CT: No Matter How You Slice It - Better, Stronger, Faster

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It's an exciting year for computed tomography debuts at RSNA, with several new systems being unveiled, and advancements in peripheral devices designed to enhance CT imaging studies. Sixty-four channel detectors are the order of the day - but enhancements to 16- and 32-slice scanners are really pushing the field, too.

Siemens Medical Solutions (booth #2729) is showcasing its FDA-approved Somatom Sensation 64 scanner at RSNA 2004. The Somatom Sensation 64 provides 64-slice sub-millimeter imaging per rotation and a fast gantry rotation time at 0.37 seconds. The new system is designed for cardiac, neurology and body imaging applications. Acquisition of 64 slices per rotation is possible through the Straton x-ray tube's "Double z-Sampling" technology, and new Siemens proprietary detector technology. "Double z-Sampling" allows two focal points in the anode by precise deflection of the electron beam within the x-ray tube that generate two overlapping beams to pass the scan field. The double readout of the detector produces 64 slice projections at down to 0.3 mm slice distance. Developed with Speed4D technology, the SOMATOM Sensation 64 includes WorkStream4D for workflow optimization and data handling, syngo InSpace4D for evaluation of the moving heart, and CARE Dose4D for automated real-time dose adaptation.

For the first time, GE Healthcare (booth #2700) will accomplish a global launch of two products simultaneously within the CT segment this year.

The first offering is the LightSpeed VCT (Volume CT), which provides a combination of simultaneous wide volume coverage and high resolution via a 64-channel detector that offers 4 cm coverage and a resolution of 0.35mm. The most significant clinical application for this system will be cardiac studies. LightSpeed VCT reduces the acquisition time for a typical exam from 20 seconds on a 16-slice scanner to about 5 seconds on this device.

This capability is considered a breakthrough, GE says, because once the contrast agent is injected, there is an initial variation of heart rate produced by introduction of the agent, then there is about a five second "golden window" where the heart rate is stable, followed by an increase in heart rate as the breath-hold produces hypoxia. It is important to have a stable heart rate to produce excellent image quality across an entire population of patients who will be imaged.

The LightSpeed VCT can capture an image of any organ in one second, scan the whole body in fewer than 10 seconds and capture images of the heart and coronary arteries in fewer than five heartbeats, according to GE.

The second product launch involves the LightSpeed Pro32 helical multislice CT, which advances the 16 series scanners. This system is described as being incrementally better compared to the 16-slice scanners, and is beneficial for cardiac studies, angiography, and perfusion studies, GE said. Although it does provide 4 cm coverage, the resolution is not up to the standard of the VCT.

Both scanners have an increase in scan rotation speed, moving from 400 milliseconds to 350 milliseconds as a single rotation of the detectors.  Both products will be fully commercially available in the first quarter of 2005.

Philips Medical Systems (booth #7113) is unveiling the Brilliance CT Scanner 64 configuration for the first time at RSNA, along with a new version of the software for the Brilliance workstation (Brilliance Workspace version 2.0). This scanner provides substantial improvements in speed of acquisition, and cardiac studies are one of the primary applications, as are lung imaging studies. Given a patient with emphysema who has a difficult time holding his or her breath, with an exam that can be completed in five seconds, enhanced comfort level is a major issue.

From a software perspective, one of the primary considerations that Philips incorporated into its new version is the ability to interface with any appropriate information system within the healthcare institution. There also is a trademarked capability, Guided Flow productivity qualities that helps the user progress through set-up, acquisition and processing of the data in a time-effective manner designed to improve throughput. New user interfaces have been designed so that information flows to the user in a logical manner, to facilitate higher productivity and shorter training times. Additionally, Philips offers a proprietary post-processing engine that permits reconstruction of up to 40 images in a second.

Both products are scheduled to begin shipping in June 2005.

Toshiba America Medical Systems (booth #7545) is showcasing its new Aquilion 64 CFX CT system that has been optimized for coronary artery exams. The system features Toshiba's 64-row Quantum detector for simultaneous 64-slice scanning with a spatial resolution of 0.35 millimeter, volume imaging capabilities and proprietary software applications designed to automate complex diagnostic cardiac studies.

The software applications suite, known as SUREWorkflow, is designed to ensure image quality, repeatability and productivity by automating complex CT studies. There is an automated cardiac scan protocol that has been clinically validated to ensure the best temporal resolution regardless of the patient's heart rate or condition, and the SURE Plaque feature offers soft plaque identification and measurement protocols for both cardiac and peripheral vessel analysis using a color-coding system based on tissue density.

Cardinal Health (booth #2721) is featuring at RSNA a new CT dose phantom that provides one complete set of quality assurance dose phantoms for children and adults. It consists of three parts: an adult body phantom, an adult head phantom that doubles as a pediatric body phantom, and the new pediatric head phantom. Each phantom can be purchased separately or combined in a kit according to a particular practice's needs. In addition, an optional sturdy carrying case has been designed to hold all three phantoms and a CT Ion chamber.

Medrad Inc. (booth #1929) is unveiling the Stellant D CT Injection system at RSNA this year.  Hourly demonstrations of this system will help visitors understand the capabilities of this product.

Medrad's Stellant CT Injection system is designed to meet the latest clinical, safety and ease-of-use requirements of rapidly evolving CT techniques. The DualFlow Simultaneous injection option enables both contrast and saline injection at the same time through variable ratios of synchronized plunger motion. With the proper ratio, the left and right heart ventricles can be illuminated uniformly for improved image quality. This device was designed following input from thought-leaders from around the world, and includes a pressure monitor graph, improved syringe design, syringe auto load and the ability to upgrade from single to dual injection.

TeraRecon (booth #4343) is introducing a scalable cone beam CT reconstruction cluster based on the Xtrillion processor technology. The system will deliver CT reconstruction of a 2048 cube in less than 30 minutes.

To enhance its line of high-resolution, high-speed 3D cone beam CT scanners, TeraRecon will announce two additional configurations with sub 10-micron resolution.