In total, 197 medical practices and clinical institutions from all over the world participated in the contest, all of which use a CT scanner from the Siemens Somatom family. Each of the many submitted images shows how users made the most of Siemens technology to reduce dose, thus underscoring the Healthcare Sector's innovative strength as part of the Agenda 2013 Initiative.
Whether tall or short, slim or large - every patient is different. That means that the right dose may vary greatly from one individual to another, depending on the clinical issue. It's not always useful to focus on reducing radiation as far as possible. What still really counts in dealing responsibly with X-ray based computed tomography is the ALARA principle (As Low As Reasonably Achievable). If the dose is too low and the clinical images ultimately do not provide sufficient diagnostic information, then even the lowest applied dose is still too high. That is why it is so important to apply exactly the right dose for each individual scan.
The images from the contest demonstrate the role that Siemens Right Dose technologies play in this. Take the image submitted by Ronald Booij, of Erasmus Medical Center in Rotterdam, Netherlands, of an aortic isthmus stenosis - a narrowing of the body's main artery - in a seven-month-old baby. This congenital arterial malformation was clearly documented using the Dual Source CT Somatom Definition Flash - the only CT with two X-ray tubes - thus ruling out a suspected malformed, doubled aortic arch. And Booij achieved this with an effective dose of just 0.28 millisievert (mSv), less than one-eighth of natural background radiation over one year, and without any kind of sedation - an aspect that is just as important in pediatrics as particularly careful use of radiation. As Booij writes in his article for the contest, the Care kV application - which automatically chose the right tube voltage of 70 kilovolts (kV) for the scan - and Safire, a technique for raw-data based iterative image reconstruction, provided significant help in "achieving optimal image quality at the lowest possible dose."
Dr. Thomas Zelesny, of Alb-Fils-Kliniken in Göppingen, Germany, submitted a cardiac scan of a 65-year-old woman, taken with the Somatom Definition AS. A detailed image of the coronary arteries was needed to rule out the possibility of coronary heart disease. Here, Care kV chose a tube voltage of 100 kV, and the Care Dose4D application automatically adjusted the tube current to the patient's anatomy during the scan. Zelesny also used Safire image reconstruction to reduce image noise that would otherwise increase appreciably at reduced radiation doses. The result was excellent diagnostic image quality, showing even the smaller lateral vessels of the coronary arteries, and at a dose of only 0.78 mSv. "So that we can use the right dose for each patient, as we did here, each scan we carry out takes advantage of every feature the CT scanner has to offer," Zelesny explains.
In addition to these two categories - vascular imaging and cardiology - the Right Dose Excellence Award is also given in neurology, oncology, pediatrics, routine examinations (as for example in diagnosing unexplained abdominal pain), trauma, and Dual Energy. This year there is also a special prize for sustainable dose management open to institutions who submit two or more cases and who also share their dose reduction experiences and strategies with other Siemens CT users. The winners will be chosen by an international jury of experts, including members of the Sierra Initiative (Siemens Radiation Reduction Alliance). Those interested can vote for the 2013 public award for the best CT image at www.siemens.com/image-contest. The prizes will be presented in December at the 99th Convention of the Radiological Society of North America (RSNA) in Chicago.
Launched in November 2011, Agenda 2013 is an initiative of the Siemens Healthcare Sector to further strengthen its innovative power and competitiveness. Specific measures, which will be implemented by the end of 2013, have been defined in four fields of action: innovation, competitiveness, regional footprint, and people development.
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About Siemens Healthcare
The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging, laboratory diagnostics, medical information technology and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source - from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better and more cost-effective. Siemens Healthcare employs some 51,000 employees worldwide and operates around the world. In fiscal year 2012 (to September 30), the Sector posted revenue of 13.6 billion euros and profit of 1.8 billion euros.