Clinical Advancements in Angiographic Imaging

Neurovascular CTA: When every second counts important for patients with subarachnoid hemorrhage. If an aneurysm is missed due to its small size, it can mean life or death for the patient. That is why it is important to accurately visualize the vessels to detect even the smallest aneurysms; particularly when the source of hemorrhage is not immediately clear. Dr. Peters: As noted earlier, the major location that brain aneurysms develop is near the skull base in the region of the Circle of Willis – this is the area that we are concentrating on when imaging patients with subarachnoid hemorrhage. SURE Subtraction allows us to image this area reliably, to perform reformations, and to visualize the vessels in an inﬁ nite number of directions or viewing angles to see if an aneurysm is present. Additionally, we’re able to completely subtract metal devices, such as aneurysm clips or coils, to be able determine if an aneurysm has completely occluded or if recanalization has taken place. How does SURE Subtraction impact your workﬂow? Dr. Peters: A regular CTA can easily take 20-30 minutes to review depending on its complexity. Now, we can review a CTA in about ﬁve minutes since there is very little processing involved using SURE Subtraction technology. It has been a beneﬁt in that we’re able to get the report to the clinician much more rapidly – basically, about half-an-hour faster than before. Dr. Jahromi: SURE Subtraction has impacted our workﬂow signiﬁcantly. For acute stroke patients, “time is Figure 5: Frontal view of Giant Internal Carotid Posterior Communicating Aneurysm. brain.” With the ability to obtain images directly from the CT scanner without a 3D workstation, we can quickly determine if an artery is blocked or not, saving crucial time for a stroke patient who has a narrow therapeutic window for treatment. Additionally, the ability for non-expert physicians to interpret 3D SURE Subtraction CTA images, without dedicating a lot of time on a 3D workstation, has greatly impacted the overall workﬂow. This makes physicians more comfortable in using CTA rather than invasive angiography as an initial imaging modality. What is the overall impact of SURE Subtraction in your clinical practice? Dr. Peters: The greatest impact has been with our residents because they’ve been able to realize how much this technology has increased their conﬁdence level when they are reviewing studies. It has also decreased interpretation time, which ultimately improves patient care. We’re treating cerebral aneurysms; therefore, determining the treatment modality as soon as possible is crucial. For stroke patients, you have a very narrow time window for therapy – about three hours for initiation of IV therapy, and six hours for interarterial therapy. Therefore, saving valuable time by using SURE Subtraction will potentially improve treatment outcomes. Dr. Jahromi: By producing more accurate, easily interpretable images, SURE Subtraction has enabled us to reach decisions more rapidly. It has markedly improved our diagnostic conﬁdence and workﬂow, resulting in better patient care. With SURE Subtraction, CTA is no longer an investigational tool, but a valid, non-invasive screening tool that should be utilized by every physician with access to a multidetector CT scanner. CA Oc tober 2 0 0 7 A public ation produced by Toshiba Medic al Sys t ems 19

Table of Contents Feed for the Digital Edition of Clinical Advancements in Angiographic Imaging

Contents PhaseXact™: Automatic Phase Cardiac Reconstruction Giant Internal Carotid Aneurysm Non-Contrast SSFP Time-SLIP Imaging: Renal Artery Stenosis Springhill Medical Center: A Partnership to Improve Patient Safety Anterior Cerebral Artery Aneurysm Right Coronary Artery (RCA) lesion with SUREPlaque analysis Neurovascular CTA: When every second counts

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