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MADE IN ITALY www.thermotherapy.it GET A FREE SAMPLE AT PAV 16 - B61 SELF HEATING DEVICES MONDAY @ MEDICA6 EH @ MEDICA No 1 2015 Superb Microvascular Ima Fast. Efficient. Precise. Sharp. Impacting on clinical decisions. Accelerating clinical routine. Following the release of its new Version 6 software upgrade for the Aplio Platinum Series ultrasound sys- tem, Toshiba has received high marks for the enhanced functions and per- formance from practitioners, each offering specific insights into how they are applying the technology. In a whirlwind world tour, here’s what they say: Superb Microvascular Imaging ‘Estimated very conservatively, I’d say that in around 20% of cases a different approach to treatment results from the use of Superb Microvascular Imaging (SMI),’ reports Professor Thomas Fischer MD, Head of Ultrasound Diagnostics at the Institute for Radiology at the Charité Mitte Hospital in Berlin. SMI is a Doppler imaging proce- dure that reacts a lot more sensi- tively to low flow speeds than normal Doppler imaging – with the added benefit of increased spatial and tem- poral resolution. The new version of the software has also reduced clutter artefacts that can affect the visualisa- tion of perfusion. SMI can be used with contrast agents, can be visual- ised in 3-D and is compatible with more transducers. In clinical diagnostics SMI has proved to be a game changer. Fischer suggests this functionality can be used wherever the objective is the diagnosis of vascularisation and he sees a particular advantage for the diagnosis of liver disease and, specifically, cancers. After the wash- in and wash-out phases of the con- trast agent, the examiner can switch to SMI, now optimised for use with contrast, and visualise vascular pat- terns, long after the bolus injection, he explained. ‘It is important for the detailed diagnosis to see how vessels grow into the tumour and to visu- alise exactly the vascular tree of the tumour, which is now also possible in 3-D technology with SMI.’ Meanwhile, half a world away at the Royal Melbourne Hospital in Australia, Robert Gibson MD finds Version 6 enhancement on the Aplio platform to be refined SMI and sim- plified its use with filter controls, which, he said, ‘should prove a real clinical advance in displaying small vessel flow and vascular morphology.’ Shear-wave elastography An essential innovation of the Aplio Platinum series was the introduction of the shear-wave elastography with propagation mode, also making it possible to visualise the propagation of the shear-wave generated in the tissue as a colour-coded image, while simultaneously measuring the abso- lute value of elasticity in a chosen region. ‘Having these available in twin view allows a greater degree of confidence in selecting reliable regions of inter- est for elastography measurement,’ Gibson said. Elastography mapping in general has been enhanced with the Version 6 upgrades to the Aplio platform, he added, with propaga- tion map cleaner than ever. ‘The Aplio 500 can indicate whether an elas- ticity measurement was successful, or not, because of the propagation mode, and the new version has even further improved this,’ Fischer said. ‘The examination procedure used to be a case of guessing the region of interest in a certain section of the image, starting the measurements and hoping that shear-wave signals were actually being measured. Now we can actually see whether or not the quality of the shear-wave propa- gation is adequate and then measure where propagation lines occur most evenly within the region of interest.’ ‘This enhanced functionality car- ries clinical impact,’ he pointed out. ‘It will lead to long-term changes for the diagnosis of liver disease. Whilst it is possible to diagnose fibrosis with the help of a biopsy, shear-wave measurements can document much larger sections of the organ. To me this makes more sense than examin- ing just a small sample.’ In its first year of routine use, the new Aplio Platinum Series has won praise from leading clinicians worldwide CEUS image of a haemangioma after 15s. Tbe use of SMI to visualise vascularisation with contrast agent after 1:12 minutes. The characteristic vascular pattern can be viewed at any point after the administration of contrast agent without the need for a new bolus administration Source:ThomasFischer Lung biopsy with thoracic contact to rule out malignancy: Smart Fusion allows the interventionist to find the lung lesion attached to the pleura easily – and even the smaller ones. The needle navigation improves his depth targeting confidence and makes the biopsy safer for the patient Bone biopsy in a humerus fracture to exclude a bone m interventionist to find the region of interest easily, whi without this system. Needle Navigation gives an extrem it has entered the bone surface In 2007, Thomas Fischer became Head of Ultrasound Diagnostics at the Institute for Radiology at the Charité Berlin. Some two years later he founded the Ultrasound Research Laboratory there. The lab, of which he is still manager, focuses on studies into new ultrasound procedures and technologies EH @ MEDICA No 12015

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