A system failure not only brings throughput to a stop but it’s, above all, a nightmare when interventions are in process. The Medical Director of the Diagnostic and Interventional Radiology Department at the Tübingen University Hospital, Germany, Professor Claus D. Claussen, MD, and various team members speak about the challenges of radiology and why proactive services such as the Siemens Guardian Program™ support clinical workflow.

By Katja Stöcker
Siemens Healthcare, Erlangen, Germany

By Marion Meusel
Business Unit CT, Siemens Healthcare, Forchheim, Germany

The latest enhancement for SOMATOM Definition CT scanners is the new software version syngo® CT 2008G. This new software will bring improved usability and the following new functionalities for the SOMATOM Definition. The highlights range from new Dual Energy applications to all new solutions for perfusion imaging and interventions:* The new syngo Dual Energy applications (Heart PBV, Brain Hemorrhage, Lung Vessels and Gout) will open new clinical fields.* With these applications, customers can take advantage of our 90 day free trial licenses. The new Adaptive 4D Spiral* scan mode allows for whole organ coverage in perfusion CT as well as phase-resolved imaging up to 21 cm. Enabled by the volume projector, it applies a continuously repeated bi-directional table movement, moving the patient smoothly in and out of the gantry over the desired scan range. Interventional procedures are supported by i-Fluoro.* Fluoroscopic scans can be acquired with low-dose techniques and displayed in real time. For fastest workflow during interventions, scan modes can be switched on the fly with a single click. Key features are configurable layout screens, an all-new Interventional Toolbar* and HandCARETM* for i-Fluoro to avoid direct X-ray exposure of the surgeon’s or radiologist’s hand during the intervention. SOMATOM Definition systems running on syngo CT 2007C will automatically receive the new software syngo CT 2008G** accompanied with comprehensive training on-site and supporting training material via e-learning CD.

*Optional components that need to be purchased separately.
**Customers will be contacted by customer service.

By Reto Merges
CT Research Collaborations, Siemens Healthcare, Shanghai, China

In China, the healthcare system is developing at a rapid rate alongside the economic growth. Innovative healthcare concepts are being implemented in all major cities of the country; therefore high-end CT systems are not a rarity anymore. At the same time, the scientific community strives for more international participation. Three years ago, Siemens founded a dedicated team to support CT research in China. To be able to cater to the diverse needs of our Chinese partners, the team today consists of two radiologists and two engineers. It is a typical win-win situation because Siemens gets a unique insight into the customers’ needs in China and the collaboration partners gain direct access to the technical knowledge, education and advice that they need in order to raise the scientific capabilities of their institutes. The activities extend from supporting research projects aimed at international publications to workshops on hot topics in radiology and scientific writing. Research topics cover a broad field of innovative CT applications, from Cardiac Imaging and CT Perfusion to Dual Energy CT. “The key is to help educate young researchers so that innovative healthcare delivery and research will go hand in hand in the future!” says Prof. Zheng Yu Jin, MD, Peking Union Medical College Hospital.

By Heike Theessen
Business Unit CT, Siemens Healthcare, Forchheim, Germany

At this year’s European Congress of Radiology (ECR) in Vienna, more than three hundred customers participated in the Hands-on Workshops organized by Siemens Healthcare. Clinical presentations by leading experts were followed by demonstrations of clinical cases during which participants were guided through the processing tools available for the syngo MultiModality Workplace platform. Sitting at one of the sixteen workstations, radiologists and technologists from over fifty countries had the opportunity to discover the capabilities of the syngo software. Michael Lell, MD, University Hospital of the Friedrich-Alexander-University Erlangen-Nuremberg, who led the session on Neuro-CT, rates these workshops to be very important because they also serve to train the user with knowledge beyond application training. More about the clinical value of Siemens Hands-on workshops can be read under the link below. There you can also order the DVD with the recording of the ECR Hands-on workshops.

By Claudia Lindner
Business Unit CT, Siemens Healthcare, Forchheim, Germany

CARE Dose4D™ and its real-time mA adjustment provide best image quality at the lowest possible dose. Every patient is different in terms of size, weight, and anatomy. Therefore, CAREDose4D was developed to provide fully automated, real-time, anatomy-based dose regulation. CAREDose4D adapts the dose automatically to the specific anatomical characteristics of each individual patient to consistently deliver a user-defined and customizable noise level. But how does it work exactly? With the new CAREDose4D e-learning, CT-users can easily learn how to utilize CAREDose4D most efficiently. The web-based version can be accessed or the CD version can be ordered via the link below. This is only one e-learning tool out of many others offered by Siemens Healthcare. As part of the SOMATOM Educate program “Life“, users benefit from Siemens clinical e-learning opportunities – and experience the latest clinical results in the various fields of CT imaging.

By Rami Kusama
Business Unit CT, Siemens Healthcare, Forchheim, Germany

Trial License: Adaptive 4D Spiral
Siemens unique Adaptive 4D Spiral moves beyond fixed detector limitations to provide full coverage of any organ in 4D. This overcomes the coverage limitation of a static detector design so the perfusion and dynamic coverage can be adapted to exactly the range needed. In stroke assessment, it provides the perfusion information, not just for a limited section of the disease, but for the whole brain,* so the physician is assured of a reliable assessment of the type and extent of cerebral perfusion disturbances. In addition, it allows tumor perfusion studies over the entire organ in both head and body,* enabling the radiologist to assess the perfusion and vascularisation of tumors. Additionally, the Adaptive 4D Spiral enables the visualization and evaluation of complex vascular structures by performing time-resolved angiographies with multiple phases. With this feature, for example, arterial and venous phases can be captured in a single acquisition and can then be evaluated time-resolved. The benefits of the Adaptive 4D Spiral can be experienced with a 90-day free trial.**
Trial License: Intervention Pro & Adaptive 3D Intervention
For 90 days, at no cost, “Intervention Pro” can be tried, supporting guidance for interventional procedures with maximal flexibility and with minimal, single-click effort. In addition, spiral sequence and fluoroscopic scan modes can be switched on the fly during interventions. A dedicated interventional toolbar supports the workflow with respect to table control and 2D/3D measurements. The additional option, Adaptive 3D Intervention, further overcomes the limitations of conventional 2D-CT guidance, allowing for 3D visualization (MPR, VRT) and needle path planning.*** Thus, a more comprehensive visualization of needle position, needle path, and surrounding organs supports in difficult procedures. This is especially helpful when using oblique needle paths, for example, during RF ablation. Intervention Pro and Adaptive 3D Intervention can be tested risk free with a 90-day free trial.**

* Maximum perfusion coverage depends on system configuration.
**Minimum system requirements need to be fulfilled for these options to be available. Therefore the related Siemens representative should be asked to check the system configuration.
***Dual Monitor for in-room support highly recommended.

Thanks to the excellent cooperation with our clinical partners, we now have a growing number of posters in the Clinical Poster Gallery. Perfect for the patient waiting room, the staff lounge or the reading room, these posters illustrate the wide range of images that are possible from a CT examination. They will help to educate staff and patients about the human anatomy as seen through a CT scanner. Key anatomy is clearly labeled, typical pathological findings are described and key features of the application are noted. To date we have the following posters available:

Q: How can I reduce my reading time in syngo Oncology?
A: By using the powerful CAD tool in syngo Oncology after an automated detection of lung lesions, for example, several markers are listed which need to be reviewed. All the marked structures are numbered and listed in the Marker List. It is also possible to have several lesions from previous examinations or lesions that are marked by the user him/herself. To save time, the space bar can easily be used to jump from one marker to the next (or the button “B” can be used to go back to the previous marker). After starting with marker number one, for instance, you only have to press the space bar to go straight to marker number two.
Q: Can I change the default display for the Global Result Segment?
A: Depending on your preference, it is possible to convert the default display in the Global Result Segment from the VRT image to a MPR image. Under Options -> Configuration, you will find the “syngo CT Oncology” icon. Double click to open the configuration menu. On the second subtask card, you can select 2D for “Default Representation”. Then press “OK”. The next time when you open the syngo Oncology application the changes are applied.

The annual Lennart Nilsson Award this year goes to Professor Anders Persson, MD (Linköping University). The Swedish radiologist is honoured for his innovative 3D images depicting the human body internally. Using CT technology, he has provided new possibilities in forensic pathology. The commendation is considered to be the world’s most prestigious award in scientific and medical photography. Read more about Persson’s methodology in the SOMATOM Sessions Magazine 22.