Toshiba International CT Symposium 2014
The Toshiba International CT Symposium was held this year in Vancouver. The meeting ran from May 23-24th with a series of lectures focused on functional CT imaging incorporating both helical and volumetric CT techniques, and integrating the very important consideration of dose.
|The conference presenters included an exceptional list of highly regarded and internationally renowned speakers The conference was well attended with 196 registrants and 13 highly regarded speakers from leading hospitals from around the world.|
On the first day, five speakers re-emphasized the significance of dose reduction and shared concrete tips on reducing dose while maximizing outcomes using technologies such as 80kV feature of the Aquilion ONE ViSION and CT Fluoroscopy. The lectures given on the second day focused more on the theme "functional CT imaging", introducing how Toshiba's newest applications such as Perfusion, Dual Energy and Iterative Reconstruction, can be used for better diagnostics. CT system features providing high quality patient care were also presented from the radiographer's perspective. Below are a few highlights from the symposium presentations.
Technique Optimization and Utility: Ultralow Dose Thoracic CT
|Dr. Narinder Paul MD, Cardiothoracic Division Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto presented "Ultralow Dose Thoracic CT: Technique Optimization and Utility"|
Dr. Paul presented a summary of a prospective Minimum Dose CT Trial that demonstrated the utility of ultra low dose CT with filtered back projection compared to chest x-ray in the detection of new disease and for patient management.
The trial demonstrated that for patients with completely resected lung cancer, surveillance with MnDCT, when compared to CXR, leads to earlier detection and higher rate of treatment of new or recurrent lung cancer. Dr Paul further added that "the early indication of Toshiba's model based iterative reconstruction is that it offers some important features: sharper images and better contrast to noise. Today we can do ultralow dose imaging with filtered back projection in the right patient population. With the new tools that are coming out, this will become part of regular practice."
Abdominal Imaging with Organ Perfusion & Dual Energy
|Dr. Rogalla, Professor of Radiology, and Head of Abdominal Imaging at the University of Toronto presented "Abdominal Imaging with Organ Perfusion & Dual Energy"|
Professor of Radiology and Head of Abdominal Imaging at the University of Toronto, Dr. Patrick Rogalla discussed abdominal perfusion imaging using computed tomography (CT) for oncology as a tool for tissue characterization, staging and monitoring treatment response to anti-angiogenesis drugs. Dr. Rogalla indicated that "CT has moved away from morphology to physiology assessment. Dynamic volume CT has paved the road into the future."
Dr. Rogalla stated that "Perfusion imaging can be integrated into clinical protocols. A great benefit for patients today is that you don't need separate appointments as you can integrate everything into one acquisition. Dual energy will add value no doubt, and there will be growing clinical acceptance and an exciting future for abdominal imaging."
Impact of single energy metal artifact reduction (SEMAR) on Orthopedic imaging
|Professor Alan Blum, Chief of the MSK, CHU Central Hospital, Nancy, presented "The Impact of single energy metal artifact reduction (SEMAR) on Orthopedic imaging."|
Professor Alan Blum, Chief of the MSK, CHU Central Hospital, Nancy, presented a number of cases demonstrating the benefits of single energy metal artifact reduction (SEMAR) on orthopedic imaging. Dr. Blum indicated that "CT is clearly the only technique which provides information on the implant components, on the bone stock, on the interface and on the soft tissues."
Dr. Blum concluded "There is a synergistic role of Iterative reconstruction and SEMAR. It improves image quality with much lower dose. Since we have started using this technique in our department, we have observed a dramatic increase in the number of CT examinations for the evaluation of hip prosthesis and metal hardware, and I believe that in the very near future this will replace standard radiography."
Dose Reduction Technologies
Consultant radiologist at Royal Bournemouth Hospital Dr. Russell Bull presented "Dose Reduction Technologies".
Consultant radiologist at Royal Bournemouth Hospital, Dr. Russell Bull presented a number of cases demonstrating how state of the art CT technology opens up the possibility of scanning CT patients using very low doses of both radiation and IV contrast using low kVp techniques, very efficient detectors and the latest generation of iterative reconstruction. In his talk, Dr. Bull discussed the role of radiology today, posing the question, "Is it to produce great images or is it to detect disease?"
Dr. Bull stated that "the great technology, great workflows and fantastic advances from Toshiba are only useful if we can do something with it and detect disease or make processes safer for the patients. The Aquilion™ ONE Next Generation we recently installed (at Royal Bournemouth Hospital) offers the combination of a more advanced detector system and AIDR 3D, pushing our radiation doses down to very low levels and that has a big impact on the way we use the technology and the kinds of investigations we do."
Dr. Bull presented data from a national radiation dose audit for cardiac CT conducted in the UK. Dr. Bull highlighted that the Royal Bournemouth Hospital submitted a total of 59 cases using the Toshiba Next Generation Aquilion™ ONE, with a Median DLP of only 77 (1.1mSV) concluding "with the best technology and the right protocols, radiation dose is now not really an issue in cardiothoracic CT. Or to put it another way, the risk of driving to the hospital is now much greater than the risk of a scan. Using the very best equipment and the right protocols all cardiothoracic patients can now be scanned using very low doses of radiation and contrast."
The impact of new CT Technology on Workflow
|Mrs. Kate Clough, Principal Superintendent Radiographer for Specialist Imaging at Bradford Teaching Hospitals NHS Foundation Trust, presented "The impact of new CT Technology on Workflow".|
Mrs. Kate Clough, Principal Superintendent Radiographer for Specialist Imaging at Bradford Teaching Hospitals NHS Foundation Trust, provided an overview of the healthcare system in the UK and highlighted the CT system features of the Toshiba Aquilion™ PRIME CT Scanner that help enable high quality patient care.
Mrs. Clough commented that with the Aquilion™ PRIME CT Scanner, "it is incredibly easy for patients to get on and off of the table. The lowest table height is just 330 mm." "As radiographers we have to remember that we are there to provide patient care. Patients are incredibly frightened when they come for their CT, they all expect the worst. The more we can let patients take care of themselves, the more independent they feel and the less frightened they are, so being able to get on and off the table themselves is a big bonus.
The gantry is small but the bore is wide, it is not intimidating to our patients. The gantry bore of the Aquilion™ PRIME CT Scanner allows you to fit things in, from drips to catheter bags, and you always have room. In addition to the small gantry, the PRIME CT Scanner offers excellent positioning devices and the scan speed minimizes time on table and the length of breath holds is reduced." The addition of Rapidview assists with smooth workflow and the SUREStart technology has allowed us to use bolus tracking for an increased number of patients which in turn has allowed us to decrease contrast does to patients."
Mrs. Clough stated, "We did move from one vendor to Toshiba, and we have been very pleased with all the dealings we have had with Toshiba. Within two weeks we had five people fully trained and two of those are super users who have been able to train the rest of our staff. I can't praise the Toshiba applications team enough. They are easy to contact and are really approachable, having been of massive help to us. Our experience is that the new Toshiba Aquilion™ PRIME CT Scanner is an excellent, all round scanner that produces high quality images at low dose rates. It does have specialist features such as cardiac and helical shuttle which provide opportunity for NHS Foundation Trust to move into highly specialist imaging areas, even though the vast majority of our work is standard CT. We are all pleased with the excellent service provided by Toshiba both during installation and ongoing."
Toshiba Aquilion PRIME: Initial experience using 160 slice CT Technology
|Dr. Mark Kon, Consultant Radiologist at Bradford Teaching Hospitals presented "Toshiba Aquilion™ PRIME: Initial experience using 160 slice CT Technology".|
Dr. Mark Kon, Consultant Radiologist at Bradford Teaching Hospitals used clinical examples to demonstrate the use of Toshiba's Integrated Dose Reduction technology (AIDR 3D and SUREExposure) to reduce noise in images along with cases to illustrate Toshiba's suite of Adaptive Diagnostics Clinical Solutions available with the new Toshiba Aquilion™ PRIME. This included SUREStart, SURECardioprospective Helical, SURESubtraction™ and Variable Helical Pitch which was specially designed for assessment of TAVI patients.
Dr. Kon demonstrated the use of AIDR 3D with the new Toshiba Aquilion™ PRIME scanner in a range of clinical indications to achieve a dose reduction of 50 – 80% "straight out of the box with excellent diagnostic image quality". Dr. Kon also commented that "AIDR 3D is built into all protocols so we don't have to choose whether to have it on or not, and we don't have to worry about it slowing down our workflow as the reconstructions are very quick".
Dr. Kon concluded "there are everyday benefits of using the Toshiba Aquilion™ PRIME CT, from the ergonomic design features of the scanner to patient and staff comfort, to health and safety and integrated dose reduction providing every day low dose imaging. Also of importance, the Toshiba Aquilion™ Prime Scanner offers superior clinical solutions though its suite of Adaptive Diagnostic Innovations".
The Role of 320 Multidetector CT in Neurological Diseases
|Dr. Donatella Tampieri, Professor of Radiology, Neurology and Neurosurgery at McGill University and Head of Diagnostic and Interventional Neuroradiology at the Montreal Neurological Institute presented "The Role of 320 Multidetector CT in Neurological Diseases"|
Dr. Donatella Tampieri, Professor of Radiology, Neurology and Neurosurgery at McGill University and Head of Diagnostic and Interventional Neuroradiology at the Montreal Neurological Institute, presented examples of clinical applications illustrating the role of CTA and CTP in the management of acute Stroke and TIAs, and the use of 4D CT in the cervical spine. Dr. Tampieri stated that "Multidetector CT, CT Angiography and CT Perfusion play a tremendous role in the evaluation of multiple vascular and non vascular neurological conditions. This type of scanner is extremely useful in the evaluation of several types of vascular disease, mainly stroke and aneurysm". "We also have the privilege of having a Toshiba biplane angiosuite and have observed that CTA has reduced the time of angiography, the number of projections, the amount of contrast injected and certainly the length of the procedure which of course has a tremendous benefit on the patient outcome."
Dr. Tampieri also presented a summary of a study assessing the diagnostic performance of low-dose 320-row CT in the evaluation of cervical spine instability with dynamic images serving as the standard of reference. CT examinations were performed using the 320-row Aquilion ONE scanner (Toshiba), using four to five volumetric acquisitions while the patient, in lateral decubitus, moved from the extension to the flexion position. The study demonstrated that Dynamic CT of the cervical spine is a novel application of Multidetector CT technology with this technique delivering a lower effective dose in comparison with conventional CT of the cervical spine, while enabling complete evaluation of the anatomical structures (discs, vertebral bodies, facets and adjacent soft tissues) as well as evaluation of the spine motility in its integrity. Dr. Tampieri commented that "Due to the time resolved CT scanning (4D) while the patient moves from the extended to the flexed position we can assess the presence of instability or facets luxation. Prospectively this novel application will shed light on the physiology and understanding of the cervical spine dynamics."
The symposium offered great ideas and knowledgeable resources
In conclusion, it was agreed that the conference provided accomplished thought leaders in all of the key areas. The speakers did an exemplary job exploring the clinical impact and clinical outcome of modern CT imaging techniques. The details of the scientific sessions will be available soon on the conference web site (www.toshiba-medical.ca).
Toshiba wishes to thank all of the conference speakers for making the 2014 International CT Symposium a wonderful success:
- Professor Alain Blum - CHU Nancy, France
- Dr. Russell Bull – Royal Bournemouth Hospital, UK
- Dr. Marcus Chen – NIH, USA
- Ms. Kate Clough - Bradford NHS, UK
- Dr. Cupido Daniels – Dalhousie University
- Dr. Bruce B. Forster - University of British Columbia
- Dr. Mark Kon - Bradford NHS, UK
- Mr. David McDougall – Toshiba of Canada Limited
- Dr. John Mayo – Vancouver General Hospital
- Dr. Narinder Paul – UHN, Toronto
- Dr. Daniel Podberesky – Cincinnati Children's Hosp. Med. Ctr.
- Professor Patrik Rogalla – University of Toronto
- Dr. Donatella Tampieri – Montreal Neurological Institute
About Toshiba of Canada Limited, Medical Systems Division
With headquarters in Markham, Ontario, Toshiba of Canada Limited, Medical Systems Division (TCL), markets, sells, distributes and services radiology and cardiovascular systems, including CT, MR, ultrasound, X-ray and cardiovascular equipment, and coordinates clinical diagnostic imaging research for all modalities in Canada. For more information, visit the TCL Medical Systems Division website at www.toshiba-medical.ca
About Toshiba Medical Systems Corporation
Toshiba Medical Systems Corporation is a leading worldwide provider of medical diagnostic imaging systems and comprehensive medical solutions, such as CT, X-ray and vascular, ultrasound, nuclear medicine and MRI systems, as well as information systems for medical institutions. Toshiba Medical Systems Corporation has been providing medical products for over 80 years. Toshiba Medical Systems Corporation is a wholly owned subsidiary of Toshiba. Visit Toshiba Medical Systems Corporation’s website at www.toshibamedicalsystems.com.
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