Dose Makes All The Difference

Since taking over radiology services for St. Joseph’s Hospital in the Tempelhof district of Berlin in 2010, “Ihre Radiologen” clinic has examined over 30,000 outpatients and inpatients of all ages each year.  Around 6,000 of these examinations involve computed tomography (CT); the clinic also offers treatments using interventional radiology, minimally invasive therapy, and neuroradiology. At the end of last year, the radiologists decided to replace their existing CT system with the world’s first 32-slice configuration of the SOMATOM Perspective.

SOMATOM Sessions spoke to Dr. Jochen Trübenbach and medical technologist Uwe Stegmann about their initial positive experiences with the new scanner.

Dr. Trübenbach, why were you interested in this particular CT scanner?

Jochen Trübenbach, M.D.: The specialist areas at St. Joseph’s Hospital are nephrology, pediatrics, trauma, and oncology. We don’t deal with cardiology diagnostics, so the 32-slice system was perfect for us. Pediatric diagnostics were also a decisive factor: Until now, we have rarely treated children using a CT scan. If it is necessary, however, radiation dose is always an issue.

What motivated you to replace your system?

Trübenbach: We inherited the old system when we took over the radiology work. But we soon became dissatisfied with the complicated operation and reduced availability. The numerous tube changes we had to make meant that the system was sometimes out of operation for up to a week.

Monitoring tumor progress in a 48-year-old female patient: end of 2013 with the previous system and a dose value of CTDIvol 20.45 mGy.

Early 2014 with 32-slice configuration of the SOMATOM Perspective and a lower radiation dose at CTDIvol 7.56 mGy.

What are the advantages of the new scanner in comparison with the old one?

Trübenbach: That’s easy: dose, scanning speed, and postprocessing. In postprocessing, in particular, things are much faster – and this makes a significant difference for outpatients especially.  With the old system, postprocessing would take up to 20 minutes, which limits patient throughput. We can now produce extremely high-quality diagnostic images within two to five minutes.

How happy are you with the system availability?

Uwe Stegmann: After two months’ operation, availability so far is approaching 100 percent, which is remarkable for the first SOMATOM Perspective 32 slice configuration installation world wide. I can only recall one period of downtime, and that was because a workman had unplugged the system. There has been no downtime due to the system itself.

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Were your expectations met in terms of X-ray dose?

Trübenbach: Absolutely. We can now perform CT examinations with SAFIRE* and up to 60 percent less radiation dose than before. In difficult cases, we can now make use of computed tomography. With children and younger patients in particular, we used to be quite restrained.

What is it like working with the eCockpit?

The eCockpit enables more cost-efficient operation before, during and after a CT scan. One of its features eStart protects the X-ray tube through an optimized warm-up phase. This extends the lifetime of this cost-intensive system component. Of course, it is also possible to use the system without activating eStart if required more urgently.

Stegmann: We almost always operate in eMode. For most patients, we don’t have to push the system to its limits, but it’s reassuring to know that we could. We only avoid eStart when we don’t have time for the warm-up phase that protects the tube. We have no direct influence on the energy-saving eSleep Mode. Our overall eRatio – the combination of eMode and eStart – is over 90 percent. If we continue working in this way, we expect to increase system availability and will benefit from a reduction in service costs from next year onwards.

What do you think of the design of the scanner, in particular the Illumination Moodlight?

Trübenbach: The machine looks very modern, and Moodlight is an interesting addition. In pediatrics, for example, I could imagine asking children what their favorite color is before an examination. The changing colors can provide distraction and reduce stress levels.

How are your medical technologists (MTs) coping with the new Siemens user interface?

Stegmann: The transition was very smooth since it’s enjoyable to work with the new system. Some of my colleagues had worked with the old system for a long time, and naturally had some reservations about the transition – but these were soon put to rest.  I’m particularly impressed by the highly flexible acquisition and reconstruction offered by the Siemens CT user interface, syngo®.

Would you recommend the system to your colleagues?

Trübenbach: I would recommend the 32-slice configuration of the SOMATOM Perspective for outpatient and inpatient diagnostics without hesitation. The system is a particularly good investment for hospitals without cardiology diagnostics and of a similar size to St. Joseph’s Hospital.