Success Story: CARTI Cancer Center – Toshiba Infinix 4D CT


In cancer treatment, so much of the patient experience can be tied up in the anxiety associated with waiting for diagnoses, the physical discomfort of certain clinical procedures, and the bedside manner of the physicians involved in treatment planning and support. Leading-edge technologies and best-practices approaches to treatment that improve on any of the traditional benchmarks in these areas have a great opportunity to not only deliver a higher standard of care, but to drive cost efficiencies while doing so.

At the CARTI Cancer Center, a 170,000-square-foot, $90-million, multi-specialty treatment facility in Little Rock, Arkansas, a new technology is helping achieve many of those ends simultaneously. CARTI specializes in medical, surgical and radiation oncology and diagnostic radiology, and supports clinics dedicated to imaging, infusion, research, and support programs. This year, the center became the first U.S. provider to install a Toshiba Infinix 4D CT with the Infinix-i angiography system and Aquilion ONE ViSION Edition CT system.


The system is helping improve treatment planning in interventional radiology and oncology specialties, providing on-demand, real-time imaging that physicians like David Hays, the Director of Diagnostic and Interventional Radiology at CARTI, can use to identify and visualize tumors, provide whole organ body perfusion, and verify that their procedures are locating the areas of treatment with greater accuracy.

Although the technology in the Infinix system has been commercially available in Japan for a number of years, it is just starting to penetrate the North American market as a combination of CT and angiography, Hays said. In concert, the two technologies enable CARTI physicians to scan and treat or scan and plan within the course of a single examination procedure.

“It’s really allowed us to be much more efficient,” he said.

Hays praised the advanced software capabilities of the Infinix as also allowing physicians to improve the safety of their procedures. In the emerging field of interventional oncology, which Hays described as an offshoot of interventional radiology, “we’re still at the basest level,” but the specialty is “gaining traction as the third cog in cancer care.”

“There’s all kinds of X-ray now, from conventional radiotherapy to proton machines to gamma knife,” he said. “As all medicine is going, it’s a different age. Twenty, 30 years ago if you needed a biopsy of your liver, they cut you open and took a piece of your liver. Now we do that with a needle.”

Diagnostic procedures increasingly rely upon miniaturized and minimally invasive technologies as health care pushes for higher, outcome-driven standards of care overall. Hays believes that the Toshiba Infinix enables him to demonstrate the viability and safety of the advanced interventional procedures in which he’s specializing precisely because of its limited physical impact to patients. Not only does it drive greater adoption of the clinical procedures, it gives patients more options for treatment beyond specialty settings when it does.

“Infinix 4D CT gives me multiple options that I can execute in the same arena where I’m not having to move patients or do one part of the procedure piecemeal,” Hays said. “This machine lets me be more accurate in my treatment. It’s safer because we’re not just putting needles in things, in and out.”

Hays said the Infinix system has enabled him to perform needle-guided biopsies on target areas that in some cases may be no more than a centimeter-and-a-half in size. The improved accuracy allows Hays to drive a greater standard of care in addition to minimizing patient discomfort, table time, and the guesswork often associated with diagnostic imaging in cancer treatment.

“With the Infinix, I scan through the region, I tell the technologist, ‘Center on table position X,’ and I step on a fluoro pedal, and that thing can collect a 16-centimeter-wide block of data,” Hays said. “If I put a needle in the skin, the tech can find where the needle goes, find the tumor, draw a line. It basically does everything but put the needle in my hand. I can see my needle going right in along that line, and if it’s offline, I can redirect. I can hit stuff that’s the size of my thumbnail in the center of the liver with one push.”

Hays said the Infinix system has allowed him to perform liver ablations in less than 15 minutes that he estimates would have previously taken him at least two hours. Since most of the time involved in executing the procedure involves positioning the needle, the device “has revolutionized the way I ablate things,” he said.

“It’s made me incredibly accurate and time-efficient doing it,” Hays said. “On the business end, it creates throughput, decreases procedural time – time somebody has to be under anesthesia. It’s insane how fast we can do this stuff.”

Hays said the Infinix system elevates the overall efficiency of his treatment procedures in a way that he believes will ultimately reduce the cost of doing business at CARTI. In general, merged technologies and procedures in places like the interventional laboratory and imaging rooms should enable providers to better comply with mandates from the Affordable Care Act, make procedures safer and more efficient, and drive better health outcomes. By helping him turn the room over and increasing throughput, Hays said the Infinix system can also help enhance the overall patient experience at CARTI, keeping facility staff from having to transfer patients between departments as well as decreasing their table time.

“CARTI is showing how real CT imaging available on demand during interventional procedures may help clinicians to improve clinical work flow, offer anatomical and functional information and reduce procedure time,” Bill Newsom, Director of the X-ray Vascular Business Unit at Toshiba America Medical Systems, said in a statement.