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Ingenia 1.5T provides impressive workflow benefits at Nemoscan

Best Practice
Teissier, Jean-Marc, M.D. Nemoscan • France

High-speed, superb-quality diagnostic MR imaging and easy patient handling combined with the IntelliSpace Portal dramatically accelerate workflow

 Jean-Marc Teissier, MD, PhD, radiologist and 
Nemoscan managing director
Jean-Marc Teissier, MD, PhD, radiologist and Nemoscan managing director

Nemoscan is an association of radiologists in Nimes, France, that has set up diagnostic imaging centers in three of the city’s healthcare institutions. In the largest of these institutions, the Franciscaines Private Hospital, which focuses on cardiothoracic, neuro and orthopedic surgery, Nemoscan recently installed an Ingenia 1.5T MR scanner and the IntelliSpace Portal.

Ingenia combines high speed with superb diagnostic image quality

According to radiologist and Nemoscan managing director Jean-Marc Teissier, MD, PhD, the fully digital Ingenia 1.5T is demonstrating its qualities every day. “Nemoscan is currently facing a major challenge in the area of MRI as surgeons are becoming more and more demanding in the speed of receiving MRI exam results, especially in emergency and semi-emergency cases,” explains Dr. Teissier. “Now thanks to the excellent performance of the Ingenia 1.5T, for the first time we have access to truly highspeed MR exams with excellent quality. In the past, using analog systems it was impossible to believe we would achieve such rapid acquisition times with this level of quality.”


“I believe Ingenia 1.5T with dStream has an impressive SNR level. The high SNR allows us to make most scanning faster, from joints to the skull to the abdomen. For example, for the lumbar spine, T1 sagittal, T2 sagittal, and T2 axial in three minutes with largely satisfactory image quality is now routinely demonstrated with rapid and robust acquisitions.”

 

The 10 min. lumbar spine exam consists of sag T2W TSE, T1W TSE, T2W IR, axial T2W TSE and
myelography. When needed, scan time for only sagittal T1W and T2W, and axial can be brought
down to 3 min. only.

“Clearly, taking a little longer, Ingenia’s high SNR can also be used to enhance image quality, spatial resolution, and contrast resolution. Ingenia also provides a large FOV and superb image homogeneity, so that all stations in whole body imaging are of high quality, including areas where images merge and on the edges. This type of imaging is acquired in about 15 minutes, and with an exceptional quality. In my opinion, whole body imaging has benefited enormously from the new coil system.”
 2 stations 1 station
2 stations
1 station
Body imaging benefits not only from the high SNR but also from
the wide bore and large FOV of 55 cm combined with excellent
homogeneity and very good fat suppression.

“Abdominal imaging and pelvic imaging have also progressed tremendously with Ingenia, thanks to the large FOV and high homogeneity,” marks Dr. Teissier. “Additionally, where we’ve previously experienced many cases where total hip replacements had a major impact on MR image quality, our Ingenia hips exams are now capable of supporting diagnoses, even in areas close to the prosthesis.”

Excellent homogeneity is demonstrated in the pelvis.

Streamlined patient setup provides speed and flexibility

“Ingenia is fitted with a coil system that is both simple and powerful,” he says. “The multi-element Posterior coil is integrated into the table, which works very efficiently. The two Anterior coils are lightweight, comfortable to position, well tolerated by patients and allow imaging of the whole body. Smaller dedicated coils only need to be added for specific cases such as bone joints.”


“With Ingenia, patient setup is easy and fast. Then, in about 80% of our exams, SmartExam helps technologists achieve fast and reproducible planning. The technologist just needs to take the relevant ExamCard and start the procedure. The exam will be performed automatically with SmartSelect automatically selecting the coil elements. Ingenia has eliminated many redundant clicks and actions by providing these tools.”


“Thanks to the system’s easy coil handling and wide bore, we can easily pass from an exam of, say, the lumbar spine to an exam of knee, skull or abdomen,” says Dr. Teissier. “That’s an enormous advantage, as we no longer have to organize logical sequences of exams. What’s more, emergency cases can be handled during the normal workflow and don’t need to be scheduled beforehand or delayed due to incompatibility with the schedule.”


“We’ve only been working with the system for a few months but I can tell you now, Ingenia has become a firm favorite with everyone involved with it – our radiologists, technologists and patients.”


According to Dr. Teissier, the benefits offered by the Ingenia 1.5T mean they can handle more patients per day and they can examine more challenging patients.


“Ingenia 1.5T allows MRI to be used, for example, on hyperalgesic patients, where their increased sensitivity to pain means they can’t remain in a supine position for very long, as well as for brain assessments of patients who’ve just undergone surgery to check postoperative status, and patients who are being ventilated or intubated who require constant monitoring during the examination.”


“For these challenging patients we use Ingenia’s FlexTrak dockable patient transport system so that we can take our time to position and prepare the patient outside the examination room. When ready, the FlexTrak with the patient is rolled to the Ingenia and the patient enters the magnet on the FlexTrak tabletop. Two or three minutes after start of the acquisition, we often find that the patient has fallen asleep. This provides simplified patient preparation, as well as easy exam set up,” he says.

Ingenia 1.5T realizes higher patient throughput

“The center started using the Ingenia 1.5T in May 2011, and after around 10 days, it was working at a rate of three patients per hour, with sufficient capacity in reserve for any emergency patients requested by surgeons at the hospital,” according to Dr. Teissier.


“Previously, our daily workload consisted of 30 planned and up to 6 emergency patients per day. Ingenia now allows us to increase the number of exams over the course of a day. In the same time, we now plan 36 patients and can still add up to 6 emergency patients per day. That represents a throughput increase of 15-20%. So, this obviously provides financial benefits.”


“Its rapid acquisition method, quick access to the interior of a comfortable wide bore, and its lightweight, easy to install coils make Ingenia easy to use, and therefore fast and comfortable for patients, technologists and radiologists,” Dr. Teissier concludes.

Very fast brain exam in 2:28 minutes.

IntelliSpace Portal connects and supports

The center also takes advantage of Philips’ IntelliSpace Portal, a multimodality server embodying advanced viewing and processing capabilities. “The multimodality character is essential, as it is unimaginable today to make a diagnosis with MRI or CT without looking at and reworking images produced earlier or with complementary methods. IntelliSpace Portal allows us to use CT and MRI images, easily and fast.”


“At present IntelliSpace Portal is used for simple viewer functions, fusing images, and re-reading images. In whole body imaging, for example, the information supplied by diffusion can be re-transcribed in the form of color images that are applied to anatomic imaging (type T1 or T2) or simply to the survey. The Portal can routinely produce and fuse these images quickly, which helps us to simply interpret pathological regions.”


At Nemoscan, IntelliSpace is used remotely by radiologists and other physicians at the different locations. In some cases, a specialized radiologist may be far from the facility where the acquisition took place. In other cases, surgeons and cardiologists use the Portal to rework the images to recalculate vascular stenoses, for example, or reread the dynamic imaging of a heart, either in their offices or in the operating room.



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Apr 17, 2012

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Best Practice
Ingenia 1.5T
Release 4
Abdomen, Anterior coil, Body, brain, dStream, Hip, IntelliSpace, Lumbar spine, Musculoskeletal, myelography, Neuro, Pelvis, Posterior coil, SNR, whole body, workflow
 

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