A radically new imaging technology, photon-counting CT, has arrived at the John Radcliffe Hospital, part of Oxford University Hospitals NHS Foundation Trust (OUH), making it the first in the UK to benefit from the system’s high resolution and dose reduction technology. The NAEOTOM Alpha® from Siemens Healthineers is also the first in the world to sit within a hybrid catheterisation laboratory. This will support OUH in optimising diagnostic and treatment pathways, as well as facilitating groundbreaking research at the Oxford Acute Vascular Imaging Centre (AVIC), part of the Radcliffe Department of Medicine at the University of Oxford, to help pave the way for photon-counting CT to be rolled out across the NHS. The new technology forms part of the University's Academic Cardiovascular CT programme, supported by OUH and the British Heart Foundation.
The system utilises cadmium telluride crystals, a new type of detector material, converting X-ray photons directly into electrical signals, overcoming the loss of information encountered in conventional CT. The better the input signals, the better the resulting images at the end of the processing chain that the radiologist can use for diagnosis. Equipped with highly-sensitive photon-counting detectors, the scanner can also achieve up to 45 percent dose reduction for ultra-high resolution, obtaining valuable new clinical information and supporting earlier diagnoses, whilst benefitting patients with lower radiation exposure.
The UK’s first photon-counting CT replaces an existing MRI at the AVIC at the University of Oxford, previously taking up to an hour to complete a single cardiac study. With the implementation of photon-counting CT, clinicians expect to reduce cardiac scanning time to just a few minutes, enabling the expansion of services to include vascular imaging for acute patients and the provision of a routine cardiac CT service.
The implementation of photon-counting CT into clinical practice at the John Radcliffe Hospital has the potential to transform patient pathways for those presenting with symptoms of a heart attack, identifying patients who can be treated at home and those who require targeted intervention. With conventional CT imaging, the calcified arteries of these patients compromise image quality, often necessitating further, invasive investigations. The NAEOTOM Alpha allows the visualisation of coronary vessels by virtually removing the calcium, in order to clearly assess whether obstructions are present, helping to avoid unnecessary hospital admissions.
Research in this area is ongoing at AVIC, where the location of the photon-counting CT within a unique hybrid facility means plaques can be visualised concurrently to intervention, providing data that has never been captured before. For the first time, doctors are able to visualise plaques before they are disturbed, allowing researchers to identify the plaques causing a heart attack and apply this knowledge to identifying vulnerable plaques before they rupture. This data will also be used to optimise artificial intelligence models at the big data facility within AVIC, with the goal of helping to predict heart attacks in the future. The combination of photon-counting CT and AI for the first time will also help to optimise heart attack diagnosis and prognosis ahead of adoption of the technology by the NHS. Additional research will be conducted with international collaborators, including the Semmelweis University, Hungary, who have just obtained similar technology.
“The photon-counting CT scanner from Siemens Healthineers is game changing for UK healthcare provision and will enable us to streamline our patient pathways. The NAEOTOM Alpha will act as a gatekeeper, reducing hospital admissions and scanning patients with symptoms of a heart attack before they are admitted. We will be able to identify patients who can undergo medical therapy as an outpatient or send patients directly for revascularisation procedures without the need for an invasive diagnostic angiogram, freeing up hospital beds and avoiding unnecessary hospitalisation,” states Professor Charalambos Antoniades, British Heart Foundation Chair of Cardiovascular Medicine at the Radcliffe Department of Medicine at the University of Oxford, and Director of the Oxford Acute Vascular Imaging Centre. “This is the first system in the UK and the first in the world within a hybrid setting, making us pioneers for a technology that will soon help transform diagnostic provision across the NHS.”
“The introduction of photon-counting CT is a development that could be compared with the move from pixelated black-and-white images to HD colour,” states Peter Harrison, Managing Director at Siemens Healthineers GB&I. “We are proud to be the first to introduce the photon-counting CT to the market and pleased to see this technology arrive in the UK for the first time at the University of Oxford. With its advanced visualisation capabilities, the system will be central to studies striving to reduce burden on the NHS and transform patient pathways. We hope the NAEOTOM Alpha will go on to inspire further breakthroughs in healthcare and support groundbreaking research taking place at the University of Oxford today and into the future.”
Dr Bruno Holthof, Chief Executive Officer of Oxford University Hospitals, said: “It’s wonderful to see this cutting-edge CT technology coming to Oxford, keeping us at the forefront of medical imaging research. This new scanner will have huge direct benefits for our patients, thanks to quicker and better diagnoses and access to the very latest treatments. The Trust showed its commitment to this clinical-academic partnership with a £11.5 million grant last year to the University of Oxford to support the development of major clinical research facilities, including the refurbishment of AVIC."