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  • By Mar-Vic Cagurangan

Milestones in medical technology

Despite challenges in specialty medicines on Guam, local medical facilities embrace state-of-the-art technologies to improve diagnostic capabilities

Suspicious images produced by an initial mammogram require a woman to take several more trips back to the radiology clinic for extra scans.

While the anxiety of waiting can add stress, the final results sometimes turn out to be nothing to worry about.

Fortunately, the latest technology that produces more precise images is now available on Guam. The 3D mammography, or breast tomosynthesis, increases the detection rate for breast cancer and — for negative results — decreases the maddening false alarms.

Dr. Nathan Berg

“Digital breast tomosynthesis allows us to have a much clearer look inside the breast rather than just having a view from the side, top or bottom,” said Dr. Nathaniel Berg, medical director of Guam Radiology Consultants.

GRC unveiled its 3D mammography in early May, adding to ground-breaking medical technologies that promise to upgrade the health care system on Guam. The new equipment acquisition is part of GRC’s plan to enhance its women center.

Digital breast tomosynthesis, which was e approved by the U.S. Food and Drug Administration in 2011 uses X-rays to produce images of breast tissue to detect any lumps or other abnormalities. The procedure is almost identical to a traditional mammogram, except that in tomosynthesis the image taker moves around the breast. It scans the breast at different angles to create a three-dimensional image that allows the radiologist to see the breast tissue in clearer detail and provide a more certain diagnosis.

Dr. Nathaniel Berg stands next to 3D mammography at GRC. Photo by Mar-Vic Cagurangan

Berg said studies have shown the 3D mammography gives 30 percent more accuracy in detecting breast cancer compared to the regular type of mammography.

“It reduces the number of times the women come back,” Berg said. “It’s going to be the way of the future of mammogram.” GRC has sent its staff and technicians for off-island training to familiar them with the new equipment.

“This is the technology that we embrace, and we thought is important for women of Guam to have this available,” Berg said. “We are hopeful that it becomes the standard of care on Guam soon.”

Although specialty medicines remain a challenge on Guam, private facilities have been investing in state-of-the-art technologies that seek to improve the medical industry’s diagnostic capabilities.

At the Guam Regional Medical City, the hospital management boasts of the first Intravascular Ultrasound Imaging procedure recently done on Guam.

“This new procedure allows us to image plaque and obstructions from inside of the artery and gives us much more anatomical detail than angiography, helping to guide medical decision-making,” said Dr. Joseph Wiedermann, GRMC’s Head of Cardiology.

Using the Intravascular Ultrasound Imaging, Dr. Wiedermann can tell how much blood flow there is in the vein as the camera moves through it and identify where the plaque thickens and might require the use of a medical tool to remove it. He can also find clots and remove those, too.

The clarity of image produced by Intravascular Ultrasound Imaging allowed the performance of a pre-intervention study to determine which medical devices will be selected based on the presence of calcium.

“He can also accurately measure the size of the vessel to determine the size of stent that will be inserted,” according to GRMC. “After coronary stenting, the Intravascular Ultrasound Imaging can be used for postintervention assessment to make sure the vessel is appropriately dilated, and the stent is fully expanded and apposed to the vessel wall.”

In September, Wiederman performed the first rotational atherectomy on Guam. The procedure uses a medical device called a Rotablator, which has a tiny diamond encrusted burr, similar to a drill bit, that spins through the artery at 150,000 RPM to remove superficial calcium from inside an artery, so a shunt or balloon can be inserted.

“Simply put, Dr. Wiedermann can now save the life of certain patients on Guam who might otherwise have died prematurely from a heart attack.

In April, a team of GRMC doctors performed the first successful Transjugular Intrahepatic Portosystemic Shunt on Guam.

Using the Intravascular Ultrasound Imaging, Dr. Wiedermann can tell how much blood flow there is in the vein as the camera moves through it and identify where the plaque thickens and might require the use of a medical tool to remove it. Photo courtesy of GRMC

The procedure was performed to restore proper flow and pressure in the portal vein carrying blood from the GI tract to a patient’s liver and then to the heart.

The TIPS procedure was performed by Neurointerventional Radiologist Dr. Scott Shay and the Cath Lab team. Prior to the successful TIPS procedure at GRMC, most patients suffering from this type of condition did not survive.

“Dr. Shay’s procedure can prevent premature death due to liver disease,” Cruz said, adding that GRMC “will continue to sharpen our edge by learning, procuring and mastering healthcare technological advancements.”


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