U.S. Army medical care is an incredibly dynamic environment, replete with the acquisition and fielding of new capabilities in parallel with the upgrade and enhancement of existing systems.
One of the critical players in this process is the U.S. Army Medical Materiel Agency (USAMMA). Headquartered at Fort Detrick, Maryland, USAMMA has the mission “To develop, tailor, deliver, and sustain medical materiel capabilities and data in order to build and enable health readiness.”
One of the significant imaging enhancements over the last few years has been the movement of “CT scan” technology “further forward” in tactical Army operations.
A leading participant in fulfillment of USAMMA’s mission is the Integrated Clinical Systems (ICS) Project Management Office, which executes a patient-centric, “system of systems” approach to ensure timely delivery of affordable, sustainable, interoperable, and information assurance compliant capabilities in support of clinical requirements for fixed and deployed military treatment facilities. Specific office responsibilities include managing picture archiving and communication systems (PACS), imaging, and teleradiology program initiatives; executing the Technology Assessment and Requirements Analysis program; and managing information assurance requirements for designated medical devices.
The medical imaging arena provides several representative examples of how USAMMA is working to acquire and field optimized diagnostic tools for service members and their families. Additionally, these Army efforts also serve to provide a glimpse of similar medical materiel activities taking place across the armed services.
According to Siamack Moaveni, USAMMA senior biomedical engineer in the ICS Project Management Office, Army patients are the beneficiaries of a number of imaging enhancements that have been introduced over the past several years. Moreover, many of those capabilities are currently undergoing continuing upgrades or new enhancements designed to further improve medical outcomes.
Moaveni pointed to representative medical imaging enhancements in three areas: computed tomography (CT); magnetic resonance imaging (MRI); and digital breast imaging.
Computed Tomography
One of the significant imaging enhancements over the last few years has been the movement of “CT scan” technology “further forward” in tactical Army operations.
“We have placed CTs in Level III hospitals in theater, which is the Combat Surgical Hospital [CSH],” Moaveni said. “At that level, the CT is used to do things like help remove any foreign objects out of the body or to identify bleeding.”
Moaveni observed that the initial deployment of CTs to these tactical settings was driven in part by the anticipation of “imminent conflict” early in the first decade of the 21st century.
The Army’s new CT scanning system’s Single Energy Metal Artifact Reduction algorithm capability reduces metal streak artifact (shown in the left image, corrected on the right) increasingly seen in patients with prosthetic devices. Photo by John Brooks, U.S. Army
“Initially, MEDCOM [U.S. Army Medical Command] had invested in some old CTs – version one,” he said. “And when the need for a better CT was identified, we were tasked with upgrading those units. Our initial concern was to find a CT that not only is superior to what we had but also is more rugged. Because you’re talking about multiple computers and a 2-ton wheel rotating around an axis with a 300-pound X-ray tube sitting on it. To take that piece of equipment and haul it 6,000 miles and drop it into the theater meant that we went through learning pains in regards to ruggedizing these machines.