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August 2002 Scanning Systems, Computed Tomography, Full-Body Scope of this Product Comparison This Product Comparison
August 2002 Scanning Systems, Computed Tomography, Full-Body Scope of this Product Comparison This Product Comparison
August 2002 Scanning Systems, Computed Tomography, Full-Body Scope of this Product Comparison This Product Comparison
August 2002 Scanning Systems, Computed Tomography, Full-Body Scope of this Product Comparison This Product Comparison
August 2002 Scanning Systems, Computed Tomography, Full-Body Scope of this Product Comparison This Product Comparison
August 2002 Scanning Systems, Computed Tomography, Full-Body Scope of this Product Comparison This Product Comparison
August 2002 Scanning Systems, Computed Tomography, Full-Body Scope of this Product Comparison This Product Comparison
August 2002 Scanning Systems, Computed Tomography, Full-Body Scope of this Product Comparison This Product Comparison

August 2002

Scanning Systems, Computed Tomography, Full-Body

Scope of this Product Comparison

This Product Comparison covers computed to- mography (CT) scanners used to obtain cross- sectional images without restriction to a particu- lar anatomic region. It also covers the CT compo- nents of combined positron emission tomography (PET)/computed tomography (CT) systems. For PET component information, see the report ti-

tled SCANNING SYSTEMS, POSITRON EMISSION TOMOGRAPHY.

UMDNS information

This Product Comparison covers the following device terms and product codes as listed in ECRI’s Universal Medical Device Nomenclature System™ (UMDNS™):

Scanning Systems, Computed Tomography, Axial, Full-Body [15-956]

Scanning Systems, Computed Tomography, Electron Beam [16-899]

Scanning Systems, Computed Tomography, Spiral [18-443]

Scanning Systems, Computed Tomography/ Positron Emission Tomography [20-161]

Purpose

CT scanners produce thin cross-sectional images of the human body for a wide variety of diagnostic proce- dures. CT is a noninvasive radiographic technique that

involves the reconstruction of a tomographic plane of the body (a slice) from a large number of collected x-ray absorption measurements taken during a scan around the body’s periphery. The result of a CT study is usually a set of transaxial slices, which can be mathe- matically manipulated to produce sagittal or coronal image slices. See Figure 1 for an illustration of body planes.

CT is clinically useful in a wide variety of imaging exams, including spine and head, gastrointestinal, and vascular.

Principles of operation

Components of a CT system

A CT system consists of an x-ray subsystem, a gantry, a patient table, and a controlling computer. A high-voltage x-ray generator supplies electric power to

A high-voltage x-ray generator supplies electric power to 174073 5200 Butler Pike, Plymouth Meeting, PA 19462-1298,

174073 5200 Butler Pike, Plymouth Meeting, PA 19462-1298, USA 5200 Butler Pike, Plymouth Meeting, PA 19462-1298, USA

424-010

Telephone +1 (610) 825-6000 ● Fax +1 (610) 834-1275 ● E-mail hpcs@ecri.org Fax +1 (610) 834-1275 E-mail hpcs@ecri.org

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Coronal Plane

Sagittal Plane Transaxial (transverse) Plane C138UN1A
Sagittal Plane
Transaxial
(transverse) Plane
C138UN1A

Figure 1. The planes of the human body

the x-ray tube, which usually has a rotating anode and is capable of withstanding the high heat loads gener- ated during rapid multiple-slice acquisition.

The gantry houses the x-ray tube, detector system, collimators, and rotational circuitry; in some scanners, it also contains a compact, high-frequency x-ray gener- ator. Two types of detectors are used in CT scanners. Xenon-gas ionization chamber detectors produce a cur- rent (the output signal) when incoming radiation ion- izes xenon atoms; this signal is proportional to the intensity of the radiation. Solid-state detectors con- tain cesium-iodide or cadmium-tungstate crystals that produce light when exposed to ionizing radiation. Sili- con photodiodes convert this light into an electrical signal.

The xenon gas in the ionization chambers is at high pressure (25 atm) to increase the detection efficiency of these chambers. Each solid-state detector has a higher detection efficiency than an individual xenon- gas ionization chamber, but ionization chambers can be packed more densely than solid-state detectors. The net result is that the overall detection efficiencies for

solid-state and ionization chamber arrays are very similar.

Collimators located near the x-ray tube and at each detector are aligned so that scatter radiation is mini- mized and the x-ray beam is properly defined for scanning. The separation of the collimators defines the thickness of the tomographic slice.

The patient table can be moved both vertically and horizontally to accommodate various scanning posi- tions. During a CT scan, the table moves the patient into the gantry, and the x-ray tube rotates around the patient. As x-rays pass through the patient to the detectors, the computer acquires and processes data to form an image. The computer also controls the x-ray production, gantry motions, table motions, and image display and storage.

Types of CT scanners

All currently marketed CT scanners use slip-ring technology introduced in 1989. Slip-ring CT scanners use grooved copper bands or rings with a series of electrically conductive brushes that provide for con- tinuous one-way rotation of the gantry allowing rapid continuous scanning. Slip-ring scanners can perform helical (also called volumetric) CT scanning. In helical scanning, the x-ray tube and detector rotate around the patient’s body, continuously acquiring data while the patient moves through the gantry. The acquired volume of data can be reconstructed at any point during the scan. Because data is collected from a volume of tissue rather than section by section, slices as thin as 1 mm can be reconstructed without increas- ing exam time. Advantages of helical CT include de- creased radiation dosage, fewer motion artifacts, and optimization of contrast levels. Additionally, helical CT improves lesion detection and decreases partial volume artifacts. Helical CT techniques also shorten exam times (from 20 to 30 minutes for a conventional exam to 5 to 10 minutes for a helical exam) to facilitate imaging of emergency cases and to somewhat increase patient throughput. This faster scanning speed mini- mizes the effects of patient movement on image quality and is, therefore, clinically advantageous for scanning trauma victims and pediatric patients. Slower CT scanners also require the patient to maintain a longer breathhold; however, helical CT’s faster scanning speed also helps improve image quality for patients who have trouble doing so.

Some manufacturers offer multislice scanners, which shorten scan time. A multislice CT scanner has — in addition to the gantry — a powerful computer proc- essor. Inside the gantry, an x-ray tube projects a fan- shaped x-ray beam through the patient to the detector

Scanning Systems, Computed Tomography, Full-Body

array. As the x-ray tube and detector rotate, x-rays are detected at a number of angles through the patient. The computer mathematically reconstructs data from each full rotation to produce an image of one slice. The second component is a detector design that incorpo- rates 1,000 elements along the length of the arc (x/y axes) and between 8 and 34 elements across the width (z-axis) of the detector. In contrast, the detector in a single-slice CT scanner is only divided into segments along the length of the detector. When using a multis- lice CT scanner, the slice width is chosen by combining data from adjacent elements across the detector in the z-axis. This differs from single-slice CT scanning, in which the slice width is selected by controlling the width of the x-ray beam with collimators. The scanners use multiple detectors to take multiple images (or multiple slices) in each pass. Multislice CT technology reduces the limitations caused by x-ray tube heating and patient movement encountered in single-slice CT scanning.

Multislice CT scanners make more efficient use of the x-ray tube because the x-ray beam may be up to four times wider than in a single-slice CT scanner. However the actual increase in tube life may not be as great as might be expected because of other factors. In addition, multislice CT scanners can acquire the data needed for isometric voxel reconstruction faster than single-slice CT scanners can. This means that larger volumes (e.g., complete organs) can now be reconstructed with a use- ful spatial resolution in three dimensions. (Figure 2 shows four CT images.) Helical and multislice CT are also used for CT angiography (CTA), a technique for imaging the large blood vessels that is used to assess renal artery stenosis, carotid bifurcation, and abdomi- nal aortic aneurysms. Multislice scanners can now ac- quire up to 16 slices simultaneously.

Developed in the mid-1980s, electron beam CT (EBCT) systems eliminate the mechanical movement of earlier designs by magnetically rotating an electron beam that strikes a tungsten target ring, producing an x-ray fan beam from multiple angles around the 210° target. The detector array consists of two 210° rings, each with 420 cadmium-tungstate detectors, directly opposite the target rings. Because only the electron beam moves during data collection, the scan times can be extremely short — on the order of 50 msec each. Scan times of 10 msec are anticipated in the future. The principal purpose of this design is to allow transaxial imaging of the beating heart without having to resort to electrocardiograph-gated data collection over several cardiac cycles. Based on its very rapid (subsecond) image acquisition, clinical applications of ultrafast CT include quantification of coronary artery calcification and pericardial disease, as well as geriatric, pediatric,

Figure 2. CT images: mid-brain (top left), chest (top right), spiral scan of abdomen (bottom

Figure 2. CT images: mid-brain (top left), chest (top right), spiral scan of abdomen (bottom left), spiral scan of pelvis (bottom right)

and trauma patient imaging (in which patient motion could affect image acquisition).

Three-dimensional (3-D) CTA is used to assess aneurysms preoperatively and postoperatively, in planning angiography and subsequent surgery, and to complement conventional angiography, ultrasound, and magnetic resonance angiography.

Additionally, studies suggest CT coronary scans (both helical and ultrafast) may detect coronary calci- fication as accurately as coronary angiography and/or intracoronary ultrasound (ICUS) most of the time. The significance of these studies is that CT coronary scanning is the first noninvasive method for visualiz- ing, localizing, and quantifying coronary disease. This allows medical personnel to recognize potential coro- nary complications even if angiography and/or ICUS is not an option.

However, increased radiation exposure during the scan should be avoided. Imaging needs and patient safety should dictate the scanning technique.

Some manufacturers also offer remote diagnostics, which allows for expedited handling of system prob- lems. With remote diagnostics, a supplier can down- load a software patch, order replacement parts, or immediately alert a repair technician to problems.

Most systems offer archiving capabilities, which allow personnel to recall the images at a later time for review. For further information, see the Product Com-

parison titled PICTURE ARCHIVING AND COMMUNICA- TIONS SYSTEMS (PACS), RADIOLOGY.

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Many suppliers now offer specialized software for bone mineral analysis, dental CT, cerebral blood-flow analysis, and pulmonary imaging. Additionally, the use of ultrafast CT to detect coronary artery aneu- rysms that were undetectable by conventional angiog- raphy has been described (Kobayashi et al. 1997).

Image manipulation

The quantitative nature of the CT image allows the reviewer to perform a large number of image manipu- lations easily. Although the numerical range of pixels in the image is rather large, the numerical range spanned by most soft tissues is relatively narrow. To adequately display the values for soft tissue and still maintain the ability to discriminate density differ- ences, CT scanners are designed to display user- selected CT numerical ranges (also called Hounsfield units) over the entire grayscale. The range to be dis- played (window width) and the central value (level) are also user selectable.

Regions of interest in the image can be selected to obtain average CT values within the region or to cal- culate total lesion volume. CT-guided needle biopsies are facilitated by the ability to measure distance and orientation between two operator-selected points in the images.

The transaxial images obtained directly from the scanner can be reformatted into sagittal, coronal, and oblique images by software manipulation. Most cur-

rent systems can also construct tomographic images at nonorthogonal orientations to provide a better display

of anatomic detail.

Most CT workstations are capable of 3-D image reconstruction. Because anatomic relationships can be

more clearly visualized by a 3-D image display than by

a planar image display, surgeons are using 3-D CT

more frequently for surgery simulations and for plan- ning reconstructive procedures. In addition, some soft- ware allows the 3-D image to be rotated to view a variety of perspectives. Clinical applications of 3-D reconstruction include craniofacial surgical planning; postoperative evaluations; analysis of the pelvis, hip, and spine; CTA; and virtual colonoscopy.

Image quality and resolution

A number of factors combine to determine the qual- ity of the image produced by any CT scanner, including radiation dose, number of attenuation measurements taken, reconstruction algorithm, size of the digital image matrix, and presence or absence of artifacts. The relationship between radiation dose, reconstruction filter, and spatial resolution is such that, for high- contrast resolution (e.g., in the inner ear), the physical

design of the detector system determines the minimum detectable lesion; beyond a certain point, nothing is gained by increasing the radiation exposure. As the lesion-to-background contrast ratio decreases, increas- ing the radiation dose and thereby decreasing the statistical noise in the image produces an apparent increase in spatial resolution. Low-contrast resolution can also be increased by using a reconstruction filter, which reduces the image noise. This relationship is important because it is used in soft-tissue imaging procedures to increase the probability of detecting low-contrast lesions, such as metastatic carcinoma in the liver. Because of this interdependence, it is critical that all of the scan performance parameters (i.e., peak kilovoltage [kVp], milliamp-seconds [mAs], radiation dose, and reconstruction algorithm) be stated when- ever the spatial resolution of a scanner is quoted.

Contrast resolution in a CT scanner is directly re- lated to radiation dose and the efficiency with which transmitted x-rays are detected. Although the 0.3% to 0.4% contrast resolution of current scanners could be increased by longer scanning times or more intense x-ray beams, a clinically relevant improvement is un- likely without a significant increase in the radiation dose. More likely, improvements in contrast resolu- tion will result from changes in design and adjust- ments in the image reconstruction algorithms.

Spatial resolution in the final CT image can be improved by several techniques, including limited fan- beam scanning and geometric magnification. Limited fan-beam scanning increases resolution by collimating the x-ray beam so that it covers only the central 20 to 25 cm of the gantry opening. Because the beam spans fewer detectors, the sampling rate is much quicker, and transmission measurements can be taken at smaller angular increments during rotation; the finer sampling, in turn, increases spatial resolution in the reconstructed image.

Radiation dose

CT uses some of the highest doses of any diagnostic imaging method, and the fact that multislice CT has the potential to increase these doses adds to the need for some form of automatic dose control. CT manufac- turers are now implementing various strategies to control dose. One such strategy is to use prepro- grammed technique factors which manufacturers are currently fine tuning to specific patient sizes, particu- larly for pediatrics. Because tube current directly af- fects the patient dose and the image quality, manufacturers are working on methods to control tube current during the exposure. One method varies the tube current based on the scout view. At least one scout

Scanning Systems, Computed Tomography, Full-Body

view is normally collected before a scan begins and is acquired by fixing the x-ray tube while moving the patient through the scanner. From the scout view, it is possible to calculate the tube current needed for each slice. The simplest dose-control system uses just one scout view, although some can make use of two views.

A more advanced dose-control method uses real-

time information about the patient’s anatomy derived from the beam signal received by the detectors as the scan is progressing. Obtaining such feedback informa- tion is possible because of the faster electronics on today’s CT scanners. The user sets the desired image quality level, and the scanner adjusts the tube current as needed. Studies with patients suggest that dose savings up to 50% may be possible using these systems (Greess et al. 2000).

Reported problems

A recent study (Brenner et al. 2001) has reported

increased radiation-induced cancer risk because CT is increasingly being used for examining pediatric pa- tients. Although the risk/benefit ratio is such that most CT examinations of children are necessary, one study (Donnelly et al. 2001) found that radiation dose of the exam can be reduced by adjusting the CT protocol based on patient weight. In particular, the mA and pitch settings were lowered for helical scanning. Some helical CT units have software that automatically chooses mA settings for the best image quality for adult imaging. The authors recommend overriding such automatic settings when imaging children. Recently, manufacturers have been fine-tuning preprogrammed technique factors to specific patient sizes, particularly for pediatrics. Dose-control mechanisms are now avail- able on many scanners, and manufacturers are experi- menting with various options to find which is the most acceptable to users. ECRI will monitor developments in this area.

Despite the superior low-contrast resolution that CT offers, the spatial resolution of CT is relatively poor compared to that of film radiographic techniques. This limit on spatial resolution is typically not a major problem for most CT applications, but it may present a problem when attempting to scan thin structures, as in bone-thickness studies (Newman et al. 1998).

Artifacts can arise in CT images from defects in the data-gathering process or as a result of the physics involved in x-ray imaging. Motion artifacts are common in images produced from projection data acquired while the patient was moving. The filtered back-projection process requires that the structures being imaged re- main stationary during the entire scanning procedure; otherwise, the positive and negative components of the

various projections will not cancel appropriately, re- sulting in linear streaks through the reconstructed image. The streaks generally originate at high-contrast interfaces, such as the bony protuberances on the inside of the skull or the interface between bowel gas and contrast material. Patient cooperation and shortened scanning time can reduce this type of artifact.

The so-called metal artifact, in which bright streaks radiate from a central high-density metal clip or bullet fragment, is in fact a motion artifact. The extremely high density and small relative size of the metal object cause severe streaks even with very little motion. These artifacts often cannot be prevented because they can arise from movement as fine as that caused by blood passing through an artery.

Failure to take enough transmission measurements during the scan often results in sampling artifacts that appear as repetitive high-spatial-frequency patterns radiating from some high-density object. The apparent source of the artifact may or may not be within the image reconstruction circle.

Using polychromatic x-ray beams from a standard x-ray tube introduces a potentially serious artifact source. The preferential absorption of lower-energy photons (beam hardening) causes a large object to appear less absorptive than a smaller object with the same attenuation characteristics. In images that are inadequately corrected for this phenomenon, beam hardening causes the CT values obtained for a particu- lar organ to be highly dependent on patient size. For example, the CT values for normal liver tissue in an infant are significantly larger than those for a large adult when both are imaged in the same system. A second effect of this phenomenon is that the thicker portions of a patient’s body appear to be less dense than the thinner portions. If severe enough, beam hardening can interfere with the radiologist’s ability to make clinical diagnoses.

Beam-hardening artifacts can be partially corrected by proper scanner calibration or by a shaped filter (one with a bow-tie-shaped cross section) through which the x-ray beam passes on its way to the patient. The x-rays passing through the shorter absorption paths at the edge of the patient body pass through a thicker portion of the filter, while the beam passing through the thin central part of the filter then passes through the thicker central part of the patient’s body. The final result is that the beam is uniformly hardened, inde- pendent of the shape of the patient’s body.

In helical CT, increased image noise, edge blur- ring, and artifacts can occur. Artifacts related to helical CT include inhomogeneous patches and halos,

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stair-stepping in 3-D images, artifacts resulting from volume averaging, and artifacts simulating ascending aortic dissection. Varying the scan protocol, decreasing table feed or slice thickness, and changing the timing of contrast medium injection can help reduce the oc- currence of artifacts during helical CT scanning.

Image quality and overall system performance should be monitored through a comprehensive quality control program that includes measurements of reso- lution, noise, patient radiation dose, and the accuracy of CT numbers. Patient couch positioning, image proc- essing, and hard-copy output should also be evaluated.

Contrast medium injection can cause several prob- lems. The most common complication is the formation of blood clots, which can lodge downstream and occlude smaller vessels. Care must be taken to avoid injecting contrast medium directly into the vessel wall, which could cause dissection or occlusion of the vessel. New catheter designs have been introduced that reportedly enable high flow while avoiding turbulence at the catheter terminus. Several incidents of toxic or ana- phylactic reactions to contrast agents have been re- ported, including minor nausea and vomiting, skin rashes, cardiac arrest, bronchospasm, ventricular fib- rillation, and renal insufficiency. The American Col- lege of Radiology and the American College of Cardiology have recently recommended the use of newer nonionic or low-osmolality agents in certain patients who are at a higher risk of suffering adverse reactions. Hospitals should implement a policy govern- ing use of high-osmolality versus low-osmolality and nonionic contrast agents. In addition, thrombus forma- tion is possible when blood mixes with nonionic con- trast medium in an injection syringe or catheter.

Purchase considerations

ECRI Recommendations

Included in the accompanying comparison chart are ECRI’s recommendations for minimum performance requirements for CT scanners; recommended specifi- cations have been categorized into three groups — low, mid, and high. The low-range category specifies a single-slice scanner; the mid- and high-range recom- mendations are for multislice scanners. Other differ- entiating criteria include the types of exams that can be performed and the patient throughput possible.

Most routine exams can be adequately performed using a single-slice system; however, scan times might be somewhat longer since only one slice is acquired in one rotation of the x-ray tube. Multislice systems ac- quire more and thinner slices in one rotation, allowing for more complex exams (e.g., cardiac) and more varied

patient populations (e.g., pediatric, trauma). However, as the number of slices that can be acquired increases, the incremental benefit actually decreases. For exam- ple, the smallest slice width on a 4-slice scanner is the same as that on a 16-slice scanner. In addition, most exams do not require the smallest slice width. Indeed, for slices wider than 5 mm, there is absolutely no difference between 4-slice and 16-slice systems.

Another important, though more subtle, difference is the speed of image reconstruction. Acquiring more slices is of little benefit if patient throughput is held up by slow image reconstruction. Conversely, there is little point purchasing a very high specification com- puter that will rarely be used to capacity. The same is true for the x-ray generator and tube. Low volume facilities will see little benefit from the more efficient use of the x-ray tube on a 16-slice scanner to warrant its over $100,000 replacement cost. Therefore, before buying a CT system it is necessary to evaluate patient population, clinical needs, and desired throughput.

Other considerations

A number of design features must be considered before purchasing a CT scanner. Comparable scanners from various manufacturers differ little in their basic clinical applications. The principal differences be- tween top-of-the-line and less sophisticated models generally involve cycle time (scanning and reconstruc- tion time), spatial resolution, data storage features, and helical scanning protocols. Any CT scanner model being considered for purchase must be examined while it is operating (preferably in a clinical setting rather than in a manufacturer’s demonstration room).

Distributed processing in the construction of CT scanners has eliminated the need for specially air- conditioned computer rooms in some cases, but such rooms are generally still required. Failure to provide adequate air-conditioning for the computer equipment severely compromises the reliability of the scanner system and ultimately shortens its useful life. In most cases, the existing hospital air-conditioning system cannot be used because its operation is tied to outdoor weather conditions, and many times it is already oper- ating close to capacity. Conditioning the electrical power supply is also required because the ability of the scanner to make artifact-free images often depends strongly on the electrical power energizing the instru- ment. Surge suppressors and means for automatic disconnection in the event of power failure should also be installed.

The length of time required to install the scanner varies with the supplier but may range from one week

Scanning Systems, Computed Tomography, Full-Body

to two months. Installation times of two weeks are common.

The complexity of CT scanners makes adequate training an absolute necessity. However, technician and physician training varies with the supplier. The usual training consists of one or more visits to the facility by an instructor provided by the supplier. Most initial training periods are three to four days, but longer visits are often desirable, depending on the in-house expertise and experience. Follow-up visits should be arranged three to six months after the initial installation.

Cost containment

Before purchasing a CT scanner, buyers should con- sider the facility’s current patient volume and the number and types of procedures performed. For in- stance, if the facility expects to perform a large number of CTA studies or expects to scan a large number of pediatric, geriatric, and trauma patients, it should consider purchasing a slip-ring CT scanner with multi- slice capabilities and an x-ray tube with a high heat storage capacity (3,500,000 heat units [HU] or greater).

Because CT scanners entail ongoing maintenance and operational costs, the initial acquisition cost does not accurately reflect the total cost of ownership. A purchase decision should be based on issues such as life-cycle cost (LCC), local service support, discount rates and non-price-related benefits offered by the supplier, and standardization with existing equipment in the department or hospital (i.e., purchasing all ra- diographic equipment from one supplier).

An LCC analysis can be used to compare alterna- tives and/or to determine the positive or negative eco- nomic value of a single alternative. For example, hospitals can use LCC analysis techniques to examine the cost-effectiveness of leasing or renting equipment versus purchasing the equipment outright. Because it examines the cash-flow impact of initial acquisition costs and operating costs over a period of time, LCC analysis is most useful for comparing alternatives with different cash flows and for revealing the total costs of equipment ownership. One LCC technique — present value (PV) analysis — is especially useful because it accounts for inflation and for the time value of money (i.e., money received today is worth more than money received at a later date). Conducting a PV/LCC analy- sis often demonstrates that the cost of ownership in- cludes more than just the initial acquisition cost and that a small increase in initial acquisition cost may produce significant savings in long-term operating costs. The PV is calculated using the annual cash

outflow, the dollar discount factor (the cost of capital), and the lifetime of the equipment (in years) in a mathe- matical equation.

The following represents a sample five-year PV/LCC analysis for a CT scanner with helical capability.

Present Value/Life-Cycle Cost Analysis

Assumptions

Operating costs are considered for years 1 through 5

Dollar discount factor is 5.8%

Inflation rate is 6% for a full-service contract and 4% for disposables (e.g., contrast media, film)

Operating and ownership costs are for one CT scan- ner operating two shifts per day Monday through Friday and one shift Saturday, with 15 scans per shift

Nonionic contrast medium is used for three scans per shift, at a cost of $125 per dose (ionic contrast medium is less expensive)

75 films per shift, at a cost of $1.50 per sheet, are generated

Costs for two full-time CT technologists include salary, benefits, payroll expenses, and continuing education

Capital Costs

4-slice, slip-ring CT system with helical scanning =

$1,200,000

Total Capital Costs = $1,200,000

Operating and Ownership Costs

Service contract, including x-ray tube, years 2 through 5 = $135,000/year

Salary and expenses for two FTEs = $110,000/year

Contrast media = $214,500/year

Film = $64,400/year

Total Operating Costs = $388,900 for year 1; $523,900/year for years 2 through 5

PV = ($3,643,022)

Other costs not included in the above analysis that should be considered for budgetary planning include those associated with the following:

Networking or interfacing the CT system to other devices such as laser imagers or workstations

Film processing costs such as for chemicals or film handlers

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Optional software packages such as for dental CT, bone mineral analysis, and CT radiotherapy simulation

Hardware and software upgrades not covered under the warranty or service contract

Utilities

Disposables and accessories related to certain procedures

Contributions to overhead

As illustrated by the above sample PV/LCC analy- sis, the initial acquisition cost is only a fraction of the total cost of operation over five years. Therefore, before making a purchase decision based solely on the acqui- sition cost of a CT scanner, buyers should consider operating costs over the lifetime of the equipment.

For further information on PV/LCC analysis, cus- tomized analyses, and purchase decision support, readers should contact ECRI’s SELECT™ Group.

The above analysis considers film costs associated with printing hard copies on a laser imager. Film costs may be reduced by purchasing radiologist worksta- tions that allow on-screen image review and diagnosis.

Hospitals can purchase service contracts or service on a time-and-materials basis from the supplier. Ser- vice may also be available from a third-party organiza- tion. The decision to purchase a service contract should be carefully considered. Most suppliers provide routine software updates, which enhance the scanner’s per- formance, at no charge to service contract customers. Furthermore, software updates are often cumulative; that is, previous software revisions may be required in order to install and operate a new performance feature. Purchasing a service contract also ensures that pre- ventive maintenance will be performed at regular in- tervals, eliminating the possibility of unexpected maintenance costs. Also, many suppliers do not extend system performance and uptime guarantees beyond the length of the warranty unless the system is covered by a service contract. Although the solid-state electron- ics of modern medical instrumentation are very reli- able, the complexity of CT scanners makes it imperative that effective service capability be demon- strated by any CT supplier under consideration. Serv- ice must be available without significant delay to ensure cost-effective use of the scanner.

ECRI recommends that, to maximize bargaining leverage, hospitals negotiate pricing for service con- tracts before the system is purchased. As a guideline, full-service contracts without tubes typically cost ap- proximately 7% to 12% of the scanner’s purchase price. Contracts with tubes are higher. Additional service

contract discounts may be negotiable for multiple-year agreements or for service contracts that are bundled with contracts on other equipment in the department or hospital.

With the current replacement-based CT market, hospitals may receive a significant discount from the list price. The actual discount received will depend on the hospital’s negotiating skills, the system configura- tion and model to be purchased, previous experience with the supplier, and the extent of concessions granted by the supplier, such as extended warranties, fixed prices for annual service contracts, and guaran- teed on-site service response. Buyers should make sure that applications training is included in the purchase price of the system. Some suppliers do offer more extensive on-site or off-site training programs for an additional cost.

Standardization of equipment can make staff train- ing easier, simplify servicing and parts acquisition, and provide greater bargaining leverage when negoti- ating the purchase of new equipment and/or service contract costs.

An alternative to the permanent installation of a CT scanner is the use of a mobile service in which the scanner facility is mounted in a specially modified truck or bus that visits the hospital or clinic on a regularly scheduled basis. Many small hospitals are finding this to be a workable alternative to the large financial commitment involved in a permanent instal- lation. Properly designed mobile systems are as reli- able as permanent systems and offer the advantage of relieving the hospital administration of the ongoing concerns of scanner and facility maintenance. Further, mobile services are usually used on a fee-for-service basis, and instituting a CT clinical service on this basis is more easily justified to the local healthcare regula- tory organization. In addition, leasing for more expen- sive, high-performance systems is becoming more common. For additional information see the Health Devices evaluation May 2002 citation listed below.

Stage of development

Although CT is now considered to be a mature technology (the first scanner for imaging the head was introduced in 1972), multislice technology introduced in 1998 is a significant development, shortening scan- ning times, improving image quality, expanding the applications of helical CT (particularly for CTA), in- creasing x-ray tube efficiency, and enabling 3-D image reconstructions. Several manufacturers offer 4-slice scanning systems, and some manufacturers offer 8- slice and 16-slice systems. Also, some manufacturers state that their scanners — including single-slice

Scanning Systems, Computed Tomography, Full-Body

models — are being designed with future hardware upgrades in mind. As more slices are added, the work- station and PACS will also need to be upgraded to handle the increased data volume; therefore, it is not just the detector that will need to be changed as this technology develops.

Some systems now offer cardiac gating as well. CT fluoroscopy, which allows for real-time image acquisi- tion and display during interventional procedures, is available with some systems. As CT scanners become more widely used for real-time imaging during inter- ventional procedures, CT fluoroscopy will likely be- come more widely available.

Manufacturers are also offering systems which per- form image overlay. The CT image is combined with a magnetic resonance image, a PET image, or an image of another radiographic modality of the same area. By using software to combine these images in an overlay (image fusion), physiologic and anatomic conditions in the area of interest may be enhanced. Details not recognized by one modality may be registered by the other.

Combined PET/CT systems are currently available that acquire both images without moving the patient. Combined PET/CT systems attempt to minimize mis- alignment in the fusion of two images which may differ significantly due to the patient having been scanned on separate PET and CT systems at different times. Combined PET/CT systems are primarily intended for oncologic imaging, in particular to enhance treatment planning for radiotherapy or surgery, because they provide both anatomic and functional information. This capability also makes combined PET/CT useful for cardiac imaging. During a PET/CT imaging proce- dure, the CT image is acquired first, then the PET scan is performed. The patient remains on the same imag- ing table throughout the procedure, which takes about 30 minutes not including the radiopharmaceutical up- take time of approximately one hour (the radiophar- maceutical is injected before the CT scan is performed). For PET scanning system specifications, see the Healthcare Product Comparison System report titled

SCANNING

SYSTEMS,

POSITRON

EMISSION

TO-

MOGRAPHY.

Bibliography

Baumgart D, Schmermund A, Goerge G, et al. Com- parison of electron beam computed tomography with intracoronary ultrasound and coronary angiog- raphy for detection of coronary atherosclerosis. J Am Coll Cardiol 1997 Jul;30(1):57-64.

Berland LL. Practical CT technology and techniques. New York: Raven Press; 1987.

Bluemke DA, Chambers TP. Spiral CT angiography: an alternative to conventional angiography. Radiology

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Bonk RT. Helical CT: principles and current applica- tions. Appl Radiol 1997 Mar;(Suppl):59-62.

Brenner DJ, Elliston CD, Hall EJ, et al. Estimated

risks of radiation-induced fatal cancer from pediat- ric CT. AJR Am J Roentgenol 2001 Feb;176(2):289-

96.

Broderick LS, Shemesh J, Wilensky RL, et al. Mea- surement of coronary artery calcium with dual-slice helical CT compared with coronary angiography:

evaluation of CT scoring methods, interobserver variations, and reproducibility. AJR Am J Roentgenol 1996 Aug;167(2):439-44.

Bushberg JT, Seibert JA, Leidholdt EM Jr, et al. The essential physics of medical imaging. Baltimore:

Williams & Wilkins; 1994.

Casey B. Computed tomography [article online]. Diag- nostic Imaging Webcast [cited 1999 Apr 1]. Avail- able from Internet: http://www.dimag.com/webcast/

wc_story3.htm.

Curry TS 3rd, Dowdey JE, Murry RC Jr. Christensen’s physics of diagnostic radiology. 4th ed. Philadel- phia: Lea & Febiger; 1990.

Dellaria MF. Future contrast media for computed to- mography. Appl Radiol 1996 Mar;(Suppl):47-50.

Donnelly LF, Emery KH, Brody AS, et al. Minimizing radiation dose for pediatric body applications of

single-detector helical CT: strategies at a large chil- dren’s hospital [perspective]. AJR Am J Roentgenol

2001 Feb;176(2):303-6.

Ernst RD, Kim HS, Kawashima A, et al. Near real- time CT fluoroscopy using computer automated scan technology in nonvascular interventional procedures. AJR Am J Roentgenol 2000 Feb;174(2):

319-21.

Gay SB, Matthews AB. Computed tomography: ten reasons why helical CT is worth a million bucks. Diagn Imaging 1998 Nov:111-4.

Greess H, Wolf H, Baum U, et al. Dose reduction in computed tomography by attenuation-based on-line modulation of the tube current: evaluation of six anatomical regions. Eur Radiol 2000;10(2):391-4.

Healthcare Product Comparison System

Guerci AD, Spadaro LA, Popma JJ, et al. Relation of coronary calcium score by electron beam computed tomography to arteriographic findings in asympto- matic and symptomatic adults. Am J Cardiol 1997 Jan 15;79(2):128-33.

Gunderman RB. Physics of helical CT. Appl Radiol 1996 Mar;(Suppl):13-6.

Hendee WR, Ritenour ER. Medical imaging physics. 3rd ed. St. Louis: Mosby-Year Book; 1992.

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10(2):86-8.

Kalender WA, Seissler W, Klotz E, et al. Helical volu- metric CT with single-breath-hold technique, con- tinuous transport, and continuous scanner rotation. Radiology 1990 Jul;176(1):181-3.

Klinke G. Helical CT: advantages and artifacts. Appl Radiol 1996 Mar;(Suppl):17-9.

Kobayashi Y, Nonogi H, Toyofuku M, et al. Coronary artery aneurysms detected with ultrafast computed tomography. Cathet Cardiovasc Diagn 1997 Nov;

42(3):302-4.

McCollough CH, Zink FE. Performance evaluation of a multi-slice CT system. Med Phys 1999 Nov;26(11):

2223-30.

McCunn M, Mirvis S, Reynolds HN, et al. Physician utilization of a portable computed tomography scan- ner in the intensive care unit. Crit Care Med 2000

Dec;28(12):3808-13.

Miller RL. The challenges of pediatric helical CT. Appl Radiol 1997 Mar;(Suppl):55-8.

Morgan CL, Morgan PM. Basic principles of computed tomography. Baltimore: University Park Press;

1983.

Newman DL, Dougherty G, al Obaid A, et al. Limita- tions of clinical CT in assessing cortical thickness and density. Phys Med Biol 1998 Mar;43(3):619-26.

Ogilvy CS, Lustrin ES, Brown JH. Computerized to- mographic angiography (CTA) assists in the evalu- ation of patients with intracranial aneurysms [article online]. [cited 1999 April 1]. Available from Internet: http://neurosurgery.mgh.harvard.edu/v-f-

94-1.htm.

Orames C. The efficiency of technology: can real-time CT scanners reduce interventional procedure times? Radiographer 2000 Aug;47(2):67-8.

Rubin GD. Three-dimensional helical CT angiography. Radiographics 1994 Jul;14(4):905-12.

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2659-68.

U.K. Medical Devices Agency. CT scanners comparison of imaging performance 12. Evaluation 2000 Mar; No. 11.

Dual slice CT scanner comparison report V.3.04. Evaluation 2001 Aug; No. 49.

Four slice CT scanner comparison report V.3.04. Evaluation 2001 Aug; No. 50.

Single slice CT scanner comparison report V.3.04. Evaluation 2001 Aug; No. 48.

Wallace SK. Current applications and techniques for computed tomographic angiography. Appl Radiol 1996 Mar;(Suppl):36-41.

Weisser G, Lehman KJ, Scheck R, et al. Dose and image quality of electron-beam CT compared with helical CT. Invest Radiol 1999 Jun;34(6):415-20.

Zickler P. Computed tomography: the current spin on helical. Med Imaging 1996 Mar;11(3):47-9.

Standards and guidelines

Note: Although every effort is made to ensure that the following list is comprehensive, please note that other applicable standards may exist.

American Association of Physicists in Medicine. Speci- fication and acceptance testing of computed to- mography scanners [report]. Diagnostic X-Ray Committee Task Group #2. 1993.

American College of Cardiology/American Heart Asso- ciation. Expert consensus document on electron- beam computed tomography for the diagnosis and prognosis of coronary artery disease. J Am Coll Cardiol 2000 Jul;36(1):326-40.

American College of Radiology. Computed tomography [policy statement]. 1980 (reaffirmed 1990).

MR and CT reimbursement [policy statement]. 1986 (revised 1996).

Standard for diagnostic medical physics perform- ance monitoring of computed tomography equip- ment. 1998.

American National Standards Institute/Association for the Advancement of Medical Instrumentation. Safe current limits for electromedical apparatus

Scanning Systems, Computed Tomography, Full-Body

[standard]. 3rd ed. ANSI/AAMI ES1-1993. 1985 (re- vised 1993).

American Society for Testing and Materials. Guide for computed radiography. BSR/ASTM E2007-99.

1998.

American Society of Radiologic Technologists. Radi- ologic technologists in radiologic sciences perform- ing computed tomography technology [position statement]. 1994 (revised 1998).

Blue Cross and Blue Shield Association. Electron beam computed tomography; clinical and cost- ef- fectiveness analyses. 1998.

Canadian Coordinating Office for Health Technology Assessment. Comparison of fixed and mobile CT and MRI scanners [technology assessment report]. 1995.

Committee for Evaluation and Diffusion of Innovative Technologies. Low-end CT scanners. 1997.

Environmental Health Directorate. Safety code 31:

radiation protection in computed tomography in- stallations. H46-2/94-181E. 1994.

International Electrotechnical Commission. Evalu- ation and routine testing in medical imaging depart- ments — part 2-6: constancy tests — x-ray equipment for computed tomography [standard]. IEC 61223-2-6 (1994-04). 1994.

Medical electrical equipment — part 1: general re- quirements for safety [standard]. IEC 60601-1 (1988-12). 1988.

Medical electrical equipment — part 1: general re- quirements for safety. Amendment 1 [standard]. IEC 60601-1-am1 (1991-11). 1991.

Medical electrical equipment — part 1: general re- quirements for safety. Amendment 2 [standard]. IEC 60601-1-am2 (1995-03). 1995.

Medical electrical equipment — part 1: general re- quirements for safety. Section 1. Collateral stan- dard: safety requirements for medical electrical systems. IEC 60601-1-1 (1992-06). 1992.

Medical electrical equipment — part 1: general re- quirements for safety. Section 1. Collateral stan- dard: safety requirements for medical electrical systems. Amendment 1 [standard]. IEC 60601-1-1- am1 (1995-11). 1995.

Medical electrical equipment — part 1: general re- quirements for safety. Section 2. Collateral stan- dard: electromagnetic compatibility — requirements and tests. IEC 60601-1-2 (2001-09). 2001.

Medical electrical equipment — part 2-44: particu- lar requirements for the safety of x-ray equipment

for computed tomography. IEC 60601-2-44 (2001- 06). 2001.

Royal Australian and New Zealand College of Radiolo- gists. Guidelines for operation of CT scanners. 1998 June.

Royal College of Radiologists. Use of computed to- mography in the initial investigation of common malignancies [report]. 1995.

U.S. Department of Health and Human Services. Food and Drug Administration. Computed tomography (CT) equipment. 21 CFR Part 1020.33. 2001.

Performance standards for ionizing radiation emit- ting products. 21 CFR Part 1020. 2001.

Citations from other ECRI publications

Health Devices

In-house servicing of x-ray and CT equipment [guid- ance article]. 1992 Jun-Jul;21(6-7):231-47.

Artifacts and the need for proper head centering on Picker PQ 2000 computed tomography (CT) scan- ners [User Experience Network™]. 1996 Feb-Mar;

25(2-3):109.

Quality control phantom for computed tomography (CT) scanners [Talk to the specialist]. 1997 Mar;

26(3):124.

GE HiSpeed Advantage computed tomography scan- ner [evaluation]. 1997 Dec;26(12):457-70.

Unnecessary initiation of warm-up routine on GE ProSpeed CT scanners [User Experience Net- work™]. 1998 Mar;27(3):118-9.

DICOM reference guide [guidance article]. 2001 Jan-

Feb;30(1-2):5-30.

Inadequate warnings on a GE CT/i (Octane) CT scan- ner may delay diagnosis [hazard report]. 2001 Apr;

30(4):149-50.

Longevity of x-ray tubes in multislice CT scanners [Talk to the specialist]. 2001 Jun;30(6):231.

Eye on medical errors: dose control in computed to- mography — automated systems are now available. 2002 May;31(5):164.

Money matters: X-ray tube life in multislice CT scan- ners. 2002 May;31(5):166.

Multislice computed tomography systems [evalu- ation]. 2002 May;31(5):161-88.

Health Devices Alerts

This Product Comparison lists Health Devices Alerts (HDA) citations published since the last update of this report. Each HDA abstract is identified by an Accession

Healthcare Product Comparison System

Number. Recalls and hazard reports include descrip- tions of the problem involved; abstracts of other pub- lished articles are referenced by bibliographic information. HPCS subscribers can call the Hotline for additional information on any of these citations or to request more extensive searches of the HDA database.

A4535 FDA issued a Public Health Notification warn-

ing healthcare workers of the radiation overdose risks

to pediatric and small adult patients during computed

tomography (CT) procedures. FDA states that the benefits of CT scanning far outweigh the risks associ- ated with the procedure but cautions that unnecessary radiation exposure should be avoided. Unnecessary

doses of radiation can occur during CT scans of children or small adults when CT scanner parameters are not appropriately adjusted for patient size. FDA states that the odds that children will develop cancer from x-ray radiation are significantly higher than those for adults because children have rapidly dividing cells and

a longer life expectancy. FDA recommends several

measures to protect children and other small patients

from unnecessary radiation exposure during CT proce- dures and encourages reporting of CT equipment mal- functions to the device manufacturer and to FDA’s voluntary reporting program, MedWatch, online at

http://www.accessdata.fda.gov/scrips/medwatch, by telephone at (800) FDA-1088, by fax at (800) FDA-0178,

or by mail at MedWatch, Food and Drug Administra-

tion, HF-2, 5600 Fishers Ln, Rockville, MD 20857. For more information about CT scanners and radiation overdose, contact Marian Kroen, FDA, by mail at the Office of Surveillance and Biometrics (HFZ-510), 1350 Piccard Dr, Rockville, MD 20850; by fax at (301) 594- 2968; by e-mail at phann@cdrh.fda.gov; or by voice mail at (301) 594-0650. Source: U.S. Food and Drug Ad- ministration. FDA public health notification: reducing radiation risk from computed tomography for pediatric and small adult patients. 2001 Nov 2.

38874 Hirai T, Korogi Y, Ono K, et al. Preoperative

evaluation of intracranial aneurysms: usefulness of intraarterial 3D CT angiography and conventional

angiography with a combined unit — initial experi- ence. Radiology 2001 Aug;220(2):499-505.

38944 Dougherty G. A comparison of the texture of

computed tomography and projection radiography im- ages of vertebral trabecular bone using fractal signa- ture and lacunarity. Med Eng Phys 2001 Aug;23(5):

313-21.

39134

Raggi P. The use of electron-beam computed

tomography as a tool for primary prevention. Am J Cardiol 2001 Oct 11;88(7B):28J-32J.

Health Technology Trends

Virtual reality applied to colonoscopy and broncho- scopy. 1995 Jan;7(1):3.

Ultrafast CT shown to predict heart disease risk in asymptomatic people. 1996 Jul;8(7):4-5.

Ultrafast CT gets cautious nod from heart association. 1996 Oct;8(10):8-9.

New CT technique may reduce unnecessary appendec- tomies. 1997 Feb;9(2):8-9.

Healthcare Risk Control

Technology overview. 1996;4:Radiology:3.

Supplier information

GE Imatron

GE

Imatron Inc

Div

GE Medical Systems [402588]

389

Oyster Point Blvd

South San Francisco CA 94080-1913 Phone: (650) 583-9964, (800) 367-6545 Fax: (650) 871-0418 E-mail: charles@imatron.com Internet: http://www.geimatron.com

GE

Medical Systems Europe [171319]

283

rue de la Miniere

boite postale 34 F-78533 Buc Cedex France Phone: 33 (1) 30704040 Fax: 33 (1) 30709855 E-mail: pascal.lucien@med.ge.com Internet: http://www.gemedicalsystems.com

GE Yokogawa Medical Systems Ltd [183063]

4-7-127 Asahigaoka Hino-shi Tokyo 191 Japan Phone: 81 (4) 2525853188 E-mail: hisao.matsuka@gemsa.med.ge.com Internet: http://www.gemedical.co.jp

GE Medical

GE

Medical Systems [102107]

PO

Box 414

Milwaukee WI 53201-0414 Phone: (262) 544-3011, (800) 643-6439 Fax: (262) 544-3384 Internet: http://www.gemedicalsystems.com

Scanning Systems, Computed Tomography, Full-Body

GE Medical Systems Europe [171319] 283 rue de la Miniere boite postale 34 F-78533 Buc Cedex France Phone: 33 (1) 30704040 Fax: 33 (1) 30709855 E-mail: info@gemedicalsystems.com Internet: http://www.gemedicalsystems.com

GE South Africa Medical Systems [340559] Private Bag X124 Halfway House 1685 South Africa Phone: 27 (11) 3156625

GE Yokogawa Medical Systems Ltd [183063] 4-7-127 Asahigaoka Hino-shi Tokyo 191 Japan Phone: 81 (4) 2525853188 Internet: http://www.gemedical.co.jp

Philips Medical

Philips Medical Systems Asia [188101] 16/Fl Hopewell Centre 17 Kennedy Road PO Box 2108 Hong Kong Hong Kong SAR People’s Republic of China Phone: 852 28215364 Fax: 852 25276726 E-mail: medical@philips.com Internet: http://www.medical.philips.com

Philips Medical Systems International bv

[152365]

Global Information Systems I.B.R.S./C.C.R.I. Numero 11088 NL-5600 PB Eindhoven The Netherlands Phone: 31 (40) 2782559 Fax: 31 (40) 2764887 E-mail: medical@philips.com Internet: http://www.medical.philips.com

Philips Medical Systems North America [102120] 22100 Bothell Everett Hwy PO Box 3003 Bothell WA 98041-3003 Phone: (425) 487-7000, (800) 526-4963 Fax: (425) 485-6080 E-mail: medical@philips.com Internet: http://www.medical.philips.com

Shimadzu

Shimadzu (Asia Pacific) PTE Ltd [172209] 16 Science Park Dr #01-02 The Pasteur Singapore Science Park Singapore 118227 Republic of Singapore Phone: 65 7786280 Fax: 65 7792935 E-mail: sales@shimadzu.com.sg Internet: http://www.shimadzuasiapac.com.sg

Shimadzu Corp Medical Systems International Marketing Div [153971] 3 Kanda-Nishikicho 1-chome Chiyoda-ku Tokyo 101-8448 Japan Phone: 81 (3) 32195641 E-mail: imd_med@group.shimadzu.co.jp Internet: http://www.shimadzu.co.jp

Shimadzu Europe GmbH [161064] Albert-Hahn-Strasse 6-10 D-47269 Duisburg Germany Phone: 49 (203) 76870 Fax: 49 (203) 766625 E-mail: webmaster@shimadzu.de Internet: http://www.shimadzu.de

Shimadzu Medical Systems [106973] 20101 S Vermont Ave Torrance CA 90502-3130 Phone: (310) 217-8855, (800) 228-1429 Fax: (310) 217-0661 E-mail: info@shimadzumed.com Internet: http://www.shimadzumed.com

Siemens Medical

Siemens AG Siemens Medical Solutions [401832] Hartmannstrasse 48 D-91052 Erlangen Germany Phone: 49 (9131) 844190 Fax: 49 (9131) 845400 E-mail: myriam.volz@siemens.com Internet: http://www.siemensmedical.com

Siemens Canada Ltd [174735] 2185 Derry Rd W Mississauga ON L5N 7A6 Canada Phone: (905) 819-8000, (888) 303-3353 Fax: (905) 819-5777 E-mail: webdesign@it.siemens.ca Internet: http://www.siemens.ca

Healthcare Product Comparison System

Siemens Medical Solutions USA Inc [399199]

186 Wood Ave S

Iselin NJ 08830-2704 Phone: (732) 321-4500 Fax: (732) 321-4780 E-mail: sales@siemensmedical.com Internet: http://www.siemensmedical.com

Siemens SA de CV [339105] Poniente 116 No 590 02300 Cd de Mexico Distrito Federal Mexico Phone: 52 (5) 3282000 Fax: 52 (5) 3282017 Internet: http://www.siemens.de

Toshiba

Toshiba America Medical Systems Inc [101894] 2441 Michelle Dr PO Box 2068 Tustin CA 92680-7047 Phone: (714) 730-5000, (800) 421-1968 Fax: (714) 832-2570 E-mail: mktgcomm@tams.com Internet: http://www.medical.toshiba.com

Toshiba Medical Systems Co Ltd [139511] 3-26-5 Hongo Bunkyo-ku Tokyo 113-0033 Japan Phone: 81 (3) 38182061 Fax: 81 (3) 38157215 Internet: http://www.medical.toshiba.com

Toshiba Medical Systems Europe bv [160817] Zilverstraat 1 NL-2718 RP Zoetermeer The Netherlands Phone: 31 (79) 3689222 Fax: 31 (79) 3689444 Internet: http://www.medical.toshiba.com

Toshiba Medical Systems Singapore [307328]

211 Henderson Rd #08-02

Henderson Industrial Park Singapore 159552 Republic of Singapore

Phone: 65 2729766 Fax: 65 2726083

About the chart specifications

The following terms are used in the chart:

Slice thickness, mm: The width (in millimeters) of the x-ray beam that passes through the patient. Image resolution and patient dose are affected by slice

thickness. Smaller slices provide greater spatial resolution but require a larger radiation dose.

Gantry tilt, °: The gantry, which holds the x-ray tube, detectors, collimators, rotation motors, and posi- tioning aids, can be tilted from the vertical to facili- tate angulation of the slice without moving the patient. With sufficient gantry tilt (about 20°), di- rect coronal scans of the head are possible.

Gantry aperture, cm: The gantry aperture is the open- ing in the scanner gantry in which the portion of the patient anatomy to be scanned is placed.

X-ray tube anode, heat storage, HU: The capacity of the x-ray tube anode to store heat generated during its operation, expressed in heat units. In certain types of studies in which high mA levels are used and many thin slices are required (e.g., spine studies), the heat storage capacity of the anode can be a limiting factor in the time between scans.

X-ray tube anode, heat dissipation rate, HU/min: The rate at which the anode cools, measured in heat units/minute. Higher rates of cooling are required to accommodate the high heat loads generated dur- ing rapid multiple-slice acquisition (e.g., volumetric scanning).

Pitch: The speed of table motion (in mm/sec) divided by the x-ray beam collimation width; when the table speed and the collimation are equal for a one-second scan time, the pitch is 1. A pitch greater than 1 is used to scan a larger area in one helical scan during a single patient breathhold.

Range of movement, longitudinal, cm: Longitudinal ad- justment of the patient table should be sufficient to allow the positioning of any portion of the patient’s body in the center of the gantry aperture.

Scannable range, cm: The maximum length that can be scanned without having to move the patient during the examination.

Scan FOVs, cm: Selecting a smaller scan field of view (FOV) for image reconstruction allows an increase in the spatial resolution of the scan. This entails using the minimum acceptable scan field diameter required by the anatomic section being scanned.

Reconstruction time, per slice, sec: The interval of time during which the computer and associated array processors transform the raw data into a recon- structed image. The reconstruction time for a single slice is a small fraction of the throughput time, but when multiple slices (10 to 20) are required, the time can significantly affect patient throughput.

Scanning Systems, Computed Tomography, Full-Body

Reconstruction time, for localization scan, sec: The time required to process new data taken during scan localization radiographs.

Matrixes, pixels: The matrix refers to the number of pixels (picture elements) in the display. Each pixel has a fixed density level in the resultant image. The larger the matrix, the more pixels and the greater the possible resolution, depending on the scan field of view.

Range of CT numbers: Density coefficients reflect the actual tissue density of the area of anatomy repre- sented by each pixel. By convention, water is as- signed a CT number of zero. Higher CT numbers reflect greater tissue density.

Hard disk, GB: Online image storage is a function of disk drive capacity (given in megabytes). A large amount of online storage space eliminates the need to move patient images to archival storage immediately.

Dynamic scan rate: The high quality and quantitative nature of CT images have led to the development of dynamic scanning techniques. This application uses scanning times of about one second per image to monitor the flow of contrast media through the vascular structure of the organ being examined. To obtain even shorter imaging times, the complete scan is divided into overlapping 240° segments. The attenuation data from these angular segments is then used to construct tomographic images.

High-contrast spatial resolution: A measure of the re- solving power of the system for objects with a con- trast difference greater than 10% (e.g., bone, soft tissue). Resolution is related to the modulation transfer function (MTF), a curve describing the sys- tem’s ability to reproduce an image. The measure- ment is expressed in line pairs per centimeter (lp/cm) or millimeters (mm) at 0% and 50% MTF to define the MTF curve for a particular system. Higher num- bers indicate better resolution.

Low-contrast resolution, mm at % at 4 rads: A measure of the ability of the system to resolve objects with a small difference in density. It is generally measured from a contrast-detail curve, which plots the mini- mum contrast detectable at various diameters of detail.

DICOM 3.0 interface: American College of Radiol- ogy/National Electrical Manufacturers Association Digital Imaging and Communications in Medicine standard; systems with this interface capability may, under certain conditions, be networked with other devices meeting the standard, regardless of the brand or image format.

Abbreviations:

ARO — After receipt of order

CD-R — Recordable compact disc

CE mark — Conformite Europeene mark

CPU — Central processing unit

CSA — Canadian Standards Association

CT — Computed tomography

DEKRA — Institut fuer Sicherheit, Umweltschutz und Energie (Institute for Health, Environ- mental Protection, and Energy)

ECG — Electrocardiogram

EN — European Norm

ETL — ETL Testing Laboratories

FDA — U.S. Food and Drug Administration

FOV — Field of view

GB — Gigabyte

HU — Heat unit

IEC — International Electrotechnical Commission

ISO —

International Organization for Standardi-

zation

JIS — Japanese Industrial Standards

mA — Milliamps

MB — Megabyte

MDD — Medical Devices Directive

MIP — Maximum intensity projection

MOD — Magneto-optical disk

MPR — Multiplanar reconstruction; a user-interac- tive image manipulation function that reformats axial scan data to display coronal, sagittal, and other views of the patient

MR — Magnetic resonance

MTF — Modulation transfer function

RISC — Reduced instruction set computer

TUV — Technischer Ueberwachungs Verein

Note: The data in the charts derive from suppli- ers’ specifications and have not been verified through independent testing by ECRI or any other agency. Because test methods vary, different products’

Healthcare Product Comparison System

specifications are not always comparable. Moreover, products and specifications are subject to frequent changes. ECRI is not responsible for the quality or validity of the information presented or for any adverse consequences of acting on such information.

When reading the charts, keep in mind that, unless otherwise noted, the list price does not reflect supplier discounts. And although we try to indicate which features and characteristics are standard and which are not, some may be optional, at additional cost.

For those models whose prices were supplied to us in currencies other than U.S. dollars, we have also listed the conversion to U.S. dollars to facilitate com- parison among models. However, keep in mind that exchange rates change often.

Need to know more?

For further information about the contents of this Product Comparison, contact the HPCS Hotline at +1 (610) 825-6000, ext. 5265; +1 (610) 834-1275 (fax); or hpcs@ecri.org (e-mail).

About ECRI

ECRI is a nonprofit health services research agency and a Collaborating Center of the World Health Organization, providing information and technical assistance to the healthcare community to support safe and cost-effective patient care for more than 25 years. The results of ECRI’s research and experience are available through its publications, information systems, databases, technical assis- tance program, laboratory services, seminars, and fellowships.

Our full-time staff includes a wide range of specialists in healthcare technology, hospital admini- stration, financial analysis, risk management, and information and computer science, as well as hospital planners, attorneys, physicists; biomedical, electrical, electronic, chemical, mechanical, and registered engineers; physicians; basic medical scientists; epidemiologists and biostatisticians; and writers, editors, and communications specialists.

Underlying ECRI’s knowledge base in healthcare technology are its integrity and objectivity. ECRI accepts no financial support from medical product manufacturers, and no employee may own stock in or consult for a medical equipment or pharmaceutical company.

The scope of ECRI’s resources extends far beyond technology. ECRI keeps healthcare professionals, manufacturers, legal professionals, information specialists, and others aware of the changing trends in healthcare, healthcare standards and regulations, and the best ways to handle environmental and occupational health and safety issues. ECRI also advises on management issues related to healthcare cost containment, accreditation, risk management, human resources, quality of care, and other complex topics.

ECRI has more than 35 publications, databases, software, and services to fulfill the growing need for healthcare information and decision support. They focus on three primary areas: healthcare technology, healthcare risk and quality management, and healthcare environmental management.

Scanning Systems, Computed Tomography, Full-Body

Product Comparison Chart

MODEL

ECRI RECOMMENDED

ECRI RECOMMENDED

ECRI RECOMMENDED

GE IMATRON

SPECIFICATIONS *

SPECIFICATIONS *

SPECIFICATIONS *

High

Mid

Low

C300 EBT

WHERE MARKETED

Worldwide

FDA CLEARANCE

Yes

CE MARK (MDD)

Yes

TYPE Number of slices acquired simultaneously

Multislice

Multislice

Single slice

Dual slice

16

4

1

1 or 2 **

GANTRY

Geometry

Rotate-rotate, slip

Rotate-rotate, slip

Rotate-rotate, slip

Rotating electron

ring

ring

ring

beam

Detectors, type

Ceramic, solid state

Ceramic, solid state

Ceramic, solid state

Solid state (2 x 1,728) ***

Number of rows Elements per row Number of detection channels Scan times, sec

16

4

1

Not specified

~1,000

~1,000

~1,000

Not specified

16 x 1,000

4 x 1,000

1 x 1,000

Not specified

360°

0.5-2

0.5-2

1-4

0.05; 0.1-2 in 0.1 sec increments

Partial Slice thickness, mm

NA

NA

NA

NA 1.5, 3, 6, 7, 10

0.3

0.3

0.7

X-ray fan beam angle, ° Gantry tilt, ° Gantry dimensions, H x W x D, cm

 

30

±30

±30

±30

See footnote

 

225 x 216 x 165

Gantry weight, kg Gantry aperture, cm Scan localizer

<2,000

<2,000

<2,000

1,485

70

70

70

78

Laser

Laser

Laser

Laser

X-RAY TUBE X-ray tube anode Heat storage, HU

5,000,000

5,000,000

2,000,000

Fixed tungsten rings with direct cooling

Heat dissipation

rate, HU/min

700,000

700,000

500,000

1,260,000, based on 21 kW of cooling Recirculating chilled water 0.6 x 2.4

Tube cooling

Oil or water

Oil or water

Oil or water

Tube focal spot, mm

0.5 x 0.7

0.5 x 0.7

0.5 x 0.7

Optional tubes

NA

Yes

Yes

None

X-RAY GENERATOR

kW output

60

60

20

83

kVp range

80-140

80-140

80-140

130

mA range

20-500

20-500

20-250

640

Colons separate data on similar models of a device.

*

These recommendations are the opinions of ECRI's technology experts. ECRI assumes no liability for decisions made based on

Luminescent crystals coupled to silicon photodiodes.

Complete scan is 210°.

**

this data.

***

8 without couch motion.

Table tilts 0-23° and swivels +23° to -23°.

This is the first of three pages covering the above model(s). These specifications continue onto the next two pages.

Healthcare Product Comparison System

Product Comparison Chart

MODEL

ECRI RECOMMENDED

ECRI RECOMMENDED

ECRI RECOMMENDED

GE IMATRON

SPECIFICATIONS *

SPECIFICATIONS *

SPECIFICATIONS *

High

Mid

Low

C300 EBT

HELICAL SCANNING Max scan time, sec Max scan volume, cm

 

Yes

100

100

60

32

150

150

150

88

 

Spatial resolution,

lp/cm

20

20

20

9.5

Pitch

NA

NA

0.5-2

0.1:1 to 2:1 **

Reconstruction time per image, sec

0.2

0.5

1

3 (512 x 512)

PATIENT TABLE Range of movement Vertical, cm Longitudinal, cm Scannable range, cm Max load capacity with accuracy, kg

40-100

40-100

40-100

72-97

150

150

150

100

150

150

150

88

200

200

200

160

IMAGE PROCESSING

 
 

Computer CPU

Dual Pentium 800 MHz

Scan FOVs, cm

50

50

50

9, 12, 15, 18, 21, 26, 30, 35, 40, 47.5

Reconstruction

matrixes

512 x 512

512 x 512

512 x 512

256 x 256, 512 x 512

Reconstruction time Per slice, sec

0.2

0.5

0.5

3 (512 x 512), 0.8 (256 x 256)

For localization

scan, sec

Real time

Real time

Real time

1

DISPLAY

 
 

Monitor size

20"

20"

20"

21"

Matrixes, pixels

1024 x 1024

1024 x 1024

1024 x 1024

256 x 256, 512 x 512

Range of CT numbers Image enlargement

-1,000 to +3,000

-1,000 to +3,000

-1,000 to +3,000

-1,000 to +3,095 Up to 10x

10x

10x

10x

Max no. of slices displayed at once

16

16

16

16

IMAGE STORAGE Hard disk, GB

100

50

50

4

 

No. online images

75,000

40,000

40,000

15,000 (256 x 256), 3,700 (512 x 512)

Archival storage

MOD, CD, DVD

MOD, CD, DVD

MOD, CD, DVD

2.3 GB MOD

Colons separate data on similar models of a device.

 

This is the second of three pages covering the above model(s). These specifications continue onto the next page.

*

**

These recommendations are the opinions of ECRI's technology experts. ECRI assumes no liability for decisions made based on this data. Takes data in a series of 210° sweeps. 2 sweeps considered 360° for pitch calculation.

Scanning Systems, Computed Tomography, Full-Body

Product Comparison Chart

MODEL

ECRI RECOMMENDED

ECRI RECOMMENDED

ECRI RECOMMENDED

GE IMATRON

SPECIFICATIONS *

SPECIFICATIONS *

SPECIFICATIONS *

High

Mid

Low

C300 EBT

PERFORMANCE

Minimum interscan

time, sec

0008 msec

Dynamic scan rate

High-contrast spatial resolution 0% MTF, lp/cm 50% MTF, lp/cm Low-contrast resolution, mm at % at 4 rads

 

34 scans/sec

20

20

20

9.5

10

10

10

5

4 at 0.3% at 2 rads

4 at 0.3% at 2 rads

4 at 0.3% at 2 rads

4 at 0.4%

Noise, % at 2.5 rads

0.3 at 3 rads

0.3 at 3 rads

0.3 at 3 rads

Not specified

CORONARY ARTERY

CALCIFICATION

SCORING

Optional

Optional

Optional

Yes

DICOM 3.0 INTERFACE

Yes

Yes

Yes

Yes

RECOMMENDED ROOM SIZE, m 2

25

25

25

60

POWER REQUIREMENTS

3 phase

3 phase

3 phase

480 VAC, 225 VA,

 

3-phase

PLANNING & PURCHASE List price, std configuration System warranty X-ray tube warranty Delivery time, ARO Training w/purchase

 

$1,900,000

1 year 150,000 scan seconds

1 year 150,000 scan seconds

1 year 150,000 scan seconds

1 year Not specified 8 weeks 8 days on-site

Yes

Yes

Yes

Remote diagnostics Year first sold USA installations World installations Fiscal year

Yes

Yes

Yes

Yes

 

2001

Not specified Not specified January to December

OTHER SPECIFICATIONS

Movie and flow mode; cardiac, multi- level, and continuous volume scanning; ECG triggering; cardiac function software; perfusion and wall motion; optional 3-D package with workstation. ISO 9001 certification.

Colons separate data on similar models of a device.

* These recommendations are the opinions of ECRI's technology experts. ECRI assumes no liability for decisions made based on this data.

Healthcare Product Comparison System

Product Comparison Chart

MODEL

GE MEDICAL

GE MEDICAL

GE MEDICAL

GE MEDICAL

HiSpeed CT/e

HiSpeed CT/e Dual

HiSpeed NXi Base

HiSpeed NXi Pro

WHERE MARKETED

Worldwide

Worldwide

Worldwide

Worldwide

FDA CLEARANCE

Yes

Yes

Yes

Yes

CE MARK (MDD)

Yes

Yes

Yes

Yes

TYPE Number of slices acquired simultaneously

Single slice

Dual slice

Dual slice

Dual slice

1222

GANTRY

Geometry

Rotate-rotate, slip

Rotate-rotate, slip

Rotate-rotate, slip

Rotate-rotate,

ring

ring

ring

low-voltage slip

 

ring

Detectors, type

HiLight ceramic

HiLight ceramic

HiLight ceramic

HiLight ceramic

Number of rows Elements per row Number of detection channels Scan times, sec

Not specified 685 + 23 reference

2

2

2

708

816

816

708

2 x 708

2 x 816

2 x 816

360°

1.5, 2, 3

1.5, 2, 3

1, 1.5, 2, 3

0.7, 1, 1.5, 2, 3

Partial Slice thickness, mm

1 optional 1, 2, 3, 5, 7, 10

NA 1, 2, 3, 5, 7, 10

NA 1, 2, 3, 5, 7, 10

NA 1, 2, 3, 5, 7, 10

X-ray fan beam angle, ° Gantry tilt, ° Gantry dimensions, H x W x D, cm

62

62

57.6

57.6

±20

±20

±30

±30

175.8 x 165.1 x 91.7

175.8 x 165.1 x 91.7

184.9 x 182.1 x 90.9

184.9 x 182.1 x 90.9

Gantry weight, kg Gantry aperture, cm Scan localizer

1,004

1,004

1,100

1,100

65

65

70

70

Incandescent

Incandescent

Laser

Laser

X-RAY TUBE X-ray tube anode Heat storage, HU

2,000,000

2,000,000

3,500,000

6,300,000

Heat dissipation

rate, HU/min

500,000

500,000

820,000

840,000

Tube cooling

Oil/air

Oil/air

Oil/air

Oil/air

Tube focal spot, mm

0.7 x 0.6

0.7 x 0.6

0.5 x 0.7, 1 x 1

0.5 x 0.7, 1 x 1

Optional tubes

NA

NA

NA

NA

X-RAY GENERATOR

kW output

24

24

42

53

kVp range

120, 140

120, 140

80, 120, 140

80, 120, 140

mA range

20-200

20-200

10-350

10-440

Colons separate data on similar models of a device.

This is the first of three pages covering the above model(s). These specifications continue onto the next two pages.

Scanning Systems, Computed Tomography, Full-Body

Product Comparison Chart

MODEL

GE MEDICAL

GE MEDICAL

GE MEDICAL

GE MEDICAL

HiSpeed CT/e

HiSpeed CT/e Dual

HiSpeed NXi Base

HiSpeed NXi Pro

HELICAL SCANNING Max scan time, sec Max scan volume, cm

Yes 30, optional 60

Yes 60, optional 90

Yes

Yes

60

120

120

120

162

162

Spatial resolution,

lp/cm

Same as axial 1 to 3:1 (0.1 incre- ments)

Same as axial 0.75:1 to 1.5:1 (2-slice mode)

Same as axial 0.75:1 to 1.5:1 (2-slice mode)

Same as axial 0.75:1 to 1.5:1 (2-slice mode)

Pitch

Reconstruction time per image, sec

6-7

1.8

2

2

PATIENT TABLE Range of movement Vertical, cm Longitudinal, cm Scannable range, cm Max load capacity with accuracy, kg

40-90

40-90

40-95

40-95

120

120

162

162

1,200

1,200

1,460

1,460

180

180

180 (±0.25 mm), 205 (±1 mm)

180 (±0.25 mm), 205 (±1 mm)

IMAGE PROCESSING

Computer CPU

Silicon Graphics

Silicon Graphics

Silicon Graphics

Silicon Graphics

Scan FOVs, cm

18, 25, 35, 43

18, 25, 35, 43

18-50

18-50

Reconstruction

matrixes

256 x 256, 320 x 320, 512 x 512

256 x 256, 320 x 320, 512 x 512

512 x 512

512 x 512

Reconstruction time Per slice, sec

6-7, optional 2

1.8

2

2

For localization

scan, sec

Real time

Real time

Real time

Real time

DISPLAY

Monitor size

17", optional 21" 1280 x 1024

21"

21"

21"

Matrixes, pixels

1280 x 1024

1280 x 1024

1280 x 1024

Range of CT numbers Image enlargement

-32,767 to +32,767 Up to 8x

-32,767 to +32,767 Up to 8x

-32,767 to +32,767 Up to 8x

-32,767 to +32,767 Up to 8x

Max no. of slices displayed at once

16

16

16

16

IMAGE STORAGE Hard disk, GB

4

9, optional 18

9 (x 2)

9 (x 2)

No. online images

9,200 (512 x 512), 500 raw data

12,000 (512 x 512), 3,000 raw data

20,000 (512 x 512), 3,000 raw data

20,000 (512 x 512), 3,000 raw data

Archival storage

2.3 GB MOD, DICOM 3.0

2.3 GB MOD, DICOM 3.0

2.3 GB MOD, DICOM 3.0

2.3 GB MOD, DICOM 3.0

Colons separate data on similar models of a device.

This is the second of three pages covering the above model(s). These specifications continue onto the next page.

Healthcare Product Comparison System

Product Comparison Chart

MODEL

GE MEDICAL

GE MEDICAL

GE MEDICAL

GE MEDICAL

HiSpeed CT/e

HiSpeed CT/e Dual

HiSpeed NXi Base

HiSpeed NXi Pro

PERFORMANCE

Minimum interscan

time, sec

1

1

0.7

0.7

Dynamic scan rate

20 scans/min

60 scans/min

85 scans/min

85 scans/min

High-contrast spatial resolution 0% MTF, lp/cm 50% MTF, lp/cm Low-contrast resolution, mm at % at 4 rads

13.3

13.3

15.4

15.4

9.5

9.5

8.5

8.5

3 at 0.3% at 0.9 rads; 20 cm CATPHAN

5 at 0.3% at 0.9 rads; 20 cm CATPHAN

5 at 0.3% at 0.9 rads; 8" CATPHAN

5 at 0.3% at 0.9 rads; 8" CATPHAN

Noise, % at 2.5 rads

0.35

0.35

0.26

0.26 at 2.41 rads

CORONARY ARTERY

CALCIFICATION

SCORING

Not specified

Not specified

Not specified

Not specified

DICOM 3.0 INTERFACE

Yes

Yes

Yes

Yes

RECOMMENDED ROOM SIZE, m 2

13

13

18

18

POWER REQUIREMENTS

460/480 VAC nominal, 50/60 Hz, 3-phase delta or Wye

460/480 VAC nominal, 50/60 Hz, 3-phase delta or Wye

460/480 VAC nominal, 50/60 Hz, 3-phase delta or Wye

460/480 VAC nominal, 50/60 Hz, 3-phase delta or Wye

PLANNING & PURCHASE List price, std configuration System warranty X-ray tube warranty Delivery time, ARO Training w/purchase

$375,000

Not specified 1 year, parts/labor Not specified Not specified Not specified

$750,000

$895,000

1 year, parts/labor 80,000 slices 45 days Not specified

1 year, parts/labor 1 year prorated 45 days 4 days HQ class

1 year, parts/labor 1 year prorated 45 days 4 days HQ class

Remote diagnostics Year first sold USA installations World installations Fiscal year

Yes

Yes Not specified Not specified Not specified January to December

Yes

Yes

1999

2000

2000

>45

20

40

>600

50

90

January to December

January to December

January to December

OTHER SPECIFICATIONS

AutoScan; Auto- Archive; AutoFilm; AutoVoice; Auto Transfer; SmartPrep; ProtocolPro; view/ edit Wizard; Dyna- Plan Plus; Image- Works; ProView; PMR; ConnectPro; SmartScore; advanced vessel analysis; perfusion; remote tilt; breathing lights; SmartmA.

AutoScan; Auto- Archive; AutoFilm; AutoVoice; Auto Transfer; SmartPrep; ProtocolPro; view/ edit Wizard; Dyna- Plan Plus; Image- Works; ProView; PMR; ConnectPro; SmartScore; advanced vessel analysis; perfusion; remote tilt; breathing lights; SmartmA.

AutoScan; Auto- Archive; AutoFilm; AutoVoice; Auto Transfer; SmartPrep; ProtocolPro; view/ edit Wizard; Dyna- Plan Plus; Image- Works; ProView; PMR; ConnectPro; SmartScore; advanced vessel analysis; perfusion; remote tilt; rear gantry controls; breathing lights; SmartmA; advanced lung analysis.

AutoScan; Auto- Archive; AutoFilm; AutoVoice; Auto Transfer; SmartPrep; ProtocolPro; view/ edit Wizard; Dyna- Plan Plus; Image- Works; ProView; PMR; ConnectPro; SmartScore; advanced vessel analysis; perfusion; remote tilt; rear gantry controls; breathing lights; SmartmA; advanced lung analysis.

Colons separate data on similar models of a device.

Scanning Systems, Computed Tomography, Full-Body

Product Comparison Chart

MODEL

GE MEDICAL

GE MEDICAL

GE MEDICAL

GE MEDICAL

HighSpeed QXi

HiSpeed Xi

HiSpeed Xi Pro

LightSpeed Plus

WHERE MARKETED

Worldwide

Worldwide

Worldwide

Worldwide

FDA CLEARANCE

Yes

Yes

Yes

Yes

CE MARK (MDD)

Yes

Yes

Yes

Yes

TYPE Number of slices acquired simultaneously

Multislice

Single-slice helical

Single-slice helical

Multislice

4114

GANTRY

Geometry

Rotate-rotate, slip

Rotate-rotate, slip

Rotate-rotate, slip

Rotate-rotate, slip

ring

ring

ring

ring

Detectors, type

HiLight ceramic

HiLight ceramic

HiLight ceramic

HiLight ceramic

Number of rows Elements per row Number of detection channels Scan times, sec

16

1

Not specified

16

912

816

816

912

4 x 912

816

816

4 x 912

360°

0.7, 1, 2, 3, 4

1, 1.5, 2, 3, optional 0.8

0.7, 1, 1.5, 2, 3; optional 0.8

0.5, 0.6, 0.7, 0.8, 1, 2, 3, 4

Partial Slice thickness, mm

X-ray fan beam angle, ° Gantry tilt, ° Gantry dimensions, H x W x D, cm

NA 0.63, 1.25, 2.5, 3.75, 5, 7.5, 10

0.7, optional 0.5 1, 2, 3, 5, 7, 10

0.5

NA 0.63, 1.25, 2.5, 3.75, 5, 7.5, 10

1, 2, 3, 5, 7, 10

55

61.5

61.5

55

±30

±30

±30

±30

208 x 223 x 109

184.9 x 182.1 x 90.9

184.9 x 182.1 x 90.9

188.2 x 222.5 x

 

100.6

Gantry weight, kg Gantry aperture, cm Scan localizer

1,269

1,100

1,100

1,269

70

70

70

70

Laser

Laser

Laser

Laser

X-RAY TUBE X-ray tube anode Heat storage, HU

5,300,000

3,500,000

6,300,000

6,300,000

Heat dissipation

rate, HU/min

840,000

820,000

840,000

840,000

Tube cooling

Oil/air

Oil/air

Oil/air

Oil/air

Tube focal spot, mm

0.7 x 0.6, 0.9 x 0.7

0.5 x 0.7, 1 x 1

0.5 x 0.7, 1 x 1

0.7 x 0.6, 0.9 x 0.7

Optional tubes

NA

NA

NA

NA

X-RAY GENERATOR

kW output

42

30, optional 42 80, 120, 140

53

53.2

kVp range

80, 100, 120, 140

80, 120, 140

80, 100, 120, 140

mA range

10-350

10-250, optional 300

10-440

10-440

Colons separate data on similar models of a device.

This is the first of three pages covering the above model(s). These specifications continue onto the next two pages.

Healthcare Product Comparison System

Product Comparison Chart

MODEL

GE MEDICAL

GE MEDICAL

GE MEDICAL

GE MEDICAL

HighSpeed QXi

HiSpeed Xi

HiSpeed Xi Pro

LightSpeed Plus

HELICAL SCANNING Max scan time, sec Max scan volume, cm

Yes

Yes

Yes

Yes

120

60

120

120

160

1,460

1,460

170

Spatial resolution,

lp/cm

Same as axial 0.75:1, 1.5:1 (4-slice mode)

Same as axial 0.5:1, 3:1

Same as axial 0.5:1, 3:1

Same as axial 0.75:1, 1.5:1 (4-slice mode)

Pitch

Reconstruction time per image, sec

1.5

4 (2 optional)

2

0.5

PATIENT TABLE Range of movement Vertical, cm Longitudinal, cm Scannable range, cm Max load capacity with accuracy, kg

51-107

40-95

40-95

51-107

160

162

162

170

160

162

1,460

170

180 (±0.25 mm), 205 (±1 mm)

180 (±0.25 mm), 205 (±1 mm)

180 (±0.25 mm), 205 (±1 mm)

180 (±0.25 mm), 205 (±1 mm)

IMAGE PROCESSING

Computer CPU

Silicon Graphics

Silicon Graphics

Silicon Graphics

Silicon Graphics

Octane

Octane

Scan FOVs, cm

25, 50

18-50

18-50

25, 50

Reconstruction

matrixes

512 x 512

512 x 512

512 x 512

512 x 512

Reconstruction time Per slice, sec

1.5

2

2

0.5

For localization

scan, sec

Real time

Real time

Real time

Real time

DISPLAY

Monitor size

20" (2) 1280 x 1024

21"

21"

20" (2) 1280 x 1024

Matrixes, pixels

1280 x 1024

1280 x 1024

Range of CT numbers Image enlargement

-1,024 to +3,071 Up to 8x

-32,767 to +32,767 Up to 8x

-32,767 to +32,767 Up to 8x

-1,024 to +3,071 Up to 8x

Max no. of slices displayed at once

16

16

16

16

IMAGE STORAGE Hard disk, GB

13.5

9

9

13.5

No. online images

20,000 (512 x 512), 2,000 raw data

10,000 (512 x 512), 1,000 raw data

10,000 (512 x 512), 1,000 raw data

20,000 (512 x 512), 2,000 raw data

Archival storage

2.3 GB MOD, DICOM 3.0

2.3 GB MOD, DICOM 3.0

2.3 GB MOD, DICOM 3.0

2.3 GB MOD, DICOM 3.0

Colons separate data on similar models of a device.

This is the second of three pages covering the above model(s). These specifications continue onto the next page.

Scanning Systems, Computed Tomography, Full-Body

Product Comparison Chart

MODEL

GE MEDICAL

GE MEDICAL

GE MEDICAL

GE MEDICAL

HighSpeed QXi

HiSpeed Xi

HiSpeed Xi Pro

LightSpeed Plus

PERFORMANCE

Minimum interscan

time, sec

1111

Dynamic scan rate

171 scans/min

30 scans/min

43 scans/min

240 scans/min

High-contrast spatial resolution 0% MTF, lp/cm 50% MTF, lp/cm Low-contrast resolution, mm at % at 4 rads

15.4

15.4

15.4

15.4

8.5

8.5

8.5

8.5

5 at 0.3% at 1.8 rads; 8" CATPHAN

5 at 0.3% at 0.9 rads; 8" CATPHAN

5 at 0.3% at 0.9 rads; 8" CATPHAN

5 at 0.3% at 1.8 rads; 8" CATPHAN

Noise, % at 2.5 rads

0.33 at 2.85 rads

0.26 at 2.41 rads

0.26 at 2.41 rads

0.33 at 2.85 rads

CORONARY ARTERY

CALCIFICATION

SCORING

Not specified

Not specified

Not specified

Not specified

DICOM 3.0 INTERFACE

Yes

Yes

Yes

Yes

RECOMMENDED ROOM SIZE, m 2

28 minimum

18

18

28 minimum

POWER REQUIREMENTS

460/480 VAC nominal, 50/60 Hz, 3-phase delta or Wye

460/480 VAC nominal, 50/60 Hz, 3-phase delta or Wye

460/480 VAC nominal, 50/60 Hz, 3-phase delta or Wye

460/480 VAC nominal, 50/60 Hz, 3-phase delta or Wye

PLANNING & PURCHASE List price, std configuration System warranty X-ray tube warranty Delivery time, ARO Training w/purchase

$1,145,000

$525,000

$765,000

$1,250,000

1 year, parts/labor 1 year prorated 45 days 4 days HQ class

1 year, parts/labor 1 year prorated 45 days 4 days HQ class

1 year, parts/labor 1 year prorated 45 days 4 days HQ class

1 year, parts/labor 1 year prorated 45 days 4 days HQ class

Remote diagnostics Year first sold USA installations World installations Fiscal year

Yes

Yes

Yes

Yes

1998

1998

1998

2000

>850

300

40

>300

>1,100

500

100

>400

January to December

January to December

January to December

January to December

OTHER SPECIFICATIONS

AutoScan; Auto- Archive; AutoFilm; AutoVoice; Auto Transfer; SmartPrep; ProtocolPro; view/ edit Wizard; Dyna- Plan Plus; Image- Works; ProView; PMR; ConnectPro; SmartScore; advanced vessel analysis; perfusion; remote tilt; in-room start; rear gantry controls; breathing lights; SmartmA; colonography. *

AutoScan; Auto- Archive; AutoFilm; AutoVoice; Auto Transfer; SmartPrep; ProtocolPro; view/ edit Wizard; Dyna- Plan Plus; Image- Works; ProView; PMR; ConnectPro; SmartScore; advanced vessel analysis; perfusion; remote tilt; rear gantry controls; breathing lights; SmartmA.

AutoScan; Auto- Archive; AutoFilm; AutoVoice; Auto Transfer; SmartPrep; ProtocolPro; view/ edit Wizard; Dyna- Plan Plus; Image- Works; ProView; PMR; ConnectPro; SmartScore; advanced vessel analysis; perfusion; remote tilt; rear gantry controls; breathing lights; SmartmA; advanced lung analysis.

AutoScan; Auto- Archive; AutoFilm; AutoVoice; Auto Transfer; SmartPrep; ProtocolPro; view/ edit Wizard; Dyna- Plan Plus; Image- Works; ProView; PMR; ConnectPro; SmartScore; advanced vessel analysis; perfusion; remote tilt; in-room start; rear gantry controls; breathing lights; SmartmA; colonography. *

Colons separate data on similar models of a device.

* Also Color Coding for Kids and advanced lung analysis.

Healthcare Product Comparison System

Product Comparison Chart

MODEL

GE MEDICAL

GE MEDICAL

GE MEDICAL

PHILIPS MEDICAL

LightSpeed QXi

LightSpeed 16

LightSpeed Ultra

Mx8000 IDT

WHERE MARKETED

Worldwide

Worldwide

Worldwide

Worldwide

FDA CLEARANCE

Yes

Yes

Yes

Yes

CE MARK (MDD)

Yes

Yes

Yes

Yes

TYPE Number of slices acquired simultaneously

Multislice

Multislice

Multislice

Multislice helical

4

16