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SOMATOM Definition DSCT Das erste Dual Source CT der Welt.

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Präsentation zum Thema: "SOMATOM Definition DSCT Das erste Dual Source CT der Welt."—  Präsentation transkript:

1 SOMATOM Definition DSCT Das erste Dual Source CT der Welt

2 Klinische Ziele für die Computertomographie in der Zukunft
CT als Routine-Methode bei Patienten mit Verdacht auf KHK CT als erste Wahl in der Notaufnahme Neue Kontraste bei CT für mehr Information bei weniger Dosis

3 Brauchen wir immer mehr Schichten?
4 16 32 64 128 256

4 Zeit für einen neuen Ansatz in der CT !

5 SOMATOM Definition SOMATOM Definition
Schneller als jedes schlagende Herz Beste Auflösung am Herz bei halber Dosis Komplette Diagnose in der Notaufnahme Mehr als Visualisierung durch Dual Energy SOMATOM Definition

6 Schneller als jedes schlagende Herz Alle Herzraten ohne “ß-Blocker“ mit konstanter zeitlicher Auflösung von 83ms SOMATOM Definition Das erste DSCT der Welt HF unabhängig von der temp. Auflösung von 83 ms Rotationszeit 0,33 s Räuml. Aufl. 0,33 mm 6 sec für 120 mm HF bpm Courtesy of University of Erlangen / Erlangen, Germany

7 Schneller als jedes schlagende Herz Alle Herzraten ohne “ß-Blocker“ mit konstanter zeitlicher Auflösung von 83ms SOMATOM Definition World’s first DSCT HR independent temp Res. 83 msec Rotation 0.33 s Spatial Res. < 0.4 mm 7 sec for 140 mm HR 71 bpm Courtesy of University of Erlangen / Erlangen, Germany

8 Kardiologische Detailaufnahme mit halber Dosis Dual Source CT = 1/2 x Dosis
SOMATOM Definition Das erste DSCT der Welt HF unabhängig von der temp. Auflösung von 83 ms Rotationszeit 0,33 s Räuml. Aufl. 0,33 mm 6 sec für 118 mm Exposure ~ 5mSv HF 78 bpm Courtesy of University of Erlangen / Erlangen, Germany Single Source < 55 55-70 70-90 >90 bpm Dual Source 100% 50%

9 Komplette Diagnose in der Notaufnahme Trauma Diagnostik mit 200cm Scanbereich und 78cm Gantry Öffnung & FoV Moore’s Law for CT: The number of slices acquired per rotation has doubled every 18 months in the last several years and has become one key differentiator between CT scanners. But, the world of CT is changing rapidly with clinical benefits becoming more and more crucial to ensure the highest level of patient care possible. The introduction of 32, 40 and 64-slice CT is already demonstrating the dawn of the slice race. To meet tomorrow’s clinical needs, to meet your and our visions, still remaining clinical challenges have to be solved. The simple extension of the number of detector rows as pursued by many vendors does not result in clinical advantages over previous 16-slice CT scanners. Siemens on the other hand truly revolutionizes CT with the introduction of the SOMATOM Definition.

10 Mehr als Visualisierung durch Dual Energy Direkte CTA aller Gefäße
SOMATOM Definition Das erste DSCT der Welt Rotationszeit ,.5 s Kollimation 0,6 mm Räuml. Aufl. 0,33 mm Spiral Pitch 1.0 Scanzeit mm Dual Energy effective mAs 80 kV, 350mA 140 kV, 150mA Courtesy of University of Erlangen / Erlangen, Germany

11 Mehr als Visualisierung durch Dual Energy Neue Möglichkeiten in der CT Diagnostik
Trennung von Fett, Gewebe und Kontrastmittel z. B. Charakterisierung von Lebertumoren …. ein Forschungsthema Kontrastmittel? Minderverfettung! Rot: Gewebe Blau: Fett Grün: Kontrastmittel Gelb: Knochen

12 SOMATOM Definition Das Gerät verfügt über zwei Röntgenstrahler und zwei Detektoren, was klinische Aufnahmen mit nicht gekannter Geschwindigkeit möglich macht. . How does it work? In routine operation the SOMATOM Definition uses one source-detector combination, comparable to the SOMATOM Sensation in its 64-slice configuration. It provides the same industry’s highest routine isotropic resolution of below 0.4 mm in combination with the fastest sub-millimeter volume coverage of 87 mm/sec. <CLICK> What’s more? The idea behind Dual Source CT is as simple as ingenious: it is merely using two X-ray sources and two detectors at the same time available when every selected by the operator.

13 SOMATOM Definition – The World’s first
Schneller als DSCT SOMATOM Definition – The World’s first jedes schlagendes Herz

14 Single Source CT zeitliche Auflösung von maximal 165 ms
With a single source CT scanner, the X-ray source/detector system has to obtain data projections of 180 degrees to take an cardiac image. Taking the industry’s fastest rotation time available into consideration the resulting temporal resolution, the time to collect this 180 degrees of data, is 165 ms (half of the rotation time). = 165 ms Rotationszeite 2 Zeitliche Auflösung =

15 Single Source CT 60 bpm 100 bpm
Optimal cardiac imaging can be best achieved in the diastolic phase of the heartbeat. The faster the heart rate, the shorter this phase becomes. At a low and stable heart rate, the time a single source CT scanner needs for imaging is sufficient. This is comparable with a camera that has a long shutter speed, imaging a car passing by very slowly. The result: sharp images. <CLICK> The faster the heart rate, the shorter the diastolic phase becomes. At higher or varying heart rates, the diastolic phase is too short for a single source CT scanner. This is now comparable to the camera with the same long shutter speed, imaging a racing car passing by very fast. The result: poor image quality, blurry images.

16 Single Source CT mit multisegmentaler Aufklärung Softwareversuch um zeitlich eine höhere Auflösung zu bekommen 1 2 To overcome insufficient temporal resolution at high heart rates, single source CT scanners use a software solution called multisegment reconstruction. Two (to five) subsequent heartbeats are used the to collect 180 degrees of cardiac data. Problem 1: As shown on the right, the coronary arteries move between each heartbeat. Problem 2: Only in case the rotation time and the heart rate is ideally in synchronization a better temporal resolution can be achieved. In daily use the temporal resolution varies between 83 and 165 ms using a two segment reconstruction approach, depending on the heart rate of the patient. (2 Segmenteaufklärung) variert zwischen= 83 and 165 ms Temporale Auflösung = Koronararterien wechseln ihre Position während der Herzschläge= begrenzte Bildqualität

17 Dual Source CT Zeitliche Auflösung = Rotationszeit 4 = 83 ms
With Dual Source CT, each of the two source/detector combinations only needs to travel 90 degrees to acquire the necessary 180 degree. The acquisition time to collect 180 degrees of cardiac data is cut by half compared to single source CT. Based on 0.33 s rotation time, this concept provides an unprecedented temporal resolution of 83 ms, independent of the heart rate. = 83 ms Rotationszeit 4 Zeitliche Auflösung =

18 Dual Source CT 60 bpm 100 bpm At low heart rates, the SOMATOM Definition’s substantially higher temporal resolution eliminates any residual motion. <CLICK> Even at higher or varying heart rates, the constant temporal resolution of 83 ms, delivers sharp and detailed cardiac images. The acquisition time is shorter than the duration of the short diastolic phase or even shorter than the systolic phase. Robust cardiac imaging at high and irregular heart rate becomes feasible, without betablockers and without drawbacks of multi-segment reconstruction algorithms – by using data from only one heart beat. This is comparable with a camera that has a very short shutter speed, imaging a racing car passing by very fast. The result: excellent image quality, crisp-clear images without any motion artefacts.

19 SOMATOM Definition – The World’s first
SOMATOM Definition Schneller als jedes schlagende Herz Verlässliche Bilder bei allen Herzraten ohne beta-blocker Schnelle Herzaufnahme, dadurch kurze Zeit des Luftanhaltens Weiterentwicklelte Darstellung von Ablagerungen und höhere Genauigkeit bei Stent-Bildern Möglichkeiten Patienten mit Herzrhythmusstörungen zu scannen Höchst genaue Darstellung von Wundabmessungen DSCT SOMATOM Definition – The World’s first

20 SOMATOM Definition – The World’s first
Kardiologische Detailaufnahme DSCT SOMATOM Definition – The World’s first bei halber Dosis * Verglichen mit dem zurzeit am Markt dosiseffizientesten single-source CT, bei einer Herzfrequenz unter 75 Schlägen.

21 Schritt 1: Dual Source CT zeigt das Herz zweimal schneller, reduziert dabei aber das Pulsfenster um die Hälfte Single Source CT Dual Source CT How is this possible to reduce dose when SOMATOM Definition uses two X-ray sources instead of one? The dose reduction happens as combination of two steps - Step 1: Left: The red boxes represent the time needed to collect 180 degrees of data using single source CT, its e.g. 165 ms. Right: The orange/green boxes represent the time needed to collect 180 degrees of data using Dual Source CT, only 83 ms. Because Dual Source CT is able to image the heart twice as fast, our newly developed adaptive ECG-controlled dose modulation can apply the dose necessary for excellent cardiac imaging in less than half the time compared to today’s most dose-efficient, single source CT scanners. And best of all, its real-time monitoring of the ECG enables a fully automated dose adjustment, reacting to any changes and abnormalities of the heartbeat. On the other hand, Dual Source CT uses two X-ray sources at the same time, doubling the applied radiation. The result: ½ the dose by reducing the ECG-pulsing window by more than half * twice the dose using two sources => no dose change = 1 Summary step 1: Using two sources results in double the temporal resolution without any dose increase.

22 Langsame Aufnahmegeschwindigkeit
Schritt 2: Single Source CT behält eine langsame Erfassung bei höheren Herzschlägen 60 bpm single source CT 100 bpm single source CT Step 2: Left: With a single source CT scanner, the X-ray source/detector system has to obtain data projections of 180 degrees within the diastolic phase. In each diastolic phase the CT scanner obtains information from a certain region of the heart in z-direction. The acquisition speed is therefore limited to the patients heart rate, to the repetition of the diastolic phase. <CLICK> Right: On high heart rates single source CT could theoretically increase the acquisition speed due to the shorter time in-between the diastolic phases. To overcome insufficient temporal resolution at high heart rates, however, single source CT scanners use multisegment reconstruction. At higher heart rates each position of the heart has to be scanned multiple times, causing a significant reduction in the acquisition speed and a limited reliability. The result: single source CT maintain slow acquisition speed even with higher heart rates causing a increase of radiation dose Langsame Aufnahmegeschwindigkeit Langsame Aufnahmegeschwindigkeit

23 Normale Aufnahmegeschwindigkeit Normale Aufnahmegeschwindigkeit
Schritt 2: Dual Source CT steigert die Patientenanzahl und reduziert die Strahlenexposotion bei höheren Herzraten 60 bpm Dual Source CT 100 bpm Dual Source CT Step 2: Left: At low heart rates the acquisition speed of DSCT is comparable to a single source scanner. <CLICK> Right: Instead of using multisegment reconstruction at higher heart rates, Dual Source CT’s highest temporal resolution allows you to always acquire cardiac images from single heartbeats, at any heart rate. Unlike single source CT scanners, SOMATOM Definition can therefore automatically adjust the table speed prior the scan to the heart rate of the patient. It increases the pitch with higher heart rates, resulting in a faster table speed and a corresponding reduction of dose exposure. In other words, the higher the heart rate, the less time is required for imaging the heart, and consequently, lower dose is needed. Normale Aufnahmegeschwindigkeit Normale Aufnahmegeschwindigkeit

24 with Pitch Adaptation and Adaptive ECG Pulsing
Kardiologische Detailauflösung bei halber Dosis Dual Source CT = 1/2 x Dosis 100% Single Source without ECG Pulsing Single Source CT with ECG Pulsing 50% x x With SOMATOM Definition, you reach a level of cardiac patient care never achieved before. The lowest radiation exposure combined with unparalleled image quality and speed lets you reach out for excellence in CT imaging. Combining the two steps of dose savings, SOMATOM Definition has 50 % lower dose at typical heart rates compared with today’s most dose-efficient, single source CT scanners. Shown data are published by Cynthia McCollough, PhD from Mayo Clinic Rochester, USA at the RSNA 2005 talks. x Dual Source CT with Pitch Adaptation and Adaptive ECG Pulsing Relative Dosis 60 70 80 90 100 110 120 Herzfrequenz min-1 Source: Cynthia McCollough PhD, Mayo Clinic Rochester, USA RSNA 2005 talk: SSE16-06 / Physics (CT: Cardiac Imaging I) / Monday, Nov , 03:50 PM - 04:00 PM, S401AB

25 SOMATOM Definition – The World’s first
One-Stop DSCT SOMATOM Definition – The World’s first Diagnose in akuten Fällen

26 Langsame Geschwindigkeit + Hohe Geschwindigkeit +
Dual Source CT vereinigt die Kraft von 2 Röntgenquellen woraus beispielose 160 kW resultieren Single source CT Dual Source CT 1 x Power 2 x 80 kW Left: Scanning obese patients with single source CT usually results in a trade-off between speed and image quality. A reduction of rotation time and travel speed enables good image quality even for obese patients. Right: Dual Source CT overcomes this limitation of insufficient power because it utilizes a second X-ray source. In other words, it accumulates the power of the two independent sources resulting in unprecedented 160 kW, providing sufficient X-ray power reserves for high quality imaging of patients whether tall or small, thin or large – at maximum volume coverage speed and fastest rotation time. Langsame Geschwindigkeit + gute Bildqualität Hohe Geschwindigkeit + hohe Bildqualität Zu wenig Energie für Hochgeschwindigkeits-Scans bei korpulenten Patienten Genügend Energie für scharfe und detaillierte Bilder bei jeder Geschwindigkeit

27 Hohe Geschwindigkeit + niedrige Bildqualität
Dual Source CT vereinigt die Kraft von 2 Röntgenquellen woraus beispielose 160 kW resultieren Single source CT Dual Source CT Left: In case an inexperienced user maintains fastest rotation time and travel speed while scanning obese patients with an single source CT, the image noise would increase significantly, resulting in bad image quality. Right: Dual Source CT overcomes this limitation of insufficient power because it utilizes a second X-ray source. Because scan speeds can be increased, the higher power is used to improve quality. Hohe Geschwindigkeit + niedrige Bildqualität Hohe Geschwindigkeit + hohe Bildqualität Zu wenig Energie für Hochgeschwindigkeits-Scans bei korpulenten Patienten Genügend Energie für scharfe und detaillierte Bilder bei jeder Geschwindigkeit

28 SOMATOM Definition – The World’s first
SOMATOM Definition One-Stop Diagnose in akuten Fällen Patienten jeder Größe und Gewicht können mit voller Qualität bei höchster Geschwindigkeit mit bis zu 160 kW gescannt werden. Schnelle und exakte Bildgebung bei Patienten mit Brustschmerzen, unabhängig von der Herzfrequenz und ohne beta-blocker. Trauma Bildgebung mit einem Scanbereich von 200 cm und einer Gantryöffnung von 78 cm Bis zu 87 mm/s Hochgeschwindigkeits-Submillimeter Scanning bei einer Auflösung unter 0.4 mm und der schnellsten Rotationsgeschwindigkeit von 0.33 s, unabhängig von der Größe und des Gewichtes des Patienten DSCT SOMATOM Definition – The World’s first

29 SOMATOM Definition – The World’s first
Mehr DSCT SOMATOM Definition – The World’s first Visualisierung mit Dual Energy

30 Dual Source CT Mehr als Visualisierung durch Dual Energy
80kV Bone 670 HU Iodine 296 HU 140kV Bone 450 HU Iodine 144 HU The X-ray tube’s kilo voltage (kV) determines the energy level of the X-ray beam. Changing the kV setting results in an alteration of photon energy and a corresponding attenuation modification of the materials scanned. In other words, X-ray absorption is energy-dependent, e. g. scanning an object with 80 kV results in a different attenuation than with 140 kV. In addition, this attenuation depends also on the type of tissue scanned. Lets look at this phantom that contains bones and a vessel filled with iodine based contrast material. Low 80 kV energy scan: Iodine has its maximum attenuation at this low energy of 296 HU, bones have a high value of 670 as well. <Click> High 140 kV energy scan: The Iodine attenuation drops more than half at high-energy scans, the attenuation of bones, on the other hand, changes only slightly when exposed to low-energy scans compared to high-energy voltage examinations. Dual energy uses this concept of how materials are visualized when scanned at different energy levels. The result: two X-ray sources running simultaneously a different energies acquire two data sets showing different attenuation levels. The material-specific difference in attenuation shown in the resulting image could facilitate classification of the tissue type.


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