At #ACC.19, Siemens unveiled a version of its go.Top platform optimized for cardiovascular imaging. The newly packaged scanner can generate the data needed to do CT-based FFR (fractional flow reserve). Photo by Greg Freiherr
Reflecting a trend toward the increased use of computed tomography (CT) in cardiology, Siemens Healthineers launched a CT scanner optimized for cardiac scanning at the American College of Cardiology conference (#ACC19). The new Siemens’ CT, a version of its Go platform, follows GE Healthcare’s launch two years ago of the CardioGraphe, a CT scanner that GE highlighted at this year’s ACC conference.
Both systems are intended primarily for sale to outpatient centers. Compact and optimized for cardiac application, both are priced under $800,000, according to sources at the companies.
Results of the ADVANCE study, which were released in the closing hours of ACC19, emphasized the undercurrent that had flowed through ACC scientific sessions and across the exhibit floor — that the utility of CT was increasing within cardiology. The one-year outcome from the ADVANCE registry for CT-based fractional flow reserve (FFR) “show low rates of events in all patients, with less revascularization and a trend toward (a lower incidence of major adverse cardiac events) and significantly lower cardiovascular death or MI in patients.”
This means patients can use CT to determine if they have a low risk of adverse cardiovascular events. And the CT-based results will apply for as long as one year. The implication is that patients can safely skip invasive testing achieved through cardiac catheterization during that period.
Siemens Cardiac CT On ACC Exhibit Floor
Introduced on the ACC.19 exhibit floor and available for sale April 1, Siemens’ cardiac system is built on a platform initially unveiled at RSNA 2017. Siemens’ go.Top CT platform was cleared for marketing in the U.S. in early 2018 and has been in production ever since. “Because the production line exists today, there will be no delay in delivery (after sales of the cardiovascular edition begin April 1),” said Matthew Dedman, Siemens director of CT product marketing.
The CV version, shown for the first time at ACC.19, features applications designed exclusively for cardiological scanning, according to Dedman.
“Historically cardiac CT was limited to the hospital environment because the technology had been expensive,” he said. By contrast, the CV-optimized go.Top allows “low total cost of ownership of our go platform and enables a high quality CT to be installed and utilized in the outpatient environment. This increases access to very valuable procedures, such as cardiac DT and additional FFR analysis.”
The 128-slice scanner is built particularly for outpatient cardiology offices, but might be installed in hospitals, as well, according to Dedman, who emphasized the ability of the scanner to gather data for coronary CTA, as well as for advanced tests, including CT-based FFR analyses by HeartFlow. Siemens developed a technical solution for the transmission of CT data from go.Top cardiovascular edition to HeartFlow, said Dedman, “for them to perform their analysis and transmit the results back to the physician.”
The system maintains, however, “the full radiological capability of the underlying go.Top,” he said. “So your traditional neuro, chest, abdomen and pelvis imaging could be performed on this machine as well.”
The tablet mounted on the side of the go.Top gantry allows technologist to set up scans from the CT table sides. This enables the tech to stay close to the patient — to help keep the patient calm and to achieve a low heart rate. “We know that probably the biggest factor in the success of the exam is patient cooperation,” Dedman said
The company’s CARE kV feature balances radiation dose and image contrast, automatically selecting the optimal kV setting for patients in increments of 10kV. In real-time, the system’s Check&GO algorithm helps identify problems with anatomical coverage and the distribution of media contrast.
GE Showcases Dedicated Cardiac CT At ACC
Although GE’s CardioGraphe was unveiled at an ACC meeting two years earlier, the company focused attention again on the CT, noting its dedication to cardiology and cost-effectiveness. “It is designed to serve the needs of the cardiologist and the radiologist who does cardiac CT,” Philippe Karam, GE’s global sales and marketing director, said. “We took all the features needed for true cardiac CT and put them in this scanner.”
The CardioGraphe, which evolved from a strategic partnership between GE Healthcare and Arineta LTD, was “built from the ground up,” Karam said. The compact system can be installed in 15 square meters. Dose efficiency is achieved using GE’s ASiR-CV. And it can be used to plan procedures including TAVR (transcatheter aortic valve replacement), according to Kira Behrens, GE’s director of premium CT for the U.S. and Canada.
The system is built for point-of-care scanning in an emergency department, a clinic (such as “a large interventional lab,” Behrens said, “where nuclear tests are frequently done”) or even a physician’s office, according to the company. In a single heartbeat, the CardioGraphe can create a 3-D image of the coronaries, valves, chambers and myocardium, as well as an angiogram of the aorta. Rotation speed is 0.24 seconds; single-beat heart coverage 140 mm, resolution 0.28 mm, according to the company.
Greg Freiherr is a contributing editor to Imaging Technology News (ITN) and Diagnostic and Interventional Cardiology (DAIC). Over the past three decades, Freiherr has served as business and technology editor for publications in medical imaging, as well as consulted for vendors, professional organizations, academia, and financial institutions.