2023-11-12 19:03:58
This cutting-edge technology contributes to making Monaco “the flagship of patient care and health. »
On December 16, 2021, the Monaco Cardiothoracic Center inaugurated its revolutionary new scanner, one of the first photon counting scanners in the world. A resolutely innovative technology, which has completely changed the patient care pathway, and which has strengthened the place occupied by the Principality on the international health scene.
Two years later, the results are more than positive because, as Doctor Filippo Civaia, cardiologist at the center, explains to us, this technology offers new, hitherto unsuspected possibilities.
After two years of using the photon counting scanner at the Monaco Cardio-Thoracic Center, what is your assessment?
It’s a real success! We were able to use this new tool on approximately 8,000/9,000 patients in two years. Half came for purely coronary explorations and the other half for vascular reasons, and in both cases, the results were strongly positive.
Already, because of the image quality, in terms of spatial and temporal resolution, which was almost unexpected! We were able to achieve a level of image quality that I did not expect when we received this scanner.
Then, because of the robustness of this technique, which is very reliable. From the start, we were able to overcome certain limitations of old systems and offer much better diagnosis and better care for our patients.
This new scanner allows non-invasive diagnosis – © CCM – Fitte
We were thus able to modify the treatment pathway thanks to this technological revolution, which is not just an improvement of an already existing machine. It is a new machine that has allowed us to open doors of exploration into coronary artery disease, the nature of plaque and the use of certain algorithms. It’s like having a brand new telescope that gives us a whole new view of the universe.
Today, we are exploring new areas, we don’t know exactly what we will discover, we will have to wait a little longer to find out.
Remind us of one of the great advantages of this machine for the management of coronary artery disease?
One of the major concerns of cardiologists is coronary artery disease. And now we can better characterize the plaques that we have on the coronaries. Everyone develops them naturally as they age, most are benign. But others are at risk, and can activate an inflammatory process, cause thrombosis or in the most catastrophic cases, lead to the death of the patient.
With this machine, we try to better characterize the different plates, to identify those which are dangerous.
Are your patients also aware of this revolution?
Of course, the changes are more complicated for patients to perceive, because it remains very technical and professional.
For the patient, it remains a CT scan, but thanks to our new system, we have reduced the number of invasive diagnostic coronary angiographies, which involve arterial puncture and hospitalization, in favor of this non-invasive coronary exploration.
Please note, this system does not completely replace diagnostic coronary angiography: they are two complementary tools! But in the first instance, we now favor the photon counting scanner. Cardiologists who are not equipped with one have also been made aware of the quality of this examination, and are increasingly calling on us for their patients.
Likewise, we have more and more requests for follow-up from patients who have a coronary stent. Until now, it was difficult to assess it by CT scan.
Another major advance for patients: the elderly no longer need to resort to invasive coronary angiography, regardless of the degree of calcification of the plaques. Same thing for young children.
Could this technology be used in another way?
We are working on future fields of application. The Holy Grail for us, cardiologists, would be to be able to create, through spectral analysis, a sort of mapping of the coronary plaque to identify the killer plaques.
We hope for improved technologies in 2024, but we can’t say more yet!
What matters, however, is that the fields of exploration have opened up, and I hope that by the time I retire, I will see the results of the research we are carrying out today. Remember that this new scanner is the result of work that began twenty years ago!
On November 3, experts from all over the world were in Monaco to discuss the pathology of the coronary arteries. What is your assessment of this day?
The results are once again very positive! This day allowed us to interact with experts from North America, Canada, Europe, Asia, the Middle East, etc. We were able to reflect together on how to improve diagnostic and therapeutic practices. Only by talking together can we move things forward.
Moreover, in medicine, any progress must be the subject of collective reflection. This is the strength of the Cardio-Thoracic Center: every morning, in accordance with the visionary projects of Professor Vincent Dor, we organize a medical meeting, where all the surgeons and all the doctors participate, to analyze a file.
And precisely, with this new scanner, do you think that the Monaco Cardiothoracic Center, and more generally the Principality, are major players in health on the international scene?
Monaco allows us to move forward more quickly than elsewhere. We have opportunities for progress and progress in many areas. Our CHPG colleagues also benefit from it. We are at the forefront and we always remain very vigilant and passionate about progressing and making Monaco the flagship of patient care, and even health!
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