Can you imagine how much you could accomplish if multiple imaging modalities were seamlessly accessible directly in the OR or interventional suite? This allows for precise and targeted treatment, valuable image information during any stage of the procedure, and direct quality control of results. Moreover, clinical workflows can be made more efficient, more convenient, and safer for the patient. At Siemens Healthineers, we have developed nexaris Therapy Suites to better integrate multimodal imaging in surgery and interventional radiology.
Angiography and CT imaging combined for interventional radiology procedures
The seamless access to and quick switching between angiography system and CT scanner enables faster and more precise treatment. By marrying the strengths of SOMATOM CT and ARTIS Angiography systems it’s easier than ever to perform challenging procedures, streamline workflows and advance therapy outcomes with the peace of mind every pioneer needs. Combining these modalities makes interventional oncology easier, e.g., for the combined ablation and embolization of a liver tumor. In a standard procedure, the patient is moved back and forth between the angiography system and the CT scanner as separate treatment procedures. With nexaris Angio-CT, all treatment stages – from path planning to tumor embolization and surgical removal of the tumor via ablation – can now take place in a single suite. Whether angiography or CT imaging is required, there is no need to move the patient.
nexaris Angio-CT also makes handling of polytrauma patients easier. As soon as internal bleeding is visualized on a CT scan, the bleeding site can be catheterized directly guided by the angiography system. “In the setting of blunt trauma, we can immediately diagnose internal bleeding with CT, allowing us to quickly stabilize the patient with angiography and transcatheter embolization, potentially saving lives,” comments Mark Wilson, MD, Chief of Interventional Radiology, Zuckerberg San Francisco General Hospital.
The CT and angiography images are now seamlessly integrated and instantly fused together. With Instant Fusion1,2, the angiography and CT images are given a common system of coordinates for the first time, so nexaris Angio-CT offers automated overlay of image information. Patient details need to be recorded only once and the treating radiologist can access them on both systems. In addition, both modalities can be operated from just a single location in the control room. The two-room solution optimizes system capacity utilization as the system can be moved to a second patient table in an adjacent room that is then partitioned off to enable diagnostic or interventional procedures using the CT system only while the angiography system can be used for routine examinations.
Intraoperative imaging with MR, CT, and angiography for surgery
For surgical procedures, a multi-room solution avoids the laborious and risky task of moving the patient between different modalities. Combining MR, CT, and angiography offers benefits for complete tumor resection, for example in neurosurgery. Using intraoperative imaging, surgeons can determine immediately if there is residual tumor tissue or if they need to adapt the chosen treatment approach. On top of that nexaris Angio-MR-CT2 makes it possible for the first time to perform MR imaging of the whole body at any time while surgery is in progress, with no need to reposition the patient. Neurosurgeons are not the only beneficiaries of additional representation of the tissue provided by MR imaging, but also visceral surgeons, for example, performing resections and ablations in the abdomen. It has the potential to have a critical influence on the treatment process.
The nexaris Angio-MR-CT can be used to combine the robot-supported angiography system ARTIS pheno, the MR systems MAGNETOM Aera and Skyra, and SOMATOM CT Sliding Gantry systems to form a multi-room solution. The Pilot Transfer Solution3 which we developed with our strategic partner Getinge, avoids the laborious and risky task of moving the patient between the different modalities. If, for example, the patient is being treated using the angiography system, he/she will lie on the Maquet Magnus table, which enables the best possible imaging and patient positioning. If MR imaging is required during the procedure, the Maquet Magnus operating table gets connected with the MR-compatible Combi Dockable Table, using docking adapters. The transfer board can be used to slide the patient onto the MR table without having to change treatment position. “These multimodality imaging suites will be the laboratory of the future,” explains Professor Lee Swanström of the Institut de Chirurgie guidée par l’Image (IHU) in Strasbourg. To ensure the best possible system capacity utilization, all of the above systems can also be used individually: MR and CT for diagnostic examinations and Artis pheno in the hybrid OR for purely angiography-driven interventions.