For nearly 20 years, Toshiba America Medical Systems has been a vanguard-level sponsor of the RSNA’s Research and Education Foundation, which funds grants for young researchers in the imaging field. Since its inception 26 years ago, the foundation has provided more than $25 million in grants to 630 radiology investigators and educators. “These grants align with Toshiba’s focus on education and research,” Cathy Wolfe, director of marketing services for Toshiba, explains.

Toshiba’s education-focused collaboration with professional associations has expanded in the past few years to include the American College of Healthcare Executives (ACHE) and AHRA: The Association for Medical Imaging Management. The company sponsors the AHRA’s Putting Patients First Program, and has completed its second round of grant giving.  The program seeks to improve the safety and quality of care in imaging both pediatric and adult patients. Putting Patients First provides six grants of up to $7,500 per year to hospitals and imaging centers to help fund programs, training, or seminars focused in this area.

In 2008, one such project involved developing a patient-handoff system to facilitate transferring patients from the hospital to the imaging department. Another looked at creating a bar-code system for identifying patients with allergies to contrast media. All grant recipients agree to share their results with others so that facilities around the country have the ability to implement similar systems, according to Ed Cronin, executive director of AHRA. Cronin notes that one of the 2008 recipients developed a seminar to present to other hospitals in the region; others wrote articles on their results for the AHRA’s journal, Radiology Management.

A similar partnership with ACHE gives a boost to midlevel managers who aspire to be leaders in the radiology field. Beginning this year, Toshiba will sponsor scholarships for 60 executives to attend a series of three leadership seminars throughout 2010, 2011 and 2012. “This is a program we developed several years ago to help middle managers move into roles in the C-suite,” Peggy Gordon, vice president of development at ACHE, explains. “It’s very intensive. The seminars happen three times a year, for three days at a time and are given by a very distinguished roster of faculty teaching management and leadership.”

The first 2010 seminar occurs in June and focuses on establishing leadership; the second takes place in August and looks at innovation and overcoming the financial challenges facing the health care industry; and the third, themed Manage for the Future, is slated for October. “Part of the reason for participating in the ACHE program is helping to strengthen health care leadership through quality education,” Wolfe says. “ACHE is an impressive organization in terms of its mission and vision, and of its focus on integrity, which we thought was a good fit with Toshiba.”

Through a fourth, emerging partnership with the Society for Pediatric Radiology, Toshiba has helped the organization develop a survey to address the concerns of pediatric radiologists. “We try to look at ways to collaborate that are more unique, that provide new benefits to the organization and an opportunity for differentiation,” Wolfe says. “We believe in investing in the industry in which we work, and one of the best ways to do that is to help ensure ongoing education of the membership.”

Finally, Toshiba is continuing its support of the Society of Cardiovascular Computed Tomography’s (SCCT) Young Investigator Awards.  The SCCT is the leading international professional society dedicated to research, education and clinical excellence in cardiovascular computed tomography (CT), and is now accepting submissions for the fourth annual awards program. Sponsored by Toshiba, the unrestricted educational grants will be awarded to two residents or fellows in either radiology or cardiology for their patient care research in the categories of technical and clinical advancement of cardiovascular CT.  The deadline for submissions is April 2, 2010.   Abstracts are being accepted in two categories – Technology of Cardiovascular CT, or Clinical Applications of Cardiovascular CT.  Applicants may enter by submitting an abstract through the SCCT Web site.

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Today’s economic environment makes it increasingly challenging for physicians and technologists to travel to educational events. Robb Young, senior manager in the CT Business Unit for Toshiba, explains that this obstacle inspired the company to begin sponsoring webinars on applications for its imaging technology. “Webinars are easier for people to access,” he says. “We can do them during the day, and we can make the expertise of a particular speaker available to a broader audience. A webinar can also be saved online, so if people missed it, they can easily access the information later.”

Toshiba’s first webinar in 2010 featured S. Bruce Greenberg, MD, professor of radiology and pediatrics at Arkansas Children’s Hospital, presenting on how radiology professionals and clinicians can leverage 320-detector row CT to reduce sedation needs and radiation exposure for patients while providing them with high-quality diagnostic images.  This webinar was so well received, that Dr. Greenberg conducted a second session in late February.  “We’re focusing on the needs in the market that drove the development of this technology,” Young says. “In pediatrics, obviously, that’s being able to image patients quickly at a low dose.”  This CME-accredited webinar will be available online in April.  At that time, please visit the following site to view the webinar and receive educational credits http://www.ceconcepts.net/CT/ .

Webinars planned for later in the year include sessions on using 320-detector row CT for cardiac care and stroke triage and diagnosis, as well as on applications and technology for non-contrast MRI. The webinars are each an hour long, are free to all attendees, and are accredited by the Accreditation Council for Continuing Medical Education. Each is worth one CME credit.

“We find these events are particularly beneficial for those who are looking at new applications of a technology, or who want to understand a technology better—especially because they get to hear about it from a user,” Young says. “The webinar format allows us to get the information out to those who need it more quickly and easily.”

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At this year’s annual scientific meeting of the American College of Cardiology (ACC), which takes place on March 14–16 in Atlanta, Toshiba (booth #1944) will showcase a range of advances in and enhancements to its cardiac-imaging technology.  Following is an overview of what Toshiba will showcase:

Infinix-i Hybrid Lab

When performing patient procedures in a hybrid setting, it is critical that the imaging system provides the flexibility to quickly and easily access both the patient and ancillary equipment. Toshiba will showcase its Infinix™ VF-i vascular X-ray system with 12” x 12” flat panel detectors and CAT-880B hybrid catheterization table, designed to create a best-in-class hybrid suite.  The new mid-sized 12” x 12″ flat panel detector expands the versatility of the Infinix-i line that features a five-axis C-arm positioner and enables unprecedented patient access and coverage. Along with the new mid-sized detector, the Infinix-i five-axis systems are now available with the new CAT 880B tilt/cradle hybrid catheterization table. This table is designed to allow greater positioning flexibility and patient access during imaging and surgery. The table functionality, with side-to-side cradle and head-to-toe tilt, permits clinicians to angle the table in the optimal position to quickly and comfortably complete procedures. The system on display will also include ancillary equipment typically used in a hybrid suite.

Cardiac Ultrasound Capabilities

The cardiac capabilities of Toshiba’s ultrasound technology will also be featured. The Aplio Artida™ system is a dedicated cardiac system which provides unique 3D Wall Motion Tracking, allowing physicians to rapidly identify wall-motion defects and the timing of cardiac events, as well as real-time, multiplanar reformatting for assessing global and regional left ventricular function. Also on display is the new Aplio™ MX system, which is midsized and cart-based for better portability. Aplio MX is a multi-modality system which includes Differential Tissue Harmonic Imaging, for better results with bariatric patients; ApliPure, which enhances image clarity and detail definition; Advanced Dynamic Flow, which shows flow with directional information for even the smallest vessels.

Cardiac CT Software Enhancements

CT will highlight cardiac-software enhancements for the Aquilion^® ONE and Aquilion Premium, including new ONE Beat Prospective Reconstruction, which shortens the interval window and reduces radiation exposure time, reducing dose by 21 percent; Real Time Beat Control, which calculates the running real-time average of the heart rate to predict the next beat more precisely (and thus, to time the scan more accurately); and optimizing timing for ^SUREStart, which accurately determines contrast uptake time for a better image. Wide Volume Cardiac Protocol on the Aquilion ONE, a work-in-progress enhancement, will enable clinicians to image the entire heart, lungs, and aorta in two rotations.

Cardiac MR

The wide range of cardiac MR capabilities on the Vantage Titan™ and Vantage Atlas^® systems will be highlighted. The Vantage MRI product line offers a range of advanced cardiac capabilities, including a cardiac coil for the Vantage Titan and noncontrast imaging for patients with renal insufficiency.

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Congenital Heart Disease (CHD) is a birth defect or malformation of the heart which can impact the heart’s structure and function. According to the American Heart Association, nearly 36,000 babies are born with a heart defect each year. While CHD can affect both children and adults and can be life threatening, revolutionary advancements in diagnosis and surgery have made treatment and reparation of such defects possible. In 2008, over one million people with CHD had survived through adulthood.

Cardiac Catheterization is a non-surgical procedure that can be used for hemodynamic and angiographic evaluations of the structure and function of the heart, helpful in the diagnosis of CHD. Transcatheter interventions for treatment of CHD can also be performed using stents, coils, and other interventional devices.

Used in conjunction with the Toshiba Infinix-i cardiac systems, the Toshiba 3D-Digital Acquisition (3D-DA) software package allows physicians to view a three-dimensional perspective of a variety of vascular structures including the pulmonary arteries. 3D reconstruction is ideal for optimizing vessel-viewing angles prior to intervention, providing a better understanding of complex anatomy and helping to determine the proper size of interventional devices to be used for planning and treatment.

Case Study: 3D rotational angiography using 3D-DA software.

Technology: Toshiba Infinix CF-i Biplane cardiovascular cath lab using 3D-DA software.

Patient History: A 14 year old girl born with complex congenital heart disease (interrupted aortic arch, ventricular septal defect) required numerous surgical procedures beginning in early infancy which culminated in a Fontan procedure at age 4. Recently she began complaining of decreased exercise tolerance prompting a cardiac MRI which raised the possibility of a left pulmonary artery stenosis which had not been appreciated during previous cardiac catheterizations despite selective left pulmonary arteriography.

Diagnosis: During catheterization performed via a right femoral venous approach, selective 2D left pulmonary angiography failed to adequately demonstrate any stenosis. Due to the high degree of suspicion a 3D-DA was performed at 30f/s using a 206 degree rotation over a 5 second acquisition while holding respiration. Fifty milliliters of undiluted contrast were injected at a rate of 10 cc/sec to obtain the images shown in figure 1. Reconstruction took 35 seconds and post-processing took another 2 minutes to produce the images shown here. By rotating the reconstructed image 90% caudal (a view, not possible with standard angiography) physicians were able to clearly view the compression of the left pulmonary artery in a front to back orientation. Two overlapping Genesis XD stents were implanted across the area with 12 mm balloon and further dilated to 14 mm to obtain the image shown in figure 2.

In this particular case the use of 3D-DA greatly enhanced the ability to diagnose an important stenotic lesion which was undetected by 2D-DA despite multiple bi-plane acquisition imaging angles. Furthermore, using 3D-DA, post-intervention provided excellent imaging of the vessel stent interface and allowed for improved assessment of the result as well as any potential complication.

Figure 1: Pre-intervention 3D-DA of the branch pulmonary arteries in a child with a significant left pulmonary artery stenosis (arrow) after a Fontan operation. In a standard projection (LAO 21/caudal 7) the stenosis is difficult to appreciate (left), however, after rotating the image to a virtual angle (LAO 35/Cranial 71), the stenosis is clearly visible as shown by the arrow (right).

Figure 2: The same structure seen in the comparable views as above following implantation of two endovascular stents to enlarge the area. Note the excellent clarity and detail of the newly implanted stents and their relationship to the vessel wall.

Pre- (left) and post- (right) 3D-DA spins.

Images courtesy of Dr. Evan M. Zahn, M.D., Miami Children’s Hospital, Miami Florida

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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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As procedure mixes continue to shift in facilities nationwide, it’s increasingly important for capital investments in imaging technology to offer versatility, according to Allen Berthe, X-ray senior product manager for Toshiba America Medical Systems. That’s why the company’s vascular labs come automatically equipped with features for cardiovascular procedures.

“One of our philosophies is that customers’ needs are changing and it is very likely a system will be required to perform cardiac and vascular procedures, so we’ve tried to gear our systems to maximize room utilization,” Berthe says. “A hospital today may know exactly what it wants, but five years from now, its staffing may change, its requirements may change, and its clinicians may like to do different types of procedures—so we created a system that would give them flexibility.”

Features that are part of the company’s vascular labs include digital subtraction angiography provided, standard, irrespective of system type or panel size, and a stepping feature that allows more efficient and accurate lower-body exams. A third feature is what Berthe calls a “true multitasking digital processor,” which, he explains, “means that if a physician comes in and wants to look at the images taken yesterday on a particular patient, he or she can do that without affecting the procedure currently in progress.” This parallel-processing capability is also included, standard, in Toshiba’s vascular labs.

Berthe notes that all labs are 3D ready; if a facility chooses to upgrade to 3D, the base system is configured to accept it, “so if your practice changes in three years, you can add it.” Labs are also optimized for fingertip-to-fingertip, head-to-toe patient access and coverage. “Our systems are designed to give you unprecedented patient access,” Berthe says. “Sometimes, cases require on-the-fly changes, and our systems can adapt to that. If there’s a lot of additional equipment around, then having an easy-to-position C-arm is really helpful.” He adds that all Toshiba systems are configured using the same base platform, the same features, the same user interface, and the same consoles. “If you’re buying multiple systems from us, you can go from room to room with high confidence because everything’s going to perform virtually the same way,” he says.

Berthe emphasizes the importance of versatile, flexible purchases in an environment of fluctuating reimbursement and potential health care reform. “We’re just making sure we give you a room that can address your clinical needs,” he says. “If you don’t have a cardiovascular program and choose to start one, you can do that. You have a system that’s ready to do it.”

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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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When patients have to have any diagnostic imaging exam, they are understandably nervous.  Often times the anxiety they feel comes from thinking that a particular exam is going to be difficult, time consuming or uncomfortable.  Toshiba has developed its technology with patients in mind and incorporates many patient friendly features into its systems.  At this year’s RSNA, Toshiba highlighted its patient friendly features.

Magnetic Resonance

For patients undergoing an MR exam, discomfort from claustrophobia and the loud noise of the magnet are among the highest complaints.  To address this, Toshiba developed the Vantage Titan^TM MR, which features a large 71-cm aperture and open bore, offering the industry’s largest clinical field-of-view (55×55×50 cm).  The bore’s diameter reduces the feeling of claustrophobia.  Titan’s ultra short, open bore was designed to increase comfort and improve the imaging of all patients, especially those who are claustrophobic and/or bariatric.  The open bore’s larger diameter enables facilities to scan bariatric patients with greater ease and provides patients with a greater feeling of openness to reduce claustrophobia. 

Toshiba’s Pianissimo^TM technology reduces noise by up to 90 percent, making Toshiba’s MR systems the quietest available.  Since the patient experiences lower noise levels with Pianissimo, patients stay more relaxed during exams and fewer motion artifacts are acquired, which helps improve image quality.  Useful for imaging pediatric patients, Pianissimo helps technologists image patients more successfully and reduces repeat exams.

With all of the concern surrounding gadolinium, Toshiba’s proprietary contrast-free MRA techniques enable safer MRA imaging of patients with known renal compromise. These techniques include Fresh Blood Imaging (FBI) for evaluating peripheral vascular diseases of the lower legs and extremities; Contrast-free Improved Angiography (CIA) for easier visualization of smaller vessels; Time-Spatial Labeling Inversion Pulse (Time-SLIP) for evaluating hemodynamic, functional assessments, and visualization of vascular structures; and Time Space Angiography (TSA) to create non-contrast time-resolved imaging with high temporal resolution.  Contrast-free techniques are safer for patients with renal conditions and require less set-up time, so the overall MR exam is completed faster, without compromising image quality.

Computed Tomography

The Aquilion® ONE was specifically developed with patients in mind.  Not only is the comprehensive exam much faster than traditional CT exams – 0.35 seconds versus conventional helical CTs that can take approximately 10 to 12 times longer – but also radiation exposure is dramatically reduced because of volume acquisition.  These patient benefits are especially important during neuro and pediatric procedures.

When a patient comes to a hospital’s emergency department 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. In fact, the system allows physicians to reduce diagnosis time for life-threatening conditions, such as a 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.

Another reason to select dynamic volume CT is for its pediatric applications.  The Aquilion ONE can significantly lower patient radiation dose exposure and decrease the sedation needed for exams.  Traditionally, when children are imaged using multi-detector CT, sedation is required to keep the patient still long enough to obtain a clear diagnostic image.  The Aquilion ONE’s fast exam time means less patient sedation is required. The system also features Toshiba’s ^SUREExposure™ Pediatric software, which automatically takes inputs on the size and age of each patient and tailors radiation dose to achieve the best and safest image quality for each exam. The software uses protocols selected based on the patient’s age, size and type of exam to ensure patients receive only the radiation required to obtain a clear diagnostic image.  ^SUREExposure Pediatric software comes standard on all Aquilion products.

X-ray Vascular

CT is not the only modality in which radiation is a concern.  Toshiba’s Infinix-i product line incorporates features that help to reduce exposure.  For example, the systems come with fluoro dose level settings and fluoro pulse rate settings.  Toshiba offers the industry’s widest range of pulse rates, which means that physicians have the ability to reduce flyoro pulse rate and fluoro dose level in an exam, providing two quick methods of reducing radiation exposure to the patient.  Additionally, Toshiba’s lateral plane variable isocenter on its biplane systems saves time and exposure.  During biplane positioning, the user will fluoro frontal plane and adjust table panning to center the part of interest.  Next, they will fluoro the lateral plane and adjust lateral isocenter to match the frontal set-up.  No additional fluoro is needed.  Not only does this cut down on fluoro exposure, but it also speeds the exam time, reducing the risk to the patient.

Infinix-i systems also provide the greatest anatomical coverage and patient access in the industry, providing more efficient and safer patient care.  Greater anatomical coverage means that the system moves around the patient, rather than moving the patient.  Moving the patient can introduce greater risk.

The Infinix-i’s tables also are more patient friendly.  Not only are the systems’ table weights the highest in the industry at 550 lbs., but also the tables include thicker pads complete with Tempur-Pedic^® technology, making extended procedures more comfortable.  Also, the new the CAT-880B hybrid catheterization table introduced at RSNA offers the lowest table top height of any catheterization table in the industry.  Toshiba has even introduced accessories that expand the width of the system tables to accommodate larger patients and make the exams more comfortable.

Ultrasound

The move toward portability in ultrasound is helping physicians deliver more comfortable patient care.  The ability to bring a diagnostic imaging system to the patient can often mean that someone already in discomfort does not have to be moved in order to be scanned. 

In addition to the Viamo handheld system, Toshiba has continued its focus on portability by introducing the Aplio MX.  Thirty percent lighter than traditional cart-based systems, the Aplio MX enables hospitals to complete advanced ultrasound exams, usually performed with larger systems, on a more portable system without sacrificing quality.  Furthermore, it enables medical staff to easily bring the system directly to the point-of-care.  For example, if someone is on a gurney and should not be moved, medical professionals can easily transport the MX to the patient’s location and get a high quality exam.

Toshiba’s Aplio MX ultrasound system includes:

• 4D imaging to produce high resolution renderings and arbitrary volume cuts in real-time or offline allowing virtual reconstruction in formats similar to CT and MRI.
• Differential Tissue Harmonic Imaging for better imaging of difficult-to-image patients, like bariatric, without sacrificing resolution to give superior border and tissue definition.
•  ApliPure to enhance both image clarity and detail definition with real-time compounding technology to simultaneously perform spatial and frequency compounding during transmitting and receiving.
•  Advanced Dynamic Flow to provide color Doppler imaging at an unprecedented level and show flow with directional information for even the smallest vessels.
• Precision Imaging to provide more detailed ultrasound images by capturing information from multiple lines to improve definition of the structure and minimizing noise and clutter.
• Elastography to enable a non-invasive medical imaging technique that evaluates tumors based on their stiffness (elasticity) compared to normal tissue.
• MicroPure to help physicians detect micro-calcifications using ultrasound, an imaging technique that is less strenuous on the technician and the patient than mammography, the current gold standard.

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