Facilities and Resources

Overview

Brigham and Women’s Hospital is a 708-bed medical complex. A 13-floor Cardiovascular building (Carl J. and Ruth Shapiro Cardiovascular Center) houses the CV imaging program since May 2008. This includes 136 inpatient beds and the outpatient clinics for Cardiovascular Medicine, Vascular Surgery and Cardiac Surgery, an integrated Noninvasive Cardiovascular Imaging Center, and Interventional services. The Noninvasive Cardiovascular Imaging Center is a fully integrated state-of-the-art facility providing multi-modality, multi-disciplinary imaging care in a patient-centric manner. The Imaging Center has approximately 22,600 square feet in area and includes general patient areas, imaging laboratories, image processing areas, and dedicated reading room.

The laboratory includes two dedicated D-SPECT systems (Spectrum Dynamics), one SPECT/CT system (VERITON-CT, Spectrum Dynamics) and two digital PET/CT 64 systems (GE DRX/VCT). The laboratory is fully integrated within the Nuclear Medicine division and has access to additional imaging systems in the main hospital building including 4 dual-head SPECT systems (Siemens e-CAM), and a SPECT/CT system (Siemens Symbia T6). The nuclear cardiology laboratory has a dedicated hot lab for handling radiopharmaceutical doses in the Cardiovascular Center, and a cGMP central radiopharmacy for
the preparation of SPECT and PET radiopharmaceuticals.

Nuclear Cardiology

Cardiac CT

The cardiac CT program has two dedicated CT scanners: a 3^rd generation dual source CT system (Siemens FORCE) and a state-of-the-art 320-Aquillon One system (Toshiba). The laboratory has advanced expertise in all aspects of cardiac CT, including coronary CT angiography, coronary plaque quantification, use of coronary CTA for pre-procedural planning, FFRct, myocardial perfusion, use of CT pre and post structural heart disease interventions, and use of CT to evaluate valvular heart disease. In conjunction with the cardiac CT core lab, the CT program uses numerous methods for plaque analysis and 3D visualization.

The laboratory includes a dedicated 3T Siemens MRI system. The laboratory is fully integrated with the MR Division and has access to four additional imaging areas within the hospital campus all available for clinical and research use that include seven additional MR systems distributed as follows: 1) the L1 level of the main hospital building has one 3T GE MRI, one 3T Siemens MRI, and one 1.5T GE MRI; 2) the main “Pike” has two 1.5T GE MRIs; 3) the Lee Bell Center for Breast Imaging has one 3T Siemens MRI; and 4) the LMRC Building (Longwood Medical Research Center at 221 Longwood Avenue) has two 3T GE MRI magnets (one long bore and one short bore) and one 1.5 T long bore GE MRI magnet (In 2008, the 3T GE long bore MRI will be replaced by a Siemens 3T MRI system). All MR systems are fully supported with inpatient and outpatient facilities, nursing and technologist staff. A full-time clinical PhD MR Physicist provides clinical MRI protocol development, and QA and implementation support. Imaging results are interpreted at electronic reading stations over a clinical PACS with interconnectivity with advanced Radiology and Hospital Information Systems.

Cardiac
MRI

Echo

The laboratory includes two dedicated CT scanners: a state-of-the-art 320-Aquillon One system (Toshiba), and a Definition Dual Source CT system (Siemens). The laboratory is fully integrated with the CT division and has access to two additional CT64 (Toshiba Aquillon, and Siemens Sensation 64) and another Siemens Definition Dual Source CT located in the main hospital building.

The Exercise Testing Laboratory is a state-of-the-art facility that has been designed to accommodate an extensive range of imaging and exercise modalities. It includes eight 170 sq ft rooms, each equipped with a GE Case station and a GE T2100 treadmill. The Exercise Laboratory also includes 3 Corival electric cycle ergometers and one arm ergometer that can be used instead of the treadmill in any of the exercise rooms based on the needs/capacities of the patient. Equipment also includes two Acuson Sequoia 512 echocardiography (permanently available for exercise and dobutamine echoes), three MedGraphics Ultima Cardiopulmonary carts, and one Cambridge Heart HearTwave II Microvolt T-Wave Alternans Systems. Each of the 8 exercise stations is sized and organized to accommodate any of the exercise testing modalities as well as any related testing option (perfusion injection, chemical stress tests, stress echocardiography, cardiopulmonary testing, or microvolt T-wave alternans) and/or combination of these modalities. The laboratory is also fundamentally organized and structured to optimize clinical and research priorities, including more than 20 hospital computers each electronically linked to clinical and research databases and an automated research database (designed to capture exercise, cardiopulmonary, and imaging data). Furthermore, two PAX workstations are situated within the lab (in its 325 sq ft workroom) as clinical, research, and teaching resources, both in addition to the primary clinical PAX workstations situated in separate Echo and Nuclear reading rooms. Likewise, ample workspace, computers, and touchdown space exist for supervising physicians, exercise physiologists, nurses, nuclear perfusionists, and technical staff involved with all inpatient and outpatient tests.

Exercise Testing Laboratory

Cardiac Imaging Core Laboratory (CICL)

The Cardiac Imaging Core Laboratory (CICL) is an academically-oriented clinical research organization that provides echocardiographic imaging analysis for large cardiovascular clinical studies. The CICL experience includes serving as the high throughput core echocardiography laboratory for over 35 clinical studies, the majority of which have focused on outcomes of patients with or at risk for heart failure (HF). Thus, CICL investigators have extensive experience studying the clinical and prognostic importance of echo measurements across the spectrum of normal myocardial function to severe HF, including hypertensive heart disease, post-MI populations, and overt HF.

The Nuclear Cardiology Core Laboratory is an academically-oriented core laboratory that provides nuclear cardiology imaging analysis for translational cardiovascular clinical studies. The laboratory experience includes quantitative image analysis for over 20 clinical studies involving both SPECT and PET, the majority of which have focused primarily on diagnostic and outcomes studies in coronary artery disease (CAD). Thus, nuclear cardiology core laboratory investigators have extensive experience studying the clinical and prognostic importance of nuclear cardiology measurements across the spectrum of CAD.

Nuclear Cardiology Core Laboratory

Cyclotron and Radiochemistry
Laboratory

The cyclotron and radiochemistry laboratory are housed in a new 2,400 SF building within the BWH campus. The facility is designed as clean room environment compatible with cGMP manufacturing procedures. The cyclotron is a General Electric PET-Trace dual particle accelerator (16.5 MeV protons and 8 MeV deuterons) equipped with 8 targets for production of C-11, N-13, O-15, and F-18 (both fluoride ion and molecular fluorine gas). This instrument is capable of irradiating eight targets (two simultaneously) with 16.5 MeV protons/deuterons. The cyclotron laboratory is equipped with computer controlled fully automated radiopharmaceutical production systems for producing routine positron emitting compounds and gaseous radioactive effluent monitoring systems.