Professional Documents
Culture Documents
16/June 2005
Stanford University’s
7th Annual International
Symposium on
Multidetector-Row CT
June 15-18, 2005
SOMATOM
www.siemens.com/medical
Sessions
Picture
Highlights
COVER STORY
Think Clinical!
Page 4
NEWS
SOMATOM Sensation –
40-Slice Technology
Page 12
BUINESS
SOMATOM Spirit – “And it
runs, and runs, and runs...“
Page 15
CLINICAL OUTCOMES
syngo Body Perfusion CT –
Differential Diagnosis of a
Pancreas
Page 20
SOMATOM Emotion 6
High Resolution Orthopedics
Examination
Page 24
SCIENCE
Archaeology – High-tech
Meets History
Page 33
CUSTOMER CARE
LIFE Educate –
A Win-Win Situation
Page 35
EDITOR’S LETTER
Dear Reader,
It is Siemens’ goal to remain the trend-setter in Computed Tomography (CT) technology and
clinical applications, and to provide innovative multislice CT and workflow solutions for all clinical
needs – from the cost-optimized SOMATOM® Spirit up to the leading edge SOMATOM Sensation
64. More than 100 of our brand-new multislice SOMATOM Spirit CT scanners are in use all over
the world, from the highlands of Tibet to Milwaukee, USA. Within one year, more than 250
SOMATOM Sensation 64-slice CT scanners have been installed in the world’s leading academic
institutions and in busy hospitals and practices. First peer-reviewed reports in leading medical
and scientific journals definitely substantiate the advantages of Siemens' proprietary z-SharpTM
Technology in neuro, chest, vascular and cardiac CT applications. Moreover, the first SOMATOM
Sensation 40 scanners, providing access to z-Sharp’s benefits at attractive investment levels, are
running successfully in Europe and the USA. And our new SOMATOM Emotion 16, which was
introduced at the ECR 2005 in Vienna, will bring advanced 16-slice CT performance to day-to-
day clinical practice at even lower investment levels. And there is much, much more in the
pipeline…
As the amount of data acquired per study is increasing, high-performance workflow and appli-
cation solutions gain importance. We have devoted most of this issue to discuss the challenges
and solutions for the efficient management of large data sets. Find out about our latest inno-
vations in clinical workflow design for cardio-vascular applications and for highly sensitive early
diagnosis of cancer. Our authors and editors have put together another outstanding collection of
useful information. Join us on a fascinating journey in space and time through the human body.
We are looking forward to your comments, suggestions, and contributions.
Sincerely,
2 SOMATOM Sessions 16
CONTENT
COVER STORY
4 Think Clinical!
8 The Fast Lane to Cardiac Diagnosis
9 Benefits of Computer-Aided Detection
10 Continuous Software Enhancements
NEWS
11 CT on its Way Beyond Slices?
11 Advanced Performance at Low Cost
12 40-Slice Technology
12 LEONARDO in Anatomy Teaching
BUSINESS
13 Cardiologists and Radiologists Unite Forces
13 Free Trial Clinical Software
14 Driving Initiatives against Colon Cancer
14 Demo Poster
15 “And it runs, and runs, and runs...“
CLINICAL OUTCOMES
16 SOMATOM Sensation 64: Low Dose Cardiac Scanning of a Neonate in one Second
18 SOMATOM Sensation 40: Peripheral Runoff
20 SOMATOM Sensation 16: Differential Diagnosis of a Pancreas
22 SOMATOM Sensation Open: Paget Sarcoma Disease in the Tibia
24 SOMATOM Emotion: High Resolution Orthopedics Examination
26 SOMATOM Spirit: Pre-operative Neurosurgical Planning
SCIENCE
28 z-Ultra-High Resolution Mode
30 Combining Forces to Improve Patient Care
33 High-tech Meets History
CUSTOMER CARE
35 A Win-Win Situation
36 Cross-country Postprocessing Events
36 CT Imaging and Cherry Blossoms
37 Exploring the Riches of Multislice CT
37 Service: Frequently Asked Questions
38 Service: CT Online
38 Information and Services Available Directly at Your CT Scanner
38 Service: Upcoming Events and Courses
39 Imprint
SOMATOM Sessions 16 3
COVER STORY
Think Clinical!
Siemens Computed Tomography is setting new trends in clinical workflow.
By Louise A. McKenna, PhD, Global Product and Marketing Manager CT-Workplaces, and Stefan Wünsch, PhD,
Global Product and Marketing Manger Clinical Solutions, Siemens AG, Medical Solutions, CT Division
Think clinical! One of the hottest topics in medical imaging Hopkins Medical Center, Baltimore, USA. “In my opinion,
today is how to deliver a fast, confident diagnosis in an Siemens is setting the trend in modern diagnostic imaging,
increasingly demanding clinical environment. Both physi- combining the most innovative scanner technologies with
cians and patients have high clinical expectations, exam vol- intelligent workflow tools and new intuitive clinical software
umes are on the increase, scan times are faster than ever, applications. Siemens is leading the way in seamlessly inte-
datasets are large, plus there is demand for improved patient grated CT solutions that help us to be fast in reaching the
safety in terms of dose, without compromising result. Deliv- right clinical outcomes reliably and efficiently, everyday.”
ering excellent clinical outcomes in medical imaging today is
no longer only about having thinnest slices, the most pow- Leadership in Workflow Solutions
erful tube and fastest rotation time. It is about having the The innovation explosion in Multislice CT technology and the
most innovative Computed Tomography (CT) scanner in introduction of 64-slice CT has revolutionized medical imag-
combination with well designed clinical workflow solutions. ing, paving the way for a wealth of new and exciting clinical
“From the clinicians’ viewpoint, achieving a fast, confident applications: fast cardiac CT in under eight seconds, whole
diagnosis relies on two key factors: the right CT technology body vascular CT with exquisite detail in under 20 seconds,
in combination with the right clinical workflow,” says Elliot K. highly sensitive virtual imaging of the colon and perfusion
Fishman, MD, Professor of Radiology and Oncology at Johns CT, to name but a few. And true to it’s tradition as an innova-
4 SOMATOM Sessions 16
COVER STORY
Excellent image quality is only one step towards a confident physician’s diagnosis.
Well designed clinical workflow solutions have become equally important.
SOMATOM Sessions 16 5
COVER STORY
6 SOMATOM Sessions 16
COVER STORY
WorkStream4D
Conventional Workflow
WorkStream4D
Scan Read
Time
enabling fully automated reconstruction in parallel to acquisi- based on a one-time loaded data-set. This includes an intelli-
tion at both Navigator and Wizard CT-workplaces, offering gently designed 1-click workflow for robust coronary vessel
users a high degree of workflow synergy. segmentation, automated stenosis quantification and opti-
mized stent planning, automated quantification of ejection
Leadership in Clinical Applications fraction, end-diastolic and systolic volume plus stroke vol-
Siemens is also setting new standards in clinical CT through ume, and 4D evaluation of up to 24 phases.
on-going innovation in integrated clinical software applica- Enhancing clinical workflow for vascular CT has been the
tions. The latest enhancements focus on improving speed focus in the further development of syngo InSpace4DTM.
and efficiency through simplifying workflow, increasing Concentrating on clinician’s requirements for more automat-
automation and integrating clinically orientated tasks into ed tools, particularly for removal of bony structures for faster
single software solutions. The current portfolio of syngo vascular analysis, a fully automated advanced bone removal
software offers the industry’s most comprehensive range of application is an integrated feature of the latest syngo
clinical solutions for cardiovascular CT, preventive care, InSpace4D. In combination with syngo Vessel View, users
oncology, neurology and routine imaging. can really optimize diagnostic workflow for a broad range of
The introduction of the SOMATOM Sensation 16 in 2001, vascular pathologies.
closely followed by the SOMATOM Sensation 64, revolution- For preventive care and oncology, syngo LungCARE CT and
ized cardiac and vascular CT. For the first time, CT was able to syngo Colonography are part of the new generation of intel-
deliver the exceptional spatial and temporal resolution cou- ligent clinical software solutions. They incorporate a number
pled with the exquisite image quality needed for non-inva- automated features such as measuring tools, synchroniza-
sive cardiac and vascular imaging. With a focus on automa- tion for easy evaluation of follow-up studies or prone/supine
tion, speed and simplicity, syngo Circulation* is the newest reads and pre-filled reports, all designed to reduce the man-
addition to the portfolio of advanced cardiac workflow tools ual workflow of the clinicians so that they can focus on diag-
designed to help clinicians realize the full diagnostic poten- nosis. In combination with Siemens’ CT technology, a lung or
tial of cardiac CT imaging. Designed in close collaboration colon exam, from scan to report, can be completed in less
with Radiologists and Cardiologists, syngo Circulation pro- than 20 minutes – the clinician input representing about ten
vides the entire toolset for a comprehensive cardiac CT exam minutes for diagnosis and reporting.
SOMATOM Sessions 16 7
COVER STORY
D E D I C AT E D S O L U T I O N S
syngo Circulation offers physicians the industry’s most comprehensive software solution for cardiac CT,
setting a new benchmark for improving clinical outcomes through innovative software solutions.
Computed Tomography (CT) fulfils many ”An accurate but fast diagnosis is crucial mentation and stenosis quantification
clinical needs – be it in neurology, oncol- in cardiovascular imaging in order to tools provide for fast, confident evalua-
ogy, angiography, in the emergency ensure the best quality of care for the tion of the coronary vessels and opti-
room or, increasingly, also in cardiology patient. This is why the workflow must mized stent planning. syngo Circulation
and preventive care. Siemens Medical be extremely fast and well organized,“ also offers tools for full functional analysis
Solutions offers specialized solutions for states Lars Hofmann, MD, Global Prod- including cine display for evaluation of
the specific needs of each of the respec- uct and Marketing Manager for Cardiac wall motion defects, automated left
tive clinical departments. “Supplying our CT at Siemens. ventricle segmentation and quantifica-
customers with hardware dedicated to syngo Circulation was developed in tion of ejection fraction, stroke volume,
their needs is not enough”, says Bernd close collaboration with leading cardiac end systolic and diastolic volumes. All
Montag, PhD, President of Siemens experts. It features a unique user-friendly qualitative and quantitative results are
Medical Solutions’ CT division. “We also workflow that guides the clinician integrated in a single, customizable re-
want to give applications and workflow through cardiac evaluation from auto- port.
tools to them that are explicitly de- mated heart segmentation, through ”The new software helps to facilitate
signed to meet the needs of their specific coronary vessel segmentation and and increase workflow for physicians
clinical department – from patient regis- stenosis quantification, fully automated with a busy clinical practice by incorpo-
tration to reporting.” functional analysis and reporting, in rating intuitive reporting functionality
syngo Circulation* is the first of Siemens’ under 10 minutes. and integrating many time-saving, ac-
new generation clinical software solu- A typical workflow begins with fast load- curate and guided procedures for the
tions. syngo Circulation is a dedicated ing of up to 24 phases, at highest image rapid examination of cardiac CT stud-
solution for cardiac evaluation, uniquely resolution. With a single click, the heart ies”, says Michael Poon, MD, Director of
designed to offer fast, robust morpho- can be isolated from the rib cage facili- Cardiology at the Cabrini Mecial Center
logical and functional analysis in one in- tating rapid assessment of the overall and Associate Professor at the Mount
tuitive software application. cardiac anatomy. Fully automated seg- Sinai School of Medicine, New York, USA.
*syngo Circulation is pending 510(k) review and is not yet commercially available in the U.S.
8 SOMATOM Sessions 16
COVER STORY
Siemens users are also in a unique position to benefit from Munich, Germany has been able to reduce the number of
state-of-the-art computer-assisted reading tools for lung reading physicians since introducing syngo LungCARE NEV:
nodules and colon lesions. syngo LungCARE CT with NEV “With this tool, we reduced the need for the second read by
(Nodule Enhanced Viewing) and syngo Colonography with a second physician screening all our chest datasets for lung
PEV (Polyp Enhanced Viewing) represent an on-going com- nodules, and therefore improved our diagnostic work-up
mitment to development of automated tools that improve and follow-up findings,” says Christoph Engelke, MD,
diagnostic confidence through the use of computer-assisted Department of Diagnostic Imaging, Technical University
second readers, which may have real impact on treatment Munich, Germany.
decisions. Centers that have already been working exten- The innovation continues in software solutions for neurology,
sively with syngo LungCARE NEV have realized a significant particularly for stroke and tumor perfusion. syngo Neuro
improvement in daily workflow. Klinikum Rechts der Isar in Perfusion CT is an established tool for the fast assessment of
SOMATOM Sessions 16 9
COVER STORY
stroke, with a complete exam requiring less than 15 minutes range of clinical needs from cardiac CT to oncology. With a
[1], which is critical for stroke patients. syngo Neuro Perfu- keen eye on the future, Siemens will continue to set new
sion CT is also designed to be versatile and is ideal for the trends for the next generation of clinical CT solutions…
analysis of brain tumor perfusion for brain tumor angio-
genesis or assessing treatment efficacy in oncology.
Currently, Siemens offers around 30 workflow and clinical [1] Tomandl B., et al. Comprehensive imaging of ischemic stroke
applications, providing solutions to meet a comprehensive with multislice CT. Radiographics 2003; 23: 565-592
syngo C T 2 0 0 6 A / G
10 SOMATOM Sessions 16
NEWS
S O M AT O M E m o t i o n 16
S O M AT O M S e n s a t i o n P R O D U C T L I N E
40-Slice Technology
Two new Siemens Computed Tomogra- McCollough, PhD, Associate Professor of
phy (CT) systems were recently intro- Radiological Physics at the Mayo Clinic
duced to the market. The world’s first College of Medicine. “In addition, the
SOMATOM Sensation 40 scanner was STRATON tube provides the X-ray output
installed at the radiology department of needed for high-quality images in very
Alamance Regional Medical Center, large patients. These are exactly the With the SOMATOM Sensation 40, Siemens
Burlington, NC., replacing the clinic’s clinical and technical attributes we were Medical Solutions rounds out its extensive
SOMATOM Sensation 10. And Mayo Clinic seeking, especially for bariatric care and high-end product portfolio in CT.
in Rochester, MN., was one of the first image guided interventions.”
clinics to install a SOMATOM Sensation Both new systems feature Siemens rev-
Open with 40-slice technology. The sys- olutionary z-Sharp Technology, which
tem features an extra-large, 82 cen- utilizes an electron beam that is accu-
timeter gantry bore and field of view. rately and rapidly deflected, creating
A new, optional high-capacity patient two alternating and overlapping X-ray
table, developed as part of the CT Clini- projections reaching each detector ele-
cal Innovation Center partnership be- ment. This doubles the scan information
tween Mayo and Siemens, was installed without a corresponding increase in
with the system to permit advanced CT dose, and routinely enables acquisition
imaging of extremely heavy patients. of 40 slices per rotation with unprece-
The table allows the scanning of pa- dented image quality and the industry’s
tients weighing up to 615 lbs, compared highest image resolution of below 0.4
to 440 lbs for conventional patient ta- millimeter. z-Sharp Technology firmly
bles. “With these features, the established a new benchmark for diag-
SOMATOM Sensation Open is ideally nostic excellence, as proven with almost
The large bore of the SOMATOM Sensation
suited for very heavy patients and our 300 installations of z-Sharp powered
Open is ideal for examinations of bariatric
Bariatric Surgery Program,” says Cynthia systems worldwide. and cancer patients.
12 SOMATOM Sessions 16
BUSINESS
S O C I ET Y O F C AR D I OVAS C U L AR C T
On March 7, 2005, the Society of Cardio- Poon, MD, President-Elect, New York, newly formed Society of Cardiovascular
vascular Computed Tomography (SCVCT) NY; Daniel Berman, MD, Vice President, CT will be very helpful in establishing
and the Society of Cardiac Computed Los Angeles, CA; Gilbert Raff, MD, Secre- the appropriate clinical role for cardio-
Tomography (SCCT) merged to form a tary, Royal Oak, MI, and Joao Lima, MD, vascular CT,” said Dr. Achenbach, SCCT
new society called “Society of Cardio- Treasurer, Baltimore, MD. President.
vascular CT” (SCCT). Both former soci- “Computed Tomography has gone The SCCT is an international organization
eties were relatively new, having just through rapid technical development in committed to the further development
been formed in January 2005. They the past years, and is increasingly appli- of cardiovascular CT through standards
soon realized that they shared common cable to imaging of the heart, coronary setting, advocacy, education, training, ac-
goals and that a single, strong society arteries and vascular system. It is impor- creditation, quality control and research.
would be more effective. tant that researchers and clinicians in Its members are physicians, scientists,
The SCCT is represented by a 15-member this field work together to create a body technologists, and others who work in
Board of Directors and five executive of- of evidence strong enough to support the field of cardiovascular CT. Siemens
ficers. Four of them and the vast majori- recommendations as to which patients CT division strongly supports the new
ty of the Board of Directors are long are most likely to benefit from the new society and encourages users of cardiac
term Siemens Computed Tomography diagnostic modalities and to assure that CT to join the society to support this fas-
(CT) users. Executive officers of the SC- CT imaging performed by appropriately cinating technology.
CT are: Stephan Achenbach, MD, Presi- trained physicians will be available to
dent, Erlangen, Germany; Michael these patients. I am confident that the k Further Information: www.scct.org
syn g o LU N G C AR E C T W ITH N EV
SOMATOM Sessions 16 13
BUSINESS
INVESTING IN PEOPLE
C T C O LO N O G R A P H Y
Demo Poster
CT Colonography (CTC) is emerging as Based on their experience with virtual
an attractive alternative to colonoscopy colonoscopy, they have designed a
for the detection and evaluation of le- poster demonstrating the spectrum of
sions of the colon in terms of excellent CTC findings in colon diseases. All dis-
diagnostic outcomes, high patient ac- eases are briefly described and exten-
ceptance and lower cost. It is ideally suit- sively demonstrated on 3D and 2D CT
ed for patients who are unable or unfit images, guiding and assisting users in
to undergo conventional colonoscopy, the reporting of findings in CTC exami-
as well as for asymptomatic and screen- nations.
ing patients. Around 600 Siemens Mul- The poster has been produced together
tislice CT users are currently utilizing with Siemens Medical Solutions, Aus-
syngo Colonography for efficient evalu- tria, and is available free of charge in ei-
ation of the colon. ther German or English.
Thomas Mang, MD, and co-workers To obtain a free CT Colonography Poster,
from the Medical University of Vienna, please send an e-mail with your postal
Austria, have performed around 280 address to
CTC exams on their SOMATOM Sensa- med.somatomlife@siemens.com, Each disease is briefly described and
tion 16 Scanner over the last two years. subject “CTC Poster”. demonstrated, based on CT images.
14 SOMATOM Sessions 16
BUSINESS
Interview
S O M AT O M S p i r i t
SOMATOM Sessions 16 15
CLINICAL OUTCOMES SOMATOM SOMATOM SOMATOM
Sensation Emotion Spirit
Case 1:
Low Dose Cardiac Scanning of a Neonate in one Second
By Jean-François Paul, MD, Anne Sigal-Cinqualbre MD, Department of Radiology, and V. Lambert, MD,
Department of Cardiopediatry, Marie Lannelongue Hospital, Le Plessis-Robinson, France
HISTORY DIAGNOSIS
An 1 day old infant was referred for cardiac CT for differential CT revealed atypical coarctation, associated with very large
diagnosis prior to surgical intervention for severe aortic patent ductus arteriosus, supplying descending aorta with
coarctation from total interruption of aortic arch. blood.
Previous foetal echocardiography had revealed asymmetry On the first acquisition [Fig. 1 and 2], only patent ductus arte-
of ventricles associated with an enlarged right ventricle, and riosus, descending aorta and left subclavian artery were opaci-
there was suspicion of coarctation of the aortic arch. At birth, fied, due to the right to left shunt between ductus arteriosus
echocardiography was not able to assess whether the baby and descending aorta. The aortic arch was not visualized.
was suffering from severe aortic coarctation or if the aortic A second acquisition was performed with a longer start delay
arch was totally interrupted. to accommodate this unusual anatomical configuration. The
aortic arch was opacified, and MIP images clearly showed
SCANNING PROCEDURE
Due to the high rotation speed (0.33 s) of the SOMATOM Sen- [ 1 ] Left lateral view using
VRT display. First acquisition
sation 64 gantry, the entire thorax could be captured in only
showed very large patent
1 second and hence it was not necessary to sedate the infant.
ductus arteriosus in connec-
Five cc of contrast medium were injected at a flow rate of tion with descending aorta.
0.6 cc/s in a small cubital vein. After the analysis of the first Left subclavian artery is origi-
acquisition data set, an additional acquisition was necessary nating from the junction
to visualize the aortic arch. Indeed, the aortic arch was not of the two vessels. Aortic
visualized at first-pass because most of the contrast flow was arch is not opacified. PDA:
going from the pulmonary artery directly to the descending patent ductus arteriosus;
DA: descending aorta;
aorta (via patent ductus arteriosus), bypassing the aortic
LSCA: left subclavian artery;
arch. A second acquisition 10 seconds later was necessary to
LPA: left pulmonary artery
get the aortic arch opacified [Fig. 3].
CARE Dose4D was applied, enabling us to perform the exam
with an exposure that was as low as reasonably achievable, [ 2 ] Same acquisition
in this case at 80 kV and 20 mAs. Total DLP for 2 acquisitions in a more posterior view
was 15, and the estimated exposure for the exam was very
low at 0.6 mSv.
Images were reconstructed at 1 mm using MIP and VRT recon-
structions for a complete description of anatomical disor-
ders.
16 SOMATOM Sessions 16
CLINICAL OUTCOMES
[ 3 ] Second acquisition (10 sec- [ 4 ] VRT display of the aortic arch, [ 5 ] VRT display in a posterior
onds after first pass): MIP view in a left lateral view. Note that the view shows the complex anatomy
showed opacified aortic arch with aortic narrowing is hidden by the associated with the aortic coarcta-
severe coarctation (arrow). AA: patent ductus arteriosus.PDA: patent tion. PDA: patent ductus arterio-
Aortic arch; DA: descending aorta ductus arteriosus; DA: descending sus; DA: descending aorta; LSCA:
aorta; LSCA: left subclavian artery; left subclavian artery; LCA: left
IA: innominate artery; LCA: left carotid carotid artery; AA: aortic arch
artery; LPA: left pulmonary artery
EXAMINATION PROTOCOL
that the aorta was severely narrowed, but not totally inter- Scanner SOMATOM Sensation Cardiac 64
rupted [Fig. 3]. Additional VRT images depicted this complex Scan area thorax
configuration [Fig. 4 and 5]. Scan length 64 mm
Surgical intervention by lateral thoracotomy was successful. Scan time 1s
The baby was discharged from our institution at day 10, with- Scan direction caudo-cranial
out complication. Heart rate 140
ACV no ECG gating
kV 80 kV
COMMENTS Effective mAs 20 mAs
Rotation time 0.33 s
This is an exemplary case for the application of 64-slice CT Slice collimation 0.6 mm
scanning for congenital heart disease patients, especially in Slice width 1 mm
newborns. Very short acquisition times, associated with thin Table feed 46 mm / s
collimation, provide very high quality images in non-inter- Reconstruction increment 0.7 mm
ventional procedures, associated with low radiation expo- CTDI 0.49 mGy
Kernel B30
sure. These data may be crucial in such critical conditions. In
case of interrupted arch, the surgical approach would have
required sternototomy with bypass circulation instead of lat- Contrast
eral thoracotomy. In case of doubt at echocardiography, a Volume 5 ml
conventional aortography may be indicated, but angiogra- Flow rate 0.6 ml / s
Start delay 10 s (central venous access)
phy is a very risky examination, especially in neonates. Multi-
slice CT is the ideal alternative to avoid such an invasive
imaging technique. Here, CT was preferred to MR due to Postprocessing MIP, VRT
superior spatial resolution, speed of acquisition (and thus
absence of respiratory artefacts), and no need for sedation.
Radiation dose delivered by CT was below 1 mSv.
SOMATOM Sessions 16 17
CLINICAL OUTCOMES SOMATOM SOMATOM SOMATOM
Sensation Emotion Spirit
Case 2:
Peripheral Runoff
Geoffrey Browne, MD, Chris DeAngelo RT ( R ), ( CT ), Alamance Regional Medical Center, Burlington, USA
HISTORY
A 56 year old male patient was presented with pain in the
muscle of the left leg after slight exercise. A CTA runoff with
the latest 40-slice CT technology was scheduled to rule out
claudication.
DIAGNOSIS
CTA revealed an occlusion of the left common iliac artery just
distal to its origin. Occlusion of the proximal two thirds of the
left external iliac artery is present. Collateral reconstitution of
the distal left external iliac artery/common femoral artery is not-
ed. Distal vessels are not affected due to collateral blood supply.
COMMENT
The case demonstrates the clinical impact of CT for non-inva-
sive assessment of vascular structures with the SOMATOM
Sensation 40. Due to the excellent speed and an isotropic
[ 1 ] VRT showing occlusion of the left iliac artery after
bone removal performed with syngo InSpace4D resolution below 0.4 mm, even finest structures can be
resolved without venous overlap.
EXAMINATION PROTOCOL
Scanner SOMATOM Sensation 40
Scan area Lower extremity runoff
Scan length upper leg: 545.5 mm; feet: 238 mm
Scan time upper leg: 19 s; feet: 8 s
Scan direction craniocaudal
kV 120 kV
Effective mAs 170 mAs (CARE Dose4D)
Rotation time 0.37 s
Slice collimation 0.6 mm
Slice width 0.75 mm
Pitch 1
Reconstruction increment 0.5 mm
18 SOMATOM Sessions 16
CLINICAL OUTCOMES
[ 3 ] Curved MPR shows calcified and non-calcified [ 4 ] VRT of the collateral vessels
plaques as well as the thrombus responsible for the
occlusion.
A B
SOMATOM Sessions 16 19
CLINICAL OUTCOMES SOMATOM SOMATOM SOMATOM
Sensation Emotion Spirit
Case 3:
Differential Diagnosis of a Pancreas
By Xue Hua Dan, MD, and Jin Zheng Yu, MD, Department of Radiology,
Peking Union Medical College Hospital, Beijing, China
20 SOMATOM Sessions 16
CLINICAL OUTCOMES
A B [ 1A and 1B ]
MPR and MIP
images show the
small endocrine
tumor as a highly
enhanced nodule
(arrow), located
at the tail of the
pancreas, with the
nutritional artery
visible.
[ 2 ] Functional parameter maps calculated in two adjacent 3 mm slices (upper and lower row) using syngo
Body Perfusion CT. The maps show increased blood flow (left, red color) and blood volume (middle, red color), but
normal permeability (right, green color). Note the excellent spatial delineation of this small tumor made possible
by robust modeling of data from thin slices and acquired in only 35 s (one breath hold).
SOMATOM Sessions 16 21
CLINICAL OUTCOMES SOMATOM SOMATOM SOMATOM
Sensation Emotion Spirit
Case 4:
Paget Sarcoma Disease in the Tibia
By J. Dinkel, MD, U. Mende, MD, PhD, Department of Radiation Oncology, and J. Debus, MD, PhD, Director,
Department of Radiation Oncology, University of Heidelberg, Germany
HISTORY
An 80 year old female with monostotic Paget’s disease of the appear superimposed on osteoclastic activity and eventually
right tibia presents with progressive pain and soft tissue predominate; and finally, the blastic phase (late-inactive), in
swelling of the right leg. A biopsy was taken that confirmed the which osteoblastic activity gradually declines.
exact pathologic diagnosis of the lesion arising from Paget’s Monostotic disease (10–35% of cases) is more often seen in
disease and a sarcomatous transformation to osteosarcoma. the axial view of the skeleton, although any site can be the
sole region of involvement. Polyostotic disease (65–90 %) is
DIAGNOSIS more frequent than monostotic disease. The patient presented
here had monostotic disease localized in the right tibia only.
Paget’s disease of the bone is a common disorder affecting VRT and MPR images of the tibia show the radiological char-
approximately 3–4% of the population over 40 years old. acteristic manifestations of Paget’s disease: a diffuse cortical
The pathologic abnormality in Paget’s disease is excessive and trabecular thickening involving the entire bone.
and abnormal remodeling of the bone. Three phases have The combination of progressive osteoclastic and osteoblastic
classically been described as discrete and distinctive, activity leads to the dichotomy of osseous enlargement but
although in reality they represent a continuum: the lytic weakening of the bone. Sequelae of this osseous weakening
phase (incipient-active), in which osteoclasts predominate; are the most common complication of Paget’s disease. An
the mixed phase (active), in which osteoblasts begin to anterior bowing of the tibia is seen in the VRT reconstruction.
1A 1B
22 SOMATOM Sessions 16
CLINICAL OUTCOMES
[ 2 ] Arterioscle-
COMMENTS rosis of posterior
tibial artery (thin
Neoplastic complications of Paget’s disease are relatively arrow); diffuse
rare. Sarcomatous degeneration is estimated to occur in 1% cortical and tra-
of patients with longstanding disease. In case of severe becular thicken-
polyostotic disease, the relative risk of sarcomatous transfor- ing involving the
mation is up to 5–10%. entire bone with
anterior bowing
A Paget sarcoma can have different appearances depending
(thick arrow)
on the matrix produced (osteolytic, osteoblastic, mixed). In
this case, the CT scan shows the osteoblastic tumor mass
extending into the soft tissue with infiltration of the skin and
skin metastases. Moreover, the CT scan of the popliteal
region reveals nodular mineralizations of metastatic lymph
nodes.
The high isotropic resolution provided by the SOMATOM
Sensation Open with 40 x 0.6 mm slices produced during [ 3 ] Nodular
mineralizations
each rotation, allows for the detection of small changes after
of metastatic
the radiation therapy. Spiral artifacts e.g. aliasing artifacts
lymph nodes
that manifest as streaks emerging from high contrast (arrow)
objects, and windmill artifacts, are almost completely elimi-
nated with z-Sharp Technology, even at higher pitch values.
In addition, z-Sharp Technology reduces image noise when
the reconstructed slice width is the same thickness as the
collimation.
EXAMINATION PROTOCOL
Scanner SOMATOM Sensation Open, 40 slices
Scan area extremity [ 4 ] Disorga-
Scan length 451 mm nized areas
Scan time 41.5 s are seen in the
Scan direction cranio-caudal distal cortex
kV 120 kV of the distal tibia
Effective mAs 66 mAs (CARE Dose4D) 90 mAs ref.
Rotation time 1s
Slice collimation 0.6 mm
Slice width 0.6 mm
Pitch 0.9
Reconstruction increment 0.4 mm
CTDI 7.24 mGy
Kernel B20 / B60
SOMATOM Sessions 16 23
CLINICAL OUTCOMES SOMATOM SOMATOM SOMATOM
Sensation Emotion Spirit
Case 5:
High Resolution Orthopedics Examination
Ly Thai Bach, MD, Chief of Radiology Unite, & Eric Devilaine, Chief of X-ray Technician Team,
Centre Hospitalier Robert Morlevat, Semur en Auxois, France
HISTORY
A 75 year old woman was referred for a detailed evaluation heel bone, but also at the level of the anterior-inferior part of
of her left ankle because of degenerative arthropathy, which the talus and at the level of the anterior part of the extremi-
also entails mechanical pain. She benefited from a local infil- ty distal of the tibia.
tration of anaesthetics some time ago, with good results. Furthermore, calcifications, probably of cartilagenous origin,
Prior standard x-rays confirmed a subastragalar arthropathy were also visible on both sides of the talus in the frontal view,
of the talus (astragalus) and probably also astragalo-scaphoid confirming the evidence of a chondrocalcinosis (deposition
and tibio-tarsal. A high resolution CT scan was requested in of multiple small calcified islands of bone within the synovi-
order to examine the different injuries of the region. um of the joint). Also, edema of the soft tissue around the
ankle at the subcutaneous level could be observed.
DIAGNOSIS
COMMENTS
Using the high resolution mode of our SOMATOM Emotion 6
with a collimation of 6 x 0.5 millimeter, we were able to view Especially for examinations of bone joints and the inner ear,
the degenerative processes in the tibio-astragalus region we primarily use the high resolution mode in order to detect
with posterior constriction. We identified the presence of smallest details, such as micro calcification. This feature
several subchondral geodes-like formations (sphere shaped allows us to provide an improved differential diagnosis com-
structure which contains a hollow cavity), some 17 mm pared to normal scan modes.
diameter, mainly visible at the level of the anterior part of the
The SOMATOM
Emotion scanners -
from the single-
slice SOMATOM
Emotion to the
new, 16-slice
SOMATOM Emo-
tion 16 – reliably
perform routine
and advanced
applications.
24 SOMATOM Sessions 16
CLINICAL OUTCOMES
EXAMINATION PROTOCOL
Scanner SOMATOM Emotion 6, high resolution mode Rotation time 1.0 s
Scan area extremity Slice collimation 6 x 0.5 mm
Scan length 80 mm Slice width 0.6 mm
Scan time 32 s Table feed / rotation 2.5 mm
Scan direction craniocaudal Reconstruction increment 0.3 mm
kV 130 kV Kernel U90s
Effective mAs 90 mAs (CARE Dose4D)
[ 1 ] The axial view shows irregular, roughly spherical, [ 2 ] Sagital view of degenerative processes of the
bodies (arrowhead) in the anterior part of the heel bone tibio-astralagus part of the talus (arrows) with posterior
as well as the presence of micro calcifications (arrow). constriction
[ 3 ] The coronal view shows the presence of micro [ 4 ] VRT of the tibia shows the geodes-like structures of
calcifications, probably of cartilagenous origin (arrow- the anterior part of extremity distal of the tibia (arrow).
head), and edema of the soft tissue (arrow).
SOMATOM Sessions 16 25
CLINICAL OUTCOMES SOMATOM SOMATOM SOMATOM
Sensation Emotion Spirit
Case 6:
Pre-operative Neurosurgical Planning
By Carsten Figge, MD, Radiology Institute/Practice Drs. Mariß/Aref/Figge, Bad Zwesten, Germany
HISTORY
A 36 year old female with a suspected tumor was admitted like enhancement. A peritumoral edema with compression
for neurosurgical evaluation after increasingly frequent of the ventricles was also noted. CTA revealed a dislocation
headaches during the last months, anosmia and emotional of the arteriae cerebri anteriores and identified the feeding
labililty. The patient refused to undergo MR scanning due to arteries of the tumor. Additionally, a hyperosteosis in the
high grade claustrophobia. Pre-operative CT scanning was lamina cribrossa can be seen. Tumor growth in the sinuses
requested by the neurosurgeons to provide more informa- can be excluded.
tion of possible tumor proliferation, infiltration into the In this specific case, having a patient with claustrophobia, the
sinuses and dislocations of vessels. combination of CTA, MIP and MPR reconstructions allowed
for successful surgical planning. This case demonstrates the
DIAGNOSIS UND COMMENTS beneficial value of CT scanning as an alternative to MR scan-
ning in the preparation for surgical interventions.
The CT scan showed an inhomogeneous frontobasal
enhancing mass, a suspected meningioma of the olfactory
groove due to related symptoms with heterogeneous rim-
26 SOMATOM Sessions 16
CLINICAL OUTCOMES
EXAMINATION PROTOCOL
Scanner SOMATOM Spirit Pitch 1.8
Scan area cerebrum Reconstruction increment 0.6 mm
Scan length 110 mm Kernel H21
Scan time 25 s
Scan direction caudo-cranial Contrast Non ionic contrast media
kV 130 kV Volume 120 ml
Effective mAs 50 mAs Flow rate 3 ml / s
Rotation time 0.8 s Start delay 25 s
Slice collimation 2 x 1 mm
Slice width 1.25 mm Postprocessing MIP, MPR, VRT
SOMATOM Sessions 16 27
SCIENCE
SOMATOM Sensation 64
z-Ultra-High Resolution Mode
By Thomas Flohr, PhD, Head of Physics and Application Development, and Karl Stierstorfer, PhD,
Physics and Application Development, Siemens AG, Medical Solutions, CT Division
A special ultra-high resolution mode, called z-UHR, providing functionality offers our users, in daily clinical routine, an
considerably enhanced spatial resolution, will be introduced isotropic detail in the range of MicroCT technology,” says
for new SOMATOM Sensation 64 scanners, starting in sum- Alexander Zimmermann, Global Product and Marketing
mer 2005: up to 0.24 millimeter isotropic resolution can Manager SOMATOM Sensation.
then be achieved in clinical routine. With z-UHR, the The new mode is intended for ultra-high resolution bone-
SOMATOM Sensation 64 has reached a level of resolution imaging, in particular for wrists, joints, and inner ear studies.
previously known only from non-clinical research CT sys- Pre-requisite for z-UHR ultra-high resolution mode is the
tems using CsI-aSi flat-panel detectors. “The combination of unique z-Sharp Technology enabled by the Siemens propri-
the revolutionary z-Sharp Technology and the unique z-UHR etary STRATON X-ray tube. A moveable tantalum comb (grid)
is positioned in front of the detector elements, covering the
Detector set-up outer detector rows and effectively reducing the z-aperture
of the inner six detector rows from 0.6 millimeter to 0.35
millimeter at iso-center [Fig. 1]. Without z-Sharp Technology,
collimated 0.35 millimeter slices would be acquired with this
X-ray focus
set-up – but unfortunately with a sampling distance of 0.6
millimeter and a corresponding “dead zone” of 0.25 millime-
ter, so that the slices would not be adjacent in the z-direction
and volume coverage would be incomplete. However,
Scanfield z-axis z-Sharp Technology provides measurement data in these
dead zones as well. Using z-Sharp Technology, rays of subse-
quent readings are shifted by 0.3 millimeter at iso-center in
the longitudinal (z-) direction. Two subsequent six-slice read-
Grid ings are interleaved and result in one twelve-slice projection
with 0.3 millimeter z-sampling distance and 0.35 millimeter
detector z-aperture – without gaps in the longitudinal direc-
tion. The data acquired with z-UHR correspond to those
0.35 mm obtained with a conventional detector with 0.3 millimeter
detector elements. The grid covers six adjacent 0.6 millime-
ter central detector elements, and thus provides the data of
12 x 0.3 millimeter collimated slices with z-UHR. Well defined
slices with 0.4 millimeter slice-width are reconstructed in a
spiral mode. Both in the scan plane and along the z-axis, an
[ 1 ] Schematic illustration of the detector set-up isotropic resolution of 0.24 millimeter (240 micron) is
used for z-UHR. A moveable tantalum grid is achieved. This can be demonstrated using the CATPHAN
positioned in front of the detector elements, (The Phantom Laboratories, Salem, NY). Turning the high
reducing their z-aperture to 0.35 millimeter at resolution insert by 90°, the bar patterns become roughly
iso-center. z-Sharp technology is used to acquire oriented along the z-direction. Fig. 2 shows an MPR of this
readings with a z-shift of 0.3 millimeter at iso- phantom in the longitudinal direction, proving that 21 lp/cm,
center. Two subsequent readings are interleaved
corresponding to 0.24 millimeter object size, can be
and result in projection data with 0.3 millimeter
resolved. Early clinical experience demonstrates that both
z-sampling distance and 0.35 millimeter detector
z-aperture. inner ear and wrist studies show significantly improved z-axis
resolution with increased clarity of sub-millimeter anatomic
structures [Fig. 3].
28 SOMATOM Sessions 16
SCIENCE
2 z-axis (mm)
0.24
0.25
[ 2 ] MPR of the high resolution insert of
the CATPHAN, demonstrating 0.24 milli-
meter isotropic resolution with z-UHR
available for the SOMATOM Sensation 64.
0.26
[ 3 ] MPR of a wrist fracture acquired
with 0.24 millimeter isotropic resolution.
The image demonstrates a level of resolu-
tion previously known only from research
0.27
CT systems with flat-panel detectors.
(Image courtesy of Klinikum Großhadern, Munich,
Germany).
SOMATOM Sessions 16 29
SCIENCE
The 2004 introduction of Symbia with TruePoint SPECT·CT SPECT·CT is going to help us in the diagnostic interpretation
technology definitely created new momentum in medical of clinical exams. Ultimately, the person who benefits from
imaging. A breakthrough in healthcare and medical imaging, this new technology will be the patient.”
it provides a new tool to improve workflow efficiency and Experts believe that Symbia will also have a profound effect
accelerate patient diagnoses. Building on the foundation of on cardiac imaging. “I’m pretty excited,” says Edward Ficaro,
Siemens’ history of innovation and technology, Symbia is the Ph.D., an assistant research scientist in the Department of
perfect merger of two equal modalities, single photon emis- Radiology at the University of Michigan Health System, the
sion computed tomography (SPECT) and computed tomog- very first clinical installation of Symbia. Ficaro has spent
raphy (CT), into one hybrid imager that will make a differ- more than a decade working to improve the accuracy of
ence in the way medical imaging is delivered. SPECT imaging SPECT imaging, from acquisition through physician review.
is predominantly used to reveal a patient’s functional or vital He works closely with cardiac specialists and expects that
processes, such as blood circulation and the metabolism and with Symbia, they will be able to register SPECT and CT
vitality of organs and tumors. The addition of CT to this imag- images of the heart with increased precision and accuracy.
ing technique provides the anatomical map for pinpointing “Registering these images isn’t being done routinely because
the exact location of disease in the body, in order match it's so difficult,‘ says Ficaro. The problem is that the thorax
metabolic or “functional” information. isn't a rigid structure. So registration is not just a fixed point
rigid transformation, it’s often an actual morphing of the
A New Concept body based upon known landmarks.“ With TruePoint
Symbia’s imaging modalities, SPECT, SPECT·CT and Multislice SPECT·CT technology, Symbia enables the examination of
CT, can be used independently or together. Used in combi- function and perfusion of the right ventricle of the heart,
nation, TruePoint SPECT·CT provides contemporaneously that, at just 1 to 4 mm thickness, is usually obscured in tradi-
acquired, coregistered SPECT and diagnostic CT images, an tional SPECT studies.
advance with immediate benefits for oncology and cardiology,
experts say. Thinking Ahead
“Experience from PET/CT tells us that there is an advantage Innovations in technology have been the backbone of
to having a diagnostic CT along with the nuclear medicine Siemens' success. Innovations such as TruePoint SPECT·CT
study to aid in tumor localization and surgical planning,” says were facilitated through an integrated team of engineers
Homer Macapinlac, MD, Deputy Chairman, Department of and scientists from nuclear medicine and CT working togeth-
Nuclear Medicine, M. D. Anderson Cancer Center, who is er to create new possibilities in the care of cardiac and cancer
planning for the installation of 5 Symbia TruePoint SPECT·CT patients.
imagers in 2005. “M. D. Anderson Cancer Center’s mission is to After the incredible growth of PET/CT, customers and engi-
eliminate cancer, and our goal specifically in the Division of neers alike began to imagine the possibilities of SPECT and CT
Diagnostic Imaging is to provide the best imaging possible to together. Extensive customer surveys led to an initial con-
empower our physicians to help cancer patients,” Macapinlac cept involving basic CT capabilities added to the powerful
said, “Because the anatomical detail is essential to have in SPECT capabilities of the e.cam Signature Series. The success
combination with the functional information, TruePoint of PET/CT systems involving high-end CT technology and the
30 SOMATOM Sessions 16
SCIENCE
SOMATOM Sessions 16 31
SCIENCE
with TruePoint SPECT·CT technology will allow us to take Torsten Kuwert, MD, Chairman of the Department of Nuclear
nuclear cardiac imaging to the next level. We expect that Medicine is confident that the addition of this hybrid imager
within the next year, we’ll be doing 80 to 90 percent of our will ultimately achieve the same success as PET/CT. “By com-
cardiac studies on these systems,” said James Corbett, MD, bining SPECT and CT, it is possible to combine high biochem-
professor of Radiology and Internal Medicine, Director of ical resolution with high anatomical resolution to really local-
Cardiovascular Nuclear Medicine, UMMC. “As we integrate ize neoplastic lesions, which should be expected to add to
this new system into our clinical practice, we expect diag- the quality of diagnosis. Hybrid PET/CT systems have already
nostic accuracy to be improved significantly, as the amount proven the diagnostic benefit, and most believe it’s not too
of information gathered will be considerably increased. This much of a stretch to expect the same from SPECT·CT.”
should make the Nuclear Medicine SPECT images more accu- Siemens expects the Symbia hybrid imaging system to
rate, and the information from the spatially registered CT appeal to a number of different medical specialists, including
scan will provide additional correlative data. We expect this radiologists, cardiologists and, of course, nuclear medicine
will prove to be important for patient care and significantly specialists. Fittingly for a system born of cooperation and
enhance the diagnostic and prognostic value to the com- integration, it may actually realize its full potential when
bined imaging procedure, compared to conventional SPECT used in concert across departmental lines, with interpreta-
imaging alone.”The University of Erlangen in Germany was tion of the diagnostic-quality CT scans and SPECT data ulti-
recently the first European recipient of Symbia. Professor mately improving patient care.
Case Study
Myocardial Perfusion
Using TruePoint SPECT·CT
HISTORY
An 82 year old male, 77 kg (169.2 lbs), with known coronary
artery disease, poorly controlled hypertension, insomnia and
other problems, came in for a routine follow-up after experi-
encing minor bouts of chest pain. His resting EKG was abnor-
Images show an apical and mal. During exercise, he experienced greater than 1 to 2 mm
anterior defect that’s mostly ST depression, but did not experience chest pain at that time.
reversible and an inferior
and inferior-septal defect DIAGNOSIS
that is significantly reversible.
A TruePoint SPECT·CT study was performed with the Symbia
CT attenuated corrected
hybrid imager using standard SPECT protocol in combination
(AC) images show greater
reversibility of inferior defect with a 6-slice CT scan. The SPECT portion of the examination
than uncorrected images. revealed an apical and anterior defect that is mostly
Also noted is post-stress LV reversible and an inferior and inferior-septal defect that is
dilatation. significantly reversible. The scan also detected post-stress
LV dilatation.
32 SOMATOM Sessions 16
SCIENCE
Archaeology
High-tech Meets History
Siemens Computed Tomography (CT) scanners help unravel the past:
In January 2005, the ancient Egyptian mummy Tutankhamen was examined
by an Egyptian team utilizing a SOMATOM Emotion 6 to explore how old
he was at death, if he had suffered from any diseases, what he died of, and to
determine the condition of the mummy itself. The following results were
announced in Cairo in March 2005.
Careful Mummification
[ 1 ] One of Tutankhamen’s
Based on the identification of at least five different types of wisdom teeth is still impacted.
resin and the many episodes of its introduction to the body [ 2 ] The king had a small cleft
and cranial cavity, the scientists concluded that great care in his hard palate.
was taken in the mummification of the pharaoh. This coun- [ 3 ] Whole body of pharaoh
ters previous arguments that the body was prepared hur- Tutankhamen
riedly and carelessly, perhaps to cover up a crime. However, Clinical images courtesy of Supreme
Council of Antiquities
the remains of Tutankhamen are in very poor shape, primarily
due to the damage done by the Howard Carter team that dis- edges, and there are two layers of resin inside. Some scien-
covered the tomb in 1922. The body is in several pieces. tists believe that the resin indicates that this can only have
Bones and skin are broken in numerous places. The king’s occurred during Tutankhamen’s life or the embalming pro-
arms, originally folded across his chest, are now by his sides. cess. They note that this type of fracture, unlike many others,
Many parts are missing, although fragments remain loose in is possible in young men. There is no obvious evidence of
the sand tray where the mummy is resting. healing, but such indications may be masked by the resin.
The scientists noted a fracture of the left lower femur, at the Since the associated skin wound would still have been open,
level of the epiphyseal plate. This fracture appears different this fracture would have had to occur shortly before death.
from the breaks caused by Carter’s team: it has ragged Carter’s team had noted that the patella on his left leg was
SOMATOM Sessions 16 33
SCIENCE
34 SOMATOM Sessions 16
CUSTOMER CARE
L i f e : E D U C AT E
A Win-Win Situation
With the SOMATOM Sensation Cardiac 64 taking cardiac CT to the next level,
the need for dedicated customer training increases. Siemens Medical Solutions
supports its customers, providing firsthand know-how, and the possibility to
exchange experience with well-versed medical colleagues.
SOMATOM Sessions 16 35
CUSTOMER CARE EDUCATION
E D U C AT E
Cross-country Post- Both, the courses at “Advanced Topics in CT Scanning“ (left), and the Hands-on
Workshop “CT-Colonography” at ESGAR (right), were met with enthusiasm.
processing Events
Following last year’s success, Siemens cialists, gave attendees the opportunity Colonography (CTC) from leading CTC
Medical Solutions again supported to work through a wealth of specially experts including Johannes Wessling,
hands-on training sessions at Professor selected clinical cases. Everyone walked MD, (Munster, Germany) and Andrea
Elliot Fishman’s popular “Advanced Top- away with a firm grasp of the principles Laghi, MD, (Rome, Italy). Day two was
ics in Computed Tomography (CT) Scan- and clinical application of 3D and virtual dedicated to tutored hands-on sessions
ning” CME accredited courses in Los An- post-processing techniques. with faculty members present to guide
geles (April 1–3rd, 2005) and Baltimore ESGAR’s 3rd CME accredited Hands-on the participants through over 100 spe-
(April 8–10th, 2005). Over 300 radiolo- Workshop, “CT-Colonography” (April 26– cially selected cases. Siemens Medical
gists and technologists took advantage 28th, 2005) was hosted by Phillipe Lef- Solutions supported the workshop with
of the opportunity to learn more about ere, MD, and Stefaan Gryspeerdt, MD, six LEONARDO workplaces running syngo
the principles of 3D and virtual imaging from Stedelijk Ziekenhuis, Roeselare, Bel- Colonography software. “The workshop
with syngo InSpace4D, CT-Angiography, gium. Places were limited to 40 for each ideally balanced between lectures and
cardiac CT, virtual colonography and of the two concurrent workshops, and a plenty of time for hands-on training. Hav-
lung imaging. Siemens provided 20 total of 80 radiologists joined the invited ing a clinical expert guiding us through
LEONARDO workplaces enabling partici- faculty in the beautiful ancient city of the more challenging test cases was very
pants to work individually during each Bruges, Belgium, for a packed two day helpful. I came away with useful tips that
of the clinical hands-on sessions. Ses- program. The first day of each workshop will certainly enhance my CTC workflow,“
sions, lead by both experienced Hopkins was comprehensive with lectures and says Christian Lauer, MD, O.L.V.V. Lour-
faculty and Siemens applications spe- hands-on demos on the essentials of CT- des-Ziekenhuis, Belgium.
T E C H N O LO G I S T E D U C AT I O N S Y M P O S I U M
36 SOMATOM Sessions 16
CUSTOMER CARE
7 T H I N T E R N AT I O N A L S O M AT O M C T U S E R C O N F E R E N C E
SERVICE
SOMATOM Sessions 16 37
CUSTOMER CARE
In addition, you can always find the latest CT courses offered by Siemens Medical Solutions at www.siemens.com/SOMATOMEducate.
38 SOMATOM Sessions 16
CUSTOMER CARE
Publisher Eric Devilaine, Chief of X-ray Technician Team, Xue Hua Dan, MD,
Siemens AG Centre Hospitalier Robert Morlevat, Department of Radiology
Medical Solutions Semur en Auxois, France Peking Union Medical College Hospital,
Computed Tomography Division Beijing, China
Siemensstraße 1 J. Dinkel, MD,
D-91301 Forchheim Department of Radiation Oncology, Tony De Lisa, freelance writer
University of Heidelberg, Germany
Responsible for Contents: Jessica Amberg; Chad DeGraaff; Thomas Flohr,
Bernd Ohnesorge, PhD Carsten Figge, MD, PhD; Lars Hofmann, MD; Louise McKenna, PhD;
Radiology Institute/Practice Drs. Mariß/Aref/Figge, Per Anselm Mahr; Bernd Ohnesorge, PhD; Rainer
Editors Bad Zwesten, Germany Raupach, PhD; Gitta Schulz; Karl Stierstorfer, PhD;
Doris Pischitz, M.A. Heiko Tuttas; Claudette Yasell; all Siemens Medical
(doris.pischitz@siemens.com) V. Lambert, MD, Solutions
Stefan Wuensch, PhD Department of Cardiopediatry,
(stefan.wuensch@siemens.com) Marie Lannelongue Hospital,
Le Plessis-Robinson, France Production
Editorial Board Norbert Moser, Siemens Medical Solutions
Jessica Amberg
U. Mende, MD, PhD,
Joachim Buck, PhD Layout
Department of Radiation Oncology,
Thomas Flohr, PhD independent Medien-Design
University of Heidelberg, Germany
Chad DeGraaff Widenmayerstrasse 16, D-80538 Munich
André Hartung
Jean-François Paul, MD,
Sandra Jeleazcov Printers
Department of Radiology,
Matthew Manuel Farbendruck Hofmann
Marie Lannelongue Hospital,
Louise McKenna, PhD Gewerbestraße 5, D-90579 Langenzenn
Le Plessis-Robinson, France
Axel Lorz Printed in Germany
Jens Scharnagl
Jin Zheng Yu, MD,
SOMATOM Sessions is also available on the
Department of Radiology,
Authors of this Issue internet: www.siemens.com/SOMATOMWorld
Peking Union Medical College Hospital,
Geoffrey Browne, MD,
Beijing, China
Alamance Regional Medical Center,
Burlington, USA
Anne Sigal-Cinqualbre MD,
Department of Radiology,
Chris DeAngelo RT (R), (CT),
Marie Lannelongue Hospital,
Alamance Regional Medical Center,
Le Plessis-Robinson, France
Burlington, USA
Note in accordance with § 33 Para.1 of the German Federal Data Protection of the drug. The treating physician bears the sole responsibility for the diag-
Law: Despatch is made using an address file which is maintained with the nosis and treatment of patients, including drugs and doses prescribed in
aid of an automated data processing system. connection with such use. The Operating Instructions must always be strictly
SOMATOM Sessions with a total circulation of 35,000 copies is sent free of followed when operating the CT System. The sources for the technical data
charge to Siemens Computed Tomography customers, qualified physicians are the corresponding data sheets. Results may vary.
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SOMATOM Sessions 16 39
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No. 16/June 2005
Stanford University’s
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Symposium on
Multidetector-Row CT
June 15-18, 2005
SOMATOM
www.siemens.com/medical
Sessions
Picture
Highlights
COVER STORY
Think Clinical!
Page 4
NEWS
SOMATOM Sensation –
40-Slice Technology
Page 12
BUINESS
SOMATOM Spirit – “And it
runs, and runs, and runs...“
Page 15
CLINICAL OUTCOMES
syngo Body Perfusion CT –
Differential Diagnosis of a
Pancreas
Page 20
SOMATOM Emotion 6
High Resolution Orthopedics
Examination
Page 24
SCIENCE
Archaeology – High-tech
Meets History
Page 33
CUSTOMER CARE
LIFE Educate –
A Win-Win Situation
Page 35
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