Addressing the obstacles to confident diagnosis:
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Too many imaging studies still result in inconclusive reports due to poor visualization or nonvisualization of anatomical structures, which can delay diagnosis and treatment, add stress for patients and staff and increase costs. The usual suspects for compromised image quality are well known: acquisition parameter errors, motion, fat and metal artifacts, operator error, and technology limitations.
The good news: we are making significant progress against the most challenging obstacles to diagnostic confidence in every imaging modality. Here are some examples of what that looks like.
Because fluoroscopy means live viewing, relevant diagnostic information in the images must be visible straightaway at the correct level of brightness and contrast. Furthermore, because the human eye is very sensitive to temporal variations, the contrast and brightness impression must be stable over time. This is particularly challenging in view of the rapid temporal variations occurring in fluoroscopy, particularly with respect to:
- The body region under examination, e.g. when examining the esophagus
- The field-of-view, e.g. when moving the patient or modifying the collimated area
- Areas of direct radiation
- The distribution of the contrast agent
- The dose level
When the dose level or the field-of-view is modified (e.g. by modifying its size, by shifting it from the body center to the periphery, or by moving the patient), Dynamic UNIQUE automatically determines the signal level in the anatomical region and maps it to an appropriate brightness level. Areas of direct radiation are reliably detected and excluded from the brightness adjustment. In contrast, simpler methods include areas of direct radiation in adjustments, resulting in dark images and obscured anatomy, as well as annoying flickering.
Optimal image stability for fluoroscopy and spot images at any time leads to comfortable viewing of high-quality images, less time needed to adapt to the luminosity, and ultimately, a smooth and efficient workflow.
Conventional CT scans often produce ambiguous or inaccurate data resulting in a need for additional testing. For example, in cases where a conventional image from a scan lacks the clarity typically provided by IV contrast, the resulting scan can be indeterminate, necessitating additional exams and resources.
IQon Spectral CT is the world’s first and only detector-based spectral CT which consistently captures spectral information without special planning or set-up.
Diagnostic certainty exists when multiple layers of spectral data allow the first exam to be the right exam, whether it’s with MonoE images, iodine images, virtual non-contrast images or Z effective images. In addition, IQon Spectral CT has been shown to reduce average scan cost.*
* Norwood, Don, MD, MBA. Economic impact of IQon for patients with renal insufficiency. 2017. Data on file.
Image courtesy of CARTI Little Rock, Arkansas, USA
Clinical case: A patient arrives in the ER with abdominal pain and is scanned to determine the cause. The conventional image result was indeterminate (left); however, because the patient was scanned on the IQon (right) using the spectral Low Mono E image the contrast visualization was improved.
Images courtesy University Hospitals, Cleveland, Ohio, USA
Small pulmonary emboli (PE) can be difficult to identify on conventional CT images alone, and perfusion defects in the area of the PE can be overlooked.
The IQon Spectral CT aids the radiologist by providing spectral results that can help identify perfusion defects. Multiple spectral results available with every patient scanned on the IQon Spectral CT can aid the radiologist in the ability to identify multiple perfusion results.
In this example, the patient presented with a suspected PE. After reviewing the conventional scan, spectral results were applied, resulting in multiple perfusion defects being identified by the radiologist in both lungs.
Images courtesy University Hospitals, Cleveland, Ohio, USA
While PET/CT is the modality of choice for large-anatomical-area lesion detection, acquisition time for analog systems (15-20 minutes) can result in patient discomfort and associated motion artifacts that compromise image quality.
Vereos Digital PET/CT is the world's first and only true digital PET/CT system, which positions radiologists to go beyond current limitations to improve patient care. Vereos’ Digital Photon Counting technology enables uncompromised lesion detectability at 1/10th the time.* With this technology, radiologists can perform a whole body FDG study in under 5 minutes.
Given Vereos’ increased sensitivity and lesion detection in less time, radiologists may adjust acquisition times depending on their need to accommodate patient comfort.
* Zhang, J, Evaluation of speed of PET acquisition: How fast can we go? - A validation of list mode PET simulation approach with true acquisitions, SNMMI 2017.
Equivalent detectability of neck lesion at 9 sec/bed, relative to a 90 sec/bed acquisition.
Sample images acquired in a clinical study of the Vereos PET/CT system at The Ohio State University. Investigational device limited by law to investigational use.
Comparison of axial fat suppressed PD-weighted imaging with (left) and without (right) MultiVane XD in the left shoulder demonstrates imaging with MultiVane XD provides excellent image quality, even in presence of motion.
Shortening MR exams without compromising image quality is a pressing challenge in radiology today. Whether in acute care or non-urgent diagnostic circumstances – and for reasons ranging from patient stress to operational costs and throughput – shorter is better. How do you reduce exam time without compromising image quality?
With our innovative MR solution Compressed SENSE, radiology departments can acquire all 2D and 3D scans faster without compromising imaging quality. Philips Compressed SENSE is a breakthrough acceleration technique that speeds up not only sequences, but also the entire exam.
Learn how Philips solutions help radiologists overcome obstacles to confident diagnosis. See them all:
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