Dear Ms. Fayerman, Thank you for taking the time to clarify that your original story called “Most Doctors Misinterpret New Scans for Detecting Strokes: Survey” was overly general and could have left readers with the impression that they are receiving sub-standard care in British Columbia. Firstly, it is incorrect in stating that CT angiography and CT perfusion are the most advanced scanning tests used to detect stroke. The actual gold standard in the detection of stroke is MRI Diffusion Weighted Imaging. This technique is the only brain imaging method to reliably demonstrate acute stroke within the first minutes to hours after onset. Unfortunately, due to the lack of MRI accessibility and cost, CT has become the test of choice in the acute setting for the assessment of stroke. CT and CTA can be useful in diagnosing and guiding management in stroke if interpreted by imaging specialists having familiarity with these techniques. We appreciate that Dr. Shamy qualifies his conclusions to acknowledge that his study did not include the input of Radiologists whom are trained to properly read these types of scans. It appears that his conclusions use the assumption that the treatment decision-making in stroke patients fall solely on the Neurologists, as the Radiologists are not available to assist. As you will recall, you wrote an article on September 20, 2013 notifying British Columbians that Vancouver General Hospital (VGH) was the first and currently the only hospital in Canada to provide Emergency Trauma Radiologists on site in the Emergency Department on a 24/7 basis. The Radiologists at VGH made the decision to provide 24/7 coverage with sub-specialty trained Level 1 Emergency Trauma experienced Radiologists. Within the VGH Emergency Department, if the Emergency Physicians determine that a patient is exhibiting stroke symptoms, the protocol is to send the patient immediately for a CT scan and a CT angiogram while waiting for the Neurologist to arrive. As the Emergency Radiology Department is located within the Emergency Department, the Radiologists are able to view the scan directly on the console screen in real time as it is being done by the CT Technician. As, these Radiologists have sub-specialty training in reading Emergency scans, the likelihood of a misinterpretation is minimized. A patient suffering a stroke can expect a diagnosis within 30 minutes of arriving at VGH from an on-site Radiologist. British Columbians can be assured that the patient care at VGH is world class. The Radiologists at VGH invite you to come by and witness the service that the Emergency Trauma Radiology Department provides on a 24/7 basis. Regards, Urmilla Mereigh BSc, CPA, FCGA. Business Manager Vancouver Imaging
Posted on: Sat, 11 Oct 2014 01:39:27 +0000
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