Myocarditis follow-up examination after two months with MyoMaps on MAGNETOM Skyra. (Copyright: Diagnostikum Berlin, Berlin, Germany)
Under the motto "More cardiology, less heartache", Siemens showcases its latest news in cardiology at the congress of the European Society for Cardiology in Barcelona, Spain. These are applications designed for a more precise diagnosis of cardiovascular diseases in computed tomography, magnetic resonance imaging and molecular imaging as well as the universal angiography system Artis one with premium features for cardiology.
Early detection of heart failure with magnetic resonance imaging
Cardiac magnetic resonance imaging (CMR) provides detailed information about the morphology and function of the heart. Current ESC guidelines consider CMR to be "gold standard" for the diagnosis and treatment of acute and chronic heart failure. This is largely due to MRI's accuracy in measuring heart volume, mass, and wall motion, including evaluation of ischemia and viability1. The MyoMaps application presented at this year's ESC Congress is Siemens Healthcare's next step in CMR.
As currently the only provider, Siemens Healthcare not only enables visual diagnosis, but offers now physical quantification of myocardial tissue with MyoMaps. MyoMaps makes it possible to record microscopic changes in myocardial tissue and represent them as pixel-based, colored images. This enables the diagnosis and quantification of diffuse myocardial pathologies, scar tissue, and edemas in the very early stages of the disease. It also allows for early detection and quantification of iron overload, which can result in heart failure.
With these results, physicians can diagnose and begin treating heart patients earlier than before and improve the course of disease. MyoMaps is now available for the 1.5 Tesla scanner Magnetom Aera and the 3 Tesla scanner Magnetom Skyra and will be available for more scanners in the future.
Using CT to evaluate the entire spectrum of myocardial perfusion
One of the developments in computed tomography highlighted by Siemens at this year's ESC congress is the "Syngo.CT Cardiac Function – Enhancement" application for myocardial perfusion. With this application, both CT Angiography and functional assessment of coronary lesions, using perfusion imaging, can be performed using only one modality. This means more convenience for the patients, offers a faster approach to diagnosis for the physician, and saves time. Together with the Somatom Force CT scanner, it is very easy to integrate the application into the day-to-day routine, since it offers significantly improved spatial coverage of the heart.
CT angiography is used to examine the coronary arteries and identify stenosis, indicating risks to myocardial blood supply. The assessment of myocardial perfusion provides physicians with important additional information to enable them to decide whether the patient is suffering from a hemodynamically relevant stenosis requiring intervention in the cath lab. Precise and reliable diagnostics are especially important in the case of patients with moderately severe stenosis, where a diagnosis based solely on the results of CT Angiography is not possible.
Physicians can achieve this thanks to evaluation using "Syngo.CT Cardiac Function – Enhancement" and an examination using the Somatom Force or Somatom Definition Flash. They can choose from the entire range of myocardial perfusion – regardless of whether the process involves first-pass enhancement for the qualitative identification of perfusion defects, late enhancement to diagnose tissue affected by scar lesions, or the quantitative evaluation of myocardial blood flow via dynamic myocardial perfusion.
Improved precision in molecular imaging
Three new applications for the Biograph mCT Flow PET•CT (Positron emission tomography – computed tomography) scanner from Siemens Healthcare will be featured at this year's ESC congress. "Phase matching" can be used with PET/CT examinations to improve quantification and image quality. For example, identical displays are automatically provided for the cardiac phase in both PET and CT measurement, enabling physicians to compare both datasets directly against each other.
The Smart Auto Cardiac Registration application automatically aligns the PET and CT images based on anatomical landmarks, providing for the correct values for PET attenuation correction at all times, even if the CT and PET data are acquired in different time points. This previously had to be done manually, which meant more time was needed and the results were less reproducible.
HD•Cardiac is a new application that enables respiratory motion management on PET cardiac scans without the need for an external respiratory trigger device. The latter has previously been needed to synchronize the acquisition with the respiratory cycle. Now, however, ECG gating and respiratory gating are performed together. There is no need for an additional respiratory gating unit alongside the ECG, because the movement of the heart caused by breathing can be corrected by the PET data itself. The result is reduced respiratory motion blur, improved visualization of PET images and less complicated patient positioning.
Artis one – angiography system with premium features for cardiology
Minimally invasive procedures are becoming more and more popular world-wide. In cardiology, these mainly include dilation of narrowed coronary arteries (coronary stenosis) or revascularization of peripheral artery disease, and implanting pacemakers. Siemens Healthcare developed Artis one for all of these routine interventions, and will showcase it at this year's ESC congress.
The angiography system is similar in positioning flexibility to a ceiling-mounted system, while requiring much less space: Artis one needs only 25 square meters, compared to the usual 45 square meters for ceiling-mounted systems. It has multiple axes that can be moved independently of each other, enabling physicians and clinical staff to select the most appropriate system position with ease to suit every procedure – regardless of whether the physician stands on the patient's right, as in the case of a coronary examination, or on the left, for pacemaker implantations.
The inclusion of Clearstent Live provides Artis one with a feature that was previously available only for the premium product family Artis Q and Artis Q.zen. This cardiology application enables the physician to mask out movement of the beating heart in order to place the stent in precisely the right position. The new HeartSweep functionality makes use of the system's double axis rotation and enables to capture all cardiac standard projections in one movement of the C-arm. This can be done in only five seconds and with only one injection of contrast agent.
For additional information on ESC see www.siemens.com/press/esc2014
The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging, laboratory diagnostics, medical information technology and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better and more cost-effective. Siemens Healthcare employs some 52,000 employees worldwide and operates around the world. In fiscal year 2013 (to September 30), the Sector posted revenue of 13.6 billion euros and profit of 2.0 billion euros. For further information please visit: http://www.siemens.com/healthcare
The products/features (here mentioned) are not commercially available in all countries. Due to regulatory reasons their future availability cannot be guaranteed. Please contact your local Siemens organization for further details.
Reference Number: HIM201408029e
Tel: +49 (9131) 84-5337
Kathrin Palder | Siemens Healthcare
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