SOMATOM ForceGet two steps ahead with Dual Source CT

Up to 20% of patients presented to the radiology department suffer from renal insufficiency. The SOMATOM Force enables radiologists to routinely perform exams at 70-90 kV, even in adults, substantially reducing the amount of CM needed and thus optimizing the entire clinical procedure. No preparation or medication prior to CT, no after-care and immediate referral to minimal invasive therapy if needed: significant improvement in the clinical results, as well as considerable savings for hospitals.

The SOMATOM Force allows for a dose reduction of up to 50% less than today's leading CT systems. In combination with its outstanding spatial resolution, unprecedented soft-tissue contrast and unmatched speed, this can help improve the early detection of occult lesions, e.g. in the lung or the colon.

Avoiding movement reduces motion artifacts and thus enhances image quality. But a significant number of patients simply cannot hold their breath: obese or elderly patients, unconscious or uncooperative cases, or small children were either excluded completely, had to be sedated, or were scanned with results unusable for diagnosis. Providing the industry's highest native temporal resolution of 66 ms at 0.25 s rotation, the SOMATOM Force helps to minimize motion artifacts even in these challenging cases.

Increasing scan speed to unmatched 737 mm/s, and providing a field of view of up to 50 cm at Flash speed coverage, the Turbo Flash mode expands the Flash Spiral capabilities. Bringing the benefits of Flash to obese and acute care patients, and potentially reducing the number of protocols and associated preparation time, the SOMATOM Force is the scanner of choice for regular operation, on call, night shift or emergency settings.

Despite the clear benefits of dynamic evaluations, the applied dose has been the crucial threshold to broaden its application, especially to body perfusion. The SOMATOM Force significantly lowers this hurdle by not only extending the coverage to 22 cm for perfusion (and even 80 cm for CTAs), but particularly by reducing the applied dose by up to 50% compared to today's leading CT systems. Perfusion studies of the liver, for example, now become possible at a dose comparable to conventional multiphase examinations.

The SOMATOM Force drastically increases sensitivity and specificity in Dual Source DE scanning, by allowing an up to 30% higher energy separation. Next to this, the improved DE acquisition speed of up to 258 mm/s, and a much broader range of applications for obese patients allow for a more precise differentiation of tissue types in oncology, cardio-vascular and acute care cases.

With the new Vectron tube, TAVI planning in a heavy patient with chronic kidney disease (shrunken kidney) can be performed at only 90 kV. The increased contrast-to-noise ratio allows the reduction of contrast media down to 40 ml. Due to the minimal renal strain, the patient can soon undergo his subsequent minimal invasive procedure.

Collimation: 2 x 192 x 0.6 mm
Spatial resolution: 0.24 mm
Scan time: 1.44 s
Scan length: 727 mm
Rotation time: 0.25 s
Tube settings: 90 kV, 194 mAs
DLP: 334 mGy cm
CTDIvol: 4.4 mGy
Eff. dose: 5.0 mSv
Contrast media: 40 mL

Thanks to the new Vectron tube, 70 kV imaging is also applicable with the Adaptive 4D Spiral Plus. The combination with the Adaptive Dose Shield allows for the coverage of long ranges at very low doses. In this dialysis patient (dialysis shunt), a high-grade stenosis could be safely identified with only 20 ml of contrast media.

Collimation: 192 x 0.6 mm
Spatial resolution: 0.24 mm
Scan time: 47 s
Scan length: 433 mm
Rotation time: 0.25 s
Tube settings: 70 kV, 80 mAs
DLP: 1404 mGy cm
CTDIvol: 23.57 mGy
Eff. Dose: 1.12 mSv

A SOMATOM Force coronary CTA shows the noninvasive diagnosis of a patent stent at 70 kV and 0.24 mm spatial resolution. With the new Cardiac Turbo Flash mode higher intravascular contrast at lower radiation doses are possible. Thus making this mode the first choice for the detection of early signs of coronary heart disease.

Collimation: 2 x 192 x 0.6 mm
Spatial resolution: 0.24 mm
Scan time: 0.18 s
Scan length: 144 mm
Rotation time: 0.25 s
Tube settings: 70 kV, 628 mAs
DLP: 31 mGy cm
CTDIvol: 1,77 mGy
Eff. dose: 0.4 mSv
HR independent Temp resolution: 66 ms

In this obese patient, suffering from dyspnea (shortness of breath), Turbo Flash scanning allowed to perform the examination without a breathhold command or the patient holding his breath. Maximizing the contrast-to-noise ratio at 70kV shows great vessel contrast while preserving softtissue contrast – with a contrast media dose of only 30 ml.

Collimation: 2 x 192 x 0.6 mm
Spatial resolution: 0.24 mm
Scan time: 0.7 s
Scan length: 294 mm
Rotation time: 0.25 s
Tube settings: 70 kV, 633 mAs
DLP: 83 mGy cm
CTDIvol: 2.38 mGy
Eff. dose: 1.16 mSv
Contrast media: 30 mL

A 140 kg patient was scanned with Cardiac Turbo Flash mode at only 100 kV and 40 ml contrast media. The left main and the left anterior descending artery are shown without artifacts from motion or photon starvation. The new mode allows a pitchdependent field of view, ranging from 35 to 50 cm, and is suitable for patients up to 220 kg.

Collimation: 2 x 192 x 0.6 mm
Spatial resolution: 0.24 mm
Scan time: 0.2 s
Scan length: 125 mm
Rotation time: 0.25 s
Tube settings: 100 kV, 581 mAs
DLP: 99 mGy cm
CTDIvol: 5,76 mGy
Eff. dose: 1.7 mSv
Contrast media: 40 mL
HR independent Temp resolution: 66 ms

This liver perfusion study, with a liver metastasis, was acquired with the new Stellar Infinity detector and the Adaptive 4D Spiral Plus, in combination with the Adaptive Dose Shield. Prior to targeted therapy, the baseline blood flow quantification was dynamically acquired over a range of 22 cm at very low perfusion dose.

Collimation: 192 x 0.6 mm
Spatial resolution: 0.24 mm
Scan time: 35 s
Scan length: 176 mm
Rotation time: 0.25 s
Tube settings: 80 kV, 100 mAs
DLP: 948 mGy cm
CTDIvol: 49,4 mGy
Eff. dose: 14 mSv
Temporal resolution: up to 1.5 s cycle time

The new 90/150 kV Sn mode and a 35 cm field of view allow for obese DE examinations (male, 48 years, 100 kg). The new Selective Photon Shield II increases energy separation by 30%. This combination expands DE information also to challenging patients for more precise tissue and material decomposition.

Collimation: 2 x 192 x 0.6 mm
Spatial resolution: 0.24 mm
Scan time: 3.6 s
Scan length: 309 mm
Rotation time: 0.25 s
Tube settings: 90/150 kV Sn, 104/76 mAs
DLP: 187 mGy cm
CTDIvol: 5.54 mGy
Eff. dose: 2.6 mSv

The SOMATOM Force delivers up to 2 x 1,300 mA, utilizing power reserves from two 120 kW generators, and direct anode cooling from the Vectron X-ray tube: offering voltages from 70 - 150 kV in steps of 10 kV, automatically selected through CARE kV, based on patient body habitus and examination type.
This unique combination allows for more patients – even obese cases – to be scanned at low kV from 70 to 90 kV. Completely redesigned Selective Photon Shields facilitate the filtration of X-ray spectra at considerably higher levels than ever before. In addition, the flying focal spot approach of z-Sharp was entirely reworked for the Vectron tube. The electron beam is now accurately and rapidly deflected, creating two focal spots alternating at 4,480/s, and thus significantly increasing in-plane resolution. In combination with a focal point as small as 0.4 x 0.5mm, the Vectron tube delivers outstanding spatial resolution of up to 0.22 lp/cm (equivalent to 24 mm) in clinical routine – without increases in dose.

Combining the low kV capabilities of the Vectron tube with the higher X-ray filtration of the two new Selective Photon Shields improves the CNR of air-to-soft-tissue contrast. The potential dose reduction of up to 50% in lung and colon exams establishes a new standard in the examination of high-risk, asymptomatic patients. The outstanding power reserves of the SOMATOM Force now allow maintained CNR at low kV levels in adults and obese patients. This means maintaining contrast concentration while reducing radiation dose – and vice versa. Having pioneered low kV scanning with the introduction of 80 kV and then 70 kV imaging, Siemens now keeps pushing the boundaries of Computed Tomography.

The unique Dual Source gantry and high-pitch table of the SOMATOM Force introduce CT imaging at unprecedented acquisition speed and temporal resolution. Its unmatched rotation speed of 0.25 s, in combination with a 50% increase in detector coverage, and ultra-high pitch scanning, facilitates an unseen temporal resolution of 66 ms and an acquisition speed of up to 730 mm / s. For the first time, CT scans can be performed with a full field of view of 50 cm, at a scan speed of close to 40 cm / s. This unique scan mode – the Turbo Flash spiral – brings the benefits of Flash scanning to a broader range of patients than ever before, making it the fastest, most versatile scan mode in the industry.

The SOMATOM Force’s fastest rotation speed is 4 rotations per second or 0.25 seconds per rotation, which equals a temporal resolution of 66 ms in cardiac imaging – independent of the heart rate. The extended coverage of the SOMATOM Force means an entire heart can be covered in approximately 150 ms: faster than a heartbeat. Additionally, high temporal resolution is provided in the entire image. As the data is natively measured, no artificial enhancement of the temporal resolution is needed.

With a volume coverage speed of up to 737 mm/s, a thorax-abdomen scan can now be performed in just one second. The capabilities of the gantry and the table are not the only important factors – when scanning at ultra-high pitch, the available power is essential. In obese imaging and fast volume coverage, maximum power is required to deliver sufficient photon flux for each slice. The SOMATOM Force delivers 2x 120 kW generator power, making it the ideal scanner for high-speed, large volume coverage.

Many institutions have introduced 4D imaging examinations of the brain as standard care for stroke patients. But when it comes to body perfusion, users are still reluctant to apply it to clinical routine as it is still considered a high dose examination. With the new Stellar^Infinity detectors of the SOMATOM Force, Siemens renders body perfusion suitable for everyday use. The increased coverage of 2x 96 rows (2x 192 slices) allows for a perfusion range of up to 22 cm, thus easily covering entire organs. The key to this breakthrough is the new Adaptive Dose Shield that allows up to 50% dose reduction in 4D imaging. Utilizing the higher resolution of the Stellar^Infinity detectors from 25% more detector channels and 2D scatter grid are the key enablers for dose reductions of up to 50% – at outstanding spatial resolution and image quality.

The quality of DE exams relies on the effective separation of energy spectra. The SOMATOM Force utilizes multiple pairings: the “standard" 80/140 kV, but also new 80, 90, and 100/150 kV modes with Sn (tin) filtration using the SPS II, e.g for obese patients. Up to 30% better energy separation means similar tissues can be differentiated precisely, leading to increased sensitivity and specificity in DE: with energy pairings and the new Selective Photon Shield II, the SOMATOM Force significantly increases precision and clinical impact. The renowned Adaptive Dose Shield was improved to meet the requirements of the SOMATOM Force by facilitating faster collimator blade movement. The key innovation for this was faster data transmission through Siemens' unique SiDaNet ultrafast databus system. With its faster blade movement, the Adaptive Dose Shield fully completes the Adaptive 4D Spiral Plus in perfusion imaging.