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CT-guided interventionsInnovative CT solutions for efficient procedure planning and needle guidance
CT-guided interventions are always critical and require great accuracy and efficiency. Modern CT scanners and advanced technologies can help the radiologist position the needle safely and reach the target area faster and with greater precision – even in challenging procedures with double angulated access paths.
Stay competitive in a growing and dynamic field
The number of CT-guided interventions performed is expected to grow rapidly. While biopsies will remain the core application, therapeutic procedures are expected to become much more important due to the obvious advantages of minimally invasive therapy: fewer complications, faster recovery times, and shorter hospital stays.
New guidelines
The growing importance of thermal ablations in cancer treatment is highlighted by a number of new guidelines.1,2
Increase in ablations
Ablation procedures in cancer therapy are projected to increase by 8 percent per year between 2020 and 2030.3
Alternative to surgery
CT-guided drainages provide an alternative to surgery with lower morbidity and mortality rates.4
577 million patients
More than half a billion patients worldwide suffered from low-back pain in 2017.5 Image-guided injections can help ease this burden and minimize surgical interventions.
Customer voices
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Michael Kostrzewa, MD 01
Doris Csillag, MD 01
Frank K. Wacker, MD 01
Ralph Bauer, MD 01
Ralph Bauer, MD, uses SOMATOM go.Up with myNeedle Companion at his radiology practice in Wiesbaden, Germany. In this video, he speaks about his experiences, for example in the ablation of hepatocellular carcinoma.
Watch the recording of Michael Kostrzewa; MD, and have a look on the first clinical results with SOMATOM X.ceed and myNeedle Companion – our novel tool for CT-guided interventions with an integrated laser guidance system.
Watch this video to hear from Doris Csillag, MD, how much time myNeedle Laser saves when using it in clinical routine.
At CIRSE 2022, Frank K. Wacker, MD, described how he uses myNeedle Laser and myNeedle Companion to facilitate drainage placements. Watch the key points of his lecture.
Ralph Bauer, MD, uses SOMATOM go.Up with myNeedle Companion at his radiology practice in Wiesbaden, Germany. In this video, he speaks about his experiences, for example in the ablation of hepatocellular carcinoma.
Watch the recording of Michael Kostrzewa; MD, and have a look on the first clinical results with SOMATOM X.ceed and myNeedle Companion – our novel tool for CT-guided interventions with an integrated laser guidance system.
Watch this video to hear from Doris Csillag, MD, how much time myNeedle Laser saves when using it in clinical routine.
At CIRSE 2022, Frank K. Wacker, MD, described how he uses myNeedle Laser and myNeedle Companion to facilitate drainage placements. Watch the key points of his lecture.
Ralph Bauer, MD, uses SOMATOM go.Up with myNeedle Companion at his radiology practice in Wiesbaden, Germany. In this video, he speaks about his experiences, for example in the ablation of hepatocellular carcinoma.
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Clinical cases
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Biopsy04
Pain management01
Drainage placement01
Thermal ablation02
Microwave ablation of a liver mass
CT-guided intervention with myNeedle Guide 3D on SOMATOM go.Up
Contrast enhanced planning spiral:
2 events
Exposure time: 12.2 s / 13.6 s
Scan length: 299 mm / 329 mm
130 kV
CTDIvol: 13.9 mGy
DLP: 379 mGy*cm / 420 mGy*cm
FAST i-Sequence:
21 events
Exposure time: 16.8 s
Scan length: 15 mm (each)
80 kV
CTDIvol: 5.57 mGy
Accum. DLP: 379 mGy*cm
Biopsy of a small suspicious lesion at the shoulder blade
CT-guided intervention with myNeedle Guide 2D on SOMATOM X.ceed
Planning and control spiral:
Exposure time: 3.6 s / 1.7 s
Scan length: 131 mm / 41 mm
100 kV
CTDIvol: 3.9 mGy / 3.15 mGy
DLP: 57.6 mGy*cm / 18.7 mGy*cm
i-Fluoro:
3 events
130 kV
Scan length: 9 mm
Exposure time: 0.7 s / 4.3 s / 0.7 s
CTDIvol: 6.48 mGy / 39.3 mGy / 6.48 mGy
Accum. DLP: 47.1 mGy*cm
Complete procedure time: 36 min
Biopsy of suspicious lesion in the liver
CT-guided intervention with myNeedle Companion on SOMATOM X.cite
Planning spiral:
Exposure time: 4.6 s
Scan length: 215 mm
80 kV
CTDIvol: 10 mGy
DLP: 256
i-Spiral:
8 events
80 kV
Scan length: 70 mm - 98 mm
Exposure time: 1.93 s (each)
CTDIvol: 4.2 mGy / 6.8 mGy
Accum. DLP: 386 mGy*cm
Biopsy of a small suspicious lung lesion
CT-guided intervention with myNeedle Guide & i-Fluoro on SOMATOM go.Up
Planning and control i-Spiral:
Exposure time: 14 s (each)
Scan length: 341 mm (each)
130 kV (each)
CTDIvol: 5.1 mGy
DLP: 160 mGy*cm
i-Fluoro to monitor needle progression:
2 events
Exposure time: 2.2 s / 12.6 s
Scan length: 9 mm (each)
110 kV
CTDIvol: 14.5 mGy / 83.7 mGy
Accum. DLP: 88.4 mGy*cm
Biopsy of a suspicious lesion between kidney and spleen
CT-guided intervention with myNeedle Guide 3D on SOMATOM X.cite
Planning and control spiral:
3 events
Exposure time: 3.6 s (each)
Scan length: 175 mm (each)
70 kV
CTDIvol: 3.3 mGy
DLP: 65.5 mGy*cm
i-Spiral to monitor needle progression:
12 events
70 kV - 80 kV
Exposure time: 2.3 s - 2.4 s
Scan length: 86 mm - 175 mm
CTDIvol: 2.2 mGy / 2.4 mGy
DLP: 6.75 mGy*cm / 23 mGy*cm
Accum. DLP: 123 mGy*cm
Complete procedure time: 1h 15 min
Cervical periradicular infiltration for pain management
CT-guided intervention with myNeedle Companion on SOMATOM X.ceed
Planning and control spiral:
5 events
Exposure time: 3-4 s (each)
Scan length: 146 mm (each)
Sn100 kV
CTDIvol: 4.61 / 5.05 mGy
Accum. DLP: 395 mGy*cm
i-Fluoro
5 events
Sn130 kV
Exposure time: 0.35 s - 5.64 s
Scan length: 9 mm
CTDIvol: 3.25 / 52.1 mGy
Accum. DLP: 92 mGy*cm
Drainage placement in Seldinger technique
CT-guided intervention with myNeedle Guide 2D & i-Fluoro on SOMATOM go.Up
Planning and control spiral:
Exposure time: 9.3 s / 4.53 s
Scan length: 232 mm / 127 mm
130 kV
CTDIvol: 7.42 mGy
DLP: 153 mGy*cm / 75 mGy*cm
i-Fluoro:
2 events
Exposure time: 10.9 s / 21.3 s
Scan length: 15 mm (each)
80 kV
CTDIvol: 58 mGy / 122 mGy
Accum. DLP: 169 mGy*cm
Microwave ablation of a liver metastasis
CT-guided intervention with myNeedle Companion on SOMATOM X.ceed
Contrast enhanced planning spiral:
Exposure time: 4 s
Scan length: 234 mm
80 kV
CTDIvol: 1.64 mGy
DLP: 43.6 mGy*cm
i-Spiral for monitoring the needle progression:
7 events
Exposure time: 2 s
Scan length: 71 mm
Sn100 kV
CTDIvol: 2.2 / 2.4 mGy
Accum. DLP: 224.5 mGy*cm
i-Spiral of arterial phase after treatment:
Sn 100 kV
Scan length: 217.6 mm
Exposure time: 5 s
CTDIvol: 2.18
DLP: 52 mGy*cm
Microwave ablation of a liver mass
CT-guided intervention with myNeedle Guide 3D on SOMATOM go.Up
Contrast enhanced planning spiral:
2 events
Exposure time: 12.2 s / 13.6 s
Scan length: 299 mm / 329 mm
130 kV
CTDIvol: 13.9 mGy
DLP: 379 mGy*cm / 420 mGy*cm
FAST i-Sequence:
21 events
Exposure time: 16.8 s
Scan length: 15 mm (each)
80 kV
CTDIvol: 5.57 mGy
Accum. DLP: 379 mGy*cm
Biopsy of a small suspicious lesion at the shoulder blade
CT-guided intervention with myNeedle Guide 2D on SOMATOM X.ceed
Planning and control spiral:
Exposure time: 3.6 s / 1.7 s
Scan length: 131 mm / 41 mm
100 kV
CTDIvol: 3.9 mGy / 3.15 mGy
DLP: 57.6 mGy*cm / 18.7 mGy*cm
i-Fluoro:
3 events
130 kV
Scan length: 9 mm
Exposure time: 0.7 s / 4.3 s / 0.7 s
CTDIvol: 6.48 mGy / 39.3 mGy / 6.48 mGy
Accum. DLP: 47.1 mGy*cm
Complete procedure time: 36 min
Biopsy of suspicious lesion in the liver
CT-guided intervention with myNeedle Companion on SOMATOM X.cite
Planning spiral:
Exposure time: 4.6 s
Scan length: 215 mm
80 kV
CTDIvol: 10 mGy
DLP: 256
i-Spiral:
8 events
80 kV
Scan length: 70 mm - 98 mm
Exposure time: 1.93 s (each)
CTDIvol: 4.2 mGy / 6.8 mGy
Accum. DLP: 386 mGy*cm
Biopsy of a small suspicious lung lesion
CT-guided intervention with myNeedle Guide & i-Fluoro on SOMATOM go.Up
Planning and control i-Spiral:
Exposure time: 14 s (each)
Scan length: 341 mm (each)
130 kV (each)
CTDIvol: 5.1 mGy
DLP: 160 mGy*cm
i-Fluoro to monitor needle progression:
2 events
Exposure time: 2.2 s / 12.6 s
Scan length: 9 mm (each)
110 kV
CTDIvol: 14.5 mGy / 83.7 mGy
Accum. DLP: 88.4 mGy*cm
Biopsy of a suspicious lesion between kidney and spleen
CT-guided intervention with myNeedle Guide 3D on SOMATOM X.cite
Planning and control spiral:
3 events
Exposure time: 3.6 s (each)
Scan length: 175 mm (each)
70 kV
CTDIvol: 3.3 mGy
DLP: 65.5 mGy*cm
i-Spiral to monitor needle progression:
12 events
70 kV - 80 kV
Exposure time: 2.3 s - 2.4 s
Scan length: 86 mm - 175 mm
CTDIvol: 2.2 mGy / 2.4 mGy
DLP: 6.75 mGy*cm / 23 mGy*cm
Accum. DLP: 123 mGy*cm
Complete procedure time: 1h 15 min
Cervical periradicular infiltration for pain management
CT-guided intervention with myNeedle Companion on SOMATOM X.ceed
Planning and control spiral:
5 events
Exposure time: 3-4 s (each)
Scan length: 146 mm (each)
Sn100 kV
CTDIvol: 4.61 / 5.05 mGy
Accum. DLP: 395 mGy*cm
i-Fluoro
5 events
Sn130 kV
Exposure time: 0.35 s - 5.64 s
Scan length: 9 mm
CTDIvol: 3.25 / 52.1 mGy
Accum. DLP: 92 mGy*cm
Drainage placement in Seldinger technique
CT-guided intervention with myNeedle Guide 2D & i-Fluoro on SOMATOM go.Up
Planning and control spiral:
Exposure time: 9.3 s / 4.53 s
Scan length: 232 mm / 127 mm
130 kV
CTDIvol: 7.42 mGy
DLP: 153 mGy*cm / 75 mGy*cm
i-Fluoro:
2 events
Exposure time: 10.9 s / 21.3 s
Scan length: 15 mm (each)
80 kV
CTDIvol: 58 mGy / 122 mGy
Accum. DLP: 169 mGy*cm
Microwave ablation of a liver metastasis
CT-guided intervention with myNeedle Companion on SOMATOM X.ceed
Contrast enhanced planning spiral:
Exposure time: 4 s
Scan length: 234 mm
80 kV
CTDIvol: 1.64 mGy
DLP: 43.6 mGy*cm
i-Spiral for monitoring the needle progression:
7 events
Exposure time: 2 s
Scan length: 71 mm
Sn100 kV
CTDIvol: 2.2 / 2.4 mGy
Accum. DLP: 224.5 mGy*cm
i-Spiral of arterial phase after treatment:
Sn 100 kV
Scan length: 217.6 mm
Exposure time: 5 s
CTDIvol: 2.18
DLP: 52 mGy*cm
Microwave ablation of a liver mass
CT-guided intervention with myNeedle Guide 3D on SOMATOM go.Up
Contrast enhanced planning spiral:
2 events
Exposure time: 12.2 s / 13.6 s
Scan length: 299 mm / 329 mm
130 kV
CTDIvol: 13.9 mGy
DLP: 379 mGy*cm / 420 mGy*cm
FAST i-Sequence:
21 events
Exposure time: 16.8 s
Scan length: 15 mm (each)
80 kV
CTDIvol: 5.57 mGy
Accum. DLP: 379 mGy*cm
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Dedicated solutions for CT-guided interventions
Our advanced technologies support routine and complex CT-guided interventions, reduce metal artifacts, enable dose modulation, and simplify workflows by giving radiologists full in-room control of all relevant parameters.
myNeedle Companion
myNeedle Companion is our modular and scalable solution for CT-guided interventions. It helps simplify even advanced needle procedures with targeted needle path planning and guidance facilitated by an AI-based needle detection algorithm, 3D volume registration and image fusion display, as well as laser-guided needle insertion with myNeedle Laser. In addition, dedicated in-room control options offer you the flexibility to work as you prefer – with or without an assistant.
myNeedle Guide 2D
myNeedle Guide 2D simplifies CT-guided interventions along the whole clinical workflow, from imaging through planning and monitoring the current needle position.
myNeedle Guide 3D
myNeedle Guide 3D6 simplifies the workflow for both routine and complex CT-guided interventions. You can easily plan multiple needle pathways in different cross sections. Both path planning and visually guided insertion of multiple needles are supported within the workflow.
The AI based needle detection algorithm myNeedle Detection supports an efficient workflow by minimizing user interaction when progressing the needle.
Integrated Image Fusion allows fusing of 3D images from different modalities or contrast-enhanced prior CT studies to accurately plan and guide needle paths around critical anatomy.
myNeedle Laser
myNeedle Laser7 is a powerful, fully integrated option designed to make the intervention workflow more efficient by automatically projecting the needle entry point and insertion angle onto the body of the patient – even in advanced double-angulated procedures with multiple needle paths.
Available on:
i-Fluoro
i-Fluoro8 mode is designed for precise and fast placement in even the most complex, moving anatomies. At the same time, it offers HandCARE a real-time dose reduction providing significant protection from radiation to both radiologist and patient.9
In-room control
The in-room control solution simplifies workflows by giving radiologists almost full control of CT-guided interventions. It is designed specifically for targeted needle placement without the need for a supporting technologist.
Artifact reduction with iMAR10
Artifacts due to metal implants or to the tool used in interventional procedures (e.g., RF ablation) often hamper image quality. Special reconstruction algorithms such as iMAR can be applied during CT-guided interventional procedures to reduce artifacts and to improve confidence even in areas adjacent to metal implants.
Dose modulation
Dose matters in CT-guided interventions for both the patient and the operator. HandCARE enables real-time dose modulation during CT-guided intervention procedures and prevents direct radiation exposure to the clinician’s hand – by switching off the X-ray exposure for a 100° angle between three possible user positions:
- 10 o’clock
- 12 o’clock
- 2 o’clock
Our scanners for CT-guided interventions
By choosing from our comprehensive portfolio of scanners, you can select the solution that best suits your clinical needs and budget for CT-guided interventions.
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The products/features and/or service offerings (mentioned herein) are not commercially available in all countries. Their future availability cannot be guaranteed.
1
Genshaft S, et al. (2021): SIR Quality Improvement Standards on Percutaneous Ablation of Non-Small Cell Lung Cancer and Metastatic Disease to the Lungs.
2
Reig M, et al. (2022): BCLC Strategy for Prognosis Prediction and Treatment recommendation.
3
Siemens Healthineers evaluation based on Clarivate: Interventional Oncology Devices Market Insights, 2021.
4
De Filippo, M, et al. (2021): CT-guided percutaneous drainage of abdominopelvic collections: a pictorial essay.
5
Wu A, et al. (2017): Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017.
6
Option. Not available for SOMATOM go.Now.
7
Option. Only available with SOMATOM X.cite, SOMATOM X.ceed, and NAEOTOM Alpha and in combination with myNeedle Guide 3D.
8
Only in combination with myNeedle Guide 2D or myNeedle Guide 3D
9
Hohl C, Suess C, Wildberger JE, Honnef D, Das M, Mühlenbruch G, et al. (2008): Dose reduction during CT fluoroscopy: Phantom study of angular beam modulation.
10
iMAR is designed to yield images with a reduced level of metal artifacts compared to conventional reconstruction if the underlying CT data is distorted by metal being present in the scanned object. The exact amount of metal artifact reduction and the corresponding improvement in image quality achievable depends on a number of factors, including composition and size of the metal part within the object, patient size, anatomical location and clinical practice. It is recommended to perform iMAR reconstruction in addition to conventional reconstruction.