Siemens at the ESC 2008: Comprehensive Concepts for Cardiology

Siemens Healthcare wants to be its customers' preferred partner in all clinical and business matters. Hence, on the 2008 congress of the European Society of Cardiology (ESC), Siemens places an emphasis on the comprehensive approach to clinical and economic aspects in cardiology. Using the example of clinical treatment paths for coronary heart disease, the visitor to the fair can learn about the share that each imaging modality and the laboratory diagnostics can contribute to prevention, acute treatment, and follow-up. Furthermore, it is demonstrated how patient management is supported by clinical IT systems.

There is undisputedly more than one way of visualizing coronaries. However, the crucial question is what benefit the patient gains from a given modality. In order to discuss this topic, worldwide renowned clinical experts will be ready to answer the visitors' questions at the trade fair booth, taking into account results from scientific investigations.

Within the scope of hands-on training events offered by Siemens exclusively at the ESC, interested visitors can gain practical experience in handling cardiac data from computed tomography and magnetic resonance tomography under the instruction of experts from clinics and from Siemens.

NOVELTIES
Acuson SC2000 is the world’s first echocardiography system to acquire instantaneous, non-stitched full-volume images of the heart in a single heartbeat

Siemens Healthcare unveils the Acuson SC2000 volume imaging ultrasound system, the first system in the world to acquire non-stitched real-time full-volume 3D images of the heart in one single heart cycle. Called “Echo in a Heartbeat,” this new technology marks the greatest paradigm shift in ultrasound since the introduction of 2D imaging in the late ’70s. Instantaneous, non-stitched, full-volume imaging comes 55 years after echocardiography pioneers Inge Edler und Hellmuth Hertz acquired the world’s first cardiac ultrasound recording using Siemens technology in 1953.

Siemens asks: What’s your SPECT’s IQ?
Taking innovation and efficiency to the next level, Siemens Healthcare announces the next big thing in SPECT imaging: “intelligence.” IQ•SPECT (Works in Progress) takes center stage as Siemens newest Symbia® feature that enables a comprehensive cardiac evaluation including perfusion, attenuation correction and calcium scoring in just five minutes.

IQ•SPECT technology is achieved with SMARTZOOM, a specially designed “smart” collimator that magnifies the heart while imaging the rest of the torso under traditional conditions. Typically, cardiac SPECT data is obtained through keeping the detectors positioned at 90 degrees and as close to the body as possible, utilizing mechanically centered detector rotation, where organ specific magnification cannot be achieved. The flexible mechanics of the Symbia S and T gantries allow an organ centric detector rotation that can zero-in on the organ of interest; in this case, the heart. Combining this organ centric orbit acquisition technique, fast, 3D iterative reconstruction that is optimized for more confident diagnoses, and improved patient comfort from a quicker scan, IQ•SPECT will set the standard for image quality, speed, productivity and throughput.

MORE HIGHLIGHTS
Integration of imaging techniques and IT
At the ESC 2008, visitors to the fair can see for themselves how interoperability between imaging techniques, reporting tools, documentation and reporting workstations, and the i.s.h.med kardio module is implemented. The i.s.h.med kardio cardiology information system adopts both hemodynamic data from the Sensis workstation and reporting data from the syngo Dynamics PACS (Picture Archiving and Communication System).

As a hospital information system, i.s.h.med also supports the workflow by visualizing clinical paths and thus enables seamless documentation of the patient procedure steps within the hospital.

Heart scan with lower dosage possible using Dual-Source CT
The Adaptive Cardio Sequence supplements the step-and-shoot method with intelligent algorithms, which monitor the heart frequency of patients and, if necessary, respond to arrhythmia, such as extrasystoles, additional heart beats. In this case, the recording phase is automatically postponed in order to avoid image errors due to the sudden movement. In addition, the recording window can be widened a little more if required so that, with the Adaptive Cardio Sequence, the robustness of the CT scan can be increased significantly overall.

A new study reveals that, with dual-source computed tomography (DSCT), the effective dosage for a heart examination can be significantly lowered, in comparison to conventional computed tomography (CT). The study also demonstrated that stenoses can be diagnosed with the same high accuracy as with invasive x-ray angiography. At the University Hospital in Zürich in Switzerland, 120 patients with suspected coronary heart disease were scanned with the world's first CT scanner with two X-ray tubes; a Somatom Definition from Siemens Healthcare. The Siemens application, Adaptive Cardio Sequence with the step-and-shoot mode, was also used for the first time with a dual-source CT. The results of the study were published in the June issue of “Heart”, the official journal of the British Cardiovascular Society.*

Fully automatic analysis of the cardiac function via MRI
Precise evaluation of the cardiac function is very important in cardiology, particularly during the treatment of patients after heart attack or with other myocardial diseases. For instance, it is a decisive parameter for identifying patients with indication for ICD implant (implantable cardioverter/defibrillator). Magnetic resonance imaging (MRI) is the current gold standard for evaluating the cardiac function.

Siemens now offers Inline VF (Ventricular Function) – the first fully automatic software module for cardiac function analysis with MRI worldwide. This powerful module is used to analyze cardiac image data immediately after acquisition without user interference, for the first time already during the examination. Up to now, the image data had first to be transferred to a post-processing computer for manual processing. Inline VF provides the physician with very fast access to highly reproducible results of the functional analysis.

Furthermore, Siemens has developed Argus 4D VF for the four-dimensional visualization of the cardiac function. This software enables the visualization and analysis of heart function disorders through the dynamic volume display of the beating heart. With this flexible tool, the cardiac function can be calculated from almost any combination of short-axis and long-axis images. As a new and unique feature, the mitral valve motion is included in the analysis. Thus, compared to conventional approaches, Argus 4D VF allows function analyses with significantly higher accuracy.

Artis zeego – Robot technology for medicine
The new Artis zeego angiocardiography system of Siemens introduces unprecedented flexibility in catheter labs. The industrial robot technology integrated in Artis zeego allows the physician to move the C-arm to almost any position around the patient, for example for especially steep angulations. This makes it easier to view the heart from various sides than to date. Moreover, innovative 3D procedures like syngo DynaCT Cardiac enable more precise diagnoses and more selective interventions. By using Artis zeego and syngo DynaCT Cardiac, CT-like images can be prepared and displayed in 3D in the catheter lab before, during, and after an intervention.
syngo Dynamics – the reporting, diagnosing, and archiving system with new functions for cardiology

Siemens has extended syngo Dynamics, its dynamic image reporting, diagnosing, and archiving system for multi-modality application to facilitate the workflow surrounding image management in cardiology. syngo Dynamics is used for evidence-based reporting and enhances the efficiency of clinical prodecure steps in cardiology, gynecology, and obstetrics as well as general imaging. The new syngo Dynamics version 7.0 can be connected to the IT systems of hemodynamics labs. It imports hemodynamic data and selected documentation data from GE MacLab system (version 6.5) and displays this information in reports and worksheets. As a result, the data from hemodynamic examinations is automatically available to the examining physician and needs no longer be entered manually.

As various modalities are supported, data from echocardiography, electrophysiology, angiography and X-ray images can be analyzed. Thus, the patient's entire anamnesis is available at the cardiologist's workplace. The compilation of reports on coronary structures for cardiac catheterization is also facilitated. During template preparation, for example, diagrams of the coronary arteries can be positioned on a worksheet or report template. Moreover, syngo Dynamics version 7 provides a new function for myocard assessment in a 17-segment model. This function includes user-friendly graphics and enhanced positions for the segments and provides overview texts for the mycardial wall motion and an analysis of the myocardial wall thickness.

Laboratory diagnostics: biomarkers for the entire treatment chain
Within the scope of its comprehensive concept for cardiology introduced at the ESC 2008, Siemens also presents the contribution that medical laboratory diagnostics can make along the treatment path for coronary vessel diseases. Whether in a risk analysis at initial potential symptoms, during an acute phase or in case of chronical heart disease – biomarkers can be used for the prevention, treatment as well as monitoring of the disease. They support the physician in reaching a fast diagnosis and decision for the appropriate treatment and follow-up. Particularly when used in connection with in-vivo procedures such as ECG, CT or MR, the biomarkers are an essential part of the integrated diagnostics concept, such as required for the innovative approach to patient management for coronary heart disease.
Enhanced performance with Best Practice Consulting
Best Practice Consulting is a service offered by Siemens to clinics searching for ways to efficiently implement treatment standards for various disease patterns. In consulting projects, the hospital's fields of strategy, processes, and technology are linked under a comprehensive perspective by interdisciplinary teams consisting of health professionals, economists, IT specialists, and medical engineers. By analyzing and improving various clinical, operational, and financial key figures, Best Practice Consulting assists in optimizing the quality and efficiency and consequently the hospital's performance. At the same time, the transparency for corporate controlling is increased.

Siemens has successfully completed approximately 400 consulting projects during the past 12 years. Many of these projects were focused on cardiology, neurology, and oncology. At the ESC 2008, the visitors can obtain detailed information about the offered consulting services and reference projects of Siemens Healthcare.

Customer CareLife – Customer Care program with comprehensive services
The Customer CareLife care concept offers training courses for almost all imaging modalities as presence events or as e-learning in German and English. Customer CareLife also includes services for customers who want to utilize today's investments throughout the system life cycle and realize a maximum return on their investments: this includes innovative applications for the selective extension of the hospital's service spectrum, customized upgrade packages for keeping the systems up to date, and individual migration concepts for paving the way to a new device generation.

With “Uptime Services”, the Customer Care program offers a multitude of innovative proactive services that enable the detection of potential faults in medical systems before malfunctions occur. This minimizes downtimes and decisively improves planning security and workflows in hospitals and medical practices. The Siemens Guardian Program, for example, allows the real-time, proactive online monitoring of medical systems. System errors and potential deviations from the current standard values can be quickly detected and remedied so that reliability and availability of the system are considerably increased. The basis for this is the Siemens Remote Service (SRS) platform to which Siemens can connect the systems of its customers worldwide. Today, up to 50 percent of all system malfunctions can be remedied by SRS via remote access.

The Siemens Healthcare Sector is one of the largest suppliers of healthcare technology in the world. The company defines itself as a medical solution provider with core competences and innovative strengths in diagnostic and therapeutic technologies as well as knowledge processing, including information technology and system integration. With its acquisitions in laboratory diagnostics, Siemens Healthcare is the first integrated healthcare company that combines imaging and lab diagnostics, therapy solutions, and medical information technology and also supplements these with consultation and services. Siemens Healthcare provides solutions for the entire supply chain under one umbrella – from prevention and early detection to diagnosis, therapy, and finally, aftercare. Additionally, Siemens Healthcare is a global brand leader for innovative hearing aids. Siemens Healthcare currently has around 49,000 employees worldwide and is represented in more than 130 countries. In fiscal 2007 (up to 30 September), Siemens Healthcare achieved sales of € 9.85 billion and incoming orders of € 10.27 billion. The Group earnings amounted to € 1.32 billion.