syngo DynaCT

In the past, different levels of expertise may sometimes have led to varying results when using cone-beam CT. In contrast, with the new 3D Wizard image-guided protocol selection, available on Artis with PURE^®, syngo DynaCT is also accessible for occasional users. The 3D Wizard leads all users to consistent and high-quality results. It helps users select the correct protocol with a visual support of clinical images, offers all relevant information on delay, injection and patient positioning, and guides users through the acquisition, step by step. This supports standardized quality of care, regardless of who performs the procedure, from occasional to experienced users.

syngo DynaCT can provide information not apparent in DSA. This additional information may result in changes in diagnosis, treatment planning, or treatment delivery. It supports sounder decision-making during the intervention – for example when employed to exclude non-target embolization during liver tumor embolization or to confirm device position within intracranial vessels. Where in the past it would have been necessary to transfer the patient into the CT unit, syngo DynaCT can be performed instead, directly in the angio suite without loss of time and with no additional risk to the patient.

Dedicated syngo DynaCT applications allow users to extend the clinical capabilities of their angio lab. syngo DynaCT Micro, for instance, enables users to visualize the smallest details, bringing additional procedures such as arthrography, intra-cranial stent placement follow-up examinations, or validation of cochlear implant placement to the angio suite. Other dedicated applications that further expand the confidence and performance of syngo DynaCT include
syngo DynaCT SMART (Streak Metal Artifact Reduction Technique): This special technique, available for Artis with PURE^®, substantially reduces metal artifacts, enabling sounder detection of bleeds even around small coil packages. syngo DynaCT 360 or syngo DynaCT Large Volume: Enable acquisition of images with an even larger volume, which can be very useful during liver embolization or needle procedures

syngo DynaCT also enables users to take on recently developed, innovative procedures – thus extending their clinical capabilities even further. For instance, in new embolization procedures such as prostate artery embolization for treatment of benign prostatic hyperplasia, syngo DynaCT helps operators to clearly distinguish between target and non-target embolization sites. syngo DynaCT gives users the right tools to tackle exciting new prospects.

Expert statement
Professor Thomas J. Vogl, M.D.
Head of Diagnostic and Interventional Radiology University of Frankfurt - Germany

Minimally Invasive Spinal Osteosynthesis
An 88-year-old female patient suffered from lower back pain. She was operated on before due to a traumatic fracture of L5 which required cementoplasty.

Stent Placement across Cerebral Aneurysm
65-year-old male with hypertension and history of myocardial infarction and coronary stenting with incidental left internal carotid artery aneurysm.

Cerebral trauma
Female patient with brain trauma for 3 days, mental imbalance and loss of consciousness.

syngo DynaCT in multiple phases for HCC
A 69-year-old male with HCC (hepatocellular carcinoma) and HCV (Hepatitis C virus)-positive hepatic cirrhosis.

Follow-up after stent-assisted aneurysm coiling
73-year-old female patient. Left middle cerebral artery (MCA) aneurysm that was treated with stent-assisted coil embolization in 2005. Because of her history of contrast allergies, we decided to complete a syngo DynaCT run with IV injection...

syngo DynaCT of the pulmonary arteries
Patient with history of recurrent pulmonary embolism and chronic thromboembolic pulmonary hypertension (CTEPH). Pulmonary angiogram and syngo DynaCT were acquired for diagnostic work-up.

Use of Cone Beam CT (CBCT) in the angio suite improves safety and outcomes in interventional tumor treatment

Dr. Michael J. Wallace on the Impact of Improved Image Quality of Angiography Equipment in Interventional Oncology

With syngo DynaCT we can visualize objects of 5 HU and 10 mm in size or 10 HU and 5 mm in size*. This enables visualization of lower contrast objects such as larger hemorrhages and tumors.
_{* as measured using a 16-cm CATPHAN phantom}

What is the FOV (field of view)?
syngo DynaCT datasets acquired with a ceiling, floor or biplane stands provide a volume of 18.5 cm height with a diameter of 24 cm.
The Artis zeego enables in addition larger volume acquisitions such as syngo DynaCT Large Volume and syngo DynaCT 360, which result in a volume of 18 cm height with a 47 cm diameter, or 24 cm height with a 35 cm diameter.

If desired, it is also possible to acquire a smaller volume using collimation* in order to reduce dose and increase image quality.
_{*collimation on the longitudinal access.}

What is the spatial resolution of syngo DynaCT and what slice thickness can be reconstructed?
The slice thickness that can be reconstructed depends on the volume of interest and the voxel size. The standard slice thickness is about 0.5 mm and there are additional reconstruction options that allow creation of lower slice thickness. The spatial resolution achieved with syngo DynaCT is about 0.22 mm. In addition, with syngo DynaCT Micro, a special protocol is available that provides high resolution 3D imaging, boosting the level of detail by using each detector pixel. With syngo DynaCT Micro an even higher spatial resolution of about 0.14 mm can be achieved.

Does syngo DynaCT offer a dedicated body protocol?
Yes, syngo DynaCT offers a dedicated body protocol, about 400 projections are acquired in less than 6 seconds*. Due to its fast rotation this protocol reduces motion artefacts providing excellent image quality. High resolution results (512 matrix) are available at tableside in less than 15 seconds*. In addition there is a dedicated syngo DynaCT protocol with reduced dose and shorter acquisition time for dose-sensitive applications.
_{*Mentioned values are for Artis with PURE and may change depending on system hardware and specific protocol used.}

Does syngo DynaCT offer a dedicated neuro protocol?
Yes, there are several syngo DynaCT protocols that can be useful for interventional neuroradiology procedures.
The standard dedicated neuro protocol acquires about 500 projections in 20 seconds. High resolution results (512 matrix) are available at tableside in about 30 seconds*.
There are also protocols for reconstructing information of subtracted scans enabling the easy visualization of vessels in relation to devices such as stents or coil packages and a special protocol for stent follow-up using an intravenous injection.
In addition, with syngo DynaCT SMART (Streak Metal Artifact Reduction Technique) a special reconstruction is included for reducing metal artifacts in the resulting images, which increases the diagnostic confidence and the chance to visualize complications such as bleeds close to metallic objects.
_{* Mentioned values are for Artis with PURE and may change depending on system hardware and specific protocol used.}