Siemens Medical Solutions to present Somatom Emotion 16 and DynaCT at the European Congress of Radiology

Vienna 03 March 2005At the European Congress of Radiology (ECR) in Vienna, Austria, Siemens Medical Solutions has launched the new Somatom Emotion 16, significantly expanding their Somatom Emotion product line. The new Somatom Emotion 16 enables hospitals and private practices with limited budgets or space allocations to install a 16-slice CT suitable for comprehensive clinical applications. The Somatom Emotion product line has been proven in almost 3500 installations worldwide, and is thus among the most successful product lines in computed tomography (CT) history. Siemens also introduced DynaCT for the first time in Europe. This new application enables users of angiographic C-arm systems to create soft tissue images based on the principles of CT. These CT-like images allow soft tissue differentiation that enables, for instance, detection of intracranial haemorrhages and visualization of the brain tissue. This in turn supports decision making during interventions. It is all made possible by modern flat detector (FD) technology from Siemens.

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The Somatom Emotion 16 and all its components require only 18,5 square meter installation space because, as an air cooled system, it does not need an external cooling device outside the gantry. In addition to the economical purchase price, this minimal space requirement, compared to other corresponding systems, and the overall low life cycle costs also contribute to the system's cost efficiency.

From a clinical perspective, the new scanner offers every advantage of a modern 16-slice system: image acquisition without movement artifacts thanks to short breath hold times, high diagnostic image quality thanks to a collimation of down to 0,6 millimeters, a maximum gantry rotation speed of 0,5 seconds, and a comprehensive set of clinical applications. Among these are, for example, syngo LungCARE CT with Nodule Enhanced Viewing (NEV) and syngo Colonography with Polyp Enhanced Viewing (PEV) for the computer supported visualization of lung lesions and colon polyps. These can be a pre-stage to cancer.

The gantry rotation speed of 0,5 seconds, combined with 16-slice technology, also enables the visualization of small vessels and of cardiac anatomy with ECG-synchronized protocols. For radiation therapy planning, the recently introduced CT Respiratory Gating application software permits the visualization of the movement of lung tumours during breathing, and an extended Field of View capability - from 50 centimeters to 70 centimeters - is available.

Additionally, the Somatom Emotion 16 is equipped with comprehensive Combined Applications to Reduce Exposure (CARE) functions, Siemens' initiative to reduce radiation exposure in CT examinations. CARE Dose4D software for automated dose adaptation, analyses the cross-sectional anatomy of each individual patient in real time and adjusts the emitted X-ray dose accordingly without need for user interaction. It greatly simplifies scanning procedures and results in the best image quality with the lowest possible radiation dose for both large-volume and paediatric examinations. Clinical results with CARE Dose4D indicate up to 66 per cent reduction in dose for the average adult patient.

The optional CARE Vision software automatically reduces dose for physician and patient in CT-guided interventions such as drainages, biopsies, or pain therapy. HandCARE automatically switches off the X-ray beam at three different positions (10 o'clock, 12 o'clock and 2 o'clock) for a 100 degree angle. As a result, HandCARE prevents direct exposure of the surgeon's hand, while still delivering optimal image quality. With their compact gantry (24 cm from the front of the gantry to the scan plane), the Somatom Emotion scanners provide easy access to the patient and are therefore frequently used in interventional CT.

With a reconstruction speed of up to 16 images per second, the Somatom Emotion 16 enables a fast diagnosis. Additionally, the optional WorkStream4D software tool permits the direct 3D reconstruction of raw data in a pre-defined series of image planes. It eliminates the need for manual reconstruction steps: within standardized protocols, the user selects the image planes required for diagnosis, and the software does the rest. Acquisition and display of oblique and double oblique images of the body is much faster than before, enabling faster diagnosis even for more complex anatomy.

After completing a comprehensive testing phase at clinical institutions in Europe, the Unites States and Asia, the Somatom Emotion 16 will be commercially available in fall 2005.

Angiographic C-arm systems are designed to generate projection images. For several years, rotational angiography and their corresponding reconstruction methods have been able to generate and visualize 3D volumes from these projection images. This method, established in hospitals, was developed to display high contrast image content from bones, vessels with contrast agent, etc. In combination with the flat detector, DynaCT now enables soft tissue differentiation. Clinical images, comparable to those generated by a CT scanner, can display organs, vessels or haemorrhages.

These new views using an angiography system open many new applications in neuroradiology, as well as abdominal or oncological interventions. Applications range from the visualization of vascular systems, with the ability to detect haemorrhages and changes in size, to support for drainage procedures, as well as tumour embolization and ablation. In many cases, computed tomography was previously used in these cases for imaging. With DynaCT, repositioning the patient from the angiography suite to a computed tomography facility is eliminated, which, in fact, was performed rarely because of the difficulty and increased risk. The time required often was enough to rule out the use of such measures.

Generating slice images at the C-arm system is extremely easy: the physician rotates the C-arm in a circle about the patient and performs a number of acquisitions in accordance with the protocol. Subsequently, images are reconstructed in the same manner as with a CT system and sent to the angiography system monitor. Within three minutes, the physician receives the results in the form of slice images, which can display objects of up to 10 HU (Hounsfield units) difference and 10 mm in size. Cranial haemorrhages, ventricles and cranial structures can be detected in these slice images. Additionally, tumours can be differentiated from healthy tissue.

Dr. Kunio Takano, the first to implement DynaCT in a clinical situation at the Chiba Cancer Center at Chiba, Japan, requires the highest level of information possible from an imaging system to have an optimum decision-making basis to ensure fast and safe treatment for patients in cancer interventions. He underscores his requirements succinctly: "We could see the unexpected performance of DynaCT. In the near future it will be an indispensable function in the interventional field."

For Dr. Norbert Gaus, head of the Angiography, Fluoroscopic and Radiographic Systems product group at Siemens Medical Solutions, Dyna CT is the result of consistent use of flat detector technology: "DynaCT is a successful example of how we use our technological advantage to benefit our customers. The customer sees us as a leader in innovation. With the flat detector, we were motivated to view this technology as more than just a replacement for the image intensifier. Our developers consistently investigated what was possible with flat detectors. Generating slice images at the C-arm is certainly a milestone in interventional radiology."

DynaCT is suited for use with all Siemens angiography systems with flat detectors. While the application is available with Axiom Artis dFA in a monoplane system, the physician can use DynaCT in a biplane system (Axiom Artis dBA) as well as a ceiling-mounted system (Axiom Artis dTA DynaCT). Artis systems that are already installed can be upgraded. DynaCT has FDA clearance for the USA. More Siemens news is available in this VMW issue's article FDA clears new, smaller Ultrasound catheter from Siemens for the visualization of entire heart during non-invasive procedures.


Leslie Versweyveld

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