Siemens at the European Congress of Radiology 2011: Innovations for imaging and diagnostics

One of the highlights was the Biograph mMR – the world’s first integrated whole-body molecular MR with simultaneous data acquisition technology. The innovative system has the potential to provide new diagnostic opportunities in neurology, oncology, and cardiology. Siemens also introduced two new radiography systems to the congress visitors: The Multix Select DR is a cost-efficient digital radiography system particularly designed to provide doctors in private practice and smaller hospitals entry into the world of digital radiography. And with Mobilett Mira, Siemens launches a mobile, digital X-ray system with a wireless detector and a more flexible swivel arm to increase ease of use for the clinical staff. Furthermore, Siemens highlighted the image management and diagnostic software Syngo.via1, which provides advanced visualization tools and automated processes leading to faster reading times and, that way, lowered costs. Siemens moreover presented its Low Dose solutions that are designed to help the clinical staff reduce radiation dose in radiology and nuclear medicine while maintaining image quality.

News at the European Congress of Radiology – ECR 2011

A world’s first in imaging: Integrated whole-body molecular MR system with simultaneous data acquisition technology

The Biograph mMR is the world’s first integrated whole-body molecular MR with simultaneous data acquisition technology, currently undergoing clinical use testing. This system comprises a 3-Tesla magnetic resonance (MR) scanner and an integrated positron emission tomography (PET) detection system with an architecture that performs as one. In the new system, it is for the first time possible to simultaneously capture MR and PET data with a whole-body system. With the simultaneous acquisition of MR and PET data, Biograph mMR is designed to provide new opportunities for imaging. While MR provides exquisite morphological and functional details in human tissue, PET goes further to investigate the human body at the level of cellular activity and metabolism. The innovative system may prove to be particularly valuable in the identification of neurological, oncological and cardiac conditions of disease and in supporting therapy planning. The Biograph mMR also opens new opportunities for research, such as the development of new biomarkers or new therapeutic approaches.

Siemens makes digital radiography more accessible with the Multix Select DR digital x-ray system With Multix Select DR, Siemens Healthcare has developed a digital entry-level x-ray system that facilitates cost-effective access to digital radiography. The system is suitable for virtually all clinical radiography applications. It is easy to use, offering above all an outstanding price-performance ratio. At a price which is around one third below comparable predecessor products of Siemens, Multix Select DR is attractive to small and medium-sized hospitals in newly industrializing countries as well as to small hospitals and physicians' clinics in industrialized countries.

More flexibility in X-ray imaging: Siemens presents its latest mobile X-ray system with a wireless detector

Siemens launches Mobilett Mira, its first mobile digital X-ray system with a wireless detector. The detector sends image data via W-LAN to an integrated imaging unit and particularly facilitates examinations of patients that are critically ill and have only limited mobility. Moreover, Siemens redeveloped its mobile X-ray imaging swivel arm system for the new Mobilett Mira. In addition to vertical movements, the new swivel arm can now also be moved horizontally up to 90 degrees, thus increasing ease of use for the clinical staff.

Minimally invasive treatment of myomas: Syngo Embolization Guidance application from Siemens makes tumor therapy easier on the patient

Siemens Healthcare has added new functions to Syngo Embolization Guidance to simplify and accelerate the minimally invasive embolization of benign tumors such as myomas. The new version of the imaging software assists with treatment planning and delivery and makes it possible to check treatment outcomes. Syngo Embolization Guidance can speed up interventions as compared with previous embolization procedures, meaning that both contrast medium and dose can be reduced. This makes the occlusion of the blood vessels supplying the myoma easier on the patient than conventional methods.

Further highlights

Increased efficiency in clinical workflows thanks to Syngo.via

Syngo.via, Siemens’ imaging software for multimodality reading of clinical cases, has been installed in more than 300 hospitals worldwide, where clinicians are now benefitting from the advantages of the software in their clinical routine. For instance, Syngo.via’s advanced visualization tools and automated processes can lead to faster reading times and lowered costs. Syngo.via helps increase reading efficiency across multiple specialties, including oncology, cardiology, and neurology. Syngo.via interfaces with imaging devices, such as MRI, CT, and PETCT, as well as with Radiology Information Systems (RIS) and Picture Archiving and Communications Systems (PACS) of leading vendors, including Siemens’ newest PACS solution, Syngo.plaza. When Syngo.via and Syngo.plaza are combined, users are presented with direct, noclick access between the two technologies and a unified user-interface for faster reading.

Dose reduction in radiology and nuclear medicine

Siemens has long been a pioneer in the field of radiation dose reduction in radiology and nuclear medicine. At the ECR 2011, Siemens presented a whole range of “CARE” (Combined Applications to Reduce Exposure) technologies, which make it possible to reduce dose while maintaining image quality. For instance, the new application CARE Analytics allows to analyze and evaluate dose received by patients during an examination with Siemens computed tomography systems, x-ray and fluoroscopy, or angiography devices. Hence CARE Analytics can help clinicians, for example, to optimize their scan protocols and to work with reduced radiation dose.

Setting Standards in Molecular Imaging

Siemens introduces another member to the Biograph family of hybrid PET-CT imagers with the Biograph mCT 20 Excel – a state-of-the-art 20-slice molecular CT scanner that fits the budget of customers without compromising clinical performance. It was designed to ensure that PET-CT imaging is available to medical institutions throughout the world, including community hospitals, smaller imaging centers and emerging markets exploring hybrid imaging for the first time. The Biograph mCT 20 Excel offers unique imaging technologies, such as a 20-slice adaptive CT; standard PET time of flight and the new HD•Chest technology. HD•Chest is a new technology that reduces blur created by respiration during PET/CT studies. More than 90 percent of today’s PETCT studies are whole-body scans that can be used to investigate the presence of small lesions in the chest or upper abdomen. By providing a highly automated, amplitude-based gating technology, HD•Chest images the chest and upper abdomen in high-definition and eliminates the fundamental problems encountered with phase-based 4D gating, which can be disruptive and time consuming. HD•Chest is an innovative combination of hardware and software that provides an accurate, sharp image as respiratory motion is frozen. It also encourages an easy workflow for the routine evaluation of chest and upper abdomen lesions, providing additional clinical value with every patient study.

Supporting dose reduction in computed tomography

Fast Care from Siemens Healthcare is a technology platform for CT-scanners designed to help hospital staff perform CT examinations faster and more efficiently than before while keeping the dose as low as possible. The Fast Care applications simplify workflows during scanning and in the preparation of image reconstructions. For instance, the system suggests parameter settings for image quality and dose reduction and automates many operating procedures. That way, processes are standardized and results are easier to reproduce. Patients benefit from lower radiation doses, while CT operators and service providers can improve their productivity.

Cardiovascular surgery: Innovative solutions for the hybrid OR

Hybrid operating rooms (OR), a combination of cath lab and open surgery, by now support many novel cardiovascular therapies. Siemens offers a complete angiography systems portfolio for imaging in hybrid ORs: from semi-mobile systems for smaller ORs, to ceiling- and floor-mounted equipment, to the Artis zeego, a system employing robotics technology to provide the physician with more flexibility during surgery. The first hybrid OR from Siemens was installed in Monaco in 1989. Since, Siemens has installed 250 hybrid ORs worldwide.

Magnetic resonance: Increasing productivity with individualized treatment and improved workflows

At the ECR 2011, Siemens presented its MRI systems Magnetom Aera 1.5T and Magnetom Skyra 3T MRI that include both Tim (Total imaging matrix) 4G and Dot (Day optimizing throughput). The combination of Tim 4G and Dot delivers patient-centered care and significantly improved productivity across the entire MRI workflow. Tim 4G is the fourth and most sophisticated generation of Siemens RF and coil technology and provides newly designed ultra high-density coils combined with 48 RF channels, the highest standard channel configuration ever offered. The Dot engine offers a customizable framework for patient personalization, user guidance, and exam automation.

Breast Care Solutions: Comprehensive solutions for the diagnosis and therapy of breast cancer

Siemens Healthcare has developed comprehensive solutions for the early detection and treatment of breast cancer under the collective name of “Breast Care Solutions”. These comprise a combination of different imaging methods such as Ultrasound, Mammography, and MRI, as well as lab diagnostics and radiation therapy solutions. Siemens places special focus on the third dimension: three-dimensional imaging of the female breast using two of the latest Siemens technologies, the ultrasound system Acuson S2000 Automated Breast Volume Scanner (ABVS), and 3D tomosynthesis with the digital mammography system Mammomat Inspiration. They enable physicians to discern more details than previously.

Advanced quality management for better images and reduced radiation dose in radiography and fluoroscopy

With the software VB10, Siemens offers a solution to support quality management in imaging for the digital radiography system Ysio and the digital radiography and fluoroscopy system Axiom Luminos dRF. VB10 features tools that help control radiation dose to achieve good image quality and, in a second step, also can contribute to reduce dose. For instance, the Clinical Assurance Program (CAP), records statistics on images that had to be deleted due to faulty setting of the parameters. Records can be used to analyze prevalent operating errors. That way, training issues for clinical staff can be developed accordingly, for instance, to reduce repeat exposures. The Clinical Exposure Index (EXI) is used to predefine maximum and minimum values for exposure times, achieving an optimal range for excellent image quality while using the lowest possible radiation dose. EXI controls for each radiography image if values remain within this range. For the Axiom Luminos dRF, VB10 also offers imaging at ten frames per second (fps). In comparison to the usual pulse rate of 15 fps, radiation dose is reduced 33 percent while image quality is virtually maintained.

Imaging for interventional neuroradiology: Syngo Neuro PBV IR displays cerebral blood flow during interventional procedures

With syngo Neuro PBV IR (Parenchymal Blood Volume, Interventional Suite), Siemens Healthcare offers an application for interventional radiology that allows to review parenchymal blood flow during minimally invasive interventions in the brain. This helps the neuroradiologist to react to the cerebral blood flow condition immediately during, for instance, treatment of stroke patients or tumor biopsies. syngo Neuro PBV IR further expands the Siemens imaging application portfolio for Artis zee, the Siemens systems for interventional radiology and cardiology.

The World of Ultrasound at the Siemens Booth

Siemens is pioneering the world’s first real-time stereoscopic 3D/4D imaging capability2 on its premier Acuson 2000 ultrasound system, delivering real-time 3D ultrasound images that are more detailed and realistic than before. This new, paradigm-shifting imaging technology improves diagnostic confidence and has the potential to become standard ultrasound imaging procedure of the future – beyond the field of Obstetrics and Gynecology. Utilizing advanced visualization technology that has its roots in immersive 3D film and video production, the Acuson S2000 now integrates the new NVIDIA Quadro 2000 professional graphics solution. In combination with the new NVIDIA 3D Vision Pro stereoscopic glasses, this remarkable display of volumetric information offers anatomic views that are not possible using conventional 3D imaging techniques. Also available off the ultrasound system using the Syngo.fourSight Workplace, this new technology provides additional diagnostic information to improve communication between surgeons and patients or aid in treatment or surgical planning. Unique, pioneering applications on the Acuson S2000 ultrasound system also include Virtual Touch HD technology, the second generation implementation of Acoustic Radiation Forced Impulse (ARFI) imaging, as well as Cadence contrast pulse sequencing technology3 to provide penetrating insight into anatomy to help physicians make more confident diagnoses.

Siemens will also highlight groundbreaking image fusion technology, which integrates real-time ultrasound with other modalities like CT and MRI. Conventional fusion techniques can take up to 30 minutes to set up and usually require several attempts. Also, patients need to lie completely still during the entire exam – which is unrealistic and impractical – or the setup must be repeated. The Siemens fusion solution incorporates proprietary technology that automatically aligns the CT or MRI image to the current ultrasound view. This approach accelerates workflow and improves the accuracy of image alignment, which can allow integrating fusion imaging seamlessly into existing practice.

A compact, portable imaging solution which delivers exceptional clinical performance across a wide variety of applications is the Acuson X300 ultrasound system, premium edition (PE). This fully-featured, comprehensive system incorporates high-end image optimization technologies, enhanced workflow features and Cadence contrast agent imaging technology6 for improved efficiency and diagnostic confidence. Featuring a new 17-inch high-resolution monitor, the Acuson X300 PE system provides a larger image display without sacrificing image quality.

Refurbishing medical equipment

Within the Siemens Proven Excellence program, used medical technology undergoes an in-depth, five-step refurbishing process. After completion of this process, the systems are rewarded with the Proven Excellence quality seal, which represents the fulfillment of strict specifications of relevant international norms and standards as well as safety regulations. The Proven Excellence process also contributes to the environment in that it extends the product lifecycle altogether and saves resources. That way, the program saves as much energy as over 5.000 three-person-households consume annually, adding up to almost 20.000 tons of CO2-reduction per year. Siemens will expand its Proven Excellence program with scalable refurbishment in the future, offering more refurbishing choices. Customers can now choose which options are necessary for their requirements, configuring a tailored solution for their own refurbished system.

The Siemens Healthcare Sector is one of the world’s largest healthcare solution providers and a leading manufacturer and service provider in the fields of medical imaging, laboratory diagnostics, hospital information technology and hearing instruments. It offers solutions covering the entire supply chain under one roof – from prevention and early detection to diagnosis and on to treatment and aftercare. By optimizing clinical workflows oriented toward the most important clinical pictures, Siemens also strives to make healthcare faster, better and, at the same time, less expensive. Siemens Healthcare currently has some 48,000 employees worldwide and is present throughout the world. During fiscal 2010 (up to September 30) the Sector posted sales worth 12.4 billion euros and profits of around 750 million euros. For further information see: www.siemens.com/healthcare.

The product mentioned here cannot yet be purchased in some countries. Due to the legal specifications pertaining to medical devices, their future availability cannot be promised in any country. More detailed information can be obtained from the relevant local Siemens organization.

1 Syngo.via can be used as a stand-alone device or together with a variety of Syngo.via-based software options which are medical devices on their own rights.

2 Work in progress

3 At the time of publication, the U.S. Food and Drug Administration has cleared ultrasound contrast agents only for use in LVO.

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