application that allows the removal of bone structures from CT angiography (CTA) datasets, thereby improving visualization of the cerebral vasculature.
Today, more than 200 medical practitioners within a 100-kilometer radius of Salem – in districts such as Namakkal, Dharmapuri, Erode, Krishnagiri, and Villupuram – refer their patients to SKS Hospital for CT scans. “Our case load has increased considerably. With the 4-slice CT, we were performing 400 to 450 scans in a month. Today, we are doing almost 750,” Vijay says.
Author’s Bio
Swati Prasad is a freelance business journalist based in Delhi. She reports from India for several publications overseas and has worked as a correspondent and editor for The Economic Times, Business Standard, The Indian Express, and Business Today.
