PET-CT imaging, a combination of PET (Positron Emission Tomography) and X-ray CT (Computed Tomography), is increasingly being used in the diagnosis of cancer, allowing oncologists to accurately pinpoint potential tumors within a patient’s body. Naturally enough, undergoing diagnostic tests for cancer is a stressful time for patients, so anything that can be done to reduce their anxiety levels is beneficial. In the case of PET-CT imaging, anxiety reduction can also improve the clinical reliability of diagnosis. To investigate ways of reducing patient anxiety during the necessary time that patients must wait between being injected with a PET tracer and their PET-CT scan, the new Hospital Area in Philips’ Experience Lab includes a simulated PET-CT uptake room. It is hoped that the results of this research will help hospitals to improve the quality of care delivery.
PET-CT in the diagnosis of cancer PET imaging for the diagnosis of cancer requires the use of a radioactive tracer called FDG (fluorodeoxyglucose) that is injected into the patient’s bloodstream. After injection, patients normally have to wait for around an hour in a PET-CT uptake room, during which time the tracer accumulates in any type of body tissue that exhibits elevated blood sugar metabolism. Due to their high rate of cell division, tumors typically exhibit elevated blood sugar metabolism.
During the actual PET-CT scan, the PET images highlight these tissues due to their increased radioactivity, while the simultaneous CT scan accurately positions the highlighted tissue in relation to other internal organs. PET-CT scans can therefore help oncologists to determine if and where potential tumors are located so that they can be treated via surgical removal and/or accurately targeted radiotherapy.
During their wait in the PET tracer uptake room it is important that patients remain as calm and relaxed as possible. This is because physical or mental activity – for example, due to anxiety – can increase metabolic activity in other tissue types, such as muscle or brown fat, with the result that they also absorb the FDG PET tracer. If this happens FDG uptake may occur in these other tissue types, making it significantly more difficult for oncologists to differentiate normal tissue from tumor tissue in the images.
However, the period spent in the PET-CT uptake room is often one of the most anxious periods in a patient’s life. Many patients, for example, are about to find out for the first time whether they have cancer. There is therefore a real need, both for patient comfort and clinical reasons, to do whatever is possible to reduce the anxiety associated with PET scan procedures for diagnosing cancer.
Developing a healing environment solution
In order to fully understand the issues involved, Philips conducted early research in PET-CT uptake rooms at The Netherlands Cancer Institute – Antoni van Leeuwenhoek hospital in Amsterdam. During this research, patient anxiety was measured using the State-Trait Anxiety Inventory at the beginning and end of the uptake period. In addition, false-positive FDG uptake (FDG uptake in non-tumor tissue) was quantified in patients.
A prototype ambient healing environment, featuring soothing lighting and positive distractions in the form of calming video images and sounds, was then installed into one uptake room, while the adjacent uptake room was left unmodified to act as a control. The first preliminary results indicate that PET images from patients who spent their uptake period in the ambient healing environment room as compare to those who spent it in the control environment have a significantly reduced incidence of tracer uptake in brown fat. The healing environment also significantly reduced patient anxiety levels.
The Hospital Area PET-CT uptake room
Further work on refining the system will continue through collaboration with leading cancer institutes and through advanced system development in Philips Research’s new Hospital Area. For example, one effective way of reducing anxiety is to distract patients via suitable auditory and visual stimulation. However, in order to achieve optimum PET imaging, the profile of this stimulation needs to be tailored to the uptake and metabolism of the FDG PET tracer. In addition to allowing scientists at Philips Research to investigate this stimulus profiling, the new Hospital Area will also allow them to investigate other aspects of the uptake room environment such as room lighting, color schemes and architectures.
Previous studies have already demonstrated that a good ‘Ambient Experience’ can improve patient satisfaction scores. These new studies by Philips Research and the Dutch Cancer Institute into ambient healing environments aim to demonstrate that there are also clinical benefits to such systems, in the form of more reliable diagnoses. Other clinical benefits could include a reduction in the use of sedative drugs and smoother clinical workflows.
+ Philips opens Hospital Research Area to develop innovative healing environments (press release)
Adaptive Healing Room