- New cardiovascular imaging and information system drives care outcomes
- Real-time 3D echocardiography offers major advantages in clinical practice
- Stents can be accurately positioned even during complex interventions
- Four-minute cardiac imaging with latest SPECT system
Cardiovascular diseases such as heart attack, stroke, and coronary heart disease have been among the most common causes of death worldwide for many years now. Advances in medical imaging play a key role in the fight against these diseases by helping achieve sound diagnoses even at earlier stages and enabling efficient interventional therapy. At this year’s Congress of the European Society of Cardiology (ESC) in London, United Kingdom, Siemens Healthcare is presenting innovative IT solutions and medical imaging systems in the areas of angiography, ultrasound, magnetic resonance tomography, and computed tomography, with the theme of “More cardiology, less heartache.” These are intended to help physicians diagnose cardiovascular diseases at an early stage, structure treatments to best suit the individual patient, and perform interventions safely.
New cardiovascular imaging and information system drives care outcomes
Growing cost pressure on hospitals increases the need for cardiologists to streamline their work processes. This is why Siemens has refined its tried and tested Syngo Dynamics cardiovascular information system (CVIS) to not only help diagnose cardiovascular diseases but also to reduce the administrative load on medical staff and provide the best possible support in outcome-focused management decisions. The main focuses for improvement were on reading and reporting capabilities as well as interoperability and integration into other systems, such as the electronic health record (EHR) system. Data exchange between disparate systems makes improved efficiency and care outcomes possible. This interoperability gives various departments within a hospital – and multiple hospitals within an enterprise– a single point of access to relevant cardiovascular information. For example, specific echocardiography data such as ejection fraction heart failure measurements can now be included more easily and at earlier stages for therapy or medication planning.
While an examination is in progress or during interventions, multi-modality clinical images and measurement data can be transferred directly into Syngo Dynamics, which reduces the risk of error compared with manual data input. Unusual results are now automatically highlighted, too, to direct attention to potential pathologies. When results or reports are being drawn up, the system also automatically reviews data plausibility1 as a means of drawing attention to any potential missing or erroneous entries. This speeds up the accurate documentation of patient flow within the hospital, which in turn saves time and reduces costs.
Real-time 3D echocardiography helps personalize treatments
In order for physicians to optimally plan and perform surgical and minimally invasive cardiac procedures, the information they obtain about the patient’s heart must be as accurate as possible. With the Prime edition of its Acuson SC2000 premium cardiovascular ultrasound system, Siemens combines two state-of-the-art technologies: A transesophegeal echocardiography (TEE) probe, which is guided into the patient’s esophagus, provides detailed real-time 3D color Doppler images of the heart anatomy and blood flow and the eSie Valves analysis software, which automatically measures individual heart valves in just seconds – much faster than any software currently on the market.
Imaging the heart in real-time makes it easier to examine and treat patients. Current imaging methods that use 3D TEE require stitching, which means combining multiple heartbeats on the computer and calculating cardiac function and blood flow from consecutive cardiac cycles. This approach can lead to potentially misleading image artifacts, especially with patients with arrhythmia.
The Siemens technology has been available on the European market since June and has proven successful in clinical practice. “It really makes a difference when you can see complete anatomy and blood flow at high volume rates with Siemens realtime 3D TEE. It enables you to perform valve procedures with more accuracy and more confidence, potentially improving patient safety and outcomes. It is truly a step forward in technology,” says cardiology Professor Stéphane Lafitte, Hôpital Cardiologique CHU in Bordeaux, France.
Stabilizing heart movements allow stents to be perfectly positioned
Many patients cannot undergo open heart surgery because of their age or health issues. That’s why minimally invasive therapies have developed into a valuable treatment alternative and have now become part of the clinical routine. One example is the use of percutaneous coronary intervention (PCI) in significant coronary stenoses, which involves balloon angioplasty to restore normal coronary blood flow. To keep the revascularized segments open permanently, cardiologists must position coronary stents or scaffolds (bioresorbable coronary stents) during PCI with absolute accuracy despite the movement of the beating heart. The Clearstent Live application, which is now available for all new Siemens angiography systems, virtually reduces heart movements during interventions, stabilizing the area around the balloon catheter. This gives the cardiologist a clear view of the stent, enabling it to be perfectly positioned – even in particularly challenging locations such as bifurcations.
To treat longer lesions, cardiologists sometimes have to place several stents in a row with accuracy down to the last millimeter, because gaps could lead to restenosis or even heart attack. The use of thinner and thinner stents or x-ray transparent scaffolds makes visibility worse. For example, the fine platinum markers on scaffolds may be barely identifiable in angiography systems, but with Clearstent Live it is much easier to position them directly against each other, thanks to reduced movement. “With the help of Clearstent Live, I now see the stent at all times in excellent detail. That makes life much easier,” says Professor Christoph Kaiser, MD, Head of International Cardiology at Basel University Hospital, Switzerland.
New SPECT system enables four-minute cardiac imaging
Siemens’ latest SPECT system Symbia Evo is designed to significantly increase productivity and offers the potential to double patient throughput compared with conventional SPECT systems: for example, by automating routine manual tasks. Nuclear cardiologists who use the new system can increase efficiency through a fourfold reduction in scan time with IQ-SPECT cardiac imaging technology. While routine SPECT cardiac acquisitions typically take about 16 minutes and risk patient movement that may result in lower image quality, a field-upgradeable hardware and software combination of Symbia Evo and IQ-SPECT enables a reduction in imaging time to four minutes with a standard dose, or up to 75 per cent lower injected dose for imaging in standard time.
Easier tissue differentiation using MRI now available to even more customers
Magnetic resonance imaging of the heart, or “cardiac MRI” for short, supplies detailed information about the myocardial perfusion, morphology, and function of the heart with no radiation exposure. Beyond a visual diagnosis, the MRI application MyoMaps from Siemens gives cardiologists physical quantity measurements of the characteristics of heart muscle tissue. The application quantifies even the smallest changes in heart muscle tissue and displays them on an image in color. This is especially helpful in the case of heart diseases that involve minimal tissue lesions that are distributed across the entire heart – for instance, scar tissue and edemas. Physicians can now make valid diagnostic and treatment decisions even earlier than was previously possible and adapt the method of treatment more quickly if necessary.
Many more customers can now make use of tissue quantification using MyoMaps. Whereas the application was previously limited as a standard feature to Siemens’ two premium MRI systems – the Magnetom Skyra 3-Tesla scanner and the Magnetom Aera 1.5-Tesla scanner – it is now also available on the Magnetom Amira 1.5-Tesla scanner, which was introduced at RSNA 2014. MyoMaps is also available via scanner upgrades on the current software platform Syngo MR E11.
A cardiac CT in a quarter of a second
Computed tomography of the heart has supported huge advances in the past decade and lends itself very well to the task of rapid diagnostic evaluation of the coronary arteries. The dual-source technology used in the current Somatom Force high-end system is what makes the fastest imaging speed on the CT market possible: A cardiac dataset can be acquired in just a quarter of a second. This means that patients require beta blockers less often to slow their heart rate in order to avoid movement artifacts. It is also not necessary for them to hold their breath thanks to the fast acquisition speed of 737 millimeters per second and high temporal resolution of 66 milliseconds.
In addition, a significantly lower x-ray dose is needed compared with existing premium CT systems. CT angiography benefits in particular from the fact that, with the optimized Care kV technology of the Somatom Force, the tube voltage can be flexibly set between 70 and 150 kilovolts (kV) and more patients can now be scanned with low-voltage values. When examining obese patients at 70 or 80 kV, this can result in a dose reduction of 68 percent over traditional 120-kV protocols. As a result, the system’s high scanning speed combined with a lower radiation dose opens up new possibilities: for example, extending the use of CT scanning to the early detection of coronary heart disease.
The products/features (here mentioned) are not commercially available in all countries. Due to regulatory reasons their future availability cannot be guaranteed. Further details are available from the local Siemens organizations.
1 This feature is currently only available in the United States.
This press release, press photos, and other information on the ESC 2015 are available on the Internet at www.siemens.com/press/esc2015
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Siemens AG (Berlin and Munich) is a global technology powerhouse that has stood for engineering excellence, innovation, quality, reliability and internationality for more than 165 years. The company is active in more than 200 countries, focusing on the areas of electrification, automation and digitalization. One of the world’s largest producers of energy-efficient, resource-saving technologies, Siemens is No. 1 in offshore wind turbine construction, a leading supplier of combined cycle turbines for power generation, a major provider of power transmission solutions and a pioneer in infrastructure solutions as well as automation, drive and software solutions for industry. The company is also a leading provider of medical imaging equipment – such as computed tomography and magnetic resonance imaging systems – and a leader in laboratory diagnostics as well as clinical IT. In fiscal 2014, which ended on September 30, 2014, Siemens generated revenue from continuing operations of €71.9 billion and net income of €5.5 billion. At the end of September 2014, the company had around 343,000 employees worldwide on a continuing basis. Further information is available on the Internet at http://www.siemens.com.
