“If you can make access to the patient easier and get the C-arm into the position you want faster, you can shorten the overall exam time and save dose,” Allan Berthe, senior cardiology product manager at Toshiba, explains. The 270-degree access of the Infinix-i C-arm gives the user an unprecedented degree of patient, equipment, and clinician access, increasing the odds of acquiring the best possible image, on the first try, with minimal difficulty. “Clinicians can see better and are more confident, and when you’re seeing better, you’re spending less time scouting around, emitting radiation ,” Berthe says.

The Infinix-i systems’ C-arm and flat-panel design also enable clinicians to position the detector as close to the patient as possible, while the systems’ flexibility permits positioning the X-ray tube on either side of the patient. “When you can position the x-ray tube closer to the panel, that reduces the radiation scatter and overall dose emission to the patient and staff” Berthe notes.

Toshiba’s table-mounted radiation shield, which includes table scatter-radiation protection, is complemented by a transparent ceiling-suspended shield with flexible positioning, both of which protect clinicians from radiation exposure. The company’s proprietary dose-management tools, including grid-pulsed fluoroscopy/fluorography and virtual collimation, help reduce patient exposure by enhancing clinician efficiency and overall image quality.

Berthe explains that grid-pulsed fluoroscopy/fluorography makes more efficient use of the x-ray signal, minimizing leading- and trailing-edge dose. “We provide, standard, the most comprehensive number of pulse–frame-rate selections in the industry,” he says. “At times the clinician may determine that superior visualization is not critical. The system operator can lower the pulse fluoro frames in these instances and then quickly increase to higher frame rates when more in-depth imaging is necessary.”

Virtual collimation, he explains, permits clinicians to position collimator blades without expending any additional dose.

“Today, dose management is critical and the Infinix-i systems provide a host of dose lowering tools that the clinicians can control right at the tableside ,” Berthe says. “The efficiency, flexibility and technology included in the Infinix-i systems are interrelated in their contribution to lowering dose to patient and staff members”

Ultrasound – Carotid Intervention
As with many other conditions, ultrasound is often the first modality physicians turn to when evaluating a patient presenting with stroke symptoms. It’s a key tool for evaluating the carotid arteries to identify the presence and type of plaque buildup the patient could have. Two key Toshiba features for ultrasound are particularly useful in stroke imaging.

Precision Imaging: This technology enhances image clarity and resolution to help physicians visualize plaque in the carotid arteries. Precision Imaging increases diagnostic confidence by providing more detailed ultrasound images so physicians can quickly determine the next steps in a patient’s treatment. As a multiresolution signal processing technology, it not only evaluates images line by line but also includes information from adjacent lines to enhance the amount of information obtained. As a Toshiba exclusive software, Precision Imaging’s ability to capture information from multiple lines improves the definition of the structure, provides more detail and minimizes noise and clutter.

Advanced Dynamic Flow™: Advanced Dynamic Flow improves very high resolution for greater diagnostic confidence for vascular structures. This sensitivity helps to better visualize the degree of stenosis in the carotid arteries. Using the same ultra-high bandwidth normally used only in B-mode for doppler signal processing, Advanced Dynamic Flow simultaneously provides both high spatial resolution and high frame rates to accurately display flow with directional information, even in tiny vessels.

CT – Faster Stroke Assessment
When a patient comes to a hospital’s emergency department (ED) exhibiting stroke symptoms, it can take hours to diagnose and treat the patient when time is of the essence. Toshiba’s Aquilion® ONE dynamic volume CT system has the ability to improve the quality of life for patients with neurological symptoms, especially related to stroke, by reducing diagnosis time to minutes with half the dose of conventional CT.

The Aquilion ONE allows physicians to reduce diagnosis time for life-threatening conditions such as stroke from hours or days to minutes. Unlike any other CT system available, the Aquilion ONE covers up to 16 cm of anatomy using 320 ultra-high-resolution 0.5 mm detector elements to image an entire organ, including the brain, in a single rotation. It can show the organ’s dynamic blood flow and real-time function. The ability to see dynamic function, such as blood flowing through the brain, is critical for stroke patients in emergency settings and enables rapid and accurate diagnosis when time is critical. Coverage can also be collimated to a smaller area to reduce the dose to the patient.

This Neuro ONE acute stroke imaging protocol on Aquilion ONE combines non-contrast CT, cerebral blood flow analysis and four-dimensional digital subtraction angiography (DSA) into a single exam. By combining these exams into a single low-dose protocol, full stroke workup can be performed in less than five minutes.

Magnetic Resonance – High-Sensitivity Stroke Imaging
MRI is particularly beneficial for diagnosing acute ischemic stroke because it is highly sensitive to detecting microscopic changes in blood and oxygen in the brain. Toshiba MR integrates other techniques that further enhance MR’s role in stroke diagnosis.

Non-contrast techniques: Not only are there safety concerns when imaging with gadolinium, but also having to add contrast injections to a stroke evaluation can take time that is not a luxury in these emergency situations. Toshiba offers the most robust suite of non-contrast techniques that are beneficial for stroke analysis. For example, the V-TRACE sequence can shorten brain imaging time.

V-TRACE Sequence: This non-contrast MRA sequence available on all Vantage Titan™ and Vantage Atlas® systems, streamlines MRA brain imaging. The sequence acquires four image contrasts in one sequence, providing an imaging application for visualizing slow- and fast-flow vessels separately and together, as well as the brain tissue surrounding the vessels.

V-TRACE MRA is a dual-echo 3D FE sequence in which the first echo is acquired using Time-Of-Flight (TOF) and the second echo is acquired using Flow Sensitive Black Blood (FSBB). The sequence combines the advantages of both techniques to produce MRA images that depict blood vessels with both high and low velocity. The sequence design reduces the Specific Absorption Rate (SAR), which is a measurement of heat generated to the body during a MRI. Additionally, the TOF data can be used to evaluate the brain parenchyma. The images produced by the V-TRACE sequence improve the speed and accuracy of diagnosis.

Patient-friendly features: Toshiba’s patient friendly MR features make imaging easier for the patient. Several features reduce the feeling of claustrophobia that often accompanies MR exams. For example, the Titan’s large bore allows patients more room during the exam. Also, Toshiba’s head coil – important in the imaging of stroke – has 10 elements and very high signal to noise, which means it is not always necessary to utilize the top of the coil to image, reducing claustrophobia during an exam.

Infinix™-i Biplane Vascular X-ray System – Efficient Stroke Treatment
Toshiba’s Infinix-i biplane system has been developed with a number of tools to provide methods for neuro-interventionalists to develop treatment plans for patients more quickly. There are four key components of the system that make it ideal for stroke analysis.

Two 12×12-inch detectors: The midsize flat-panel detectors are ideal for brain imaging because they allow physicians to get two complete views of the cerebral vascular anatomy with each contrast injection, which not only helps to minimize the contrast load to the patient, but also provides better visualization due to the increased anatomical coverage when compared to two small detectors. Additionally, these midsized detectors allow physicians to obtain steeper compound angle views than can be obtained on systems with two large detectors.

3D angio visualization: This technology provides a three-dimensional image volume that can be rotated and manipulated in real time to ideally sort out superimposed vascular anatomy. Additionally, the two-dimensional multiplanar reformations enable physicians to dissect the image data from a variety of angles.

Variable isocenter: This key feature can dramatically improve patient safety during imaging. For example, some patients who are experiencing an aneurysm or subarachnoid hemorrhage may need a ventriculostomy to monitor and control intracranial pressure. Changing the table height in order to get the best imaging angles can present a dangerous challenge for physicians, because changing the table height can negatively impact the intracranial pressure and potentially injure the patient. Toshiba’s lateral plane variable iso-center feature allows optimal positioning for imaging the brain, eliminating the need for table height adjustment, as is done on all competitive biplane angiographic systems. Physicians do not have to raise or lower the table to get the best angle, eliminating simple positioning as a concern for causing change in intracranial pressure.

Five-axis positioner: Toshiba’s Infinix-i C-arm offers unprecedented patient access with a C-arm five-axis positioner that allows head-to-toe and fingertip-to-fingertip coverage. The freely moving components, ergonomically friendly design and five-axis positioner enable physicians to obtain optimal angles for neurological diagnosis and interventional procedures without repositioning the patient. Neuro-interventions typically are done with the patient under general anesthesia or heavy sedation, requiring anesthesia support during the procedure. The five-axis c-arm provides multiple setup configurations to provide unrestricted access to the headend of the table for patient care while preserving biplane projection capabilities.

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Toshiba’s Aquilion® ONE dynamic volume CT system has changed the scope of brain perfusion analysis by enabling dynamic imaging of the entire brain and dramatically improving the ways physicians diagnose and treat stroke. One feature, available only on the Aquilion ONE, due to its ability to image the entire brain in one rotation, is the Singular Value Decomposition Plus (SVD+) perfusion algorithm. The SVD+ algorithm produces advanced CT perfusion imaging that is unmatched in the industry.

“The Aquilion ONE dynamic volume CT system with the SVD+ perfusion algorithm is emerging as a new standard of care for brain perfusion analysis,” said Erin Angel, PhD, manager, CT Clinical Science, Toshiba. “The fast exam time, high image quality and lower radiation doses of the Aquilion ONE, combined with the more accurate perfusion analysis produced by SVD+, are changing the ways physicians identify and treat stroke quickly.”

Toshiba’s SVD+ Perfusion Algorithm
Brain perfusion imaging in CT is used to determine if the patient has had a stroke and to distinguish which areas of the brain are beyond repair and which areas of the brain may be saved through intervention. Perfusion analysis can help clinicians estimate treatment response and develop therapeutic pathways designed specifically for individual patients. The advanced SVD+ algorithm was developed for the Aquilion ONE to improve the quantitative maps produced by perfusion imaging and to give physicians more accurate data for the evaluation of stroke.

Standard SVD algorithms can sometimes produce perfusion maps that are not completely accurate, since they have difficulty calculating certain delays in blood flow. These blood flow delays, if not identified appropriately, produce perfusion maps that provide unclear results to the physician. Toshiba’s SVD+ is an advanced perfusion algorithm that eliminates these issues. SVD+ is a delay-insensitive SVD algorithm that uses an innovative technique to account for delays in blood flow and perform calculations with faster computation times. The SVD+ algorithm is unique in that it always begins prior to the contrast’s arrival to more accurately quantify the region of the brain being imaged.

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She went about her daily routine, until one day, after blacking out at work, Pamela found herself at St. Elizabeth Healthcare’s emergency room (ER). Unbeknownst to her and her doctors, she was on the verge of suffering a stroke.

According to Dr. Jeff Dardinger, director of Imaging, Vascular Institute, St. Elizabeth Healthcare, a typical patient presenting with these symptoms would have to undergo a battery of tests and be admitted to the hospital before a diagnosis could be made. For example, a patient would likely have had a CT exam of the head and neck and been admitted to the hospital while an MRA exam was scheduled. After a consultation the next day, the patient would have the MRA. According to Dr. Dardinger, this process could take anywhere from two to four days. For anyone who has had a stroke or knows someone who has, you know this timetable can prove fatal or debilitating.

Fortunately for Pamela, she was taken to St. Elizabeth – the first hospital in Kentucky to purchase an Aquilion® ONE. Because of the Aquilion ONE’s ability to capture the entire brain in one rotation, as well as its ability to show function over time, physicians diagnosed Pamela within an hour and prevented a stroke from occurring at all. This system is ideally suited for detecting neurovascular conditions quickly. It uses 320 ultra-high-resolution detector rows to capture up to 16 cm of coverage, enough to image the entire brain or heart and show organ movement.

Images confirmed that Pamela’s right carotid artery was 90 percent occluded, which significantly reduced blood flow to the brain. By diagnosing this condition within the hour, physicians immediately planned stent treatment to open the artery passage, preventing a stroke.

“Toshiba’s Aquilion ONE allowed us to accurately diagnose the patient quickly, dramatically improving her quality of life,” explained Dr. Dardinger, who interpreted Louderback’s images. “Without dynamic volume CT, the patient would have undergone a series of tests for two to four days, at a minimum, to uncover the occlusion. Being able to diagnose the patient within an hour allowed us to plan treatment immediately and prevent a stroke from occurring.”

“I truly believe this system saved my life,” explained Louderback. “I had several exams over the past few months, none of which could detect why I was having dizzy spells. It wasn’t until I was imaged in the ER, using the Aquilion ONE, that a definitive answer could be found.”

Introduced in November 2007, dynamic volume CT scans an entire organ in a single pass and produces 4D videos that show an organ’s structure, its movement and its blood flow. In comparison, a 64-slice, 128-slice or 256-slice CT scan can capture only a portion of an organ in a single pass, requiring physicians to “stitch together” multiple scans of an organ to get a full image. The new technology helps reduce multiple exposures to radiation and exam time.

Designed for today’s healthcare environment, the Aquilion ONE reduces overall healthcare costs and streamlines diagnosis by replacing several tests with a single, comprehensive exam. The Aquilion ONE’s single exam helps reduce unnecessary testing, as well as the accompanying accumulative radiation and contrast dose.

“The Aquilion ONE can dramatically improve patient care by providing a fast, comprehensive exam for patients suffering from life-threatening conditions, like stroke and heart attack, while helping to lower healthcare costs,” explained Robb Young, acting director, CT Business Unit, Toshiba. “St. Elizabeth Healthcare is an excellent example of where the Aquilion ONE enabled physicians to diagnose and treat a patient before a serious stroke occurred.”

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An ectopic pregnancy is a condition in which an abnormal pregnancy occurs and the fertilized egg attaches to a region outside of the womb (uterus). It is estimated that 20 of every 1,000 pregnancies are ectopic. 95% occur in the ampulla or isthmus of the fallopian tube, 2-3% are interstitial, while cervical, ovarian, and abdominal ectopics are rare. While there is no way to save the fetus during an ectopic pregnancy, quick treatment of this condition is necessary as continued growth of the egg may cause damage or rupture of the attached region.

Clinically, patients present 6-8 weeks after their last menstrual period, however it may be later. Classic symptoms include amenorrhea followed by vaginal bleeding, and localized pelvic pain. If the fallopian tube ruptures, the patient may present with sharp stabbing pain in the pelvis, vaginal bleeding, dizziness, and possible hypotension.

Ultrasound is a non-invasive imaging procedure used to visualize the condition of a pregnancy. Abdominal and transvaginal ultrasound is often used to visualize the intrauterine gestational sac – absence of this intrauterine gestational sac suggests the presence of an ectopic pregnancy.

Case Study: Abdominal ultrasound imaging of the pelvis was used to diagnose this right-side ectopic pregnancy.
Technology: Toshiba Aplio XG ultrasound.

Patient History: A 25 year old female presented to the emergency room with right lower quadrant pain, nausea, and vomiting. The patient was gravid 3 Para 1. The patient’s quantitative beta-hcg level was 1,843 IU. The patient’s clinical history was significant for prior ectopic pregnancy.

Ultrasound imaging of the pelvis shows a normal appearing uterus with a normal endometrial stripe. No intrauterine pregnancy is noted. The images of the right adnexa show a right paraovarian cystic lesion with thick echogenic rim. A small amount of free fluid is located in the posterior cul-de-sac.

The ultrasound findings, combined with the patient’s beta-hcg levels, are diagnostic of a right sided ectopic pregnancy. The ectopic gestation contains a yolk sac and possibly a fetal pole; however, no embryonic cardiac activity was identified.

Image Gallery

Normal uterus with abnormal right ovary show paraovarian cyst small pocket of fluid in the posterior cul de sac. Images courtesy of Amy Rutledge, RDMS Chief Sonographer, University Hospital Case Medical Center

Reference:
E A. Lyons, The first trimester, C M Rumack, Diagnostic Ultrasound, Third edition 2005, Obstetrics and Gynecology, Volume 1, Berman, Craig, and Kawamura.

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The American Heart Association estimates that nearly one million US residents die of heart disease annually, and according to the US Centers for Disease Control and Prevention it is the leading cause of death for both men and women. As a result, finding ways to detect heart disease earlier and more accurately are becoming increasingly important. Toshiba’s advancements in MRI are helping physicians quantify heart disease, thus improving diagnosis and treatment.

MRI has long been used to assess the structure and morphology of the heart, but as the technology advances, so do the procedures available to clinicians for quick and accurate diagnosis of heart disease in their patients. “The bread-and-butter sequence is called SSFP [steady-state free precession] cine imaging,” Erin Kelly, clinical science manager for MRI at Toshiba America Medical Systems, explains. “It gives an image of the heart as it moves through the cardiac cycle to tell the clinicians how the muscles are functioning, and they can use these images to calculate ejection fraction and left-ventricular volume.”

The ability to perform SSFP cine imaging is one of many cardiac-friendly features included in Toshiba’s Vantage™ Titan MRI, a 1.5T system that also includes a 16-element cardiac coil that can be combined with the 32-element spine coil. The center elements are smaller, resulting in higher-resolution imaging of the heart, and “the elements in the coils can be turned on and off to optimize the signal-to-noise ratio,” Kelly notes. Various sequences and parameters are selectable from the scanner to facilitate successful evaluation of the heart, including delayed-enhancement, myocardial imaging, retrospective gating, black-blood imaging, and real-time motion correction to name a few. Non-contrast techniques are also available on all Toshiba MR systems. For example, Whole Heart Imaging is one contrast-free sequence that allows physicians to assess the coronary arteries without contrast.

Timothy Albert, MD, is medical director of the Cardiovascular Diagnostic Center at Salinas Valley Memorial Healthcare System, Salinas, California, and he uses the Vantage Atlas system. He says, “We try to use noncontrast imaging as much as possible, both for patient convenience and safety and because of concerns about patients with kidney problems. For scar imaging, you still need contrast, but the other stuff, we can often do without it.”

Albert says that MRI has an important place in the portfolio of modalities used to detect and plan treatment for heart disease. “I use CT for coronary imaging, but that’s a small part of the cardiac question,” he says. “MRI’s strengths are really in functional imaging—the shape of the heart and how it’s beating. There’s an increasing amount of scientific data coming out about new uses for MRI in cardiac care.” Albert and his team even run a two-day training course designed to help educate referring physicians on the robust applications of cardiac MRI.

“MRI is ideal for assessment of the heart-failure patient, looking at the potential causes to guide treatments and diagnostic tests, and we use it to determine whether someone would benefit from being revascularized after a heart attack,” Albert says. “For patients with congenital abnormalities, it’s the gold standard, since CT radiation could be cumulative over time. In the future, we hope physicians will hear about these new uses for MRI and recommend it more frequently.”

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Echocardiography is a valuable tool in the diagnosis of coronary artery disease, but evaluation of myocardial function using 2D echocardiography relies primarily on visual detection of wall-motion abnormalities. In 2009, Toshiba America Medical Systems introduced a proprietary 3D Wall Motion Tracking (WMT) tool for its Aplio™ Artida ultrasound system, which helps clinicians quantify the function of the left ventricle in 3D—including left-ventricular ejection fraction, volume, and strain information.

“3D Wall Motion Tracking allows sonographers and physicians to quickly and accurately identify wall motion defects and the timing of cardiac events,” Berkeley Cameron, cardiac marketing manager for Toshiba, explains. “This greatly improves the detection of wall motion abnormalities in many cardiac disease states and Cardiac Resynchronization Therapy (CRT), and helps physicians optimize pace maker settings.”

In addition, the tool can be useful in diagnosing heart disease in women. Although stress studies have been shown to detect heart disease fairly accurately in men, women sometimes experience an increased risk of false-positive results. “Usually, for women, physicians want to do stress echocardiography instead of a treadmill study,” Cameron says. “That’s one area where Wall Motion Tracking is particularly useful for women. Having quantitative data help make the diagnosis more accurate.”

The response from clinicians using the tool has been enthusiastic, Cameron says. “We’ve gotten quite a bit of positive feedback,” she notes. “The clinicians using WMT feel it’s going to help them diagnose coronary artery disease. Anything they can do to diagnose disease earlier and to be more accurate—to make echocardiography less subjective—is a big benefit.”

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ASD is a congenital heart defect that is ideally suited for evaluation using cardiac MRI. Cardiac MRI allows accurate assessment of heart structure, function, and blood flow. In addition, cardiac MRI is an ideal method of evaluation because it does not use radiation and is non-invasive.

Cardiac Magnetic Resonance imaging can be challenging due to the constant motion of a beating heart and respiration. To successfully image the heart using MR it is essential to acquire images rapidly with optimal resolution and contrast.

Toshiba uses a 16 element Atlas SPEEDER body array coil coupled with the 32 element Atlas SPEEDER spine array coil to produce the signal required for successful evaluation of the heart. Vantage MRI systems have a complete cardiac software package available which includes specialized sequences for speed and image quality as well as the post processing software for cardiac analysis.

Case Study: MRI of the heart to evaluate cause for shortness of breath and heart murmur.

Technology: Toshiba Vantage Atlas MRI system using body array and spine array coils. The heart is imaged using SSFP cine sequences in varying planes.

2D cine sequences clearly depict the atrial septal defect allowing blood to flow between the right and left atrium. High blood-flow between the atria leads to volume overload and can lead to right heart failure. In this patient the right ventricle is enlarged consistent with a large ASD. This contributes to the patient’s shortness of breath and can progress to heart failure if not treated.

By using Toshiba’s cardiac MR system and specialized sequences no contrast or radiation was necessary in making this diagnosis.

Four-chamber (left) and short axis (right) cine views of the heart demonstrating atrial septal defect (ASD). (Cines and images courtesy of Dr. T. Albert, MD, FACC, Cardiovascular Diagnostic Center, Monterey, CA.)

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While efficiency has always been important in health care, the changes we see in today’s environment are requiring the medical community to be even more diligent.  Many are starting to recognize that the right equipment can make important differences.  At this year’s RSNA, Toshiba showcased how its systems are helping health care professionals meet the demands for efficiency without sacrificing quality.

Magnetic Resonance

The patient-focused features of the Vantage Titan™ improve exam efficiency and accuracy while mitigating issues around imaging claustrophobic and bariatric patients.  The Vantage Titan features a large 71-cm aperture open bore and offers the industry’s largest clinical field-of-view (55×55×50 cm).  The bore’s diameter enables technologists to scan patients with greater ease and reduces the feeling of claustrophobia.  Toshiba’s patented Pianissimo™ technology, which reduces acoustic noise by as much as 90 percent, is also increasing the comfort level of patients during exams.  Improving comfort level is critical because it often reduces the need for re-scans, thus improving efficiency.

St. Anthony Hospital in Gig Harbor, Wash., has experienced these benefits first hand.  “The Toshiba Titan has been the workhorse MR system for us and is able to accommodate the wide variety of MR exams we perform each day,” said Gary Leslie, MRI technologist at St. Anthony.  “We are imaging multiple patients a day and have received direct patient feedback that the system is quieter and feels less claustrophobic than other MR systems.  This has helped us to greatly improve exam efficiency and department throughput.”

Additionally, the system’s Atlas integrated coils allow physicians to perform multiple exams without repositioning the patient and also enable feet-first imaging for feet-to-shoulder exams.  This means a more comfortable exam experience and results in enhanced workflow and technologist productivity.  Also, Toshiba’s SPEEDER parallel imaging allows for increased acquisition speed and reduced examination times.

X-ray

Today’s emergency departments are challenged to provide rapid, accurate diagnoses for a variety of patient conditions when time is of the essence. Toshiba’s RADREX™-i digital radiographic system is designed to provide the features emergency departments require to offer the highest level of patient care.

The comprehensive RADREX-i offers a 600-lb. table weight limit, 600 kHU X-ray tube and an 80-kilowatt generator, allowing hospitals to image a variety of patients, including bariatric. The X-ray system enhances workflow with the RexView, a color LCD screen located on the overhead tube crane (OTC). Since the image appears on the OTC, technologists have immediate access to review the image and determine if they have what is needed for diagnosis, ultimately reducing exam time and increasing the chance of a positive patient outcome.

The RADREX-i’s automated features also save time in emergency settings by automating exam selection and X-ray positioning. These features include:

• Auto-tracking to eliminate the need to manually position the X-ray tube detector by providing synchronization for table and wall-stand tracking
• Auto-collimation to save crucial time for the patient and technologist by automatically selecting the correct collimation size for the patient’s body part
• Auto-program to eliminate the need for the technologist to manually select the program on the generator by automatically selecting the correct program
• Auto-center stop to provide visual guidance for fast, simple detector centering

St. Luke’s Community Hospital in Ronan, Mont. uses the RADREX-i in its emergency department.

“When treating emergency patients, acting quickly is critical,” said Steve Sivak, radiology manager, St. Luke Community Hospital. “The advanced features of the RADREX-i help us streamline workflow and accelerate throughput, providing a tremendous benefit to patients when time is limited.”

Ultrasound

Many hand-carried ultrasound systems offer better access to patients when space is compromised, but cannot provide all of the advanced radiology capabilities required to perform exams in today’s demanding ultrasound environment.  Toshiba’s new works-in-progress Viamo™ ultrasound system meets the needs of today’s hospitals by combining portability with high-end radiology features.  Viamo is the industry’s no compromise ultrasound system with advanced radiology capabilities, previously unavailable on hand carried systems.

The Viamo combines the portability of a laptop system with advanced radiology features to deliver outstanding image quality, enhance diagnostic confidence and improve ease-of-use. Developed from a radiology foundation, Toshiba’s Viamo provides the confidence to image patients at bedside, which generally require larger, more expensive cart-based systems. When an immobile patient needs a high-end ultrasound exam, the portable Viamo laptop ultrasound is brought to the patient to improve the patient’s comfort without compromising exam quality.

The new Toshiba Viamo laptop ultrasound system offers:

• Best-in-class imaging capabilities in a laptop size, making it ideal for high-end radiology, vascular, emergency and OB/GYN exams, even at bedside. For example, Viamo is beneficial during liver transplants when medical personnel must image the anastomoses to assess blood flow through the vessels.
• Excellent image quality and color flow comparable to larger, more expensive cart-based systems.
• Ease-of-use with a simple touch-screen interface that is programmable in panel or tablet modes.
• Ability to interchange Toshiba transducers while using the Viamo’s transportation pole, thus improving productivity and flexibility, while saving health care costs by reducing the need to purchase multiple transducers. This unique feature improves productivity and saves money for current customers by using their existing Toshiba transducers on the Viamo.  Additionally, new customers are able to use Viamo transducers with other Toshiba ultrasound systems they may purchase in the future.

Computed Tomography

Overall, Toshiba’s Aquilion® line continues to be focused on exam efficiency and the company has added several new features to help the medical community.  The Aquilion line comes with a host of ^SURETechnologies that automate parts of the exam, which not only provides efficiencies, but also safer exams.  For example, Variable Helical Pitch (vHP) ensures greater workflow efficiency by enabling physicians to complete an exam of more than one anatomical region consecutively – i.e. without stopping to alter the helical pitch of the exam.  Toshiba’s CT line also features items like the iStation, a screen on the gantry that provides automatic exam feedback to the technologist, and a table with a 660-lb. weight limit that also lowers within inches of the ground, enabling patients to sit on the table more easily.

While the entire Aquilion line boasts efficiencies, Toshiba’s Aquilion® ONE is designed for today’s health care environment because it can streamline workflow by providing a more accurate, complete and timely diagnosis with one exam.  The Aquilion ONE can image a patient in 0.35 seconds, whereas conventional helical CTs can take four or five seconds, approximately 10 to 12 times slower.  Beyond its fast acquisition time, the Aquilion ONE can replace several tests with one exam, eliminating the time, cost and staff required to perform additional unnecessary exams.  It also allows physicians to treat at-risk patients immediately and send healthy patients home without additional testing and staff support.

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At this year’s RSNA, the AHRA: The Association for Medical Imaging Management and Toshiba announced the six recipients of the second annual Putting Patients First grant program.

This year’s Putting Patients First grant program was expanded to include imaging centers and three additional grants specifically for pediatric programs. The six recipients were selected by the AHRA selection committee to receive up to $7,500 grants to fund programs, trainings or seminars aimed at improving patient care and safety in diagnostic imaging.

In its second year, this program has expanded its scope to include improving the imaging of children.  Children have special imaging needs – exposure to radiation and contrast are concerns within the industry, as is ensuring that children are well prepared for the imaging experience.  Putting Patients First will help facilities address these very specific needs.

“Grant programs like Putting Patients First are critical given today’s health care environment and the pressures hospitals face due to limited resources and other financial challenges,” said Debra A. Lopez, AHRA president, CRA, FAHRA. “This year’s winning programs demonstrated quality and innovation in patient care. They will make significant improvements to patient care and better the imaging experience for physicians and patients, alike.”

The programs funded by the AHRA/Toshiba Patient First grants include:

Children’s Healthcare of Atlanta at Egleston – Use of Bismuth Shields in All CT Exams

• Several recent publications report radiation dose reduction benefits when using bismuth shielding for pediatric patients undergoing multidectector CT. Therefore, Children’s Healthcare of Atlanta at Egleston will implement the use of bismuth shields in all patients undergoing CT examinations. Implementation of this shielding program will entail staff training, purchase of bismuth breast and thyroid shields, ongoing review of images, development of resident and parental educational programs, and a cost analysis.

Community Health Network – Pediatric CT Imaging Simulation Program

• By enabling pediatric patients to better understand the CT imaging process, radiation dose will effectively be reduced, patient comfort will be improved and the overall imaging experience will be safer. Therefore, Community Health Network will create an Internet-based simulation program to educate pediatric patients and their caregivers about the diagnostic imaging process (focused on CT).  By incorporating audio, avatars and animation through a user-friendly computer program, patients will know what to expect of the imaging process and be more comfortable and compliant during the procedure.

Memorial Hermann Outpatient Imaging Division – Improved Process Program

• Memorial Hermann’s goal is to emphasize the importance of keeping radiation dose during CT procedures as low as reasonably achievable for pediatric patients, while still maintaining good image quality. It also recognizes the need for more education for the technologists and pediatricians on pediatric radiation safety. Therefore, Memorial Hermann will implement the Improvement Process Program to: 1) document the dose electronically PACs; 2) scan once – multiphase scanning is usually not necessary in children; 3) reduce or “child-size” the amount of radiation used; 4) audit and evaluate image quality monthly; and 5) provide physician and technologist continued education.

Highline Medical Center – Improvement Project for Scheduling Inpatients for Imaging Exams

• One of Highline Medical Center’s goals is to provide a patient-centered environment that personalizes, humanizes and demystifies patient care. Therefore, Highland Medical Center is undertaking an improvement project to develop, implement and spread a process for scheduling inpatients for imaging exams to accomplish safer patient care through: 1) better communication among the staff caring for the patient; 2) increasing involvement of the patient in his/her own care; 3) better coordination between services for tests and treatments leading to streamlined clinical pathway; 4) eliminating delayed/missed or incorrect imaging exams; 5) improving patient flow to potentially decrease overall length of stay; and 6) having imaging techs rounding on patients prior to high risk, invasive or advanced imaging procedures.

Shields Health Care – Understanding and Reducing Patient Anxiety

• Shields Health Care wants to engage the patient in a common language that educates and reduces patient anxiety. Therefore, Shields Health Care will develop multi-lingual web-based tools as well as professional staff training. Phase one of the program will be to research causes and develop solutions; phase two will be to implement and cross train professionals and technical staff; and phase three will be dedicated to reflection on lessons learned and measuring program effectiveness and outcomes.

St. Patrick Hospital – Interactive Utility to Improve the Imaging Process

• Inaccurate or inappropriate exam orders contribute to increased costs to patients, staff and facilities in terms of dose, money and time. Therefore, St. Patrick Hospital will create on its intranet Web site an interactive utility that is readily accessible to all staff to provide guidance regarding appropriate imaging studies and help facilitate clear exam orders to maximize the value of imaging studies. Once the program is developed for intranet users, St. Patrick Hospital will provide a condensed version of the utility on its hospital Web site with more links to helpful information in order to improve patient understanding of the process. This version also will be a tool used by clinicians and staff when discussing exam specifics with patients.

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