Innovative Platform for CT Sets New Standards for Dose Reduction

The FAST CARE applications, from Siemens Healthcare (Erlangen, Germany) simplify workflows during scanning and in the preparation of image reconstructions. Patients benefit from lower radiation doses and shorter examination times as the system automates many operating procedures, suggests parameter settings for image quality and dose reduction, and standardizes processes that makes results more readily reproducible. These enhancements help CT operators and service providers improve their productivity. FAST CARE will be available on the Somatom Definition AS scanners in March 2011, and on the Somatom Definition Flash scanners in May 2011. Somatom Definition product family CT scanners that are already on the market can be upgraded to the new platform.

Two of the key current needs in CT for which Siemens has developed FAST CARE are optimization of the processes relating to patient diagnostic examinations and reducing the doses necessary for such examinations. The new technology platform's applications therefore focus on two aspects: Fully Assisting Scanner Technologies (FAST) support process optimization and Combined Applications to Reduce Exposure (CARE) assist with dose reduction.

The FAST technologies simplify and automate time-consuming and complex procedures in computed tomography. This improves not only the workflows, but also the results: as they make it easier to operate the equipment and to reproduce results. The FAST functions support doctors and radiology technologists at every step of a CT examination, from planning and image acquisition to reconstruction and diagnosis of the images. The major feature is that the anatomy of the individual patient is automatically taken into account.

The most important applications in this family include FAST Planning for standardized determination of the correct scan and reconstruction areas. FAST Cardio Wizard offers step-by-step instructions in the user interface to help operators gain practice in the complex preparations for cardiac examinations. FAST Scan Assistant and FAST Adjust determine the appropriate parameters for performing CT examinations with the best possible image quality. FAST Spine can reduce the work of preparing for spine reconstructions, resulting in considerable timesavings. With just a single click, the operator can select the desired region of the spine from a list of typical predefined scan regions. FAST Spine then determines the correct position of the planes to be reconstructed and identifies all vertebrae and intervertebral discs accordingly. This results in considerable timesavings, particularly with emergency patients, and can enhance the therapeutic safety of interventions.

When used in combination with syngo.via, the software platform for diagnosing clinical images from Siemens, FAST CARE optimizes the entire examination process, as it brings together all the steps involved, from scan preparation and performance through image reconstruction to diagnosis, in a single integrated solution.

From the patient's point of view, however, it is not enough just to improve the processes-- administering the lowest possible dose is just as important. In CT, a large amount of importance is rightly attached to the Alara principle (as low as reasonably achievable). Along with its FAST applications, Siemens CT delivers a comprehensive range of new CARE applications for dose reduction. These include, for example, automatic display of the dose distribution for the planned examination using CARE Profile. The CARE Dashboard shows the operators the activated dose reduction functions, so that they can then further optimize the examination protocols and scan parameters.

In essence, it is possible to improve the image quality significantly and at the same time to optimize the dose by selecting the correct kV level for the CT for the particular patient and organ involved. If the tube voltage is altered, however, all the other scan parameters also have to be adjusted accordingly. But as the dependencies are not linear, the values must currently be calculated manually using complex formulae. Studies have shown that for this reason, operators do not usually alter kV values and thus do not exploit the full potential for dose reduction. Siemens is providing an answer to this problem for the first time: CARE kV suggests the correct tube voltage depending on the patient's anatomy and the organ to be examined. All other parameters are automatically adjusted to suit the selected kV level. This optimizes the contrast-to-noise ratio in the image and allows reduction of the dose by up to 60%.

While voltages typically used today lie between 80 kV and 140 kV, with CARE Child CT examinations can be performed using just 70 kV, significantly reducing dose levels. This achievement has been made possible by Siemens' development of its Straton tube, enabling it to produce this low voltage.

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