CT-guided therapy

Driving progress with CT-guided therapy.

CT-guided therapy
 
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Enhance your clinical capabilities in the field of interventional radiology, radio therapy, neurosurgery and trauma surgery by exploiting the whole range of CT-guided therapies.

"The fact that we use the latest technologies enables patients that would normally have to go to other cities for a simple test – to have it done here."

João Carlos Costa
MD at the Diagnostico por Imagem, Portugal


Angio-CT image guidance in interventional radiology

Dr. Lacey explains the clinical & operational benefits of Adaptive 3D Intervention Suite.

David Lacey
Interventional Radiologist at Iowa Methodist Hospital, Des Moines, USA
 

Hear all about the financial benefits of the Miyabi Angio-CT hybrid suite – from Todd Kranpitz.

Todd Kranpitz
Executive Director of Radiology at Iowa Methodist Hospital, Des Moines, USA

See an Angio-CT Miyabi suite in action - Watch a TACE case

David Lacey
Interventional Radiologist at Iowa Methodist Hospital, Des Moines, USA

David Lacey, MD, presents the benefits of Siemens' new product – a MIYABI Angio-CT suite. MIYABI solutions set-up as combined suite for Angio-CT and integrate diagnostic imaging with therapeutic interventions thus providing the ability to merge the advantages of both modalities.



CT image guidance in radio therapy

In radiation oncology, the use of CT simulators (SOMATOM Definition AS Open) is now being expanded to drive higher patient loads and more efficient operation. Emerging uses include CT-guided brachytherapy and placement of fiducial markers for image-guided radio therapy (IGRT). In these cases, delivering the dose to the target while sparing healthy tissue has the highest priority. For moving organs like the prostate or liver, IGRT aims to achieve this by tracking fiducials, including gold markers implanted prior to treatment. These markers are used as surrogates for identifying the position of the target during treatment. The CT-guided implantation of fiducials allows for their precise positioning in the tissue surrounding the tumor.



CT image guidance in neurosurgery

In spinal fusion surgery, there are three big advantages to an intra-operative sliding gantry CT. First of all, the patient does not have to move during the surgery and can be operated on using a standard surgical table. The CT scanner simply slides on rails over the patient, providing imaging on demand. The CT scanner can then be moved out of the way when not in use, giving the surgeon full access to the surgical site. Secondly, the images that are required for the surgical navigation-aided stabilization procedure are generated in the patient’s final surgical position. This results in highly accurate images and therefore more precise surgical navigation and screw placement. The third advantage is that the position of the implants can be controlled immediately. Spine surgeons can see whether the screws or rods are compressing any structure and act without delay. This can spare the patient from complications and the potential for costly additional surgeries. With intra-operative CT, there are even workflow benefits: Thanks to the integration of the CT scanner with the neuronavigation system (for example, Brainlab), the coregistration procedure with CT images occurs automatically.
Patients who need spinal fusion surgery are not the only ones to benefit from intra-operative CT.
Neurosurgeons want to resect brain tumors and their margins as accurately as possible and prevent damage to the normal brain. But a neuronavigation system is only as reliable as the images that it draws on. During surgery, however many things can change. When resecting glioma tumors, the brain is known to shift. In meningioma patients, the surgical field changes as a result of the bone drilling that needs to be performed. Using intra-operative CT allows the dataset for the neuronavigation system to be updated whenever necessary. The result is that it becomes easier to preserve delicate structures – and at the same time, neurosurgeons can be more confident that they have removed the tumor and its margins as completely as possible.
Neurovascular surgeons can monitor the results of complex aneurysm-clipping surgeries with intra-operative CT: They find that CT angiography and CT perfusion scans can be helpful. CT angiography visualizes the site and shows whether or not the vessel patency has been preserved. With CT perfusion scans, neurovascular surgeons can view the distant perfusion in order to evaluate whether the clipping had a detrimental effect on other brain regions.
Compared to most mobile CT vendors, which primarily focus on visualizing bones (that is, the spine) in non-obese patients, the soft-tissue contrast offered on Siemens intra-operative CT systems is far superior, and enables the visualization of tumors and nerve structures in greater detail. Equally superb is their ability to perform CT angiograms, CT perfusion imaging, metal artifact reduction, Dual Energy capabilities, and iterative reconstruction methods to reduce dose. Siemens intra-operative CT is the modality of choice for those neuro and spine surgeons who need to see more than just bone in a wide variety of patients, from pediatric to obese.



CT image guidance in trauma surgery

In trauma surgery, every minute counts. A dual room with a SOMATOM Definition Edge sliding gantry CT with Adaptive 3D Intervention Suite and an Artis zeego angio system is the ultimate solution. Using a mobile operating table with a shuttle system, you can transfer the patient to the CT and then to the hybrid OR without having to reposition the patient.

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