It isn’t unusual for visitors to be caught by surprise by the size and scope of the University of Arkansas for Medical Sciences (UAMS) Radiology Department. The hospital has seven magnetic resonance imaging (MRI) machines, including one with the ability to do whole body imaging. UAMS also has a portable computed tomography (CT) machine that can be used in operating rooms, and with MRI performs very sophisticated brain imaging techniques for tumor planning. “Everybody likes pictures that are in color,” said David Amerson, BSRT, assistant director for radiology, UAMS. “These are like nothing you have ever seen before.”UAMS has 185 people who work in radiology, working around the clock. Amerson said radiology is a very dynamic service that provides care support 24/7 for their patients on all levels.“We have a very large department,” Amerson said. “We are very proud of what we do. UAMS is a very large hospital with more than 10,000 employees, which makes us the largest employer in Little Rock and the largest public employer in the state. We are a unique hospital because we have most specialties available.Two of the seven MRIs are 3-T, which relates to how powerful the magnets are. Most MRIs are 1.5-T. These MRI’s are placed in different areas of the hospital.”Amerson said the whole body imaging is helpful for a population of patients with multiple myeloma. The whole body imaging is used to evaluate how well the patient related treatments are working.“Multiple myeloma is a bone marrow disease that is very complicated, but we are also looking at other health conditions,” he said. “We do a sequence called a whole body diffusion scan. The scan used looks from head to toe, and creates a snapshot of information that is used to look at patients in terms of their progress in therapy. A comparison would be a positron emission tomography (PET) scan, and we probably do more PET CT scans than anyone in the country. A diffusion scan looks like a PET CT scan with the exception that it doesn’t use any radiation. “The full body MRI represents a large percent of our MRI volume on a daily basis and was developed with Phillips Medical Systems into an important clinical tool.Another use of MRI is for brain tractography, a 3-D modeling technique using data collected by diffusion tensor imaging (DTI). Another advanced neuro imaging technique is Functional MRI where the patient moves an arm/leg or may read a statement with the corresponding image reflecting areas of the brain are being highlighted. In combination with DTI, the results are greatly beneficial in pre-op planning for brain tumor management.”White matter tracts are what carry nerve impulses in the brain. Amerson said the brain tractography assists surgeons with brain tumor planning and gives direction for the best approach in performing surgery. There are certain tracts you want to stay away from. Brain tractography gives surgeons a pathway of where to operate, and is a good predictor in planning brain surgeries.In addition to cancer patients, the UAMS Radiology Department has a large work effort with trauma patients.“The Trauma Center here does a tremendous job,” he said. “If you are in a car wreck, an anesthesiologist, neurosurgeon and trauma surgeon are waiting on you when you get here. UAMS has many faces. The trauma side is very dedicated to taking care of various levels of injury and the cancer side performs a very special effort to patients who have various complicated issues. We have a population of patients who come from literally all over the world because of the top medical specialists UAMS has attracted and the latest medical equipment that allows a superior level of care.”Amerson finds it refreshing to work with patients from other countries, many of whom may have known little about Arkansas or Little Rock before coming to UAMS. “They are often surprised at how well we do things,” Amerson said. “So we always welcome the opportunity to show what we can do. We like research. We like the opportunity to learn new things. We never stop as far as developing our skills, science and understanding.”Michelle Buchanan, a radiologic technologist with UAMS, said UAMS attracts a lot of doctors who do procedures not available at most hospitals. For example, neurosurgeon Erika Petersen, MD, does deep brain stimulation for Parkinson’s patients. She also does spinal cord stimulations. Buchanan and others in her unit run a mobile CT machine, a C-Arm, that can be used in the operating room. When a surgeon is doing a procedure and needs to see a specific part of the anatomy, it is not easy to take the patient out of the operating room and get a CT scan. It saves time and is safer to do the CT scan in the operating room.Buchannan said they also use a Medtronic O-arm in the operating room. “It does 2-D and 3-D reconstruction images before the patient leaves,” she said. “If any revisions are needed, it can be done before the patient leaves the operating room. It is the only equipment like it in Arkansas.”Buchannan said their department attracts and retains skilled technologists with a lot of experience in the field. “Three of us here have almost 100 years of combined experience,” she said. “It says something about UAMS to be able to retain employees for so long.”
