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  • 1. www.siemens.com/somatom-definition-edgeThe Reference in Single Source CTSOMATOM Definition Edge Answers for life.
  • 2. SOMATOM Definition Edge
  • 3. Siemens CT Vision Today’s reality Our approach • to maximize workflow efficiency Better healthcare for all patients is a key In order to meet our share of responsibility • to make state-of-the-art CT affordable priority for the entire medical industry. in addressing these challenges, Siemens, • to set the standard in customer care But the realities of clinical practice often from the earliest stages of research, product make this simple-to-understand goal quite development, and design, relies upon the Our vision difficult to realize: staying within budgets, advice and recommendations of external As a partner to our customers, we create reducing hospital stays, speeding up time to medical experts to determine our focus –  CT innovations that lift clinical practice to diagnosis, and dealing with personnel issues, and this focus has been on the needs and the next level of excellence and enable wide while maintaining high clinical standards demands of our end users. Over the years, access to better patient care. We believe and throughput. At the same time, patients this focus has been fine-tuned in four that even the farthest technical horizons demand better and faster results. key areas: are temporary and can be surpassed • to lead technological and medical with consistent dedication to improved advancement healthcare. This visionary approach, backed2
  • 4. up by the, by far, largest R&D budgets in the standard for Single Source CT: the patient radiation. With the SOMATOMhealthcare industry, has made Siemens the SOMATOM Definition Edge with the revo- Definition Edge, Siemens again pushes theundisputed innovation leader in CT over lutionary Stellar Detector with TrueSignal boundaries of patient care.the last 35 years. And our ambitious global Technology. Developed with the clear goalteam continues to set the trend in an of providing the latest in CT technology,always changing environment, providing the SOMATOM Definition Edge integratesAnswers for Life. the unique innovations of the SOMATOM Definition Flash into a groundbreakingOur solution Single Source CT system. Finally, SingleIn 2008, Siemens introduced the gold Source CT imaging can unleash itsstandard in CT technology, still unrivaled full potential: offering uncompromisedtoday: the SOMATOM® Definition Flash. diagnostic outcome with highest imageAnd now, again, Siemens sets the quality, acquired at impressively low 3
  • 5. SOMATOM Definition Edge The Reference in Single Source CT4
  • 6. See the Unseen 09Unprecedented spatial resolution 12Uncompromised temporal resolution 14Clinical field: Cardiovascular 16Unparalleled acquisition speed 18Clinical field: Acute care 20Get More from Less 23Dose reduction in low-signal imaging 26Dose reduction with SAFIRE 28Dose reduction with CARE kV 30Combined Applications to Reduce Exposure (CARE) 32Specify the Unspecific 35Calculi characterization in clinical routine 38Gout identification in clinical routine 40Reducing metal artifacts in clinical routine 42Improved dynamic imaging in clinical routine 44Benefits and Technical Specifications 46International Version. Not for distribution in the US. Scan to see the unseen of Edge Technology features.www.siemens.com/somatom-definition-edge 5
  • 7. SOMATOM Definition Edge The Reference in Single Source CT See the unseen Get more from less Specify the unspecific For decades, Siemens has been the undisputed innovation leader in high-end CT imaging. But the clinical need for higher image quality persists. Therefore, we proudly introduce the SOMATOM Definition Edge with the revolutionary Stellar Detector, the first fully-integrated detector. Designed to minimize electronic noise, it takes CT imaging where it has never gone before.6
  • 8. The uniqueness of the Stellar Detector allows the SOMATOM Definition Edgeto generate ultra-thin slices, thus delivering the highest spatial resolution in CT.You can visualize even the finest image details, for example, for the mostaccurate stenosis and stent analysis. It lets you see what was previously unseen.The minimized noise level of the Stellar Detector together with SAFIRE – ourraw-data-based iterative reconstruction – is perfect for ultra low-dose imaging,eliminating the contradiction of outstanding image quality with minimal dose.You get more diagnostic quality with less patient radiation.Additionally, Dual Energy (DE) is a reality for Single Source CT imaging.With the novel capabilities of the Stellar Detector and the only dose-optimizedSingle Source DE scan mode, the SOMATOM Definition Edge enables you toadd tissue characteristics to the morphology. You can now specify formerlyunspecific information for higher diagnostic outcome.With these unrivaled features, the SOMATOM Definition Edge enters newfrontiers in medical imaging, becoming: The Reference in Single Source CT. 7
  • 9. EdgeTechnology
  • 10. See the Unseen
  • 11. See the Unseen Introducing the latest generation of CT detector technology: Siemens’ unique Stellar Detector, together with innovative Edge Technology, delivers slices thinner than the detector spacing. focal spot The Stellar Detector Edge Technology A general principle in CT is that thinner slices The Stellar Detector introduces the Minimized cross-talk from the deliver more image detail, but also less light next generation in detector technology, Stellar Detector creates an quants per voxel, i.e., higher image noise. succeeding gas and solid-state technology. almost perfect model of the This lowers the signal-to-noise ratio (SNR) Using nanotechnology, it is possible to focal spot. The result is a slice thickness of 0.5 mm. and leads to slice blurring. Conventional CT miniaturize the electronic components compensates by increasing dose. Clinical on the detector elements, enabling their Conventional Technology experience following the ALARA (As Low As integration directly at the photodiode. Cross-talk resulting Reasonably Achievable) principle has shown So, for the first time, the electronics of from slice blurring in that a 0.6 mm collimator width is the opti- the detector elements are fully integrated conventional detector. detector mum combination of slice thickness and in the photodiode. This full electronic projection dose. So further reduction of slice thickness integration is Siemens revolutionary was limited. Until now. TrueSignal Technology.10
  • 12. Edge TechnologyElectronic noise and cross-talk are mini-mized thanks to full electronic integration.Without cross-talk, intrinsic slice blurringbetween neighboring detector rows canbe avoided and individual slice profilesare much more precise. Siemens’ Edge Scan to learnTechnology creates an almost perfect model more aboutof the focal spot and detector, generating the newa slice thickness of 0.5 mm. Thanks to Stellar Detector.minimized electronic noise, the 0.5 mmslice has a sufficient signal contributionto be used in clinical routine. www.siemens.com/edge-stellar 11
  • 13. 0.30 mm Unprecedented spatial resolution Innovation delivers outstanding results Increased image detail Higher signal-to-noise ratio High spatial resolution in combination In addition to the Stellar Detector, the But how can the reduced light quants of with a high signal-to-noise ratio (SNR) is a SOMATOM Definition Edge is equipped with a 0.5 mm slice be compensated for? The reliable indicator for excellent image quality. Siemens’ renowned STRATON® tube with secret is the TrueSignal Technology of the Together they describe the image detail level z-Sharp™ Technology. This combination is Stellar Detector. Instead of increasing dose, and sharpness that can be made visible while the essence of increasing spatial resolution. it makes more efficient use of the initially acquiring diagnostic CT images. In addition, Using a flying focal spot with two distinct available quants per voxel: As the electronic a homogenic slice profile with the same spa- X-ray beams, z-Sharp acquires two individ- noise of the detector is virtually eliminated, tial resolution and SNR everywhere in the ual, overlapping slices. With Edge Technol- the overall noise is reduced so that the quants entire Field of View (FOV) is essential for con- ogy, the Stellar Detector now delivers slices contribute to a higher SNR. Consequently, sistent high image quality. Other approaches with a thickness of 0.5 mm, resulting in a thin slices of 0.5 mm can be used in in the market had to make compromises, for spatial resolution of up to 0.30 mm, which clinical practice. example by reducing the FOV size. is equivalent to approximately 19 lp/cm.12
  • 14. More consistent image qualityBy acquiring two distinct slices, z-Sharpcollects twice the amount of projections.This avoids miscalculation of data points,as they are measured and not interpolated,providing a higher data quality. And as theslices are acquired in parallel, the data pointsare equidistant, resulting in a more consis-tent slice thickness compared to conjugateapproaches. Adding the reduced slice blurringof the Stellar Detector, the slice profile over-all becomes more homogeneous with con-sistent spatial resolution over the entire FoV. 13
  • 15. 142 msec Uncompromised temporal resolution Uncompromised rotation speed Uncompromised performance The core technology to achieve high noise. Until now, this typically had to be The unique combination of Stellar Detector, rotation speed is the renowned STRATON compensated for by increasing the applied STRATON tube and new gantry is the key tube. Based on direct anode cooling, it current which consequently required a benefit of the SOMATOM Definition Edge. eliminates the need for heat storage and higher generator power. But the Stellar With a rotation speed of 0.28 sec, it delivers has an unmatched compact design. Detector with TrueSignal Technology a temporal resolution of 142.5 msec. At the Together with new gantry architecture, reduces electronic noise in the detector. same time, it utilizes the unique spatial this enables an additional increase in the This optimizes the initial SNR and thus resolution of up to 0.30 mm provided by rotation speed of the SOMATOM Definition avoids the need to further increase the Stellar Detector. And its gantry concept Edge. Increased rotation speed means generator power. now makes it possible to use it within the shorter rotation times. That means that the entire FoV of up to 500 mm. Only with this available signal per rotation is also reduced, uncompromised performance can you which results in lower SNR or higher image achieve outstanding clinical results.14
  • 16. Uncompromised image detailHigh temporal resolution is essential formotion-artifact-free imaging, e.g., in cardiacexaminations to perform accurate stenosismeasurements. But this benefit is contra-dicted when compromises like reducedimage detail or limited FoV have to be madein order to utilize high rotation speeds.Therefore, the SOMATOM Definition Edgewas specifically designed to go beyondthese limitations. Its revolutionary StellarDetector provides unprecedented imagedetail independent of rotation speed. 15
  • 17. Clinical field: Cardiovascular High spatial resolution High temporal resolution In-stent restenosis Cardiac imaging combines two In cardiology, high spatial resolution only Spatial resolution is of no benefit without A common clinical question typically posed crucial requirements in CT makes sense when it can be provided in high temporal resolution. Limited spatial in stent follow-up examinations is whether imaging: high spatial resolution concert with high temporal resolution. resolution can lead to motion artifacts from the vessel has re-occluded after the stentat high temporal resolution. One With only limited spatial resolution, the the respective vessel. This increases the has been set. As stents are very small example that demonstrates the benefits of the new SOMATOM visualization of small occlusions might be danger of false positive findings, meaning objects within constantly moving vessels, Definition Edge regarding impaired, resulting in blurring artifacts. a stenosis is diagnosed, although the this procedure requires precise image details artifact-free high resolution is These may affect the diagnosis, as it can finding is a result of the misinterpreted without motion artifacts. With the unique stent imaging in cardiology. conceal the actual stenosis. With higher fuzzy visualization of the vessel. Therefore, combination of highest spatial resolution at spatial resolution, blurring artifacts are high spatial resolution must be delivered uncompromised temporal resolution, the reduced, allowing better assessment of together with high temporal resolution; SOMATOM Definition Edge offers the most the lumen. not one or the other. advanced solution for this clinical challenge.16
  • 18. collimation:128 x 0.5 mmspatial resolution:0.30 mmtemp resolution:142 msecscan time:5 secscan length:119 mmrotation time:0.28 secCTDIvol:38 mGyDLP:656 mGy cmeff. dose:9.2 mSvHigh resolution imaging ofstents at uncompromisedtemporal resolutions allowsfor sound exclusion ofin-stent stenosis. 17
  • 19. 230   mm / sec Unparalleled acquisition speed Uncompromised spatial resolution In conventional CT systems, high One of the most challenging demands In such cases the SOMATOM Definition resolution means scanning at in CT is providing high acquisition speed Edge is in a class of its own. The new level reduced pitch. With z-Sharp, without compromising spatial resolution; of image detail with a spatial resolution of high resolution is independent for example, in acute-care scenarios when up to 0.30 mm provided by the Stellar of pitch, making high resolution available for high-pitch acute unconscious or uncooperative patients Detector allows visualizations of even the care examinations. have to be scanned quickly. Here the finest fractures or lesions. Additionally, ‘golden hour’ to diagnosis mandates the newly designed gantry, together with precise localization and identification of Siemens’ most advanced patient table, critical injuries. The goal is to prevent now allows an acquisition speed of up to motion artifacts when patients have only 230 mm/sec. This takes motion out of a limited ability to hold their breath. the equation, increasing the diagnostic reliability in such crucial cases.18
  • 20. Conventional technology z-Sharp technology R2 R1 R2 R1 R2 R1 R1 R1 R1 pitch = 1.4 pitch = 1.0 pitch = 0.55 pitch = 1.4 pitch = 1.0 pitch = 0.55High-pitch high-resolution CTIncreasing spatial resolution beyond the The uniqueness of the SOMATOM Definitiondetector width requires overlapping slices. Edge is the combination of the StellarFor conventional CT systems, this means Detector, the STRATON tube with z-Sharp,reducing pitch to facilitate the slice overlap. the new gantry with 0.28 sec rotation speed,For scans requiring high pitch, the reduced and the patient table that supports a pitchor missing overlap then reduces spatial of 1.7. This allows a scan speed of up toresolution. But with z-Sharp, the overlap 230 mm/sec. Clinically, this means scanningresults from an acquisition with two distinct the whole heart in half a second, a 50 cmprojections coming from the STRATON tube. thorax in roughly two seconds or performingConsequently, the two slices overlap inde- a two-meter scan of the entire body inpendently of the pitch used and can always nearly eight-and-a-half seconds, all at aprovide highest resolution. spatial resolution of up to 0.30 mm. 19
  • 21. Clinical field: acute care The golden hour High-resolution high-speed imaging Acute care is one of the most Acute care demands the highest spatial In addition to the fact that every second whether very small fractures of the spine challenging applications in CT. resolution at the fastest possible acquisition counts in the golden hour, there is another have impacted the spinal cord. So it isThis clinical field shows how the speed, which is very challenging. The reason to use the fastest possible acquisition imperative to acquire the highest possible new SOMATOM Definition Edge reason is that the ‘golden hour’ is crucial: speed. Acute-care patients are often spatial resolution at the fastest possible is the answer when examiningan acute-care patient with severe Appropriate therapy which is instituted uncooperative, so it is essential that the acquisition speed. The SOMATOM Definition injuries of the upper spine. within this time frame is likely to have a CT scan is performed as fast as possible to Edge with the unique STRATON tube makes much more significant impact on improving reduce movement artifacts. But you want to spatial resolution independent of the patient outcome by decreasing morbidity be sure you are not reducing spatial resolu- selected pitch. And having the patient table and mortality. Consequently, the guiding tion. When looking at fractures, for example, from the SOMATOM Definition Flash at imaging for these decisions must deliver the it is essential to assess whether larger a pitch of 1.7 is possible. This allows an required answers quickly. Therefore, CT is fractures or broken bones have ruptured small acquisition speed of up to 230 mm/sec at the modality of choice. vessels and caused internal bleeding, or a spatial resolution of 0.30 mm.20
  • 22. collimation:128 x 0.5 mmspatial resolution:0.30 mmscan time:7.6 secscan length:230 mmrotation time:1.0 secCTDIvol:22.4 mGyDLP:590 mGy cmeff. dose:8.9 mSvSpine image of a 70-year-oldpatient with vertebraedegeneration visualizing eventhe finest bone structures. 21
  • 23. TrueSignalTechnology
  • 24. Get More from Less
  • 25. Get More from Less The unique Stellar Detector with TrueSignal Technology reflects the continuation of Siemens’ commitment to deliver best image quality at lowest signal or lowest dose. TrueSignal Technology The low signal capability There are various reasons to scan with TrueSignal Technology with the full of a detector can be described low signals. For example, bariatric patients integration of the Stellar Detector virtually best by a high SNR. The Stellar can cause strong attenuation. But low eliminates electronic noise in the detector Detector with TrueSignal signals can be fully intentional, mainly elements. The resulting SNR is increased so Techno­ogy minimizes electronic l noise – optimal for low signal driven by the desire to reduce dose. Many that even very low signals are sufficiently and dose imaging. recent innovations, especially iterative strong enough for the detector to cope with. reconstruction solutions, reflect this. Low-signal images benefit from increased They were explicitly developed to lower the sharpness and clarity, as the detector can applied dose. So it follows to introduce a now differentiate the signal of an individual detector that is specially optimized for voxel much better than the surrounding low-signal imaging: the Stellar Detector image data. with TrueSignal Technology.24
  • 26. SOMATOM noise Definition Edge [HU] 40 cm 40 cm fit Conventional CT 40 cm 300 40 cm fit -25% at 200 mA -20% at 300 mA 200 -12% at 400 mA 100 0 current [mA] Dose savings at the same noise level with 0 50 100 150 200 250 300 350 400 450 500 SOMATOM Definition EdgeComparable noise level at lower signalThe outcome can be best visualized when Due to minimized electronic noise, thelooking at noise measurements of large available signal is less impaired, so that thepatients. When comparing conventional CT same noise level can be achieved withtechnology with the SOMATOM Definition significantly lower signal levels. This meansEdge and the Stellar Detector with TrueSignal that when there is high attenuation fromTechnology, the resulting noise is more or very large patients, the detector can makeless the same for high signals. But when better use of the resulting low signal. Or,the signal is lowered – either by high the dose can be further reduced to achieveattenuations from obese or broad- a comparable image quality.shouldered patients, or by reducing theapplied mA – the impact of TrueSignalTechnology increases. 25
  • 27. Up to 25% Dose reduction in low-signal imaging Obesity – the new global disease Optimized bariatric imaging More and more patients suffer One example of how reducing electronic By minimizing electronic noise, the State-of-the-art CT systems have to react from obesity. Therefore, the noise with TrueSignal Technology benefits detector’s SNR increases, providing much to the new challenges presented by the capability to deliver sound low-signal efficiency is bariatric imaging. more flexibility in handling low signals. This increasing number of bariatric patients. This bariatric imaging is essential for Obesity is on the rise: In the US and some is essential for bariatric imaging, as often means having the appropriate ergonomics state-of-the-art CT imaging. European countries, more than 1/3 of the maximum power is applied, but the signal to handle these patients, as well as having population is considered obese. Therefore, reaching the detector is very low. Conven- the technology to achieve the image quality there is a growing need to scan large tional detectors have a comparatively high necessary for reaching sound diagnoses. patients. However, obese patients attenuate intrinsic noise level and impaired image The SOMATOM Definition Edge delivers the a significant portion of the signal, so quality. Due to the electronic integration of ideal solution with a 78 cm gantry bore, and regardless of scanner ergonomics, many the Stellar Detector, this noise level is a table load capacity of more than 300 kg, conventional CT systems are unsuitable, significantly lower, so the available signal all enhanced by the new Stellar Detector as the signal is too low. can be processed more efficiently. with TrueSignal Technology.26
  • 28. collimation:64 x 0.6 mmspatial resolution:0.33 mmscan time:1.5 secscan length:155 mmrotation time:0.5 secCTDIvol:21 mGyDLP:325 mGy cmeff. dose:4.55 mSvConventional detectortechnologies have difficultieshandling low signals, resulting,for example, in streak artifacts(left). With its higher SNR,the Stellar Detector is perfectlydesigned to cope with lowsignals (right). 27
  • 29. Up to 60% Dose reduction with SAFIRE Low dose is low-signal imaging Iterative reconstruction SAFIRE and the Stellar Detector* The following test method was used The significant reduction of mA when scan- After the initial reconstruction using Superior image quality in regard to to determine a 60% dose reduction ning with iterative reconstruction solutions weighted filtered back projection (WFBP), contrast and noise can be obtained with when using the SAFIRE reconstruction software: Noise, like SAFIRE (Sinogram Affirmed Iterative the CT images are retransferred to raw data. this methodology. And it can be used to CT numbers, homogeneity, Reconstruction) also results in lower signals By comparing this new synthetic raw data initially acquire the data at lower mA and low-contrast resolution and high- at the detector, so these examinations also with the acquired data, differences can be then compensate the image quality during contrast resolution were assessed in a Gammex 438 phantom. benefit from the advantages of TrueSignal identified by applying a dynamic raw-data the reconstruction. By using this approach, Low-dose data reconstructed with Technology. The computational power of based noise model. An updated image is SAFIRE enables a dose reduction of up to SAFIRE showed the same image systems like FAST IRS fascilitate iterative then reconstructed, with reduced image 60%.* This reduction in dose means a lower quality compared to full-dose data based on this test. Data on file. reconstruction in a wider range of clinical noise but without noticeable loss of sharp- signal at the detector. So now unique low- applications. The number of iterative ness. This is repeated several times – image signal capabilities of the Stellar Detector reconstruction scans is thereby increased, noise can be incrementally reduced and further optimize the image quality, resulting resulting in more benefits for patients. geometrical imperfections corrected. in even higher sharpness and clarity.28
  • 30. collimation:128 x 0.6 mmspatial resolution:0.33 mmscan time:11 secscan length:245 mmrotation time:0.5 secCTDIvol:8.5 mGyDLP:460 mGy cmeff. dose:6.9 mSvSignificantly improved imagequality at lower dose usingSAFIRE with the Stellar Detector(right) compared to a regularWFPB on a conventionaldetector (left). 29
  • 31. Up to 60% Dose reduction with CARE kV Real time dose modulation CNR optimized kV settings The main dose-relevant In 1994, Siemens introduced CARE Dose4DTM After the patient’s stature and the mAs, the kV, and sets all other parameters accordinglyparameters for a CT scan are the to actively modulate the applied power for selected voltage (kV) is the third dose- to get the defined CNR. Reducing the tube applied current and voltage, scans, according to patients’ anatomy. relevant value for a CT scan. Selecting the voltage helps optimizing dose and improves depending on the examination CARE Dose4D aims to regulate mA in real right kV settings is essential for achieving image quality, e.g., for contrast-media type and the patients habitus.Only when taking all parameters time so that image quality is uniform across optimal clinical outcome. CARE kV can auto- enhanced examinations. With the new, into consideration, does the whole scan range. But CT scanning is matically suggest kV and effective mA to improved STRATON tube, the voltage rangedose protection become compre- not only adapting mA values: The right kV optimize the contrast-to-noise ratio (CNR) of is lowered to 70 kV. This, together with the hensive and patient-centric. settings play an equal if not more important the image, while limiting the applied dose. unique CARE Child scan modes, helps further role in achieving optimum clinical outcome. CARE kV takes the patient’s habitus from the reduce the dose for pediatric or neonate Changing kV values also means adapting all topogram and the chosen examination type patients. With these features, an additional other values according to the respective (non-contrast, bone, soft tissue, vascular) dose reduction of up to 60% is possible. patient and examination type. into consideration, proposes the appropriate Additionally, the system identifies bariatric30
  • 32. kV usage [%] 100 90 Without CARE kV 80 70 60 With CARE kV 50 40 30 20 10 0 Tube voltage [kV] Lower dose in 67% of patients 70 80 100 120 140 with CARE kV Benefit for many patientspatients and sets the parameters accordingly An evaluation of CARE kV with more than 30% came with no compromise in imageto make full use of the system’s reserves to 12,000 patients in the first months after its quality; CNR could be maintained withoptimize CNR, and achieve the best image introduction showed that there was a clear no impact on workflow, as all systemquality possible for these patients. shift towards 100 kV and 80 kV scans (see parameters are automatically set. above). Dose could be saved in more than two thirds of these patients, compared to the initial protocols. And the dose reduction itself was significant. For example, regular abdomen scans could be reduced to below 10 mGy using 100 kV, down from 14.1 mGy with the former standard protocol set at 120 kV. This dose reduction of approximately 31
  • 33. Combined Applications to Reduce Exposure (CARE) Radiation exposure 9 Comprehensive dose protection Dose reduction lies at the [mSv] Dose reduction in cardiac CT Following the ALARA principle, Siemens heart of the CARE philosophy. 8 introduced its CARE philosophy in the Each application is designed to 7 mid-1990s. The idea is to utilize everycontribute dose reduction during 6 means available to reduce patient exposure. every step of the examination process resulting in an absolute Siemens is the only vendor to offer a 5 minimum exposure. dose protection portfolio that comprehen- 4 sively takes all relevant scan parameters 3 into consideration and optimizes the scan accordingly, from patient size to 2 examination type, from mA to kV, and 1 from scan preparation to data evaluation. 0 Adaptive CARE kV CARE MinDose Adaptive SAFIRE ECG Pulsing Dose4D Dose Shield32
  • 34. collimation:128 x 0.5 mmspatial resolution:0.30 mmtemp resolution:142 msecscan time:5 secscan length:119 mmrotation time:0.28 secCTDIvol:7 mGyDLP:95 mGy cmeff. dose:1.33 mSvCardiac examinations areamongst the most sensitivewhen it comes to dose,so combining all availableapplications to reduceexposure is key. 33
  • 35. HiDynamics
  • 36. Specify the Unspecific
  • 37. Specify the Unspecific The TrueSignal Technology of the Stellar Detector brings yet another innovation: HiDynamics. Its unique, full dynamic range provides higher image sensitivity, especially for low-signal and low-energy scans. HiDynamics A larger dynamic range expands Thanks to the full electronic integration of the detector’s sensitivity. As in a the TrueSignal Technology, the Stellar backlit photo with a conven- Detector can now utilize its full dynamic tional camera, the front regions range instead of having to switch bandwidthturn black. But with higher sensi- tivity, details remain visible. 1st scan 140 kV like conventional detectors. This unique feature is called HiDynamics. It increases the detector’s sensitivity at the respective energy level and allows for differentiation of 2nd scan 80 kV even the slightest signal changes, especially when scanning with very low kV levels.36
  • 38. Comparison of the 80 kV Dual Energy data set (left) with the 140 kV Dual Energy data set (right) shows: almost identical image detail level in 80 kV due to the improvement resulting from HiDynamics.The benefits of the Stellar Detector Dose-optimized Single Source DEThe benefits of TrueSignal Technology and When multiple scans of the same region The scan mode consists of two successiveHiDynamics are also clear in functional have to be performed, dose protection spiral scans at different energy levels. Inimaging applications, such as Dual Energy, becomes even more important in order to order to avoid doubling the dose, both spi-as well as in dynamic examinations. They adhere to the ALARA principle. Therefore, rals are performed at half the dose, so thatacquire multiple scans of the same region it is imperative to exploit every possibility there is no dose penalty for the resultingto add functional information, such as to reduce dose. Following this philosophy, Dual Energy image. But, as it uses regulartissue characteristics or perfusion data to Siemens has introduced a Single Source spirals, all dose reduction features can bethe morphology. In both cases, the scan Dual Energy scan mode that utilizes all utilized without limitations. The capabilitiesmodes acquire data at low kV. HiDynamics dose-reduction functionalities without of the Stellar Detector regarding lowsignificantly increases the detail level and limitations: e.g., CARE Dose4D for real-time dose / signal imaging represents thesharpness of the images for these data sets. mA modulation, or SAFIRE to reduce the industry’s only Single Source Dual Energy mA created by iterative reconstruction. scan mode optimized for low dose. 37
  • 39. Calculi characterization in clinical routine Urinary stone disease Kidney stones are a good Approximately 13% of men and 7% of require intervention later. Current evidence does not require intravenous contrast and example of how tissue women in the United States will be from the study “Urological Diseases in covers the entire abdomen and pelvis. With characterization can lead diagnosed with urinary stone disease in America” suggests an increasing prevalence this imaging modality, nearly all stone types to finding the appropriate their lives. Most stones are symptomatic of urinary stone disease in the United can be visualized. The essential benefit in therapy. Dual Energy informa- tion adds tissue information and cause pain, obstruction, and infection. States. In addition, the likelihood of recur- the diagnosis with Dual Energy CT is that to the morphology. They frequently require visits to the emer- rence is estimated to be up to 50 % during the stone type can be identified. With this gency room, hospitalization, mechanical a five-year period. Thus, the diagnosis of information at hand, the appropriate extraction or even surgical removal. Some kidney stones has substantial impact with treatment can be applied. For patients, this stones may be asymptomatic and are respect to patient morbidity and healthcare means that many interventional treatments only detected incidentally. However, even budgets. The imaging modality of choice for can be avoided, as it can be determined when stones are initially asymptomatic, urinary stone disease is a low-dose, non- upfront if a stone can be treated with symptoms may develop very quickly and contrast CT scan. It is very easy to perform, drugs or not.38
  • 40. collimation:128 x 0.6 mmspatial resolution:0.33 mmscan time:1.3 secscan length:117 mmrotation time:0.5 secCTDIvol:5.28 + 3.02 mGy(140 / 80 kV)DLP:80 + 40 mGy cm(140 / 80 kV)eff. dose:1.8 mSvCharacterization with syngoSingle Source DE Kidney Stonessupports treatment decisions. 39
  • 41. Gout identification in clinical routine Gout Gout is the most widespread Gout is the most widespread form of recurrent episodes. The classic symptoms duced by the disease is directly verified,form of crystal arthropathy and a crystal arthropathy and the most common of gout are painful, visibly swollen confirming the definite diagnosis of gout. common inflammatory joint inflammatory joint disease in men. It is peripheral joints. However, gout is difficult The benefit for patients is not only thatdisease. However, gout is difficult caused by the deposition of uric acid to diagnose, as there are various forms of the painful puncture in a conventional to diagnose. Dual Energy can detect gout in regions that are crystals in joints. Up to 1 in 200 people in arthritis that have similar symptoms. With examination can be avoided, but also often overlooked. the western world, 2.1 million people in the Dual Energy CT and syngo® Dual Energy that the risk of false negative outcomes US, and some 1.5 million people in Germany Gout, a non-invasive assessment of gout is is reduced in cases where the puncture are currently afflicted by this painful, feasible. The algorithm color codes different misses the respective tissue. destructive disease. Furthermore, due to our attenuation values at different energy levels eating habits, these figures are constantly so that the uric acid crystals are color coded increasing. Gout can affect numerous joints in red, while calcium and bone formations throughout the body, especially during are displayed in blue. Thus, uric acid pro-40
  • 42. collimation:128 x 0.6 mmspatial resolution:0.33 mmscan time:4 secscan length:181 mmrotation time:0.5 secCTDIvol:3.32 + 4.46 mGy(140 / 80 kV)DLP:71 + 95 mGy cm(140 / 80 kV)eff. dose:0.13 mSvClear identification with syngoSingle Source DE Gout avoidsfalse negative diagnosis ofconventional procedures. 41
  • 43. Reducing metal artifacts in clinical routine Metal artifact reduction with Dual Energy Metal artifacts pose severe A big challenge in CT imaging is the impact artifact free as possible. For example, when And syngo Dual Energy Monoenergetic difficulties in CT imaging of metal objects on image quality. Due to assessing organs in the pelvic region, images Imaging enables the minimization of metal due to the resulting artifacts. the high attenuation of metal compared to are often impaired if the patient has a hip artifacts by specifically selecting the respec- Single Source Dual Energy the surrounding tissue, images can suffer prosthesis. The high attenuation of this mas- tive kV level at which the metal objects have now delivers a solution. from streaks or even shadows around sive metal object causes adjoining regions least impact on image quality. With this the metal objects. The cause for this is to suffer from very low signals. Until now, unique combination, implants, clamps or so-called ‘beam starvation.’ Typical metal these artifacts could not be compensated screws can be ideally dealt with in order to artifacts result from implants, e.g., in teeth, for. But now, two solutions come together: obtain the highest diagnostic outcome. or when clamps and screws are used in The unique Stellar Detector in the invasive treatments. But when it comes to SOMATOM Definition Edge is specifically treatment decisions or treatment follow-up, optimized to handle low signals with its it is essential that the image is as TrueSignal Technology and HiDynamics.42
  • 44. collimation:128 x 0.6 mmspatial resolution:0.33 mmscan time:5 secscan length:228 mmrotation time:0.5 secCTDIvol:12.31 + 4.46 mGy(140 / 80 kV)DLP:380 + 129 mGy cm(140 / 80 kV)eff. dose:7.64 mSvSignificant reduction of metalartifacts from hip implant withsyngo Single Source DE Monoen-ergetic delivers much higherdiagnostic image quality 43
  • 45. Improved dynamic imaging in clinical routine Adaptive 4D Spiral and HiDynamics Perfusion information is Stroke is one of the three most frequent With the Adaptive 4D Spiral, Siemens has Spiral are specifically set to this length crucial in many clinical fields causes of death worldwide. The diagnosis introduced a scan mode that performs per- for stroke evaluations. In addition, the such as stroke or tumor and treatment of stroke cases is a clinical fusion evaluations beyond the limitations of SOMATOM Definition Edge, with the Stellar assessments. The Adaptive 4D field in which time is of the essence – or a static detector. By applying a continuously Detector and HiDynamics, is the perfect Spiral is key to making theseexams ready for clinical practice. where ‘time is brain,’ meaning that the right repeated bi-directional, smooth table choice for better differentiation of the decisions have to be made ideally within the movement over the desired scan range, perfusion level, as brain perfusion studies first hours after the first symptoms have a perfusion assessment covering a region are typically performed at 80 kV. Regardless occurred. Consequently, it is essential that of up to 15 cm can be performed. Recent of cause – from infarctions due to stroke the diagnostic information is delivered publications have shown that a scan range and extensive bleeding, to subarachnoid quickly, reliably, and accurately, and gives of approximately 10 cm is ideal to assess hemorrhage or a ruptured aneurysm –  a comprehensive overview about the status brain perfusion. Consequently, the neuro seeing clearly makes a crucial difference of the disease. perfusion scan modes with the Adaptive 4D in determining treatment.44
  • 46. collimation:128 x 0.6 mmscan time:45 secscan length:100 mmrotation time:0.285 secCTDIvol:260 mGyDLP:3069 mGy cmeff. dose:6.4 mSvComprehensive perfusionevaluation with syngo VPCTNeuro delivers crucialinformation regarding tissueat risk after a stroke. 45
  • 47. SOMATOM Definition Edge The Reference in Single Source CT See the unseen Edge Technology – The reference in image quality • Unprecedented spatial resolution • Uncompromised temporal resolution •  nparalleled acquisition speed U Get more from less TrueSignal Technology – The reference in dose efficiency • Optimized low-signal imaging •  ptimized low-dose imaging O •  ptimized patient-centric imaging O Specify the unspecific HiDynamics – The reference in functional imaging • Routine ready Single Source Dual Energy • Routine ready metal artifact reduction • Routine ready dynamic imaging46
  • 48. Technical Specifications• Stellar Detector with TrueSignal Technology• 256 x 0.5 mm slices and 0.30 mm spatial resolution with Edge Technology• Dose-optimized Single Source Dual Energy and HiDynamics• 128-slice acquisition with STRATON tube and z-Sharp Technology• Up to 384-slice reconstruction• 0.28 sec rotation time with 142.5 sec temporal resolution• 1.7 maximum pitch with 230 mm/sec acquisition speed• Patient table: 227 kg capacity (300 kg optional), 200 cm scan range• With up to 60 fps FBP and 20 fps SAFIRE reconstruction speed• 4D scan range: 15 cm for perfusion, 48 cm for CTA imaging with Adaptive 4D Spiral• Reduced energy consumption by up to 20% in system stand-by with the Stellar Detector 47
  • 49. In the event that upgrades require FDA approval, SOMATOM Definition Edge is under development,Siemens cannot predict whether or when the FDA will and is not commercially available in the US.issue its approval. Therefore, if regulatory clearance The information about SAFIRE (Sinogram Affirmedis obtained and is applicable to this package, it will be Iterative Reconstruction) is being provided for planningmade available according to the terms of this offer. purposes. The product is pending 510(k) review, and isOn account of certain regional limitations of sales not yet commercially available in the US. In clinicalrights and service availability, we cannot guarantee practice, the use of SAFIRE may reduce CT patient dosethat all products included in this brochure are available depending on the clinical task, patient size, anatomicalthrough the Siemens sales organization worldwide. location, and clinical practice. A consultation with aAvailability and packaging may vary by country and is radiologist and a physicist should be made to deter-subject to change without prior notice. Some/all of the mine the appropriate dose to obtain diagnostic imagefeatures and products described herein may not be quality for the particular clinical task.available in the United States.The information in this document contains generaltechnical descriptions of specifications and options aswell as standard and optional features which do not Courtesy list Global Business Unitalways have to be present in individual cases. Department of Radiology, University of Erlangen, Germany Siemens AG Mayo Clinic, Rochester (Minnesota), USA Medical SolutionsSiemens reserves the right to modify the design, Nan Xi Shan Hospit al / Guilin, P.R. China Computed Tomographypackaging, specifications, and options described herein Beihua University 1st Hospital / Jilin, P.R. China & Radiation Oncologywithout prior notice. Please contact your local Siemens Siemensstr. 1sales representative for the most current information. DE-91301 ForchheimNote: Any technical data contained in this document Germanymay vary within defined tolerances. Original images Order No. A91CT-04015-51C1-7600 | Printed in Germany Phone: +49 9191 18 0always lose a certain amount of detail when reproduced. CC CT WS 11111.5 | © 11.2011, Siemens AG Fax: +49 9191 18 9998Global Siemens Headquarters Global Siemens Healthcare ­ eadquarters H Legal ManufacturerSiemens AG Siemens AG Siemens AGWittelsbacherplatz 2 Healthcare Sector Wittelsbacherplatz 280333 Muenchen Henkestrasse 127 DE-80333 MuenchenGermany 91052 Erlangen Germany Germany Phone: +49 9131 84 0 www.siemens.com/healthcare