The Department completed many capital projects within the past year, greatly increasing its MR capacity and replacing old equipment. Indeed as this is written, there are no active construction projects within Radiology, a situation that is both rare and short-term, as we are awaiting state approval on a project to replace two body interventional rooms within Moffitt. We also are in the bid process for construction that will remodel the mammographic reading room at Mt Zion. 

MRI Expansion
This was the year in which Radiology experienced its greatest expansion in MR capacity ever. We installed a total of four magnets, two inpatient and two outpatient, all 3T units. On the inpatient side, two 32-channel, GE HD750 systems were installed in Moffitt 3 North, a space new to Radiology. The space comprises nearly 3,700 sq. ft., and the cost of equipment and construction topped $12 million. To complete this project, the entire infrastructure in this part of Moffitt Hospital had to be improved, including air handling, electrical capacity, and the data networks. A large chiller was installed on the roof. The floor had to be strengthened not just under the magnet locations, but also under the path for transporting the magnets to their locations. This necessitated closing the cafeteria, which is under the magnets, for several months. The new magnet space was designed to support patients requiring anesthesia during their procedures and was carefully developed to assure safety within the magnet area. The magnets sit side by side, requiring substantial shielding to prevent interference between them . With the addition of these two magnets, the longstanding 1.5T magnet in a trailer located outside the emergency room entrance was finally shut down. 

The third magnet added to Radiology is located in the Medical Office Building on Post Street near Mt Zion Hospital, on the ground floor adjacent to a 64-slice CT scanner. Patient reception and changing areas are shared with CT, improving efficiency.  The magnet is a Siemens Verio 3T, the first such magnet installed in Northern California.  This system features a 70 cm bore and a table supporting 550 pounds. The magnet is a 32-channel system configured for all types of imaging. This magnet will be used to further develop breast imaging in collaboration with Siemens, using a Sentinelle breast coil.

The fourth magnet is also a 32-channel GE HD750, is located in a new building near the Mission Bay Campus within the recently opened Orthopedic Institute. This facility is nearly 50,000 sq. ft. and is now where most of UCSF's orthopedic work is done. Radiology has a bone reading room on-site and staffs the equipment, which also includes two GE Definium digital radiographic rooms and a Philips EasyDiagnost R/F room. The latter has both a table and a wall-mounted digital detector. Other imaging equipment at the Orthopedic Institute includes a portable X-ray unit, a C-arm portable fluoro unit and a Fuji CR. All imaging systems connect to Radiology's PACS.

The magnet count at UCSF is now 10 clinical magnets, six 1.5T systems and four 3Ts.  In addition the Department has three research magnets for human studies, two 3Ts and a 7T.

Parnassus Campus
While the 3 North MRI addition was being worked on, Radiology was also building in several other areas. Equipment replacement in the Moffitt radiographic/fluoroscopic rooms was completed with the installation of two Siemens Luminos units. We also completed installation of neurointerventional's second Siemens, flat-panel, biplane angiographic room. This major project took nearly two years to complete and required expanding the room space by relocating two offices and closing a darkroom. The neurointerventional project replaced the sole remaining piece of equipment installed when Long Hospital was built in 1986!

Some new equipment at Moffitt/Long did not require construction. The ultrasound section acquired three new GE Logiq E9 US machines. These couple to a new ultrasound miniPACS implemented in May 2009, made by Imorgon. After years of frustration with the old display system, the Imorgon miniPACS was eagerly awaited.

The Department acquired new portable X-ray equipment that enables digital acquisition of images at the bedside. Two GE Definium X-ray units with a digital detector tethered to the unit are now in use. Because these units communicate wirelessly, a patient worklist is available to the technologist and images are sent to PACS without connecting to a network port. The Department some will receive three portable systems from Fuji called CR Go units. These portables use CR, but the CR reader is part of the portable unit. They will also function wirelessly.

Mt. Zion Campus
In addition to the new magnet, most of the activities at Mt Zion involved mammography.  With the closure of the mammographic rooms within the ACC building on Parnassus, all mammography is now done in the Women's Pavilion or within the Cancer Center at Mt Zion. All remaining analog units have been replaced with Hologic Selenia systems bringing the total number of these systems at UCSF to six. All film processors within mammography are now gone. The mammographic reading room will begin a remodel in September and a dedicated miniPACS for mammography made by Sectra is on order. Mammography has also acquired a new mammographic reporting system made by a local company, Jambeyang Research.

China Basin
With the expansion of imaging equipment, the Department's Agfa Impax PACS system has had to expand. PACS core components have been installed in a computer room at China Basin, including data storage devices and, importantly, a redundant database server. The latter component eliminates a single point of failure that previously existed. In the coming year, we have been given resources to fully implement a backup system at this site for disaster recovery and business continuity.

China Basin has become the site for most outpatient nuclear medicine studies. A nuclear cardiac stress lab is fully operational. We are exploring the possibility of adding more nuclear cameras in this location.

The Future
The Department will continue to replace old equipment in the upcoming year. We have been approved to replace the body interventional angiographic room at Mt Zion.  Also at Mt Zion, we have approval to add a radiographic room. This is greatly needed, as Mt Zion now has only a single, non-digital radiographic room, requiring use of CR and causing problems in the event of any downtime. Within Moffitt/Long construction will occur as we install the new interventional rooms, a CT scanner, and at least one nuclear camera. All of these projects were approved in previous years and are finally ready for work to begin.

By Robert G. Gould, Sc.D.
Robert G. Gould, ScD, is a professor of radiology in residence and vice-chair for Technology and Capital Projects. He oversees the purchase of the department's capital equipment.

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