30
European Journal of Radiology, 16 (1992) 30-34 0 1992 Elsevier Scientific Publishers treland Ltd. AH rights reserved. 0720-048X/92,605.00
EURRAD 00357
Solving difficult site problems for MRI and PET John E. Brock Burt Hill Kosar RitrelmannAssociates.Butler, PA, USA
Key words: Radiology and radiologists, design of radiologic facilities
Introduction Many of our most sophisticated hospitals are located in urban areas where available land is at a minimum. Consequently ideal sites for diagnostic equipment like PET, medical cyclotrons, and MRI scanners are not available. These sites require special structural considerations, shielding provisions, and construction access. Due to the processes involved in PET and MRI scanning, shielding for radiation, radio frequency, and magnetic fields are required in order to protect adjacent functions. The process of evaluating potential sites and coordinating the design and construction requires a higher degree of planning, management, and technical considerations in order to succeed. The challenge is then to handle these difficult project aspects as well is all of the normal design considerations. Project teams often involve administration, physicians, physicists, hot lab technicians, equipment manufacturers, architects, and engineers and must be well coordinated in order to solve all of the design and technical issues. The process described here has been developed through a series of project efforts. Included in this discussion are two sample projects from our work at the University of Pittsburgh Medical Center. Sample projects These projects required a refined process to solve
and coordinate complex issues. The projects are a three 1.5 Tesla MRI Department, and a PET Scanner Department with two cameras and an 11 Mev cyclotron. Currespondence to: J.E. Brock, Burt Hill Kosar Rittelmam Associates, 400 Morgan Center, Butler, PA 16001-5977 USA.
Sites for these project were selected after extensive review of potential locations within the existing University of Pittsburgh Medical Center’s Presbyterian University Hospital. This hospital is located in a highly developed district of Pittsburgh. Typical installations of this equipment and shielding are ideally at grade level. This urban hospital had no on-grade sites available and, for functional reasons, required location of the MRI Department on the first floor, adjacent to the existing Diagnostic Imaging Department. The PET Scanner Department was to be located on the ninth floor of a recently constructed high technology facility, convenient to researchers as well as patient elevators. Each project site presented unique challenges to the project team.
A4RI l Three adjacent 1.5 Tesla MRI exam rooms with future capabilities of one magnet being ramped to 2.0 Tesla. l Planning of access and delivery route for MRI equipment. l Location of MRI exam rooms within 50 feet (15 m) of a 20 MW electrical substation which serves multiple buildings on the medical campus. l Design of a six-sided steel plate box to provide magnetic shielding by limiting the stray magnetic field to less than 9 gauss (0.9 milli Tesla) in non-controfied areas around the MRI Suite. The design of the magnetic shield also evaluated the possible effects of magnetic anomalies from electric substation and the traffic on the city street. l Separate radio frequency shielding to alternate ambient radio frequencies in the specified frequency range to 122 db. l Programming and design of an MRI Department
31
Fig. la. Floor plan level 1 - MRI. Legend: 1, Of&e; 2, Lobby; 3, Toilet; 4, Housekeeping; 5, Conference; 6, Family Waiting; 7, Receptionist; 8, Handicapped Toilet; 9, Interview; 10, Dressing; 11, MRI Exam Room; 12, Cryogen Storage; 13, Control Room; 14, Computer Equipment Room; 15, Film Processing; 16, Dark Room; 17, Equipment; 18, Nurse Station; 19, Dats & Communication Closet; 20, St&Toilet; 21, Critical Cave; 22, Work Room; 23, Clean Utility; 24, Soiled Utility; 25, Patient Toilet; 26, Patient Holding; 27, Staff Lounge; 28, Men’s Lockers; 29, Women’s Lockers; 30, Viewing; 31, Clerical File Room; 32, Electrical Closet. b. Perspective view Level 1 - MRI exam room.
for both outpatient and inpatient clinical service within a major teaching hospital. l MRI magnet access for both installation and future potential equipment exchanges. PET Scanner (Fig. 2 a,b) l Installation of a 120000 lb (54432 kg) 11 Mev cyclotron on the ninth floor of a diagnostic wing. l Design and construction of radiation shields for the cyclotron to protect occupied floors below and above the cyclotron. l Programming and design of a, PET scanner for both outpatient and inpatient clinical service within a major teaching hospital. At this time, both project installations have been completed. Magnetic and RF shielding installations have been tested and demonstrated to perform in excess of specified requirements. In order to succeed in both of these complex projects, a process was followed that included extensive planning early in the schedule, constant communication among team members, and identifying all potentials before they impeded progress.
Design Research
Key issues were defined through early research into the application of MRI and PET Scanner technologies and shielding. This aided both the hospital administration and medical staff in decision making, and allowed physicists and the architectural/engineering design team to proceed with site evaluation. Short study efforts documenting available equipment, relative space requirements, shielding requirements, weights, clinical capabilities and limitations were conducted. Through such early research efforts, the following decisions were achieved: l Equipment type, strength, and manufacturer selection. l The hospital and the manufacturer’s physicist began to make a preliminary statement about type and quantity of radiation shielding that would be required .
The architectural and engineering team began to evaluate design and construction feasibility. l Medical staff began to develop space programs with assistance from the architectural designer. l Site review and evaluation by the architect and engineer team were initiated. l
32
M
‘---&”
-
Fig. 2a. Floor plan level 9 - PET. Legend; 1, Camera Room; 2, Electronics Room; 3, Control Room; 4, Intervention; 5, Cold Chemistry; 6, Non-Radio Production; 7, Radio Chemistry Lab; 8, Radio Chemistry Production; 9, Cyclotron Room; 10, Staff Toilet; 11, Heat Exchange; 12, Gas Cylinder Storage; 13, Shop/Storage; 14, Office; 15, Housekeeping; 16, Post Processing/Fellows; 17, Conference; 18, Residents & Post Doctorate Fellows; 19, Reading Room; 20, Storage/Utilities; 21, Electrical Closet; 22, Communications Closet; 23, Prep; 24, Dressing; 25, Patient Toilet; 26, Blood Gas; 27, Dark Room; 28, Film Processing; 29, Research Lab; 30, Lockers; 31, Lounge; 32, Toilet; 33, Nurse; 34, Inpatient Waiting; 35, Consultation; 36, Reception; 37, Records; 38, Outpatient Waiting. b. Perspective view levels 9 - Cyclotran room.
This research effort provided the basic information required to define the project requirements. 0 Space 0 Utilities 0 Structure l Floor-to-floor dimension requirements l General shielding requirements and preliminary shielding concepts l Site access/equipment delivery requirements With these project requirements defined, it is possible to quickly eliminate unsuitable sites and identify areas that would be both technically feasible and functionally desirable within the existing hospital. Through this process of evaluation and elimination, the best site available for each project was selected.
high cost of the equipment and specialized related construction, project abort decisions occurring late in the process would result in a significant waste of funds. Therefore, problem seeking must occur early in the process to avoid costly project abandonment or delay. For the MRI and PET Scanner projects, these problems included: (Table 1) The involvement of the physicist, structural engineers, equipment manufacturer, equipment rigging and installation contractor at this stage is critical to resolving these issues and providing enough information so that the owner can make a finaI decision on the project. Prior to owner commitment, each issue had reached a resolution.
Early problem seeking
Space programming
To validate early assumptions, a problem seeking process was used. For such complex projects, it is essential that the management and design team identify problems early in the process for resolution, or if not resolved, to make project abort decisions. Given the
With the owner committed to the project, a detailed refinement of the space and functional program was conducted. The project architect conducted meetings with the owner’s user task force which consisted of the medical and research staffthat would ultimately occupy
33 TABLE
1
Problems facing MRI and PET projects MRI
PET
l
l
Could the heaviest piece of equipment be lifted to the 9th floor elevation and rolled across the floor into its final location?
l
Protection of MRI equipment from magnetic fields from electrical substations, electrical interference from high voltage lines, RF interference from radio transmitters, and adjacent traffic. Magnet access installation
l
l
Constructability
l
Structural capacity for both the equipment installation and radiation shielding. Feasibility of upper and lower shield for the cyclotron that would allow for normal functions to occur on the floors above and below.
- a diflicult site.
the departments. Detailed space and equipment inventories were developed. To establish a common dialogue for the task force and designers, a series of field trips to similar project sites were conducted. Goals for these trips included: l Validation of early programming assumptions. l Lessons learned from other sites. l General understanding of final assembled equipment installation. l Review of construction and installation details with equipment manufacturers. This review process, coupled with ongoing task force review meetings, led to a refined set of program and equipment requirements, and ultimately, a project plan. Separate tracks - d@xlt/normal By carefully matching design talent to both difficult and normal aspects of the project, a successful outcome of high technology installation and soundness of the overall department design can be maintained. These focused groups of specialists greatly reduce the liability risk for the owner and design team. Specialized equipment within the MRI and the PET Scanner Departments occupies only a fraction of the total floor area. Of course, that area requires a higher degree of expertise and time devoted to the project. The strategy was to assign a separate sub-team to the new technology application. For example, on the PET Scanner cyclotron, an architectural designer with significant technical experience in unique structural solutions was assigned to specifically coordinate the details involving the cyclotron. The project architect responsible for the overall project continued in a normal fashion with the ongoing development of the remaining 12000 square feet of diagnostic and support space. The specialized team working on the cyclotron room was given an earlier deadline to complete their work. It was important to compress this time so that the momentum gained in early planning with the physicist, manufacturer, architects, and engineers was main-
tained. Early completion of the cyclotron design allowed for this work to proceed through bidding and construction ahead of the completion of the overall department. This approach allowed more time to be devoted to details of the hot lab, PET Scan camera rooms, and support areas. Equipment manufacturer involvement No one knows the requirements and limitations of this type of equipment better than the manufacturers. Therefore, it is critical that the manufacturers be involved from the beginning of the project with specific objectives. The manufacturer is providing an expensive clinical device and will offer highly trained technical assistance in the process. Planning the manufacturers’ involvement in meetings, conference calls, and the project schedule is essential. It is also essential that the equipment manufacturer be involved in a pre-bid meeting with the contractors. During this meeting, construction requirements are typically reviewed. However, by adding the equipment manufacturer to the agenda, a presentation of equipment requirements and contractor responsibilities for the equipment can be made. A higher level of understanding on the part of the contractor supports a more competitive bidding environment and ultimately a better project. Radiation shield design As with manufacturer involvement, it is essential that the physicist be involved early in the problem seeking process. The physicist’s radiation shielding design efforts must be coordinated into the project schedule. The physicist should participate in the task force process and set a realistic deadline for final shielding recommendations in order to maintain the project schedule. Maintaining a coordinated eflort Complex projects of this nature must be appropriately managed from the start. The project work plan,
34
the form of a published project schedule (Fig 3), should be negotiated in early task force meetings. It is essential that this plan be considered a draft document when presented to the task force. At the task force meeting, the project plan should be subject to negotiation in order to ensure that each participant is agreeing to realistic time frames. The project plan must include scheduled activities of each of the following project participants: Hospital Administration Hospital Purchasing Equipment Manufacturer Physicist Architect Engineer Once the project work plan becomes a published schedule, it is essential that this schedule be reviewed in each subsequent task force meeting. As shown on the project schedule, the status can simply be indicated by marking each task C for complete, or L - for late. This review takes only a few minutes and profits from the in
-iI q 0 8-H ,ag 2 2-e g I
C
Constructionconsiderations
For projects of this type, contractors should be prequalified prior to invitation to submit proposals. Typically, the construction documents prepared by the architects and engineers will include only the building elements that surround the equipment. It is necessary to provide complete owner-supplied equipment information so that the contractor can more thoroughly understand the project requirements.
19901991 DIJIF/MIAIMIJIJIAISIOINIDIJIFIM Illlllllll~llllllllr~llllI~~~~~
EVENT
-Y
dynamics of a group situation. Each role player in the project is motivated to perform their responsibilities on time. Typically with this approach, a task is not late for more than one meeting. We have found that projects with this type of published work plan generally stay in control. When a part of the project is running late, it is generally only one part of the project and it is possible to develop a contingency plan to maintain the overall schedule. Projects without work plans can take control of the task force, the consultants, and the owner’s budget.
DESIGN
1992
I I I
Ixlawwr DIOIcl~CoIvlMcr r
Fig. 3. Project schedule, PET scanner - Level 9 D wing. Status, C = complete 1= late, * = task force meeting, IIIII planned activity, w activity.
actual
European Journal of Radiology, 16 (1992) 30-34 0 1992 Elsevier Scientific Publishers treland Ltd. AH rights reserved. 0720-048X/92,605.00
EURRAD 00357
Solving difficult site problems for MRI and PET John E. Brock Burt Hill Kosar RitrelmannAssociates.Butler, PA, USA
Key words: Radiology and radiologists, design of radiologic facilities
Introduction Many of our most sophisticated hospitals are located in urban areas where available land is at a minimum. Consequently ideal sites for diagnostic equipment like PET, medical cyclotrons, and MRI scanners are not available. These sites require special structural considerations, shielding provisions, and construction access. Due to the processes involved in PET and MRI scanning, shielding for radiation, radio frequency, and magnetic fields are required in order to protect adjacent functions. The process of evaluating potential sites and coordinating the design and construction requires a higher degree of planning, management, and technical considerations in order to succeed. The challenge is then to handle these difficult project aspects as well is all of the normal design considerations. Project teams often involve administration, physicians, physicists, hot lab technicians, equipment manufacturers, architects, and engineers and must be well coordinated in order to solve all of the design and technical issues. The process described here has been developed through a series of project efforts. Included in this discussion are two sample projects from our work at the University of Pittsburgh Medical Center. Sample projects These projects required a refined process to solve
and coordinate complex issues. The projects are a three 1.5 Tesla MRI Department, and a PET Scanner Department with two cameras and an 11 Mev cyclotron. Currespondence to: J.E. Brock, Burt Hill Kosar Rittelmam Associates, 400 Morgan Center, Butler, PA 16001-5977 USA.
Sites for these project were selected after extensive review of potential locations within the existing University of Pittsburgh Medical Center’s Presbyterian University Hospital. This hospital is located in a highly developed district of Pittsburgh. Typical installations of this equipment and shielding are ideally at grade level. This urban hospital had no on-grade sites available and, for functional reasons, required location of the MRI Department on the first floor, adjacent to the existing Diagnostic Imaging Department. The PET Scanner Department was to be located on the ninth floor of a recently constructed high technology facility, convenient to researchers as well as patient elevators. Each project site presented unique challenges to the project team.
A4RI l Three adjacent 1.5 Tesla MRI exam rooms with future capabilities of one magnet being ramped to 2.0 Tesla. l Planning of access and delivery route for MRI equipment. l Location of MRI exam rooms within 50 feet (15 m) of a 20 MW electrical substation which serves multiple buildings on the medical campus. l Design of a six-sided steel plate box to provide magnetic shielding by limiting the stray magnetic field to less than 9 gauss (0.9 milli Tesla) in non-controfied areas around the MRI Suite. The design of the magnetic shield also evaluated the possible effects of magnetic anomalies from electric substation and the traffic on the city street. l Separate radio frequency shielding to alternate ambient radio frequencies in the specified frequency range to 122 db. l Programming and design of an MRI Department
31
Fig. la. Floor plan level 1 - MRI. Legend: 1, Of&e; 2, Lobby; 3, Toilet; 4, Housekeeping; 5, Conference; 6, Family Waiting; 7, Receptionist; 8, Handicapped Toilet; 9, Interview; 10, Dressing; 11, MRI Exam Room; 12, Cryogen Storage; 13, Control Room; 14, Computer Equipment Room; 15, Film Processing; 16, Dark Room; 17, Equipment; 18, Nurse Station; 19, Dats & Communication Closet; 20, St&Toilet; 21, Critical Cave; 22, Work Room; 23, Clean Utility; 24, Soiled Utility; 25, Patient Toilet; 26, Patient Holding; 27, Staff Lounge; 28, Men’s Lockers; 29, Women’s Lockers; 30, Viewing; 31, Clerical File Room; 32, Electrical Closet. b. Perspective view Level 1 - MRI exam room.
for both outpatient and inpatient clinical service within a major teaching hospital. l MRI magnet access for both installation and future potential equipment exchanges. PET Scanner (Fig. 2 a,b) l Installation of a 120000 lb (54432 kg) 11 Mev cyclotron on the ninth floor of a diagnostic wing. l Design and construction of radiation shields for the cyclotron to protect occupied floors below and above the cyclotron. l Programming and design of a, PET scanner for both outpatient and inpatient clinical service within a major teaching hospital. At this time, both project installations have been completed. Magnetic and RF shielding installations have been tested and demonstrated to perform in excess of specified requirements. In order to succeed in both of these complex projects, a process was followed that included extensive planning early in the schedule, constant communication among team members, and identifying all potentials before they impeded progress.
Design Research
Key issues were defined through early research into the application of MRI and PET Scanner technologies and shielding. This aided both the hospital administration and medical staff in decision making, and allowed physicists and the architectural/engineering design team to proceed with site evaluation. Short study efforts documenting available equipment, relative space requirements, shielding requirements, weights, clinical capabilities and limitations were conducted. Through such early research efforts, the following decisions were achieved: l Equipment type, strength, and manufacturer selection. l The hospital and the manufacturer’s physicist began to make a preliminary statement about type and quantity of radiation shielding that would be required .
The architectural and engineering team began to evaluate design and construction feasibility. l Medical staff began to develop space programs with assistance from the architectural designer. l Site review and evaluation by the architect and engineer team were initiated. l
32
M
‘---&”
-
Fig. 2a. Floor plan level 9 - PET. Legend; 1, Camera Room; 2, Electronics Room; 3, Control Room; 4, Intervention; 5, Cold Chemistry; 6, Non-Radio Production; 7, Radio Chemistry Lab; 8, Radio Chemistry Production; 9, Cyclotron Room; 10, Staff Toilet; 11, Heat Exchange; 12, Gas Cylinder Storage; 13, Shop/Storage; 14, Office; 15, Housekeeping; 16, Post Processing/Fellows; 17, Conference; 18, Residents & Post Doctorate Fellows; 19, Reading Room; 20, Storage/Utilities; 21, Electrical Closet; 22, Communications Closet; 23, Prep; 24, Dressing; 25, Patient Toilet; 26, Blood Gas; 27, Dark Room; 28, Film Processing; 29, Research Lab; 30, Lockers; 31, Lounge; 32, Toilet; 33, Nurse; 34, Inpatient Waiting; 35, Consultation; 36, Reception; 37, Records; 38, Outpatient Waiting. b. Perspective view levels 9 - Cyclotran room.
This research effort provided the basic information required to define the project requirements. 0 Space 0 Utilities 0 Structure l Floor-to-floor dimension requirements l General shielding requirements and preliminary shielding concepts l Site access/equipment delivery requirements With these project requirements defined, it is possible to quickly eliminate unsuitable sites and identify areas that would be both technically feasible and functionally desirable within the existing hospital. Through this process of evaluation and elimination, the best site available for each project was selected.
high cost of the equipment and specialized related construction, project abort decisions occurring late in the process would result in a significant waste of funds. Therefore, problem seeking must occur early in the process to avoid costly project abandonment or delay. For the MRI and PET Scanner projects, these problems included: (Table 1) The involvement of the physicist, structural engineers, equipment manufacturer, equipment rigging and installation contractor at this stage is critical to resolving these issues and providing enough information so that the owner can make a finaI decision on the project. Prior to owner commitment, each issue had reached a resolution.
Early problem seeking
Space programming
To validate early assumptions, a problem seeking process was used. For such complex projects, it is essential that the management and design team identify problems early in the process for resolution, or if not resolved, to make project abort decisions. Given the
With the owner committed to the project, a detailed refinement of the space and functional program was conducted. The project architect conducted meetings with the owner’s user task force which consisted of the medical and research staffthat would ultimately occupy
33 TABLE
1
Problems facing MRI and PET projects MRI
PET
l
l
Could the heaviest piece of equipment be lifted to the 9th floor elevation and rolled across the floor into its final location?
l
Protection of MRI equipment from magnetic fields from electrical substations, electrical interference from high voltage lines, RF interference from radio transmitters, and adjacent traffic. Magnet access installation
l
l
Constructability
l
Structural capacity for both the equipment installation and radiation shielding. Feasibility of upper and lower shield for the cyclotron that would allow for normal functions to occur on the floors above and below.
- a diflicult site.
the departments. Detailed space and equipment inventories were developed. To establish a common dialogue for the task force and designers, a series of field trips to similar project sites were conducted. Goals for these trips included: l Validation of early programming assumptions. l Lessons learned from other sites. l General understanding of final assembled equipment installation. l Review of construction and installation details with equipment manufacturers. This review process, coupled with ongoing task force review meetings, led to a refined set of program and equipment requirements, and ultimately, a project plan. Separate tracks - d@xlt/normal By carefully matching design talent to both difficult and normal aspects of the project, a successful outcome of high technology installation and soundness of the overall department design can be maintained. These focused groups of specialists greatly reduce the liability risk for the owner and design team. Specialized equipment within the MRI and the PET Scanner Departments occupies only a fraction of the total floor area. Of course, that area requires a higher degree of expertise and time devoted to the project. The strategy was to assign a separate sub-team to the new technology application. For example, on the PET Scanner cyclotron, an architectural designer with significant technical experience in unique structural solutions was assigned to specifically coordinate the details involving the cyclotron. The project architect responsible for the overall project continued in a normal fashion with the ongoing development of the remaining 12000 square feet of diagnostic and support space. The specialized team working on the cyclotron room was given an earlier deadline to complete their work. It was important to compress this time so that the momentum gained in early planning with the physicist, manufacturer, architects, and engineers was main-
tained. Early completion of the cyclotron design allowed for this work to proceed through bidding and construction ahead of the completion of the overall department. This approach allowed more time to be devoted to details of the hot lab, PET Scan camera rooms, and support areas. Equipment manufacturer involvement No one knows the requirements and limitations of this type of equipment better than the manufacturers. Therefore, it is critical that the manufacturers be involved from the beginning of the project with specific objectives. The manufacturer is providing an expensive clinical device and will offer highly trained technical assistance in the process. Planning the manufacturers’ involvement in meetings, conference calls, and the project schedule is essential. It is also essential that the equipment manufacturer be involved in a pre-bid meeting with the contractors. During this meeting, construction requirements are typically reviewed. However, by adding the equipment manufacturer to the agenda, a presentation of equipment requirements and contractor responsibilities for the equipment can be made. A higher level of understanding on the part of the contractor supports a more competitive bidding environment and ultimately a better project. Radiation shield design As with manufacturer involvement, it is essential that the physicist be involved early in the problem seeking process. The physicist’s radiation shielding design efforts must be coordinated into the project schedule. The physicist should participate in the task force process and set a realistic deadline for final shielding recommendations in order to maintain the project schedule. Maintaining a coordinated eflort Complex projects of this nature must be appropriately managed from the start. The project work plan,
34
the form of a published project schedule (Fig 3), should be negotiated in early task force meetings. It is essential that this plan be considered a draft document when presented to the task force. At the task force meeting, the project plan should be subject to negotiation in order to ensure that each participant is agreeing to realistic time frames. The project plan must include scheduled activities of each of the following project participants: Hospital Administration Hospital Purchasing Equipment Manufacturer Physicist Architect Engineer Once the project work plan becomes a published schedule, it is essential that this schedule be reviewed in each subsequent task force meeting. As shown on the project schedule, the status can simply be indicated by marking each task C for complete, or L - for late. This review takes only a few minutes and profits from the in
-iI q 0 8-H ,ag 2 2-e g I
C
Constructionconsiderations
For projects of this type, contractors should be prequalified prior to invitation to submit proposals. Typically, the construction documents prepared by the architects and engineers will include only the building elements that surround the equipment. It is necessary to provide complete owner-supplied equipment information so that the contractor can more thoroughly understand the project requirements.
19901991 DIJIF/MIAIMIJIJIAISIOINIDIJIFIM Illlllllll~llllllllr~llllI~~~~~
EVENT
-Y
dynamics of a group situation. Each role player in the project is motivated to perform their responsibilities on time. Typically with this approach, a task is not late for more than one meeting. We have found that projects with this type of published work plan generally stay in control. When a part of the project is running late, it is generally only one part of the project and it is possible to develop a contingency plan to maintain the overall schedule. Projects without work plans can take control of the task force, the consultants, and the owner’s budget.
DESIGN
1992
I I I
Ixlawwr DIOIcl~CoIvlMcr r
Fig. 3. Project schedule, PET scanner - Level 9 D wing. Status, C = complete 1= late, * = task force meeting, IIIII planned activity, w activity.
actual
