Above:Joseph Carrozza, M.D., with the digital cath labs’ flat-panel technology.

The interventional cardiologist studies an on-screen image as he threads a stent through the patient’s artery, clearing a blockage with precision that was once unimaginable. While the artery is tiny, the imaging screen in one of Beth Israel Deaconess’s all-digital cardiac catheterization labs clearly distinguishes it from surrounding heart structures.

In just two years, BIDMC’s four digital cath labs have already provided faster, safer imaging for more than 7,500 patients undergoing coronary angiography, stent placement and other common cardiac procedures. The labs’ next-generation technology has a dynamic range ten times that of other cath lab technology, helping interventional cardiologists view hard-to-visualize structures within patients’ hearts from many angles.

“Our labs are the only truly all-digital, flat-panel cath labs in Boston,” says Joseph Carrozza, M.D., chief of interventional cardiology, who heads a team of cardiologists using the new labs. “They are truly state-of-the-art. The enhanced clarity of the images they produce is like that of high-definition television, compared to conventional television. Doctors who have worked in other hospitals’ non-digital labs attest to how much better these new labs are. Digital labs give doctors a better chance of identifying critical detail, while reducing the patient’s exposure to radiation by up to 60 percent.”

The machines work by shooting an X-ray beam through the patient into a flat-panel detector, which transforms the X-rays into light. The light then becomes a series of electronic charges, each representing one tiny piece of the picture. A sophisticated ultra-low noise system “reads” and converts the charges piece by piece, sending them to a real-time image processor which displays them. The result: Images with amazingly high resolution that show heart structures from many angles, devoid of the distortion common with older imaging systems. Shorter procedure times, lower radiation exposure and less contrast injected into the patients mean improved patient comfort, and allow the labs to operate more efficiently.

In coming years the number of bypass surgeries is expected to drop by 30 percent in favor of interventional procedures, which require shorter hospitalizations and recoveries. This means that digital labs will soon play an even more crucial role in cardiac care.

Says Manager of Invasive Cardiology Georgann Bruski, “Eventually, all cardiac X-ray imaging will be digital. We just got into the future a little bit early.”


- Valerie Hope Goldstein
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