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CARE Right Tiago Campos
(Siemens Europe)
Dual Source CT User Meeting – Saturday, 5 October 2013, NEMO33 in Brussels
Copyright © Siemens AG 2012. All rights reserved. Copyright © Siemens AG 2013. All rights reserved.
International Version - not yet approved for external distribution in the U.S., and maybe in other countries
CARE Right Committed to the Right Dose in CT
Tiago Campos
SWE CT BM
Drogenbos, October 5th 2013
Is 1 mSv the right dose
for every patient?
Male, 43 cranial CT to exclude lesion
Female, 59 CT scan of whole aorta to detect dissection
Female, 54 Abdominal CT
In this particular case,
0.9 mSv was the right dose
In this particular case,
7.9 mSv was the right dose
In this particular case,
2.4 mSv was the right dose
Courtesy of Wexford General Hospital / Newtown, Ireland Courtesy of Inselspital Bern / Bern, Switzerland Courtesy of C.I.M. Laennec / Cesson Sevigne, France
For the ideal balance
between radiation dose
and image quality:
Courtesy of Wexford General Hospital / Newtown, Ireland
CARE Right
The unique Siemens approach
CARE Right
Committed to the Right Dose in CT Right dose technology
Right dose levels
Right dose management
CARE Right
Committed to the Right Dose in CT
Right dose technology
Right dose levels
Right dose management
Right Dose Technology
Proven innovation and technological leadership
CARE Dose4D
UFC
X-CARE HandCARE
CARE kV
CARE Dashboard
Dose Alert
SAFIRE
IRIS
Flash Spiral Adaptive Cardio Sequence
Adaptive Dose Shield
80kV Pediatric Protocols
Selective
Photon Shield
Dual Source CT
Stellar Detector
CARE kV
First automated voltage setting
Allows contrast-to-noise ratio to
be optimized
Up to 60% dose reduction can be achieved
without compromise in image quality1
Zero click automated kV setting for each
individual patient
Maximum dose savings are
achieved when scanning a thin
patient. With CARE kV, 80 kV is
selected compared with the
standard 120 kV protocol
Up to
60%*
* Dose saving potential may vary depending on body region. 1: Vollmar SV, Kalender WA. Reduction of dose to the female breast in thoracic CT: a comparison of standard-protocol, bismuth-shielded, partial and tube-current-modulated CT examinations. Eur Radiol. 2008 Aug;18(8):1674-82.
Stellar Detector
Taking CT imaging to the next level
TrueSignal Technology
25% dose savings at the same noise
level
Minimized electronic noise allows for
higher signal-to-noise ratio
Increased sharpness with iterative
recon
Better utilization of mA reserves in low
kV scans
Up to
25%
2013-06-03
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The new Stellar detector
Detector module
2013-06-03
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The new Stellar Detector
The Stellar Detector – the 1st fully integrated detector
• Detector design with full electronic integration
• X-rays in digital signal out
Photodiode
ADC
ADC Photodiode
2013-06-03
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Page 13 H IM CR MK
Key To Success
Miniaturized detector electronics
Standard Detector New Stellar Detector
AD circuit
Loss free
digital signal
Scatter Object
Photodiode
UFC
Photodiode
AD circuit board
Scatter Object
“weak” digital signal
• Ohmic loss
• Capacitive cross-talk
• Induction
UFC
Analogue cables
Conventional Detector New Stellar Detector
2013-06-03
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Page 14 H IM CR MK
Stellar Detector
The first fully integrated detector
First fully integrated CT detector
• The detector provides the digital output signal
no sensitive analog cables, external AD converters...
• Better image quality and less dose at high attenuation
by a significant reduction of the electronic noise
• Better spatial resolution
by a significant reduction of cross talk
Conventional
photodiode (PD)
Complex board
with AD-converters
Photodiode and AD-
converters in one ASIC
Simple board
without analog cables
and AD-converters
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The new Stellar Detector and Edge technology
Minimized cross-talk
• Minimized slice blurring for ultra-thin slices and increased spatial resolution
0.6 mm septa
aperture
~0.5 mm z - direction
X-ray
Detector signal (ideal)
cross-talk
Detector signal with cross-talk
Blurred slice profile Loss of spatial resolution
2013-06-03
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Page 16 H IM CR MK
The new Stellar detector and Edge technology
Minimized cross-talk
• Minimized slice blurring for ultra-thin slices and increased spatial resolution
0.6 mm septa
aperture
~0.5 mm
X-ray
minimized cross-talk
Detector signal with minimized cross-talk
Minimized slice blurring
Increased spatial resolution
z - direction
2013-06-03
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Page 17 H IM CR MK
Stellar Detector with Edge Technology
Physical proof of high resolution imaging
Standard Detector New Stellar Detector Conventional Detector New Stellar Detector
18.2 lp
MTF rho2
MTF: Modulation Transfer Function // FWHM: Full width at Half Maximum // Lp: Line Pairs per cm
0.52 mm FWHM 0.69 mm FWHM
0.6 mm slice
B70
0.5 mm slice
I70
Wire Phantom Wire Phantom 16.4 lp
MTF rho2
Increased
sharpness in the
visible spectrum
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Page 18 H IM CR MK
Comparison between 0.5 and 0.6 mm
Higher diagnostic confidence with 0.5 mm
Courtesy of CIMOP Bizet, Paris, France
collimation: 128 x 0.6 mm
spatial resolution: 0.30 mm
scan time: 6 s
scan length: 146 mm
rotation time: 0.28 s
80 kV, 75 eff. mAs
DLP: 72.65 mGycm
CTDIvol: 4.38 mGy
1.0 mSv
HR: 67 bpm
SOMATOM Definition Edge
White arrow: soft plaque
0.6 mm
2013-06-03
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Page 19 H IM CR MK
Comparison between 0.5 and 0.6 mm
Higher diagnostic confidence with 0.5 mm
Courtesy of CIMOP Bizet, Paris, France
collimation: 128 x 0.6 mm
spatial resolution: 0.30 mm
scan time: 6 s
scan length: 146 mm
rotation time: 0.28 s
80 kV, 75 eff. mAs
DLP: 72.65 mGycm
CTDIvol: 4.38 mGy
1.0 mSv
HR: 67 bpm
SOMATOM Definition Edge
Higher diagnostic confidence with 0.5 mm slices!
Orange arrow: fibrocalcified plaque White arrow: oft plaque
0.5 mm
2013-06-03
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Page 20 H IM CR MK
Higher diagnostic confidence with 0.5 mm
Courtesy of CIMOP Bizet, Paris, France
collimation: 128 x 0.6 mm
spatial resolution: 0.30 mm
scan time: 6 s
scan length: 146 mm
rotation time: 0.28 s
80 kV, 75 eff. mAs
DLP: 72.65 mGycm
CTDIvol: 4.38 mGy
1.0 mSv
HR: 67 bpm
SOMATOM Definition Edge
Higher diagnostic confidence with 0.5 mm slices!
Orange arrow: fibrocalcified plaque White arrow: soft plaque
0.5 mm 0.6 mm
2013-06-03
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Page 21 H IM CR MK
Comparison between 0.5 and 0.6 mm
Sharper edges with 0.5 mm
Courtesy of CIMOP Bizet, Paris, France
collimation: 128 x 0.6 mm
spatial resolution: 0.30 mm
scan time: 3 s
scan length: 99 mm
rotation time: 0.28 s
100 kV, 81 eff. mAs
DLP: 250 mGycm
CTDIvol: 12.83 mGy
3.5 mSv
HR: 57 bpm
SOMATOM Definition Edge
White arrow: soft plaque
0.6 mm
2013-06-03
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Page 22 H IM CR MK
Comparison between 0.5 and 0.6 mm
Sharper edges with 0.5 mm
Courtesy of CIMOP Bizet, Paris, France
collimation: 128 x 0.6 mm
spatial resolution: 0.30 mm
scan time: 3 s
scan length: 99 mm
rotation time: 0.28 s
100 kV, 81 eff. mAs
DLP: 250 mGycm
CTDIvol: 12.83 mGy
3.5 mSv
HR: 57 bpm
SOMATOM Definition Edge
Sharper edges with 0.5 mm slices!
Orange arrow: fibrocalcified plaque White arrow: soft plaque
0.5 mm
2013-06-03
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Page 23 H IM CR MK
Comparison between 0.5 and 0.6 mm
Sharper edges with 0.5 mm
Courtesy of CIMOP Bizet, Paris, France
collimation: 128 x 0.6 mm
spatial resolution: 0.30 mm
scan time: 3 s
scan length: 99 mm
rotation time: 0.28 s
100 kV, 81 eff. mAs
DLP: 250 mGycm
CTDIvol: 12.83 mGy
3.5 mSv
HR: 57 bpm
SOMATOM Definition Edge
Sharper edges with 0.5 mm slices!
Orange arrow: fibrocalcified plaque White arrow: soft plaque
0.5 mm 0.6 mm
2013-06-03
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Page 24 H IM CR MK
0.5 mm slices
Sharper edges and higher diagnostic confidence
Courtesy of CIMOP Bizet, Paris, France
Sharper edges and higher diagnostic confidence with 0.5 mm slices!
0.5 mm 0.5 mm
Orange arrow: fibrocalcified plaques White arrow: soft plaque
2013-06-03
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Page 25 H IM CR MK
Stellar Detector in Coronary CTA
Increased vessel delineation and minimized blooming
enhanced stent evaluation
Courtesy of Department of Centre Cardio Thoracic, Monaco, Monaco
enhanced
calcified &
plaque lesion
evaluation
CARE Right
Committed to the Right Dose in CT
Right Dose Technology
Right Dose Levels
Right Dose Management
Right Dose Levels
Understanding of absolute dose values
Altitude (ft)
30,000
15,000
0
Cosmic
Radiation
9,000
Example: Comparison of radiation exposure due to reduction of flight level
But the absolute level is what counts
Reduction by
30%
Reduction by
50%
Right Dose Levels
Using the absolute dose values
Knowing the clinical targets to scan with the right dose
Initial abdomen @ 120 kV
14 mGy with standard protocol Follow-up abdomen @ 100 kV
9.7 mGy using CARE kV
Clinical image courtesy of University of Erlangen, Germany
Right Dose Levels
Scanning at the right dose levels with Siemens CT
SOMATOM Definition Flash with absolute dose values
CARE Right
Committed to the Right Dose in CT
Right Dose Technology
Right Dose Levels
Right Dose Management
Right Dose Management
The sustainable dose management
DoseMAP
Access, report and manage dose data
EduCARE
Continuous education of staff
Optimize CARE CT
Optimization of the current dose
situation
Right Dose Management
2013-06-03
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Page 32 Ivo Driesser H IM CR MK P
CT Image Contest
We are back
Footnote: Arial Regular 8 point. line spacing. 1.0 line. max. double spaced.
Dolor situs cum hab ilitarum itum alus es caus us imanenter status ex land.
October 21st 2013: end of submission
2013-06-03
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Right Dose Image Contest
Highlights
• Attract participants
• Boost inter-activity
• Reach out to more
than 15,000 fans
• Your own profile page
• Self promotion
• Create your own picture
gallery
• Always the right dose
• Three h of webinars
• “How to” guides and
literature
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Right Dose Image Contest
Highlights
Consistency Award Valuable Prizes
• Image Quality
• Dose Level
• Consistent Dose Management
• Award, Certificate and Image
• Be part of our event at RSNA
• PR Support
CARE Right
Committed to the Right Dose in CT
Right dose management
Right dose levels
CARE Right
Committed to the Right Dose in CT
Copyright © Siemens AG 2012. All rights reserved. © Siemens AG 2012. All rights reserved.
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