ppt_飞利浦ct低剂量技术进展

飞利浦CT低剂量技术进展,飞利浦低剂量技术进展,硬件技术,降低辐射剂量,迭代重建,提高图像质量,飞利浦低剂量影像链,自动准直器：根据患者情况自动改变形状,智能滤线栅：提高射线硬化程度，滤过软射线,月蚀准直器: 自动遮挡螺旋扫描两端无用射线,月蚀动态准直器,End-effects,Imaging Area,Total Area Being Irradiated,辐射剂量降低: 24.3 2.4%,Walker, M. J.; Olszewski, Halliburton, S. S. & Flamm, S. D. (2009), Journal of Cardiovascular Imaging.,Improved Efficiency by a Fully integrated detector design,Old school,Ahead of its time, similar to most other competitors today,Foundation of theiCT & Ingenuity familiesSince 2007,Philips NanoPanel3D86% Noise Suppression by Tach2 Technology,Detector Noise,Conventional,TACH,TACH 2,采样率：4800view/圈,微幅射成像星光iDose4平台,+ 星光iDose4Accelerated Model based Iterative Reconstruction,CT检查步入微辐射检查新时代,iDose4 迭代重建原理,双空间、多模型,CT重建技术进展基于原理和临床结果,各厂家技术,IRIS (Siemens), AIDR (Toshiba),ASIR (GE), SAFIRE (Siemens), AIDR3D (Toshiba),Veo (GE),FBP所有厂家,iDose4 (Philips),2013年医学装备学会CT/MR市场分析研讨会,高建华，武警总医院,2013.08.16,微辐射平台,各种迭代技术降低辐射剂量的比较 权威文献,Eur Radiol,12 Jan 2013,iDose4降低辐射剂量技术最领先,星光iDose4重建速度满足急诊检查需求,IR does not result in clinically important CT image reconstruction delays in an emergency setting.No substantial differences in reconstruction time and speed were found between different IR levels.,Insights Imaging (2013) 4:391397,iDose4临床应用,降低辐射剂量,研究历时16年,入组154,091病例,全美1/10筛查中心参与,结论：每年胸片筛查不能提升肺癌检出率每年胸片筛查不能降低被检者死亡率每年胸片筛查对肺癌发现时的分期和组织类型无影响,14,研究历时7.5年,入组53,454病例,全美33家医学中心参与,结论：低剂量CT较胸片肺癌检出率高低剂量CT筛查较胸片可以降低被检者肺癌死亡率20%,Minnies 2011 final resultsOctober 25, 2011Voting is now complete for the 2011 edition of the Minnies, AuntMinnies annual event to recognize excellence in radiologyScientific Paper of the YearReduced lung-cancer mortality with low-dose computed tomographic screening. Aberle DR, New England Journal of Medicine, August 4, 2011. For AuntMs coverage of this paper,15,American Cancer Society Lung Cancer Screening Guidelines,年龄：55-74岁吸烟史：有三十年吸烟史，正在吸烟或者15年内戒烟的人群,CA Cancer J Clin 2013,按照NLST标准，美国实行肺癌低剂量筛查，每年可以拯救1万2千患者的生命,CT lung cancer screening could save 12K lives a year,Cancer Feb 25, 2013,“The hybrid IR technique and low-dose CT imaging with 50 mAs enabled noise and to maintain the detectability for GGOs in a chest phantom that is equivalent to the reference acquisitions of 200 mAs with FBP”,“Detection of ground-glass opacities by use of hybrid iterative reconstruction (iDose) and low-dose 256-section computed tomography: a phantom study”Ko Higuchi,Michinobu Nagao,Yoshio Matsuo,et al.Radiol Phys Technol 2013,iDose4 Phantom study,Radiol Phys Technol 2013,综合模型及临床数据结果，针对临床肺部低剂量诊断及筛查建议采用的剂量及iDose4水平合适组合：50mAs采用常规FBP就可以满足临床肺部诊断需要25mAs采用iDose4-4和6可以达到较好的诊断效果 15mAs采用iDose4无法达到100mAs图像质量效果，但是可用于肺部疾病低剂量的筛查。,256层CT迭代重建低剂量技术的体模和临床研究,长征医院放射科,2013年军队影像沙龙（杭州）,The radiation dose was 71.35% less for the low-voltage protocol. Compared with standard FBP reconstruction, the iDose4 iterative reconstruction yields higher SNR, CNR, and better image quality in contrast-enhanced chest CT with low tube voltage settings.,第二军医大学长征医院,低剂量肺部扫描,0.22mSv,The Radiographer 59 (1) 2012,0.065mSv,0.063mSv,星光iDose4肺部低剂量体检筛查,漏斗胸患者,肺癌患者,星光iDose4肺部低剂量体检筛查,星光iDose4胸部体检筛查 剂量 0.049mSv,FBP,iDose4,incorporating CCTA into a triage strategy improved the efficiency of clinical decision making,CCTA Predicts heart attack in people without risk factors.,N engl j med 367;4 july 26, 2012,Radiology February 19, 2013,CCTA临床价值获得肯定,iCT 冠脉CTA临床应用,“Comparisons of image quality and radiation dose between iterative reconstruction and filtered back projection reconstruction algorithms in 256-MDCT coronary angiography.” Yang H, Xin L, Qiyong G, et al. AJR 2012.“Iterative reconstruction can provide equivalent or improved coronary image quality on coronary CT angiography, compared to routine-dose FBP reconstruction, while enabling radiation dose reductions of 55%.”,Low dose CCTA with iDose4,中国医科大学附属盛京医院,“The optimal dose reduction level using iterative reconstruction with prospective ECG-triggered coronary CTA using 256-slice MDCT.” Yang H, Mani V, Qiyong G, et al. Eur J Radiol 2012.“Iterative reconstruction techniques can provide 63% effective dose reduction in prospectively-triggered coronary CTA using 256-slice MDCT while maintaining excellent image quality.”,中国医科大学附属盛京医院,Low dose CCTA with iDose4,“Optimizing radiation dose level in prospective ECG-triggered coronary CTA using iterative reconstruction techniques: a phantom and patient study.” Yang H, Mani V, Qiyong G, et al. PLOS ONE 2013.“iterative reconstruction technique used in prospectively ECG-triggered 256-slice coronary CTA can provide radiation dose reductions of up to 62.5% with acceptable image quality.”,中国医科大学附属盛京医院,Low dose CCTA with iDose4,iCT&星光iDose4 后门控冠脉CTA检查,星光iDose4 后门控冠脉CTA扫描 心率 135BPM 有效剂量 0.79mSv,0.79mSv,iCT&星光iDose4 前门控冠脉CTA检查,常规FBP重建,星光iDose4有效剂量0.14mSv,Brilliance iCT心脏扫描模式（with iDose4）,Low dose CT Neuroimaging e.g. (Head),“How far can the radiation dose be lowered in head CT with iterative reconstruction? Analysis of imaging quality and diagnostic accuracy.” Tunghsin W, Shengche H, Chengyen C, et al. Eur Radiol 2013.“Head CT with 43% reduced tube current reconstructed by IR provides diagnostic imaging quality for outpatient management.”,台湾荣民总医院国立台湾大学,Low dose CT Neuroimaging e.g. (Temporal Bone),“Radiation doss reduction in temporal bone CT with iterative reconstruction technique.” Yantao N, Dhruv M, Zhenchang W, et al. AJNR 2012.“The iDose4 IRT can help reduce radiation dose of temporal bone CT by 50% relative to routine institution protocols with FBP, while maintaining diagnostic image quality.”,北京同仁医院,Wide coverage brain perfusion assessment with Low Dose,8 cm Nanopanel3D,* Wintermark, M.; Flanders, A. E.; Velthuis, B.; Meuli, R.; et al Perfusion-CT assessment of infarct core andpenumbra: receiver operating characteristic curve analysis in 130 patients suspected of acute hemispheric stroke., Stroke 37(4), 979985.,16 cm Jog Scan,71 y/o female presented with right hemiparesis; CT brain perfusion demonstrates left MCA stroke; 80 mm coverage; 80 kVp; 125 mAs; 3.2 mSv,iDose4临床应用,提高图像质量,120 kV, 25 mAs, 1.7 mGy,FBP,iDose4,提高诊断信心克服低剂量伪影,头颈CTA扫描，不再受肩部伪影的困扰,FBP,iDose4,30 April 2012,“Low-dose,wide-detector array thoracic aortic CT angiography using an iterative reconstruction technique results in improved image qualite with lower noise and fewer artifacts”,“IRT is associated with reduced noise and shoulder artifact and allows for low-dose aortic CT imaging”,改善肥胖患者图像质量减少低光子形成的噪声及伪影,FBP,iDose4,European Journal of Radiology 82 (2013) 288 295,“Improved coronary in-stent visualization using a combined high-resolution kernel and a hybrid iterative reconstruction technique at 256-slice cardiac CTPilot study” Seitaro Oda ,etal,“The Iterative algorithm combined with the high-resolution kernel significantly improved diagnostic performance in the detection of in-stent stenosis.”,提高冠脉支架再狭窄诊断信心,Acad Radiol 2012 Nov:19(11):1324-31,iDose 改善冠脉支架成像,低剂量时改善冠脉支架显像,Barry Daly, MD “Leveraging Iterative Reconstruction to Optimize Triple Low Dose (kVp, mAs, Iodine) in CT Angiography”/isct2013mdct/documents/05da2d915bc25a9