2. The Past: Imatron Firsts!
• First and only electronic CT 1983
• First CT movie of the beating heart 1984
• First Multi-slice CT 1985
• First Bolus Phase imaging in CT 1988
• First continuous rotation scanner 1988
• First Coronary Calcium studies 1988
• First sub-second reconstruction 1994
• First CT coronary angiography 1995
• First CT 4D Cine EBA 2000
• C300 New platform for growth 2001
4. Types of Scanners in the
field
C150 Version 11 3
C150LXP Version 12 19
C150LH “ “ 2
C150XP “ “ 47
C150HR “ “ 57
C300 Version 14 24
Mobiles 4/v12 and 3/v14 7
total 159
C100 is extinct
Model software number
5. Global Distribution of EBT
USA sites 102
European sites 18
Japanese sites 25
Other Asia sites 14
total 159
27. Future
Faster scan speed
Thinner slices
More cine frames
More one-touch analysis and reporting
The Goal: replace invasive
diagnostic angiography
Editor's Notes
Ladies and gentlemen,
Welcome to the 12th EBT symposium, and special welcome to those who have flown from distant parts of the globe to be here with us. And a special welcome to Peter Arduini and his colleaques from GE Milwaukee who are also joining us for the meeting.
Imatron was the first to introduce many advances in CT scanning. A lot of these were short-lived because after a few years, mechanical scanners caught up. We are still the only no-motion CT, the only wide 8-slice machine (good for myocardial and organ perfusion), and the only Cine Angiographic CT. The C300 platform introduced in 2001 is a platform for future development.
Installations of C300 EBT machines will reach 35 in 2002 showing a very positive trend in growth.
In a little more than 1 year the number of C300 installations has grown to 31 and will soon be the majority. C100 models are extinct.
This slide shows the geographic distribution of of 102 EBT scanners in the U.S. as of September 2002. The sites are designated by scanner serial number.
EBT continues to enjoy unique capabilities that are not available at all in mechanical multi-slice spiral scanners.
Mechanical cardiac CT scanners typically employ intravenous drugs to slow the heart rate to 70 bpm or less.
This is a two phase EBA. The first phase was triggered at approximately 40% R-R. at the point recommended by Dr. Mao et. al., to be the time of lowest coronary motion. At this phase at least the proximal arteries are well seen in 3D VR. The axial images are clear in all slices. At phase 2 the VR quality is broken up.
Only EBT can scan provide multiple slice coverage of an volume with an 8-cm axial extent. This is ideal for myocardial perfusion imaging and indeed this was the intended in the original design.
EBT is the only modality that produces 3D-cine-angiogrpahic images of coronary arteries. Recent advances in the GE Advantage Windows workstation software has greatly enhanced the tools available for the analysis of such images.
Cine electron beam angiography, CineEBA, is generally described by the number of phases in the cine sequence. C150 scanners typically use two phases of up to 70 levels with 1.5 or 3mm slice thickness. This is a two-phase CineEBA study from Ankara Turkey. The first phase is at the Dr. Mao of Harbor-UCLA, recommended optimal phase, roughly 40% of R-R. The second phase is 116 msec later. Thisis a curved reformatted MIP of an LAD with a proximal stent.
The C300 scanner enables three phase 100msec studies with up to 85 levels. This is a 3-phase CineEBA of a 55 yo male physician who was asymptomatic but requested a coronary artery study. Cine volume rendering revealed a long narrowing in the mid portion of the LAD, and an occlusion in the first diagonal.
Using one-click automatic vessel analysis, the coronary arteries are automatically extracted in a freely rotatable 3D VR view.
A more detailed coronary artery extraction wizard requires the user to place a point in the proximal and distal portions of the artery in one image. This is a two-click operation. The wizard then automatically finds the axial profile of the artery in all phases.
The profiles are then used for extracting the vessel with many forms of 3D rendering. In this cine display, shown from top left clockwise are: 1. curved reformatting MIP, 2. Lumen area analysis, 3. Best oblique thin slab MIP, and 4. Endoscopic navigational view.
More detail of the curved reformatting showing the mid-LAD stenosis
A rotation movie of the extracted artery using a thin slab Volume Rendering (VR) method.
The green circle traverses the axial profile enabling readout of the true lumen area at each point in the image.
The curved MIP has been linearized and displayed above a profile of the cross section area.
The curser can be used to indicate the measured cross section area at each point. Here the vertical marker indicates an area of 6.5 mm2.
The normal coronary artery would show a uniform reduction in area as a function of distance from the origin. The area marked in yellow is thus an indication of the plaque volume for that phase.
The automatic axial profile can also be used as a navigational path for fly-through endoscopy. Calcifications are marked with white.
At any point in the artery, the cine-endoscopic rendered view can be displayed. Here we are at a point proximal to the bifurcation with the first diagonal looking downstream.
The future will bring additional upgrades to the C300 platform for more speed, thinner slices, and more cine frames. The Advantage Windows platform will continue to evolve to support the future scanning technologies and to simplify reporting requirements.
