News | June 24, 2015

Texas Children's Hospital Utilizes Aquilion ONE in Surgical Planning of Conjoined Twins Separation

Volume imaging and unique cardiac scan mode help develop detailed 3-D modeling

CT System

Texas Children's Hospital successfully separated Knatalye Hope and Adeline Faith Mata in late February, completing one of the most complex conjoined twins separations ever. The procedure took months of planning, and Toshiba's Aquilion ONE CT system played a crucial role in determining the feasibility of separating the twins and producing images that helped radiologists build detailed 3-D models of the organs.

"The Mata twins separation presented some unique complexities and very challenging anatomy that we were able to capture because of Toshiba's Aquilion ONE," said Rajesh Krishnamurthy, M.D., section chief of radiology research and cardiac imaging at Texas Children's. "We used a target mode prospective EKG gated volumetric acquisition, using all 320 detector rows to elucidate the cardiovascular and coronary anatomy, and helical imaging with sequential and separate contrast injections into each twin to delineate the visceral anatomy and status of the abdominal and pelvic vasculature. A composite dataset was created by fusing information from all three acquisitions, which was used for segmentation of the organs and vasculature, 3-D modeling and 3-D printing. The ultrafast acquisition speed allowed us to image the anatomy without motion artifact, despite variable breathing and heart rates. The high quality of the images was critical to help plan for this first-of-its-kind surgery."

The separation required intensive planning by a multidisciplinary team, as the twins shared a chest wall, lungs, pericardial sac, diaphragm, liver, intestines, colon and pelvis. Toshiba's 640-slice Aquilion ONE and its volume imaging capability captured the entire cardiovascular and visceral anatomy and helped assess how the organs were shared. Additionally, the system's target CTA cardiac mode, which gives users control of when to trigger the X-ray, enabled Texas Children's to image the twins without the need for sedation, decreased artifacts and kept radiation exposure as low as possible.

"Toshiba puts customers first and developed the Aquilion ONE Family to meet virtually any CT imaging need, including the most challenging clinical situations, like the successful conjoined twins separation at Texas Children's," said Satrajit Misra, senior director, CT Business Unit, Toshiba. "It's an astounding surgery that Texas Children's completed and an example of how the Aquilion ONE's large coverage area, quick speed and unique scan modes can assist in complex surgical planning."

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