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Cologne enjoys Panorama 1.0T advantages

Best Practice
Gossmann, Axel, M.D. Cologne, University of Cologne Germany

In June 2005, the University of Cologne (Germany) became the first European Panorama 1.0T installation. Panorama 1.0T features a 160 cm patient aperture that greatly reduces patient anxiety and its vertical field design affords imaging performance comparable to cylindrical high field scanners. Cologne's Dr. Axel Gossmann gives a comprehensive appraisal of Panorama 1.0T, touching on its major strengths.


 Dr. Axel Gossmann and the Panorama 1.0T. Superb T1 contrast; all details, including cartilage are well visualized. By virtue of its 1.0T field strength,
Panorama 1.0T shows virtually no
susceptibility effects, allowing it to
excel in brain stem imaging.
Dr. Axel Gossmann and the Panorama 1.0T.
Superb T1 contrast; all details, including cartilage are well visualized.
By virtue of its 1.0T field strength, Panorama 1.0T shows virtually no susceptibility effects, allowing it to excel in brain stem imaging.

University of Cologne applies Panorama 1.0T in modern routine MR and advanced kinematic studies

The University of Cologne determined it needed an open MRI scanner among their new system purchases, which also included Achieva 1.5T and 3.0T systems. Clinicians felt they could trade some field strength for better patient acceptance and access for certain studies. However, it became clear early in the evaluation and thereafter that acquiring the Panorama 1.0T would entail none of the compromises sometimes associated with lower field open scanners.


"The Panorama 1.0T is a complete system that is comparable to high field cylindrical systems," asserts University of Cologne radiologist, Axel Gossmann, M.D. "This system covers the whole spectrum of modern MRI. We use it not only for all routine studies, but also for sophisticated kinematic joint studies and interventional MRI procedures. The open gantry is highly accepted by all classes of patients."


T2-weighted   0.45 x 0.45 x 3.0 mm voxels.Post-contrast T1-FFE   0.5 x 0.5 x 2.0 mm voxels.
Post-contrast T1-FFE
0.45 x 0.45 x 3.0 mm voxels.
0.5 x 0.5 x 2.0 mm voxels.

  High resolution images demonstrating a lesion in the brain of a

  24-year-old male. These images were made using the SENSE

  Head coil and CLEAR.


Open design means patient comfort, access and isocenter imaging

Panorama 1.0T's spacious aperture has made an immediate impact at Cologne, Dr. Gossmann affirms. "Claustrophobic patients simply are not claustrophobic in this system," he says. "Also, larger-sized patients are more easily accommodated and pregnant patients can be scanned in more comfortable positions. Since we can allow parents to be present right next to children having scans, pediatric patients are more relaxed as well."


Patient access is a major Panorama 1.0T advantage, he adds. Dr. Gossmann will site trauma cases, in particular, which typically are done with CT rather than MRI due to better patient access. "Our much improved access will allow us to use MRI for trauma cases in which MRI is superior - spinal injuries received in a car accident, for example."


Patient access also is critical in cardiac stress imaging. "Panorama gives us great access to the patient if a cardiac arrest is induced. And, the system's dockable couch allows me to get the patient out within seconds."


In addition, the ample space between magnet poles and the ability to slide the patient couch laterally have made positioning off-center anatomy (e.g. wrist, shoulder) in the magnet isocenter extremely simple. "The signal is better and more uniform in the isocenter, the 'sweet spot' of the magnetic field, so positioning anatomy in the isocenter gives better quality images with uniform signal throughout," he says.


  Isocenter imaging of the wrist yields high resolution images of

  excellent quality. Positioning also is more comfortable than in

  a cylindrical system, where the wrist must often be placed

  superior to the head, which is often difficult for patients in pain.


"Cylindrical-like" performance and advanced applications

Dr. Gossmann was impressed not only by the spectrum of studies he could perform on Panorama 1.0T, but also by the excellent image quality. "The T2-weighted FLAIR brain images and diffusion-weighted images are great and the brain stem images show hardly any susceptibility effects by virtue of the 1.0T field strength," he says. "The spine images are exceptional and we can clearly see the nerve roots with virtually no artifacts. In musculoskeletal imaging, we obtain great T1 contrast and the cartilage images look superb."Also angiographic MR techniques, such as time-of-flight MRA or contrast-enhanced MRA of the carotid artery, show impressive image quality, he adds.


Cologne is exploring the potential of MR-guided biopsies (e.g. liver, breast) facilitated by Panorama 1.0T's open architecture. "Lesions frequently unseen on CT or ultrasound are plainly seen on MR, but biopsy needle placement historically has been difficult," he says. "Panorama 1.0T will give us the positioning flexibility to aim the needle precisely in the lesion's center while providing high image quality."



  These images demonstrate excellent Panorama 1.0T image

  quality, comparable to that of higher field cylindrical systems.


Kinematic studies afford dynamic look at pathology

Particularly breathtaking are Panorama's kinematic joint studies, which provide cine movies of joint flexion that can be evaluated for problems associated with bone or ligament pathology. "You can't do these knee, shoulder and spine studies in a cylindrical system," he says. "In an open system, full joint flexion is possible, enabling us to view pathology dynamically in all planes. A classic example would be a case in which a neutral knee joint position, for instance, shows no obvious pathology, but during dynamic hyperflexion demonstrates the precise point where meniscal pathology results in abnormal bone-to-bone contact.


"Witnessing the capabilities of Panorama for these advanced studies and all types of routine scans in Best made me a true believer in this system," Dr. Gossmann says. "I can say now I'm even more impressed with Panorama 1.0T as one of our key day-to-day scanners."



Isocenter kinematic imaging of the knee with high spatial and temporal resolution, enables full

90 degrees flexion of the knee.


Anteflexion Retroflexion

  The Panorama 1.0T enables kinematic spine imaging. Also, axial

  images can be obtained from different positions.The referring

  neuroradiologist was impressed by this application.

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Nov 25, 2005

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Best Practice
Panorama HFO
Release 1
Ankle, Brain, Brain stem, Carotid, Elbow, Foot, Hand, Hip, Knee, Lumbar spine, Musculoskeletal, Neuro, Shoulder, Vascular, Wrist

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