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A New Paradigm for Medical Care in Canada

A New Paradigm for Medical Care in Canada. Head to Toe 4D Screening Richard Gordon Radiology and Electrical & Computer Engineering University of Manitoba + TRLabs. Presented at Medical Networks Workshop, TRLabs, Winnipeg, March 12, 2003.

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A New Paradigm for Medical Care in Canada

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  1. A New Paradigm for Medical Care in Canada Head to Toe 4D Screening Richard Gordon Radiology and Electrical & Computer Engineering University of Manitoba + TRLabs Presented at Medical Networks Workshop, TRLabs, Winnipeg, March 12, 2003

  2. Gordon, R. (2002). A New Paradigm for Medical Care in Canada Head to Toe Screening via the 4D Imaging Annual Checkup, A Report Invited by Mr. Roy Romanow, Commission on the Future of Health Care in Canada, Winnipeg University of Manitoba.

  3. Contact: • Richard Gordon, Departments of Radiology and Electrical & Computer Engineering • University of Manitoba, Room GA216, Health Sciences Centre • 820 Sherbrook Street, Winnipeg, MB R3A 1R9 Canada • Phone: (204) 789-3828 (recorder), Fax: (204) 787-2080, E-mail: GordonR@ms.UManitoba.ca • http://www.umanitoba.ca/faculties/medicine/radiology/stafflist/rgordontitle.html

  4. Handheld Ultrasound

  5. “There is a phenomenon loose on the land, a genie out of a bottle, an opportunity to serve the consumer by providing a wanted service. We are witnessing a consumer movement that forgoes traditional healthcare models…. changes in technology, diffusion of knowledge about medicine, an interest in self knowledge in general, and increased affluence, have allowed a significant fraction of the population to take control of many aspects of its healthcare, one of these being knowing as much as possible what is going on in their body. They are asking for individualized care, for artisan product, and they are willing to spend disposable income on this pursuit. The history of medical care in the US is that which the affluent can access eventually becomes accessible to larger and larger numbers of people, and eventually becomes the norm for all who have some type of coverage…. Within the next few years we will see thousands of screening centers come into operation.” Kaufman, L. (2002). The Growth of Screening Imaging Services, http://www.rtportal.com/mp/articles/a052802.htm

  6. People need and want to know what is happening inside their bodies and how that might affect their health or longevity • Those who can afford it now are having themselves screened head to toe • This creates two-tier access to high technology 3D screening • Screening is placing an increasing burden on our public health care system that may overwhelm it

  7. 4D Screening: Calculate Changes Between Consecutive 3D Images • 4D screening as a new approach to medical care is possible and desirable • New priorities: • periodic screening of everyone • prevention • cure

  8. Where’s Waldo? Gordon, R. & R. Sivaramakrishna (1999). Mammograms are Waldograms why we need 3D longitudinal breast screening [guest editorial]. Appl. Radiol.28(10), 12-25.

  9. Waldo Background

  10. Another Waldo Background

  11. All three superimposed • Now try to find Waldo

  12. Subtract: • All 3 with Waldo • Minus all three without Waldo • Same problem as two 3D images taken some time apart, with a small tumor growing in the interim = 4D screening

  13. Extrapolation of Breast Cancer Data Sivaramakrishna, R. & R. Gordon (1997). Detection of breast cancer at a smaller size can reduce the likelihood of metastatic spread a quantitative analysis. Acad. Radiol.4, 8-12.

  14. Target: 4 mm tumors

  15. Imaging Modalities for 4D Screening • CT = Computed Tomography • MRI = Magnetic Resonance Imaging • EIT = Electrical Impedance Tomography • US = Ultrasound • SkinScan = Skin Scanning

  16. Network Capacity Needed • In Manitoba, (population 1 million), 200 people per hour (at 2 shifts/day) • Compare with 3D airport baggage scanners handling 800 bags/hr now • 100 GB per year per person stored in computers = 105 TB per year for 1 million people • Computing power needed is about 2000 teraflops • Network capacity of 3 GB/second for transmitting images between eight health regions for Manitoba.

  17. 3D Baggage Scanners http://www.invision-tech.com/products/

  18. Work to be Done • Computer programs, running on an array of parallel and/or grid computers, to detect every disease that we learn to visualize by 4D imaging • A new hardware and software industry to continually improve the detection of the earliest signs of disease via 4D screening • Storage of all data for the sake of the individual for retrospective application of new computer programs • Epidemiological analyses of screening effectiveness

  19. Predicted Benefitsof 4D Screening • Relatively inexpensive early detection • Watchful waiting and timely intervention could keep small medical problems from becoming huge ones • Reduced mortality, morbidity, hospitalization and sick leave, and extended healthy life • Costs more than recovered: it takes only a 25% savings from the 2002 Province of Manitoba health budget of $2.8 billion, namely $700 million/year, to make 4D screening more than cost effective

  20. TRLabs Roles • Develop imaging modalities for 4D screening: •     EIT •     CTM-OPT(CT Mammography - One Photon at a Time) • Develop networking capabilities

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