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The Backbone of our Diagnostics

The Department of Diagnostic Radiology and Neuroradiology for Emmental Hospital Group in Switzerland has recently upgraded its CT capabilities with two new CT scanners from Canon Medical - The Aquilion ONE / PRISM Edition and the Aquilion Prime SP. Featuring exceptionally high image quality and low dose, the two new CT systems have expanded capabilities for the entire team. Dr. Urspeter Knecht, Neuroradiologist and Head of the Department, and Prof. Dr. med. Marwan El-Koussy, Deputy Chief of the Radiology Department at the hospital Langnau and Burgdorf, explain to VISIONS how the two systems have quickly become the backbone of the Department.

Image VISIONS spoke with Dr. Urspeter Knecht (Neuroradiologist and Head of the Department) and Prof. Dr. med. Marwan El-Koussy (Deputy Chief of the Radiology Department at the hospital Langnau and Burgdorf) of the Department of Diagnostic Radiology and Neuroradiology for Emmental Hospital Group in Switzerland.

Over the last few years, Emmental Hospital Group’s Department of Radiology and Neuroradiology has experienced burgeoning workloads and has expanded significantly from a small team to double the number of radiologists it employs. In addition, as elsewhere, it has faced changes introduced with the COVID-19 pandemic.

“It has been a big challenge to build a bigger and bigger department in such a short time,” remarked Dr. Knecht. “During this time there has also been COVID-19, which has meant that all the steps we have to perform are extended and more complicated. We have also introduced subspecialities to our Radiology department.”

“We have a great number of CT examinations to carry out – many more per day, this became a really great challenge for us,” added Prof. Dr. med. El-Koussy.

New capabilities

Replacing older scanners with Canon Medical’s Aquilion ONE / PRISM Edition and Aquilion Prime SP systems has enabled the Radiology team to achieve better imaging, higher diagnostic confidence and a much higher workflow.

“One of our systems was quite an old scanner that was performing badly. Its image quality was not brilliant, and the radiation dose was quite high. Each CT examination required a long acquisition time. And sometimes, we would need to cool down the CT scanner after the examination. All-in-all, it could often take over half an hour or an hour before we were ready to perform the next scan,” explained Dr. Knecht.
“Replacement of this scanner with a new Aquilion Prime SP has changed a lot. Now, we are able to just complete examinations at the patient’s convenience, and we don’t have to wait anymore. So, we can complete many more examinations within a certain time and have a higher throughput and improved workflow.”

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“With the new Aquilion ONE / PRISM Edition, we achieve much better image quality, lower radiation dose, and we have been able to expand our range of examinations,” he continued. “We can now perform some special examinations that we were not able to perform in the past. For example, cardiac imaging. Or, we have better performance in some interventions, such as periradicular therapy (PRT).”

“Our work is much more straightforward, because the performance of the Aquilion CTs is considerably higher.”

Dr. Urspeter Knecht, Neuroradiologist, Emmental Hospital Group, Bern, Switzerland.

About Dr. Urspeter Knecht
Dr. Urspeter Knecht is a Neuroradiologist and is the Head of the Department of Diagnostic Radiology and Neuroradiology, Emmental Hospital Group, Bern, Switzerland. His focus is Neuro-Oncology and advanced Neuro-Imaging, especially MR-Spectroscopy.

More advanced procedures and services

The radiology team can also carry out cutting-edge techniques with the new CT systems.

“We can perform more advanced procedures with the Aquilion ONE / PRISM Edition in particular, including cardiac imaging,” said Prof. Dr. med. El-Koussy. “We have also been able to expand our number of interventions, due to new features that we have gained with this scanner. So, we can perform periradicular nerve root blockades, infiltrations, as well as CT fluoroscopy of different locations, especially difficult locations.”

The team have also performed some spectral examinations with the Aquilion ONE / PRISM Edition, starting with kidney stone quantification.

“We may also begin some spectral studies connected with COVID-19, because we performed some studies of our patients that were here in our hospital,” said Prof. Dr. med. El-Koussy.

The systems are unlike any that the team have used previously.

“Our work is much more straightforward, because the performance of the Aquilion CTs is considerably higher,” said Dr. Knecht. “One of the biggest improvements for us was the new detector of the Aquilion ONE. With the 16 cm detector, we are able to acquire volume scans. And we use this quite often, in different situations, such as imaging smaller body parts or joints, brains, or volume scanning during infiltrations or CT fluoroscopy interventions.”

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Besides this, the team has been able to build and expand its neurological department with the new capabilities.

“We started our neuroradiology imaging with MR imaging, but now we have advanced imaging, we can carry out advanced CT procedures too,” said Dr. Knecht. “We are now able to perform the CT perfusion imaging required in stroke patients with the Aquilion ONE / PRISM Edition. Before the installations, we were not able to offer this service.”

“We can perform more advanced procedures with the Aquilion ONE / PRISM Edition in particular cardiac imaging.”

Prof. Dr. med. Marwan El-Koussy, Deputy Chief of the Radiology Department at the hospital Langnau and Burgdorf, Neuroradiology and Radiology, Switzerland.

About Prof. Dr. med. Marwan El-Koussy
Prof. Dr. med. El-Koussy is Deputy Chief of the Radiology Department at the hospital Langnau and Burgdorf in Switzerland. His focus is Neuroradiology, especially advanced Neuro-Imaging of cerebrovascular diseases and stroke as well as Neuro-Oncology.

Impressive dose reduction

Dr. Knecht and his team have been especially impressed by the significant dose reduction achievable with the Aquilion CTs.

“We also very much appreciate the Advanced intelligent Clear-IQ Engine (AiCE) technology, which enables us to scan with low dose and high image quality,” he said.

AiCE is part of Canon Medical’s Altivity suite of solutions, leveraging AI to overcome challenges of image appearance and/or reconstruction speed when used in a clinical setting.

Another feature that Dr. Knecht finds increasingly useful is variable helical pitch. Workflow can be improved through three-phase Variable Helical Pitch (vHP3) designed to combine gated and non-gated, optimized SUREExposure and Helical Pitch settings within a single helical scan.

“We are using variable helical pitch more and more, mostly when we have some big scan areas. I think this is a great feature,” he said.

“Now that we can show that we have much lower doses in CT, the future standpoint of CT is broader than it has been in the last few years.”

Dr. Urspeter Knecht, Neuroradiologist, Emmental Hospital Group, Bern, Switzerland.

Improved workflow

The team have found that operating the Aquilion ONE / PRISM Edition is a much easier process than other CTs. With semi-automated workflow they are able to simply choose the patient region of interest of the study and select a protocol, which sets itself automatically, with all associated parameters set automatically for the desired examination.

“Our radiographers do not have to press a lot of buttons or make a lot of mouse clicks with the Aquilion ONE. It’s all automatic or semi-automatic,” remarked Prof. Dr. med. El-Koussy.
“So, they do not have to change much in the CT. It’s very easy. All Radiographers are able to scan with the new CT system without any problems.”

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CT renaissance

Dr. Knecht believes there is a kind of renaissance of CT scanners occurring, mainly because of improved dose reduction.

“Now that we can show that we have much lower doses on the CT scanner, the future standpoint of CT is broader than it has been in the last few years,” said Dr. Knecht. “We are very happy that we decided to have two Aquilion CT systems. With these, we have compatible imaging in our department. And CT has quickly become the backbone of our work.” //

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The content reflects information available at the time of publication and may differ from current information.