This document summarizes a study comparing coronary CT angiography performed with the first generation Aquilion ONE 320-detector row CT scanner and the second generation Aquilion ONE ViSION Edition scanner. The study found:
1) Use of the Aquilion ONE ViSION Edition allowed more patients (78% vs 62%) to be imaged in a single heartbeat compared to the original Aquilion ONE, due to its faster 275ms gantry rotation speed.
2) Radiation dose was significantly lower with the Aquilion ONE ViSION Edition, with a mean dose of 2.07mSv compared to 2.71mSv with the original scanner.
3) The faster rotation speed and other advances
Early Detection of Left Ventricular Dysfunction in Type II Diabetic Patients ...Premier Publishers
To assess Left ventricular (LV) systolic dysfunction using 2D speckle tracking echocardiography (STE) in asymptomatic type II Diabetic patients. We acquired three LV short-axis, and three LV apical views in 100 asymptomatic diabetic patients with normal LV ejection fraction (EF) and 25 age-matched healthy volunteers. We measured end-systolic longitudinal strain (LS), radial strain (RS), and circumferential strain (CS) in 18 LV segments. There were no significant differences in LVEF between two groups. Diabetic patients had more advanced diastolic dysfunction and increased LV mass compared with controlled group. Basal, middle, and apical LSs were significantly lower in diabetic patients compared with control subjects, with 43% (43/100) of the diabetic patients showing abnormal global LS values (cut-off value: 217.2 mean 2SD in control subjects Conclusion: Detecting subclinical LV systolic dysfunction by using 2D speckle tracking echocardiography (STE) might provide useful information of the risk stratification in an asymptomatic diabetic population.
Early Detection of Left Ventricular Dysfunction in Type II Diabetic Patients ...Premier Publishers
To assess Left ventricular (LV) systolic dysfunction using 2D speckle tracking echocardiography (STE) in asymptomatic type II Diabetic patients. We acquired three LV short-axis, and three LV apical views in 100 asymptomatic diabetic patients with normal LV ejection fraction (EF) and 25 age-matched healthy volunteers. We measured end-systolic longitudinal strain (LS), radial strain (RS), and circumferential strain (CS) in 18 LV segments. There were no significant differences in LVEF between two groups. Diabetic patients had more advanced diastolic dysfunction and increased LV mass compared with controlled group. Basal, middle, and apical LSs were significantly lower in diabetic patients compared with control subjects, with 43% (43/100) of the diabetic patients showing abnormal global LS values (cut-off value: 217.2 mean 2SD in control subjects Conclusion: Detecting subclinical LV systolic dysfunction by using 2D speckle tracking echocardiography (STE) might provide useful information of the risk stratification in an asymptomatic diabetic population.
CT coronary angiography in ED chest pain patientskellyam18
CT coronary angiography is the new kid on the block for assessing emergency department patients with chest pain. How accurate is it? What are the down sides? How useful is it? Which patients is it suitable for? This presentation attempts to answer these questions in light of current evidence.
Doppler Ultrasound of the Renal Arteries in Hypertensive Patients in Senegal:...Premier Publishers
Twenty-one patients were included in the study. The mean age was 40.3 years old (26 - 64 yo). There were 14 women and 7 men corresponding to man-to-woman sex ratio of 1:2. In the right renal artery (RRA), the mean peak systolic velocity (cm/s) was 67.85, 66.46 and 42.08 respectively at the ostium, trunk and hilum. In the left renal artery (LRA), the mean PSV were 80.10, 50.90 and 40.13 respectively at the ostium, trunk and hilum. Regarding the resistance index, the mean values in the RRA were 0.67 at the ostium, 0.66 at the trunk and 0.61 at the hilum. The same parameters in the LRA were respectively 0.66, 0.64 and 0.57. The mean acceleration time (ms) in the RRA was 56.76 at the trunk and 65.85 at the hilum. The measurements of the same parameters in the LRA were respectively 56.39 and 50.18. The DU was normal in 17 patients (80.9%); it was not affirmative in 3 patients (14.3%) and SRA was diagnosed in 1 patient (4.8%). Overall, the DU of the RA was efficient in 18 patients; this corresponds to a sensitivity of 85.7%.
CT coronary angiography in ED chest pain patientskellyam18
CT coronary angiography is the new kid on the block for assessing emergency department patients with chest pain. How accurate is it? What are the down sides? How useful is it? Which patients is it suitable for? This presentation attempts to answer these questions in light of current evidence.
Doppler Ultrasound of the Renal Arteries in Hypertensive Patients in Senegal:...Premier Publishers
Twenty-one patients were included in the study. The mean age was 40.3 years old (26 - 64 yo). There were 14 women and 7 men corresponding to man-to-woman sex ratio of 1:2. In the right renal artery (RRA), the mean peak systolic velocity (cm/s) was 67.85, 66.46 and 42.08 respectively at the ostium, trunk and hilum. In the left renal artery (LRA), the mean PSV were 80.10, 50.90 and 40.13 respectively at the ostium, trunk and hilum. Regarding the resistance index, the mean values in the RRA were 0.67 at the ostium, 0.66 at the trunk and 0.61 at the hilum. The same parameters in the LRA were respectively 0.66, 0.64 and 0.57. The mean acceleration time (ms) in the RRA was 56.76 at the trunk and 65.85 at the hilum. The measurements of the same parameters in the LRA were respectively 56.39 and 50.18. The DU was normal in 17 patients (80.9%); it was not affirmative in 3 patients (14.3%) and SRA was diagnosed in 1 patient (4.8%). Overall, the DU of the RA was efficient in 18 patients; this corresponds to a sensitivity of 85.7%.
A Speckle Tracking Echocardiographic Study for Correlation Between Global Lef...Premier Publishers
Global longitudinal strain (GLS) measured by Two-dimensional speckle tracking imaging (2D-STI) has been shown to be useful for assessing subtle changes in the left ventricular function with increasing severity of aortic stenosis (AS) in patients with preserved left ventricular ejection fraction (LVEF). To evaluate the relation between the severity of valve stenosis and GLS measured by 2D-STI in AS patients with normal LVEF. We studied 65 subjects (age, 53_75 years) with normal LVEF (≥50%) but without overt coronary artery disease. Patients were stratified into four groups (control, mild, moderate and severe AS), the clinical characteristics and echocardiographic findings were compared among the groups. Using dedicated software, we measured GLS in the apical four, two and three -chamber views. LVEF was not significantly different among the four groups. However, GLS showed significant differences among the four groups (controls;18.9±1.4, mild: 18.8±1.3, moderate: 15.35±1.6and severe: 12.42±1.4, ANOVA P = 0.001), GLS was significantly correlated with AVA, mean PG and LV mass index. Despite unchanged LVEF, GLS gradually decreased as severity of AS increases. GLS measured by 2D-STI is useful to assess subtle changes in LV function in AS patients.
Lower Mortality with Transradial PCI Compared to Transfemoral PCI in 21 000 Patients with Acute Myocardial Infarction - Results from the SCAAR Database
VISIONS magazine is a publication of Canon Medical Europe and is offered free of charge to health professionals.
The magazine is published twice a year. Registration to access full, previously published, digital editions can be done via the website: https://eu.medical.canon/visions-magazine
VISIONS magazine is covering Canon Medical’s European region and as such reflects products, technologies and
services for this particular area. The mentioned products may not be available in other geographic regions.
Please consult your Canon Medical representative sales office in case of any questions.
VISIONS magazine is Canon Medical’s customer magazine about innovative technologies and applications in medical imaging. Read all about diagnostic imaging in the fields of CT, MRI, X-Ray, Ultrasound, HII, Eye Care and stay up-to-date with the latest developments in your clinical environment.
This Veterinary Special edition of VISIONS magazine is a publication of Canon Medical Europe and is offered
free of charge to health professionals. To download the digital edition of this Veterinary Special, please visit:
https://eu.medical.canon/visions.
VISIONS magazine is covering Canon Medical’s European region and as such reflects products, technologies
and services for this particular area. The mentioned products may not be available in other geographic regions.
Please consult your Canon Medical representative sales office in case of any questions.
No part of this publication may be reproduced in whole or in part, stored in an automated storage and retrieval
system or transmitted in any manner whatsoever without written permission of the publisher. The opinions
expressed in this publication are solely those of the authors and not necessarily those of Canon Medical.
Canon Medical does not guarantee the accuracy or reliability of the information provided herein.
News, articles and the full edition of VISIONS magazine are announced firstly, as pre-publication, via the
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actively participate in discussions about the content and future direction of the magazine.
Canon Medical Systems VISIONS Magazine - issue 35
VISIONS magazine is a publication of Canon Medical Europe and is offered free of charge to medical and health professionals. The magazine is published twice a year.
Registration to access full, previously published, digital editions can be done via the web site: https://nl.medical.canon/visions-magazine.
VISIONS magazine is covering Canon Medical’s European region and as such reflects products, technologies and services for this particular area. The mentioned products may not be available in other geographic regions. Please consult your Canon Medical representative sales office in case of any questions.
No part of this publication may be reproduced in whole or in part, stored in an automated storage and retrieval system or transmitted in any manner whatsoever without written permission of the publisher. The opinions expressed in this publication are solely those of the authors and not necessarily those of Canon Medical. Canon Medical does not guarantee the accuracy or reliability of the information provided herein.
News items and articles are announced firstly, as pre-publication, via the dedicated VISIONS LinkedIn Group: https://www.linkedin.com/groups/3698045. In this group you can actively participate in discussions about the content and future direction of the magazine.
This MR Special edition of VISIONS magazine is a publication of Canon Medical Europe and is offered
free of charge to health professionals. To download the digital edition of this MR Special, please visit:
https://eu.medical.canon/visions.
VISIONS magazine is covering Canon Medical’s European region and as such reflects products, technologies
and services for this particular area. The mentioned products may not be available in other geographic regions.
Please consult your Canon Medical representative sales office in case of any questions.
VISIONS magazine is a publication of Canon Medical Europe and is offered free of charge to health professionals.
The magazine is published twice a year. Registration to access full, previously published, digital editions can
be done via the web site: https://nl.medical.canon/visions-magazine. Canon Medical stores and uses personal
data of the registration to send out the magazine and inform members about new developments. Members can
customize preferences or opt-out, after registration, in the online VISIONS profile.
Canon Medical Systems VISIONS Magazine - issue 31
VISIONS magazine is a publication of Canon Medical Europe and is offered free of charge to medical and health professionals. The magazine is published twice a year.
Registration to access full, previously published, digital editions can be done via the web site: https://nl.medical.canon/visions-magazine.
VISIONS magazine is covering Canon Medical’s European region and as such reflects products, technologies and services for this particular area. The mentioned products may not be available in other geographic regions. Please consult your Canon Medical representative sales office in case of any questions.
No part of this publication may be reproduced in whole or in part, stored in an automated storage and retrieval system or transmitted in any manner whatsoever without written permission of the publisher. The opinions expressed in this publication are solely those of the authors and not necessarily those of Canon Medical. Canon Medical does not guarantee the accuracy or reliability of the information provided herein.
News items and articles are announced firstly, as pre-publication, via the dedicated VISIONS LinkedIn Group: https://www.linkedin.com/groups/3698045. In this group you can actively participate in discussions about the content and future direction of the magazine.
The assessment of cardiac function is essential in the athletic population not only as part of the screening process for underlying cardiac disease, but also to longitudinally assess performance and training adaptations - Source: Toshiba's VISIONS Magazine #26 | www.toshiba-medical.eu/visions
Post contrast iodine maps were introduced as part of dual-energy imaging over 10 years ago but these have never become part of routine practice in most centres for the investigation of pulmonary thromboembolic disease.
CASE: 58 year old male presented with a liver lesion seen on prior imaging. A dual energy scan was performed to further characterize the lesion. Volumetric Dual Energy scans were performed following the injection of 80mls of contrast. Scans were performed during Arterial Phase, early Portal Phase and Delayed at 3mins. Monochromatic images, iodine maps and virtual non contrast images were generated for review.
Computed tomography angiography (CTA) of the coronary arteries is a useful noninvasive tool to rule out significant coronary artery disease (CAD) in many clinical situations. Recent guidelines of stable CAD and non-ST segment elevation myocardial infarction endorse the use of CTA in symptomatic patients with low to intermediate likelihood of the disease, given the particularly high negative predictive value of the technique. However, in patients with high pre-test likelihood of CAD, the technique is not recommended, and one of the reasons is the high probability of coronary calcification in these patients, which interferes with the analysis of the images and reduces the specificity and negative predictive value of CTA.
(TOSHIBA CTEU140095) - Article from Toshiba's VISIONS Magazine#25, March 2015
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
White paper "coronary ct angiography with reduced radiation dose using the aquilion one vi sion edition"
1. A large single center comparison
with the Aquilion ONE
Introduction
Coronary CT angiography using the Aquilion ONE
with its 320 detector rows and 16cm z-axis
coverage has been shown to have good diagnostic
accuracy to detect significant coronary stenoses
compared to invasive catheter angiography1–2
. In
patients with a heart rate of less than 65 bpm the
entire heart can be acquired in a single heartbeat
for a low radiation dose3
. The use of prospective
gating, where only a portion of the heart cycle is
imaged, SURE
Exposure and the novel iterative
reconstruction algorithm AIDR 3D all assist in
lowering the radiation dose as much as possible.
In patients with higher heart rates (>65 bpm) the
temporal resolution of 175 ms is not fast enough
to freeze cardiac motion, thus multi-segment
reconstruction is necessary to improve temporal
resolution. As multiple beats need to be scanned,
the radiation dose is increased.
In 2012 Toshiba introduced the Aquilion ONE
ViSION Edition. In this system the gantry speed is
increased from 350 ms to 275 ms and thus the
temporal resolution of a scan acquired in a single
heart beat has improved to 137 ms. As a result,
this second generation 320-row scanner is ex-
pected to allow excellent coronary imaging across
a wider range of heart rates as compared to the
first generation scanner. To date two papers have
been published comparing the two systems4–5
.
In the study by Chen et al.4
coronary CT angio-
graphy was performed in 107 consecutive and
unselected patients, who were enrolled regardless
of heart rate, cardiac rhythm, body size, previous
cardiac history (such as coronary bypass grafting)
or clinical indication. The only contraindications
Gladys Lo, Hong Kong Sanatorium & Hospital, Hong Kong, China
Chloe Steveson, Toshiba Medical Systems Corporation, Otawara, Japan
Joanne Schuijf, Toshiba Medical Systems Europe, Zoetermeer, The Netherlands
Coronary CT Angiography with
reduced radiation dose using the
Aquilion ONE ViSION Edition
ONEn=250 ViSIONn=250 Pvalue
BMI – Mean (SD) 24.6 (3.5) 24.6 (3.5) 24.6 (3.5)
Underweight 10 (4) 9 (3.6) 0.815
Normal 157 (62.8) 153 (61.2) 0.712
Overweight 75 (30) 74 (29.6) 0.922
Obese 8 (3.2) 14 (5.6) 0.191
Heart Rate – mean (SD) 62.86 (0.8) 66.75 (1.1) 0.0046*
<50 bpm 35 (14) 19 (7.6) 0.021
51–60 bpm 93 (37.2) 88 (35.2) 0.642
61–75 bpm 84 (33.6) 96 (38.4) 0.264
75–90 bpm 29 (11.6) 28 (11.2) 0.888
>91 bpm 9 (3.6) 19 (7.6) 0.052
Arrhythmia
Yes 8 (3.2) 16 (6.4)
0.094
No 242 (96.8) 234 (93.6)
Table 1: Selected patient demographics
ONEn=250 ViSIONn=250 Pvalue
Number of Beats
1 155 (62) 195 (78) <0.001*
2 72 (18.8) 36 (14.4) <0.001*
3 20 (8) 15 (6) 0.381
4 3 (1.2) 4 (1.6) 1.000
kV
100 174 (69.6) 224 (89.6) <0.001*
120 71 (28.4) 26 (10.4) <0.001*
135 5 (2) 0 (0) 0.061
Radiation Dose – mean (SD) 2.71 (2.47) 2.07 (2.57) 0.0047*
Mean with arrhythmia patients
excluded (SD)
2.49 (1.81) 1.69 (1.52) <0.001*
<1mSv 34 (13.6) 83 (33.2) <0.001*
1 mSv 86 (34.4) 97 (38.8) 0.307
2 mSv 61 (24.4) 32 (12.8) 0.001*
3 mSv 21 (8.4) 11 (4.4) 0.068
>4 mSv 48 (19.2) 27 (3.2) 0.009*
Table 2: Selected scan parameters
2. 2 Coronary CT Angiography with reduced radiation dose using the Aquilion ONE ViSION Edition
were pregnancy or poor renal function. This cohort
was compared with a similar consecutive cohort
imaged with the Aquilion ONE in 2010. The scans
performed on the Aquilion ONE did not use AIDR 3D
or SURE
Exposure. In this study the mean radiation
dose was reduced from 2.67 mSv with Aquilion
ONE to 0.93 mSv with the ViSION, representing
a 65% dose reduction. This significant reduction
is due to the implementation of many dose saving
features such as AIDR 3D and SURE
Exposure in
addition to the increased gantry rotation speed.
A similar comparison was performed by Tomizawa
et al.5
In this study however, a more restricted
population was investigated where the only variable
between the Aquilion ONE and Aquilion ONE ViSION
Edition patient cohorts (n=48 each) was the rota-
tion time. Also in this study, use of the Aquilion ONE
ViSION Edition resulted in a substantial reduction
in radiation dose. From a practical perspective, it is
important to establish whether these observations,
obtained in single academic expert centers, can
be generalized to the larger imaging community.
The current paper therefore compares the two
systems in a radiology department in a private
hospital setting with a higher patient throughput
and a larger number of patients with arrhythmia
than the two published papers.
Patients
We sought to compare the radiation dose reduction
for coronary CT angiography between the Aquilion
ONE and Aquilion ONE ViSION Edition systems when
the only variable was the rotation speed. 500
patients were retrospectively studied, 250 were
imaged with Aquilion ONE from September–
October 2012 and 250 imaged with the ViSION
Edition from December 2012–January 2013.
Patients presented with atypical chest pain, positive
exercise stress test or multiple risk factors for
coronary artery disease. Other parameters such
as iterative reconstruction and SURE
Exposure
settings were the same for both groups. Selected
patient demographics are shown in Table 1. The
BMI was not significantly different between the two
systems. The mean heart rate however was slightly
higher with the ViSION Edition. The percentage
of patients with a very slow heart rate decreased
and the percentage of patients with heart rates
between 61 and 75 bpm increased. The number
of patients with high heart rates also increased
slightly corresponding to an increase in the number
of patients with arrhythmia, though this was not
statistically significant. Overall the patients in each
group were similar. Generally, the cohort studied
0
50
100
150
200
250
1 2 3 4
62%
18.8%
14.4%
8% 6%
1.2% 1.6%
78%
Aquilion ONE
ViSION Edition
0
20
40
60
80
100
120
<1 1 2 3 >4
13.6%
34.4%
38.8%
24.4%
12.8%
8.4%
4.4%
19.2%
3.2%
33.2%
Aquilion ONE
ViSION Edition
Mean Effective Dose
ONE = 2.71 mSv
ViSION = 2.07 mSv
p= 0.0047
0
50
100
150
200
250
1 2 3 4
62%
18.8%
14.4%
8% 6%
1.2% 1.6%
78%
Aquilion ONE
ViSION Edition
0
20
40
60
80
100
120
<1 1 2 3 >4
13.6%
34.4%
38.8%
24.4%
12.8%
8.4%
4.4%
19.2%
3.2%
33.2%
Aquilion ONE
ViSION Edition
0
50
100
150
200
250
100 120 135
69.6%
28.4%
10.4%
2% 0%
89.6%
Aquilion ONE
ViSION Edition
Mean Effective Dose
ONE = 2.71 mSv
ViSION = 2.07 mSv
p= 0.0047
0
50
100
150
200
250
1 2 3 4
62%
18.8%
14.4%
8% 6%
1.2% 1.6%
78%
Aquilion ONE
ViSION Edition
0
20
40
60
80
100
120
<1 1 2 3 >4
13.6%
34.4%
38.8%
24.4%
12.8%
8.4%
4.4%
19.2%
3.2%
33.2%
Aquilion ONE
ViSION Edition
0
50
100
150
200
250
100 120 135
69.6%
28.4%
10.4%
2% 0%
89.6%
Aquilion ONE
ViSION Edition
Mean Effective Dose
ONE = 2.71 mSv
ViSION = 2.07 mSv
p= 0.0047
Figure 1: Number of Beats Figure 2: Radiation Dose
Figure 3: kV selected Figure 4a: 3D VR
Number of Beats
NumberofPatients
NumberofPatients
Radiation Dose (mSv)
kV selected
NumberofPatients
3. Coronary CT Angiography with reduced radiation dose using the Aquilion ONE ViSION Edition 3
Clinical Case History
This 68 year old woman with BMI 24.2 presented with a history of smoking,
dyslipidemia and hypertension. The heart rate at the time of scan was
70 bpm. A one beat scan was performed with 100 kV. The DLP was 39.0
and the effective dose was 0.5 mSv (k=0.014). No significant coronary
artery disease was demonstrated in this scan.
with the Aquilion ONE ViSION Edition had a higher
mean heart rate and an increased prevalence of
arrhythmia as compared to standard populations
typically studied with coronary CT angiography4
.
Scan Parameters
On both scanners, coronary CT angiography was
performed according to the recommended protocol.
Following a breath exercise, SURE
Cardio automatically
determined the number of beats and exposure
window; however the radiographer was allowed
to modify these settings if desired. SURE
Exposure
was used to select the mA and kV according to
the patient’s size. AIDR 3D iterative reconstruction
and phaseXact were applied to all reconstructions
to ensure the best motion free images at the
lowest dose. Selected scan parameters are shown
in Table 2.
Single beat imaging
The improved temporal resolution on the ViSION
Edition has important implications for the number
of patients that can be imaged in a single heart
beat. Whereas the previous generation scanner
allowed single-heartbeat scanning with heart
rates of up to approximately 65 bpm, with the
ViSION Edition patients with heart rates up to
75 bpm can be imaged in a single heart beat.
At this site, there was a statistically significant
increase in the number of one beat scans per-
formed on the ViSION Edition (78% compared
with 62%), and a corresponding decrease in the
number of 2 beat scans (Figure 1). As expected,
the number of three and four beat scans did not
change as the number of patients with arrhythmia
was similar between the two groups; generally
only patients experiencing arrhythmia during
the acquisition have more than 2 beats imaged.
Overall 92.4% of patients were imaged with
either a one or two beat scan on the ViSION
Edition compared to 80.8% with the Aquilion ONE.
Dose reduction
A radiation dose of less than 1 mSv was achieved
in significantly more patients, 33.2% on the ViSION
Edition compared with 13.6% on the Aquilion ONE.
On the other hand, a general reduction in the num-
ber of patients receiving over 2 mSv was seen as
well (Figure 2). Patients with heart rates between
65 and 75 bpm benefit most from the increased
gantry rotation speed on the ViSION Edition as they
are now imaged with one beat rather than two
beats. The improved temporal resolution has also
allowed the exposure window to be narrowed to a
single gantry rotation in patients with heart rates
Figure 4b: LAD
Figure 4c: LCx Figure 4d: RCA