Feature | November 10, 2010 | Dave Fornell

Vascular Imaging Systems

Dose Lowering, Navigation Aids Among Top Trends in Angiography

This article appeared as an introduction to the Vascular Imaging Systems comparison chart.

Lowering radiation dose and improving navigation abilities of angiography systems have been among the top priorities of manufacturers over the past year. Another big trend is integration of angiography systems in hybrid cath lab/operating rooms (ORs) as collaboration between surgeons and interventionalists improves with increasingly less-invasive procedures. Following are some of the innovations in angiography technology that have been introduced in the past year.

CT-Like Imaging
An important step forward has been the creation of computed tomography (CT)-like images in the cath lab using rotational angiography. Originally introduced by GE in 1997, most angiography manufacturers created their own systems, where the C-arm makes a rotation around the patient to create a 3-D image dataset. The image can be used as an overlay for better navigation, anatomical reference and to help view device positioning. The images also overcome a shortcoming of angiography, which does not show the true lumen wall in vessels with stenosis.

The Siemens Artis zeego delivers large-volume syngo DynaCT, offering CT-like slice images of the heart in motion and an ECG-triggering option. Philips’ 3-D coronary angiography (3-D-CA) imaging creates a 3-D model of the coronary vessel tree. The cardiac imaging volume can also be used to select the optimal viewing angle throughout the examination. The system will move the C-arm into the selected viewing angle automatically so additional dose is not used to reposition the arm.

Advanced Visualization Aids Navigation
At RSNA 2009, GE introduced new visualization tools for its Innova 4100IQ. With the Advantage Workstation VolumeShare 4, it uses software to provide precise anatomical detail. It includes subtracted 3-D, which quickly visualizes vessels without having to remove surrounding bone, tissue and implanted devices. It also allows side-by-side nonsubtracted 3-D, subtracted 3-D or 3-D mask images to compare, merge and analyze complementary images.

GE’s Blended Roadmap helps navigate complex anatomy by superimposing any angiography or InnovaBreeze bolus image with fluoroscopy using the table-side controls. Registration tools correct for patient movement and help improve vessel and anatomy visualization.
Philip’s StentBoost stent visualization feature helps better define the stent in relation to the vessel wall for more accurate placement. Philips’ Allura Xper FD20 offers the MR/CT Roadmap feature to synchronize live fluoroscopy with previously acquired MRA/CTA datasets. Philips said this helps reduce contrast media use and X-ray dose compared to standard 2-D or 3-D navigation.

Veran is collaborating with GE to integrate its ig4 multimodality navigation system with Innova. The ig4 uses electromagnetic localization and image fusion to display an interventional instrument on a computer monitor that also displays a CT-based model of the target organ.

Lowering the Dose
Progress has been made in lowering X-ray dose with technical enhancements. Software now helps record and track exposure levels. Technologies were also created to allow more efficient use of the X-rays and contrast.

Innova’s dose-efficient technology, powered by the AutoEx control system, automatically and continuously adapts to customize radiation dose for each patient and procedure to help keep image quality and patient dose at optimum levels. It can reduce patient dose by as much as 40 percent without compromising image quality.

Philips offers similar dose-lowering features with its iDose technology. Its XperSwing feature also provides rotational angiography that reduces both X-ray dose and contrast usage. The C-arm rotates on a dual-axis, allowing a curved trajectory, so several anatomical views can be imaged in a single run. Conventional C-arms move along one axis, so several runs might be necessary.

For clinicians, Philips introduced DoseAware. It offers a live tracking display of clinician X-ray dose and warns them when they enter the radiation field. It records the information and generates exposure reports.

Table Technology
Angiographic system tables have become more versatile to allow better access to the patient and better positioning for optimal imaging. They are also being designed for use in hybrid cath labs. The newest generation of tables is motorized for accurate positioning and has the ability to tilt and pan.

GE’s InnovaIQ Table features auto-positioning so the patient can be brought back into repeatable clinical positioning for 2-D and 3-D acquisitions. It also allows for fast transitions from one complex position to another.

Toshiba’s CAT-880B hybrid suite table offers head-to-toe tilting and side-to-side cradling to meet the needs of both interventionalists and surgeons. The table features a 550-pound table weight limit, allows for angulations of up to 16 degrees in all four directions, and offers one of the lowest table-top heights.

Siemens’ Artis zeego robotic-assisted positioning enables variable working heights. It is also configured with specific parking positions for the C-arm in hybrid rooms to maximize room space during patient transfers.

Related Content

New U.S. Tariffs on Chinese Goods Include Imaging Equipment
News | Radiology Business | June 15, 2018 | Jeff Zagoudis, Associate Editor
The Office of the U.S. Trade Representative (USTR) released the much-anticipated list of Chinese-manufactured goods...
High Prevalence of Atherosclerosis Found in Lower Risk Patients
News | Magnetic Resonance Imaging (MRI) | June 08, 2018
Whole-body magnetic resonance angiography (MRA) found a surprisingly high prevalence of atherosclerosis in people...
Geraldine McGinty Elected First Female Chair of American College of Radiology

Image courtesy of the American College of Radiology

News | Radiology Business | May 22, 2018
The American College of Radiology (ACR) Board of Chancellors has elected Geraldine McGinty, M.D., MBA, FACR, as chair....
FAST Study Demonstrates High Diagnostic Accuracy of CAAS vFFR
Technology | Angiography | May 22, 2018
Pie Medical Imaging announced that clinical data on its CAAS vFFR (Cardiovascular Angiographic Analysis Systems for...
Joint ACR-SIIM Summit to Examine Economics of AI in Healthcare
News | Artificial Intelligence | May 15, 2018
On May 30, 2018, the American College of Radiology (ACR) Data Science Institute (DSI) and the Society for Imaging...
PET Imaging Shows Protein Clumping May Contribute to Heart Failure Development
News | PET Imaging | May 11, 2018
A team led by Johns Hopkins University Researchers has discovered that protein clumps appear to accumulate in the...
360 Photos | Angiography | May 03, 2018
A 360 degree view of the newest cath lab at...
Guideline updates and clinical research highlight the need for improved understanding of gender differences by clinicians and patients
Feature | Women's Health | May 03, 2018 | By Jeff Zagoudis
Clinical research has revealed men and women often have different presentations for cardiovascular disease (CVD).
Cardiac MRI being performed at the DeBakey Heart Hospital.

Cardiac MRI being performed at the DeBakey Heart Hospital.

Feature | Cardiac Imaging | May 03, 2018 | By Jeff Zagoudis
Magnetic resonance imaging (MRI) for cardiac assessment provides a radiation-free alternative to other commonly used...
Charles E. Kahn Jr., M.D., M.S., will become editor of the new online journal, Radiology: Artificial Intelligence

Charles E. Kahn Jr., M.D., M.S.

News | Artificial Intelligence | May 02, 2018
The Board of Directors of the Radiological Society of North America (RSNA) announced that Charles E. Kahn Jr., M.D., M....
Overlay Init