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Clinical Workshops at the Pulse of CT Technology
By Heike Theessen, Business Unit CT, Siemens Healthcare, Forchheim, Germany
Learning with well-known clinical experts in Europe: Attending clinical workshops in Paris/France to get started with Cardiac CT or coming to Münster/Germany to learn about state-of-the-art applications in DSCT.
Due to long-term cooperation with key users, Siemens Healthcare is able to provide high quality, peer-to-peer training with experts in Cardiac CT and DSCT. Clinical workshops are offered in various locations throughout Europe and throughout the year.
Clinical Workshop on Cardiac CT in Paris/France
A very small group – maximum six participants – will be the core of this workshop, which offers in-depth education in Cardiac CT. Jean-Francois Paul, MD, will guide the participants through the basics of Cardiac CT and provide plenty of tips and tricks along the way. During the first day, the participants will experience live patient examinations. Going from patient preparation to contrast optimization and acquisition, a strong focus will be on radiation dose reduction. After that, the “work” comes back into the workshop. Most of the afternoon and during the second day, participants will work on syngo MultiModality Workstations to review datasets and re-evaluate images with coronary stenosis, plaque imaging and left ventricular function. Each case will be discussed in the group, sharing the challenges and complexity of each individual patient. The workshop will be held at the Marie Lannelongue Surgical Centre, an internationally recognized, 200-bed hospital that specializes in thoracic and cardiovascular diseases in adults and children. The team of the radiology department is developing new applications for cardiovascular CT. The interest in using DSCT for congenital heart disease is particularly high and the team already has considerable experience in this emerging area. Technical aspects, especially radiation dose issues and contrast protocols are their main field of interest.
State-of-the-Art Applications Workshop in Münster/ Germany
Theory and practice are combined in this four-day workshop. Johannes Wessling, MD, Harald Seifarth, MD, and their colleagues will familiarize the participants with state-of the-art applications and show how to use DSCT in the most efficient way. The first two days will focus on Cardiac CT. The participants will be familiarized with scanning techniques on two different scanners (SOMATOM Definition and SOMATOM Definition AS+) with live examinations on each scanner. The following days will focus on virtual colonography and detection and characterization of pulmonary nodules as well as modern concepts for the imaging of patients suffering from ischemic stroke. Clinical lectures will summarize examination technique, patient selection and preparation as well as image interpretation and processing techniques. The main focus will be on hands-on training and interactive interpretation of case studies using syngo MultiModality Workstations. The workshop will be held at the University Hospital of Münster (UKM). With more than 7,500 highly qualified employees and a capacity of over 1,500 beds, the University Hospital of Münster is one of the largest hospital complexes for specialized medical care in northern Germany. Approximately 420,000 patients per year receive inpatient or outpatient treatment in 33 clinics. Research closely linked to patient care has contributed largely to the international reputation of the University Hospital of Münster. Thanks to interdisciplinary cooperation, innovative new methods and findings in fields such as inflammatory process, strokes, heart and vascular diseases and transplantation medicine are progressively created and developed.
www.siemens.com/life-courses
Now is the Time to Elevate SOMATOM AR and SOMATOM Plus 4 Scanners
By Marion Meusel, Business Unit CT, Siemens Healthcare, Forchheim, Germany
The first SOMATOM® AR and Plus 4 scanners left the Siemens CT factory back in the 90s. Since then, even though modern CT technology has evolved rapidly from single row, single source scanners to multislice Dual Source systems, many AR and Plus 4 scanners still do a pretty good imaging job. But after more than 10 years of reliable service, these products are now reaching the end of their useful lifespan. Generally, Siemens Healthcare supports its imaging products for 10 years after the last system is produced. As equipment ages, however, it is much more difficult to maintain support because some suppliers discontinue the production of needed components. The SOMATOM AR and Plus 4 scanners will reach the end of their feasible servicing period by the end of this year. For AR or Plus 4 owners, advantageous upgrade programs exist to switch over smoothly to a new SOMATOM CT scanner from the current Siemens CT portfolio. The new technologies help to reduce dose, improve workflow, increase procedures and enhance patient comfort.
www.siemens.com/ct-elevate
syngo DE lung PBV
Free 90 Day Trial Licenses for Clinical Applications
Trial License: Dual Energy CT
For 90 days, the unique Dual Energy applications can be tried at no cost. It has always been Siemens’ aim to collect as much information as possible for the differentiation of tissues. Providing Spiral Dual Energy scanning, SOMATOM® Definition and SOMATOM Definition Flash open the door to a new world of characterization, visualizing the chemical composition of material. Many applications are already available for daily clinical use, such as an accurate subtraction of bone in CTAs, assessment of pulmonary and myocardial perfusion, characterization of kidney stones or atherosclerotic plaque and iodine removal from liver scans to generate a virtual unenhanced image. By enabling not only faster and more reliable diagnoses, but also by further broadening the application spectrum of CT, Spiral Dual Energy makes a difference in everybody’s daily work.
Dual Energy trial applications available:
- syngo DE Direct Angio
- syngo DE Hardplaque Display
- syngo DE Lung PBV
- syngo DE Virtual Unenhanced (VNC)
- syngo DE Calculi Characterization
- syngo DE Musculoskeletal
- syngo DE Lung Vessels
- syngo DE Gout
- syngo DE Brain Hemorrhage
- syngo DE Heart PBV
Clinical Poster on CT-guided Vertebroplasty
In recent years, there has been a steady rise in the use of CT for biopsy and for image-guided, minimally-invasive therapies. Thanks to the excellent cooperation between Ralf Hofmann, MD, from the University of Munich, Campus Großhadern, Germany and Siemens a new clinical poster was designed. Based on 600 CT-guided interventions, vertebroplasty has been identified as a key area. The poster informs both, physicians and patients about state-of-the-art interventional procedures in vertebroplasty, offering information regarding indications, contra-indications as well as access paths and results. Hence, it is perfectly designed for the scanning room and the patient waiting room. With this new member, a total of 4 clinical posters will be available in the Clinical Poster Gallery. A free copy can be ordered via www.siemens.com/ct-posters in late summer 2009.
www.siemens.com/ct-posters
3D guided treatment of a tumor
GEST 2009: Siemens Healthcare Demonstrated Innovation Leadership in Interventional Oncology
By Stefan Wünsch, PhD*, Susanne von Vietinghoff*, Oliver Meissner, MD**
*Business Unit CT / **Business Unit AX, Siemens Healthcare, Forchheim, Germany
Siemens used the opportunity at the GEST 2009 meeting (Global Embolization Symposium and Technologies) in Paris April 15th-18th to demonstrate their latest developments in CT and angiographic guided interventional oncology. The congress focused on embolization, hands-on workshops and training courses, as well as highly focused industry symposia. At the Siemens booth, presentations on 3D advanced applications, the Artis zee and the SOMATOM CT families were shown. At workplaces, interventional opportunities with CT and the latest guided technologies from angiography – iGuide CAPPA1, an electromagentic needle guidance system – were demonstrated. Additionally, the customers were invited to join the symposium “Siemens Innovations in Interventional Oncology”. Mike Wallace, MD, M.D. Anderson Cancer Center, Houston, TX, USA, presented first results with the new needle guidance system, syngo iGuide and iGuide CAPPA, offering electromagnetic needle tracking. Tobias Jakobs, MD, University of Munich, Campus Großhadern, Germany, demonstrated Siemens’ leadership in CT guided interventions using the latest Adaptive 3D Intervention Suite for SOMATOM Definition CT systems2, thus highlighting the fast and efficient 3D guided treatment of various tumors with full in-room control. The symposium showed Siemens’ unique strenghts and gave a comprehensive overview of latest imaging techniques in interventional oncology.
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1 Skalej M, MD et.al., AXIOM Innovations 08 p22-23.
2 Hoffmann RT, MD et al., SOMATOM Sessions 23 p50-51; Jakobs TF, MD et al., SOMATOM Sessions 23 p52-53.
ESGAR Workshops on CT Colonography
CT-Colonography (CTC) has proven to be a viable alternative to conventional colon examinations like double contrast barium enema and colonography. However, CTC scanning and especially the evaluation of CTC results, require specific knowledge and skills. Therefore, ESGAR, the European Society of Gastrointestinal and Abdominal Radiology, frequently offers CTC workshops across Europe. Siemens, a long-term partner in these workshops, was pleased to be part of the 10th ESGAR hands-on workshop on CT-Colonography, which took place in February 2009 in Harrogate/UK. During one day of lectures, over 100 participants learned fundamental clinical details on CTC. During the second day, more than 30 datasets were reviewed on the workstations provided. This review started with easy cases, going to more difficult ones, ending with cases that showed typical pitfalls of CTC. The next CTC workshop from ESGAR will take place in Stresa/Italy in September 2009. Registering is possible via the ESGAR website.
www.esgar.org
Example of the SOMATOM Definition scanner trigger card
Frequently Asked Questions
How can I reduce dose in cardiac scans?
The following tips can help to reduce dose up to 50% in cardio scans.*
- Use 100 kV protocols instead of 120 kV for patients lighter than 80 kg (175 lbs) and adapt the mAs/rot by a factor of 1.28. With 100 kV, the contrast to noise is much better and you can therefore reduce the dose up to 25%. A default scan protocol with 100 kV is available on your scanner.
- When you change the scan length from an average of 17 cm to 14 cm, the dose saving is up to 15%.
- Use the smallest possible ECG-pulsing window and MinDose if functional imaging is not desired. When the heart rate is < 75 bpm, use a pulsing window of 70 to 70% (Fig.1), saving up to 40% dose** in comparison to a window of 60 to 80%. When the heart rate is > 75 bpm, use a pulsing window of 35 to 70%, saving up to 20% dose** in comparison to a window of 30 to 80%. With an ECG-pulsing window of 70 to 70%, you still have the possibility to shift the reconstruction window for +3% or -3% to obtain the best image quality.
- For lowest possible dose, use the Adaptive Cardio Sequence scan protocol that is by default installed on your scanner. With this protocol, the system will react when there is an extra-systolic heartbeat and set the Flexpadding to 0.
* All numbers and facts are based on a SOMATOM Definition with software version syngo CT 2008G.
** For non-arrhythmic patients.
News in the CT World
Healthcare industry is constantly subject to rapid changes. Remaining up-to-date is of vital importance. The Siemens' CT e-Newsletter brings targeted information on the latest developments and important events.
The monthly CT e-Newsletter provides:
- Highlights on business, clinical outcomes, science and customer care topics,
- Upcoming CT events and courses,
- Answers to frequently asked questions,
- Selection of tips and tricks on “how to …” efficiently use Siemens CT scanners and applications in daily clinical practice.
Siemens Experience Lounge during ECR 2009
Experience Lounge at ECR 2009
By Heike Theessen, Business Unit CT, Siemens Healthcare, Forchheim, Germany
At this year’s European Congress of Radiology (ECR) in Vienna, Siemens once again invited customers to visit the Experience Lounge and join clinical handson Workshops for Computed Tomography (CT), Magnetic Resonance (MR) and Molecular Imaging (MI). More than 400 participants from 49 countries joined the sessions and could enjoy an update on state-of-the-art techniques for these modalities. At the beginning of each session, a theoretical introduction was given by a clinical expert. Radiologists from well known Siemens cooperation partners shared tips and tricks and explained how certain procedures are done in their environment. These were followed by demonstrations of clinical cases during which participants were guided through the processing tools available for the syngo MultiModality Workplace platform. Siemens will also offer the Experience Lounge at the upcoming RSNA 2009 in Chicago. The ECR hands-on workshops in 2008 have been recorded. This DVD can be ordered via the following link (click on E-Learning):
www.siemens.com/somatomeducate
