In case of serious doubts during a procedure in a conventional angio suite, the procedure could be stopped, and the patient must be transferred to the CT scanner in another room. To reduce this hour-long delay to just a few minutes, to leave the patient on the operating table with the catheters still in place and ready to work again, Interventional radiologists have moved the CT into the angio suite for immediate answers to their questions.
Having a full-scale CT available in the same room as the angiography system bring new capabilities to the medical team for planning the intervention, for treatment, and verification of the effects of treatment. Introducing the INFINIX 4DCT, Toshiba adds a new dimension to image guided therapy with a powerful hybrid imaging system combining the world’s most flexible angio suite with the most advanced dynamic volume CT.
INFINIX 4DCT systems can be configured with an angiography system and one of four Aquilion CTs, the 32-slice Aquilion Large Bore version, the 160 slice Aquilion PRIME, the 640 slice Aquilion ONE and the 640 slice Aquilion ONE Vision Edition.
Toshiba’s signature wide detector CT technology with up to 16 cm coverage in a single rotation provides an outstanding ability to serve a wide range of procedures from interventional oncology to trauma, from neuro to cardiac.
Unique to the INFINIX 4DCT configurations with the 640-slice Aquilion ONE is the 16 cm full anatomical coverage that adds a fourth dimension to 3D full volume scans by showing time lapse images in a cine mode, for example the perfusion of the liver.
The INFINIX 4DCT suite also integrates Toshiba’s SURE guidance for rapid, accurate target positioning. From a CT scan data set the clinician selects the reference slice with the best view of the pathology and loads it to the angio system so that the C-arm moves precisely to the target. The C-arm continuously tracks any table movement to remain on target.
SUREGuidance works in the other direction as well with the CT scanner targeting with precision a position loaded from the angio image. “Having such a system with a CT scanner takes us one step further by acquiring anatomical and functional data simultaneously with high spatial and temporal resolution,” said René Degros, Business Unit Manager X-Ray Europe.
“You can not get this field of view, neither would you have such a level of detail with any other modality,” he said, adding that multiple publications have demonstrated CT perfusion provides the greatest sensitivity.
“With angio, you might think you are covering the entire tumor, yet on CT we can clearly see signs that we should look to other arteries that may be feeding this tumor, and it then becomes easier to locate these extrahepatic feeders and ensure we treat the entire tumor,” he said.
INFINIX 4DCT brings also a new dimension to other procedures, such as gastric-intestinal (GI) bleeding, bronchial artery embolization, complex endoleak embolization or complex drainage, he added. During radio frequency ablation of a tumor, it becomes critical to identify vessels adjacent to the targeted tumor and block the blood flow that can dissipate the full heating effect meant to destroy the tumor.“ This is only possible if you have a CT in the room,” he said.
With a GI bleed it can be very difficult to locate the bleed using the angio view or cone-beam CT due to motion artefacts caused by breathing, “yet with a CT scanner in the room, it becomes easier,” he said.INFINIX 4DCT incorporate DoseRite and AIDR3D functions that optimize image quality at low-dose exposures with iterative reconstruction as well as Toshiba’s Adaptive Diagnostics functionalities for bone free contrast enhanced imaging, or metal artefact reduction.
“Each intervention holds a risk. Yet if we bring a CT scanner into the room, we have the option to do studies that can give us clear endpoints, to determine whether we have treated the patient’s condition sufficiently and not expose the patient to further risk caused by additional interventions.”
“In the future, I believe we will find that adding this hybrid imaging capability can change the way we treat patients,” he said.