Dual Source CT shown at SCCT
Siemens Showcases Latest Applications, Low-Dose Scanning with Dual Source CT at SCCT
July 14, 2010
Las Vegas, Nev. - In computed tomography angiography (CTA), radiation dose now can be reduced most of the times to below one millisievert (mSv) for one scan even in clinical routine. However, this is only possible using the latest Siemens Dual Source CT technology, as leading heart specialists will report this
week at the 2010 Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography (SCCT), in Las Vegas, July 15-18. At SCCT, SOMATOM® Definition Flash CT scanner users will also show how they use the system to display the coronary vessels, as well as the aorta, within one scan.
Recently, cardiologists have been using the SOMATOM® Definition Flash to plan the procedure for one of the newest therapy methods for valvular heart disease:
Transcatheter Aortic Valve Implantation (TAVI). Prior to this minimally invasive intervention, physicians had to examine the heart's anatomy closely. This demand is also supported by the cardiovascular CT applications of the imaging software syngo®.via1. With automated processes, these applications can spare the cardiologists many manual steps that before were necessary - for instance, to measure the vessels. Furthermore, syngo.via also supports intraoperative imaging during the TAVI procedure.
"SOMATOM Definition Flash enables us to significantly reduce CTA radiation dose in clinical routine into the sub-mSv range for the vast majority of patients," said Jörg Hausleiter, MD, cardiologist and director of the Intensive Care Unit at the German Heart Center in Munich, Germany. Hausleiter and his colleagues have examined 60 to 70 percent of their patients with a radiation dose below one mSv. The Siemens scanner enables them to display the entire heart volume within only one heartbeat - independent of the patient's heart rate. This is a quantum leap in CTA of the coronary vessels, where, until now, conventional technology has required considerably higher dose rates. Examinations in the sub-mSv range were only possible in very few, selected patients. Dual Source CT allows scanning every patient with high or irregular heart rates - even without the use of beta blockers to slow down the heart rate. This means that even patients who cannot tolerate beta blockers may be spared referral to invasive angiography.
SOMATOM Definition Flash's low-dose scanning potential also benefits patients with heart valve disease who were selected for a TAVI and must be examined by CT in order to plan the procedure. The minimally invasive TAVI treatment is particularly appropriate for older patients with a high perioperative risk during heart surgery. It links the implantation of an artificial heart valve with a balloon dilatation in the catheter laboratory. The great advantage is that the patient's thorax must not be opened as the new valve is inserted through the femoral artery or through a small incision between the ribs.
For the preparation of this procedure, SOMATOM Definition Flash brings even more benefits to the user. TAVI patients are usually multimorbid and suffer from renal insufficiency. They can barely metabolize larger quantities of contrast agent that often have to be applied for a CTA to display the coronary arteries and the aorta.
"For us, SOMATOM Definition Flash is the best solution to plan a TAVI because it allows us to reduce contrast agent significantly," said Tobias Pflederer, MD, cardiologist at University Hospital Erlangen, Germany. "Single-Source CTs, for example, require 100 or even 150 milliliters of contrast agent for assessing the abdominal aorta. With the Definition Flash, we need only 40 milliliters for the aorta and the coronary arteries." The cardiologists in Erlangen only need two seconds to assess the whole aorta including the coronary arteries in one scan. "Using the resulting information, we can plan every single step of the TAVI procedure," said Pflederer.
Prior to the TAVI treatment, the cardiologists need to clarify many anatomical issues regarding the vessels. They must know, for example, whether there are stenoses in the peripheral arteries. In that case, they could not insert the new valve through the femoral artery. Furthermore, they must determine the diameter of the aortic bulbus (initial part of the aorta) to select the right size of the artificial valve. syngo.via combines the application modules syngo.CT Vascular Analysis and syngo.CT Cardiac Function to display a dedicated TAVI planning workflow that helps physicians answer all these questions quickly, easily, and securely. The software, for instance, automatically exposes the aorta and its valves virtually. It reconstructs the vessel in the most important planes and automatically indicates the measurements that the physician has to conduct for his diagnosis.
"With syngo.via, we are also able to predict the angulations that we will need for invasive fluoroscopy in the TAVI procedure, and we can load and adjust them right in the cath lab," said Pflederer. "Our first experiences are that this way, the workflow inside the cath lab can be accelerated by 30 percent." The University Hospital Erlangen conducts three to four TAVI interventions per week. Pflederer believes that the quantity will increase and that TAVI then may also be used for non-high-risk patients. He assumes that soon, other valve diseases may be treated by transcatheter approaches, as well.
At SCCT, Professor Stephan Achenbach, MD, senior physician at the Department for Cardiology and Angiology at the University Hospital Erlangen, will show how he brings sub-mSv CTA examinations with SOMATOM Definition Flash into the clinical routine. He will also give a live case emonstration of syngo.via's TAVI planning workflow, together with John R. Lesser, director of Cardiovascular MRI and CT at the Minneapolis Heart Institute/Abbott Northwestern Hospital.
1syngo.via can be used as a standalone device or together with a variety of syngo.via-based software options, which are medical devices in their own rights. The information is preliminary. The product and the syngo.via based software options are pending in some countries the necessary releases and thus are not yet available for sales in all countries.
The products mentioned here are not commercially available in all countries. Due to regulatory reasons the future availability in any country cannot be guaranteed. Please contact your local Siemens organization for further details.
The outcomes achieved by the Siemens customers described herein were achieved in the customer's unique setting. Since there is no "typical" hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that others will achieve the same results.
The University Hospital Erlangen and the German Heart Center Munich have a cooperation contract with Siemens Healthcare.
The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging, laboratory diagnostics, medical information technology and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source from prevention and early detection to diagnosis, and on to treatment and aftercare.
By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better and more cost-effective. Siemens Healthcare employs some 48,000 employees worldwide and operates around the world. In fiscal year 2009 (to September 30), the Sector posted revenue of 11.9 billion euros and profit of around 1.5 billion euros. For further information please visit:
www.siemens.com/healthcare.
week at the 2010 Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography (SCCT), in Las Vegas, July 15-18. At SCCT, SOMATOM® Definition Flash CT scanner users will also show how they use the system to display the coronary vessels, as well as the aorta, within one scan.
Recently, cardiologists have been using the SOMATOM® Definition Flash to plan the procedure for one of the newest therapy methods for valvular heart disease:
Transcatheter Aortic Valve Implantation (TAVI). Prior to this minimally invasive intervention, physicians had to examine the heart's anatomy closely. This demand is also supported by the cardiovascular CT applications of the imaging software syngo®.via1. With automated processes, these applications can spare the cardiologists many manual steps that before were necessary - for instance, to measure the vessels. Furthermore, syngo.via also supports intraoperative imaging during the TAVI procedure.
"SOMATOM Definition Flash enables us to significantly reduce CTA radiation dose in clinical routine into the sub-mSv range for the vast majority of patients," said Jörg Hausleiter, MD, cardiologist and director of the Intensive Care Unit at the German Heart Center in Munich, Germany. Hausleiter and his colleagues have examined 60 to 70 percent of their patients with a radiation dose below one mSv. The Siemens scanner enables them to display the entire heart volume within only one heartbeat - independent of the patient's heart rate. This is a quantum leap in CTA of the coronary vessels, where, until now, conventional technology has required considerably higher dose rates. Examinations in the sub-mSv range were only possible in very few, selected patients. Dual Source CT allows scanning every patient with high or irregular heart rates - even without the use of beta blockers to slow down the heart rate. This means that even patients who cannot tolerate beta blockers may be spared referral to invasive angiography.
SOMATOM Definition Flash's low-dose scanning potential also benefits patients with heart valve disease who were selected for a TAVI and must be examined by CT in order to plan the procedure. The minimally invasive TAVI treatment is particularly appropriate for older patients with a high perioperative risk during heart surgery. It links the implantation of an artificial heart valve with a balloon dilatation in the catheter laboratory. The great advantage is that the patient's thorax must not be opened as the new valve is inserted through the femoral artery or through a small incision between the ribs.
For the preparation of this procedure, SOMATOM Definition Flash brings even more benefits to the user. TAVI patients are usually multimorbid and suffer from renal insufficiency. They can barely metabolize larger quantities of contrast agent that often have to be applied for a CTA to display the coronary arteries and the aorta.
"For us, SOMATOM Definition Flash is the best solution to plan a TAVI because it allows us to reduce contrast agent significantly," said Tobias Pflederer, MD, cardiologist at University Hospital Erlangen, Germany. "Single-Source CTs, for example, require 100 or even 150 milliliters of contrast agent for assessing the abdominal aorta. With the Definition Flash, we need only 40 milliliters for the aorta and the coronary arteries." The cardiologists in Erlangen only need two seconds to assess the whole aorta including the coronary arteries in one scan. "Using the resulting information, we can plan every single step of the TAVI procedure," said Pflederer.
Prior to the TAVI treatment, the cardiologists need to clarify many anatomical issues regarding the vessels. They must know, for example, whether there are stenoses in the peripheral arteries. In that case, they could not insert the new valve through the femoral artery. Furthermore, they must determine the diameter of the aortic bulbus (initial part of the aorta) to select the right size of the artificial valve. syngo.via combines the application modules syngo.CT Vascular Analysis and syngo.CT Cardiac Function to display a dedicated TAVI planning workflow that helps physicians answer all these questions quickly, easily, and securely. The software, for instance, automatically exposes the aorta and its valves virtually. It reconstructs the vessel in the most important planes and automatically indicates the measurements that the physician has to conduct for his diagnosis.
"With syngo.via, we are also able to predict the angulations that we will need for invasive fluoroscopy in the TAVI procedure, and we can load and adjust them right in the cath lab," said Pflederer. "Our first experiences are that this way, the workflow inside the cath lab can be accelerated by 30 percent." The University Hospital Erlangen conducts three to four TAVI interventions per week. Pflederer believes that the quantity will increase and that TAVI then may also be used for non-high-risk patients. He assumes that soon, other valve diseases may be treated by transcatheter approaches, as well.
At SCCT, Professor Stephan Achenbach, MD, senior physician at the Department for Cardiology and Angiology at the University Hospital Erlangen, will show how he brings sub-mSv CTA examinations with SOMATOM Definition Flash into the clinical routine. He will also give a live case emonstration of syngo.via's TAVI planning workflow, together with John R. Lesser, director of Cardiovascular MRI and CT at the Minneapolis Heart Institute/Abbott Northwestern Hospital.
1syngo.via can be used as a standalone device or together with a variety of syngo.via-based software options, which are medical devices in their own rights. The information is preliminary. The product and the syngo.via based software options are pending in some countries the necessary releases and thus are not yet available for sales in all countries.
The products mentioned here are not commercially available in all countries. Due to regulatory reasons the future availability in any country cannot be guaranteed. Please contact your local Siemens organization for further details.
The outcomes achieved by the Siemens customers described herein were achieved in the customer's unique setting. Since there is no "typical" hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that others will achieve the same results.
The University Hospital Erlangen and the German Heart Center Munich have a cooperation contract with Siemens Healthcare.
The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging, laboratory diagnostics, medical information technology and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source from prevention and early detection to diagnosis, and on to treatment and aftercare.
By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better and more cost-effective. Siemens Healthcare employs some 48,000 employees worldwide and operates around the world. In fiscal year 2009 (to September 30), the Sector posted revenue of 11.9 billion euros and profit of around 1.5 billion euros. For further information please visit:
www.siemens.com/healthcare.