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Special report: Despite setbacks, CT market blossoms

by Diana Bradley, Staff Writer | January 20, 2012
From the January 2012 issue of HealthCare Business News magazine

“In the past, it has been a slice war and customers have purchased more equipment than was truly needed,” says Chris McHan, business director and general manager of Neusoft Medical, a medical equipment supplier. “Today, customers are purchasing the equipment that is most appropriate for their clinical needs without all the extra software. The main concerns in the industry are dose and the continued hesitation to buy based on uncertainty regarding government spending and mandates.”

In an effort to reduce costs and increase workflow, NeuroLogica developed BodyTom, a portable full body CT scanner that can be wheeled around the hospital as needed. BodyTom received FDA clearance in early 2011.

“In the past, you had to have an expensive installation, which would involve crews coming in and disturbing workflow,” says Powell. “With our portable BodyTom, this is eliminated.”

Traditionally, patients were scanned with 120 kV; last year this went down to 100 kV; and now it has been reduced to 80 kV. Limiting kV from 120 to 100 reduces dose by 30 percent, while limiting kV from 120 to 80 reduces dose by 60 to 70 percent, according to Fishman.

“It’s easy to scan at low dose, but low dose becomes low information and then the study has not been at all worthwhile – it’s about getting the best of both worlds: the same information with lower dose,” he adds.

Dose levels can be minimized through hardware, such as active collimation or beam filters; and software, such as noise reduction tools and adaptive iterative dose reduction software, including Toshiba’s Boost3D and Quantum Denoising Software, which can achieve a dose savings of up to 50 percent.

Supporting the Medical Imaging & Technology Alliance’s Radiation Dose Reduction Plan and its CT Dose Check Initiative, Toshiba installed the first Aquilion ONE CT system featuring Toshiba’s Dose Check Software and additional low dose technologies last year. Computerized imaging reference systems also offer devices that can be used to measure the dose delivered during different CT protocols.

Toshiba Aqulion PRIME

There are many different methods of iterative reconstruction currently implemented or in development, allowing comparable image quality at lower dose. One of the main challenges is that previous metrics of image quality used in the last 60 years have proven ineffective when it comes to assessing the image quality of CT images produced by IR.

In November, Siemens Healthcare’s iterative reconstruction algorithm SAFIRE – Sinogram Affirmed Iterative Reconstruction – received FDA clearance. This new generation of image reconstruction software and hardware aims to reduce radiation dose by up to 60 percent in CT exams and improve image quality.

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