Page 15

1697_AX_Kundenmagazin_CC.indd

Professor Wacker, your department performs more than 140,000 examinations per year. What is your main focus? We are one of the largest comprehensive transplant centers in Europe, so many of our patients come here before or after a transplantation. In addition to diagnostic procedures, we perform approximately 1,200 angio procedures and approximately 500-600 CT-guided procedures. What are the main interventional therapies you perform in the angio suite? We treat a lot of liver cancer patients who are seen by our hepatologists at the MHH. In our multidisciplinary liver tumor board, we see fifteen to twenty patients with liver cancer per week, and many of these patients undergo transarterial chemoembolization (TACE) of the liver. TACE is indeed a bread-and-butter intervention in our angio suite but we also perform TIPS, we treat GI bleeding, and we do arterial recanalization and venous thrombolysis, but our main patient load is TACE. Your new Artis Q system was installed around two months ago (June 2013). What were your expectations? When Siemens informed us that they were developing a new system with a new tube delivering more power from smaller focal spots with shorter pulses, and a 16-bit detector, I was intrigued, however it is hard to estimate what such new technology really means in daily routine. To satisfy this curiosity we decided to test the system ourselves and measure dose levels before making any purchasing decision. A team lead by Bernhard Meyer, MD, the head of IR at the MHH, visited the Siemens factory in Forchheim to measure the possibilities of dose reduction and gauge the real benefit of this new technology. From June until August your team has already performed around 140 procedures with the new system. What is your impression so far? When a system is installed for the first time worldwide you always expect some hiccups or downtime, but we did not experience any of this. This is really amazing! From the first procedures, we started to lower the fluoroscopy dose gradually from intervention to intervention and were surprised that we could actually go lower and lower – and the image quality was still good. In some cases we could reduce the level to as little as twenty percent of the original dose. Where is this significant dose reduction most important? I think the greatest benefit lies in fluoroscopy. When you perform DSA and fluoroscopy, everyone in the room is affected by the radiation, not just the patient but also the operator, the technologist, and the radiologist. They are all close to the table, often for a fairly long time, and that is why a low dose is doubly important. At the same time you need good image quality to ensure that you do not have to repeat the DSA run or the syngo DynaCT. How satisfied are you with the image quality? You always expect better image quality from a new system. We wanted sharp images whenever we need them, with excellent contrast to see the smallest vessels, but at the same time we expected that the dose level for the whole procedure would be lower than what we had before. So far we are more than happy with what we got! You perform a great number of different interventions in the angio suite. Did the purchase of the new system influence your range of treatments? We treat more aneurysms now, both iliac and aortic aneurysms, in cooperation with our vascular surgeons. Normally they perform these interventions in the OR with a simple C-arm. But once they saw the image quality we can now provide (see video) and the 3D capabilities of syngo DynaCT, they were hooked! They now come down to our department with some of their more complicated cases. “When a system is installed for the first time worldwide, you always expect some hiccups or downtime, but we did not experience any of this. That is really amazing!” Prof. Frank Wacker, MD Head of the Department of Diagnostic and Interventional Radiology, Hannover Medical School, Germany Artis Q Angiography AXIOM Innovations | December 2013 | www.siemens.com/angiography  15


1697_AX_Kundenmagazin_CC.indd
To see the actual publication please follow the link above