SOMATOM Force

Computed Tomography
Page 1 | © Siemens Healthcare GmbH, 2017
 Menno Fokke, Clinical education specialist CT
Forchheim, Germany

Computed Tomography
SOMATOM Force

© Siemens Healthcare GmbH, 2017

SOMATOM Force

Is CT nog het stralingskanon

van de radiologie?

Computed Tomography
Page 3 | © Siemens Healthcare GmbH, 2017
SOMATOM Force
Key components
VectronTM X-ray tubes StellarInfinity detectors High-speed patient table

• 2 x 1,300 mA @ 70 - 150 kV • 2 x 96 rows (2 x 6 cm) • 737 mm/s speed

• 2 x 120kW generator • 3,120 detector channels • up to 22 cm perfusion range
• up to 80 cm dynamic range
• Turbo Flash or High Pitch scan

Computed Tomography
Page 4 | © Siemens Healthcare GmbH, 2017
Low-dose early detection with Tin Filter
CT imaging at the dose of conventional X-ray1)
SOMATOM Force Radiology 2008;248:254-63

Collimation: 192 x 0.6 mm

Scan time: 0.4 s
Scan length: 289 mm
Rotation time: 0.25 s
Sn100 kV, 68 mAs
CTDIvol: 0.23 mGy
DLP: 8 mGy cm
Eff. dose: 0.1 mSv

Lung examinations with significantly

improved air-to-soft-tissue contrast
allow doses of conventional X-ray1)

ADMIRE Strength Level 5

Courtesy of UMM, Mannheim, Germany Computed Tomography

1) Invest Radiol. 2014 Jul;49(7):465-73. Page 5 | © Siemens Healthcare GmbH, 2017
Early detection with low-dose lung scans
Outstanding image quality even in obese patients
SOMATOM Force
Collimation: 192 x 0.6 mm
Scan time: 2.0 s
Scan length: 274 mm
Rotation time: 0.5 s
110 kV, 79 mAs
CTDIvol: 4.13 mGy
DLP: 134 mGy cm
Eff. dose: 0.28 mSv

Early detection low-dose lung scan in

an obese patient with a very low
dose of 0.28 mSv with outstanding
image quality.

Computed Tomography
Courtesy of Hospital Saint Joseph, Marsaille, France Page 6 | © Siemens Healthcare GmbH, 2017
Cardiac imaging with high heart rates – ultra-low-dose
Turbo Flash Spiral at a heart rate of 117 bpm
SOMATOM Force
Collimation: 2 x 192 x 0.6 mm
Scan time: 0.12 s
Scan length: 93 mm
Rotation time: 0.25 s
80 kV, 289 mAs
CTDIvol: 1.33 mGy
DLP: 19.7 mGy cm
Eff. dose: 0.28 mSv
HR: 117 bpm
CM: 30 mL

Rule out of coronary disease

within 0.12 s at average heart rate
of 117 bpm with Turbo Flash mode.

Computed Tomography
Courtesy of Baotou Central Hospital, Baotou, Inner Mongolia Page 7 | © Siemens Healthcare GmbH, 2017
SOMATOM Force

Is CT nog het stralingskanon

van de radiologie?

Dosis reducerende
technologie in de
Siemens SOMATOM Force

Computed Tomography
Page 8 | © Siemens Healthcare GmbH, 2017
CARE technology
Combine Applications Reduce Exposure
CARE Dose Configurator
Dose
Management
CARE Contrast
CARE Profile Dose
Visualization
CARE Dashboard

CARE Child
Dose
CARE Dose4D
Reduction
CARE kV

Iterative Reconstruction

Scan Parameter Image

Scan Reading
preparation adjustment recon

SOMATOM Scanner syngo.via

Computed Tomography
Page 9 | © Siemens Healthcare GmbH, 2017
CARE Dose4D

More precise configuration

of dose modulation

• Configuration for
different body habitus
and organs individually

• New and more specific

modulation curves

• Definition of threshold
values for Dose Alert
according to IEC
regulations

Unrestricted © Siemens Healthcare GmbH 2016 All rights reserved. Computed Tomography
Page 10 January 2016 Page 10 | © Siemens Healthcare GmbH,
HC2017
DI CT
CARE Dose4D and CARE kV

Dose relevant scan parameters

• Patient's body habitus
• Effective current (mAs)
• Voltage dep. on examination (kV)

Current modulation w/ CARE Dose4D Voltage setting with CARE kV

• Automatic patient and organ
specific protocol adaption
• Automatic modulation in X,Y
& Z direction in real time

Computed Tomography
Page 11 | © Siemens Healthcare GmbH, 2017
CARE kV

Example: Abdomen @ 100 kV

100

90
Without CARE kV
80
kV usage [%]

70

60

50

40

30

20

10

0
70 80 100 120 140
Tube voltage [kV]

100 With CARE kV

90

80
kV usage [%]

70

60 Dose (CTDIvol): 9.7 mGy

50
Dose reduction compared to:
40

30 • Siemens 120 kV stand. prot.: 14 mGy

20 • Competitor‘s 120 kV protocol*: 25 mGy
10

0
70 80 Tube voltage
100 [kV] 120 140

*Source: Internal data evaluation based on anonymous assessment on SRS connected scanners. Clinical image courtesy C. McCullough, Mayo Clinic,
Rochester, MN, USA * Sagara Y et al. Abdominal CT: comparison of low-dose CT with adaptive statistical iterative reconstruction and routine-dose CT Computed Tomography
with filtered back projection in 53 patients. AJR Am J Roentgenol. 2010 Sep;195(3):713-9. Page 12 | © Siemens Healthcare GmbH, 2017
ADMIRE
The newest generation in iterative reconstruction
ADMIRE in three steps
Non ADMIRE ADMIRE

• Raw data statistical modeling:

Statistical weighting of all projections in raw data
space

• Model based noise cancelation:

Noise cancelation based on an intelligent approach
in image space

• Advanced system modeling:

Advanced modeling is the base for the forward
projection and eliminates artifacts

Computed Tomography
Page 13 | © Siemens Healthcare GmbH, 2017
ADMIRE
Excellent image quality

WFBP* ADMIRE

*) Weighted Filtered Back Projection

Courtesy of UMM, Mannheim, Germany

Computed Tomography
Page 14 | © Siemens Healthcare GmbH, 2017
Patient with dissection
Low kV imaging with reduced contrast media (20 mL)
SOMATOM Force
Collimation: 2 x 192 x 0.6 mm
Scan time: 1.1 s
Scan length: 740 mm
Rotation time: 0.25 s
80 kV, 140 mAs
CTDIvol: 2.09 mGy
DLP: 155 mGy cm
Eff. dose: 2.32 mSv

Gated, examination with

20 mL1) of contrast media
without breath-hold
in patient with
limited function in right kidney.

Courtesy of UMM, Mannheim, Germany Computed Tomography

1) 400 mg/mL Page 15 | © Siemens Healthcare GmbH, 2017
Two steps ahead in Freezing Motion
“Free-breathing” CT imaging
Ultra-high-speed imaging with the unique
SOMATOM Force in combination with ADMIRE

Next generation Dual Source CT (DSCT) with

• Two VectronTM tubes
• Two StellarInfinity detectors with
25% more detector channels (1,840)
• Up to 22 lp/cm (0.24 mm) spatial resolution
• Advanced Modeled Iterative Reconstruction
(ADMIRE)1) for lowest possible dose

Up to 66 ms native temporal resolution utilizing

DSCT at 250 ms rotation speed
1) Image quality as defined by low contrast detectability using a model observer method for evaluation. Equivalent low contrast detectability can be achieved with 80% to 85% less dose using
ADMIRE at highest strength level for thin (0.6 mm) reconstruction slices in measured and simulated body and head phantoms for low contrast objects with different contrasts. See ADMIRE Computed Tomography
date sheet for further information. In clinical practice, the use of ADMIRE may reduce CT patient dose depending on the clinical task, patient size, anatomical location, and clinical practice. A
consultation with a radiologist and a physicist should be made to determine the appropriate dose to obtain diagnostic image quality for the particular clinical task.
Page 16 | © Siemens Healthcare GmbH, 2017
“Free-breathing” CT imaging
No anesthesia, no sedation1) for babies/kids

Baseline (previous high-end CT) Follow-up (SOMATOM Force)

Standard low-dose thorax CT Turbo Flash ultra-low-dose thorax CT
3 mSv effective dose 0.4 mSv effective dose; 0.3 s scan time
11 s scan time Pediatric imaging without breath-hold and sedation!1)

Courtesy of UMM, Mannheim, Germany Computed Tomography

1) The inherent temporal resolution – the ‘native’ temporal resolution acquired by the scanner – is highly important to freeze patient motion, e.g. in lung exams or
in patients who cannot hold their breath long enough. This is also important, in pediatric CT where it also can help reducing the need for potentially harmful sedation. Page 17 | © Siemens Healthcare GmbH, 2017
Preventive care in cardiac imaging
Ultra-low-dose Turbo Flash Spiral with 0.09 mSv
SOMATOM Force
Collimation: 2 x 192 x 0.6 mm
Scan time: 0.2 s
Scan length: 142 mm
Rotation time: 0.25 s
70 kV, 128 mAs
CTDIvol: 0.36 mGy
DLP: 6.6 mGy cm
Eff. dose: 0.09 mSv
HR: 56 bpm
BMI: 24

Rule out of coronary disease within

0.2 s and with ultra-low-dose with
only 0.09 mSv.

Computed Tomography
Courtesy of Adventist Hospital Sydney, Australia Page 18 | © Siemens Healthcare GmbH, 2017
Two steps ahead in Decision Making
Precise Dual Energy quantification
Dual Energy (DE) imaging with improved
energy separation

VectronTM tube plus StellarInfinity detectors

• New energy pairings, e.g. 90 and 150 kV Sn
for imaging of obese patients
• Up to 35 cm DE field of view (FoV)
• Up to 258 mm/s DE scan speed
• Tin Filter (Selective Photon Shield II) utilization

Up to 30% increased energy separation

for better DE imaging outcomes
Computed Tomography
Page 19 | © Siemens Healthcare GmbH, 2017
Precise Dual Energy quantification – pancreatic head
tumor illustrated with different DE reconstructions
SOMATOM Force
Collimation: 2 x 128 x 0.6 mm
Scan time: 4.35 s
Scan length: 207mm
Rotation time: 0.5 s
100/Sn150 kV, 117/60 mAs
CTDIvol: 6.88 mGy
DLP: 162.9 mGy cm
Eff. dose: 2.4 mSv Mixed

Advanced diagnostic information:

Monoenergetic Plus allows energy
spectrum shift to lower levels which
significantly improves image quality
and pancreas-to-lesion constrast1).

Mono+ 55 keV VNC

Courtesy of MUSC Medical Center, Charleston, USA
1) Frellesen et al. (2015): Dual Energy CT of the pancreas: improved Computed Tomography
carcinoma-to-pancreas contrast with a noise-optimized monoenergetic reconstruction algorithm. Page 20 | © Siemens Healthcare GmbH, 2017
Precise DE quantification – tissue differentiation and
therapy response assessment of liver cancer
SOMATOM Force
Collimation: 2 x 192 x 0.6 mm Suspected
Scan time: 4 s cyst
Scan length: 182 mm
Rotation time: 0.5 s
100/Sn150 kV, 202/190 mAs
CTDIvol: 11.99 mGy
DLP: 254 mGy cm
Eff. dose: 3.81 mSv

Dose neutral Dual Energy enables

advanced diagnosis of liver Tumor tissue
metastases and cyst tissue.

Computed Tomography
Courtesy of University Hospital Zuerich, Switzerland Page 21 | © Siemens Healthcare GmbH, 2017
Kidney-friendly scanning – change treatment
decisions with more comprehensive 4D imaging
SOMATOM Force
Collimation: 48 x 1.2 mm
Scan time: 36 s
Scan length: 222 mm
Rotation time: 0.25 s
70 kV, 200 mAs
CTDIvol: 43.46 mGy
DLP: 905 mGy cm
Eff. dose: 13.6 mSv
CM: 12 mL

Kidney-friendly dynamic angiography

of EVAR, Type II endoleak scanned
with only 12 mL1) of contrast media
in 72 year old patient.

Courtesy of UMM, Mannheim, Germany Computed Tomography

1) 400 mgl/mL Page 22 | © Siemens Healthcare GmbH, 2017
SOMATOM Force
Two steps ahead

Freezing motion – avoiding Outstanding quantitative

artifacts certainty
Dual Source CT with Turbo Fast Dual Energy acquisition with
Flash Spiral improved spectral separation

More channels. More coverage.

Kidney-friendly scanning
Excellent image quality.
VectronTM X-ray tubes with
StellarInfinity detectors – with
maximum power at low kV
anti-scatter 3D collimator grid

Perfusion imaging in routine

Dynamic imaging with low kV Low-dose early detection
and unique Adaptive Dose Tin Filters with ADMIRE
Shield

2 x 192 1,300 mA@70 kV 70 - 150 kV

Slices mA Rotational coverage 184 mm/rot kV
(2 x 576 recon) 1,300 mA@80 kV 10 kV Steps
Max. scan
737 mm/s Temp. res. 66 ms Power 240 kW (2 x 120 kW) Channels 1,840
speed

Computed Tomography
Page 23 | © Siemens Healthcare GmbH, 2017
SOMATOM Force

Is CT nog het stralingskanon

van de radiologie?

Computed Tomography
Page 24 | © Siemens Healthcare GmbH, 2017
Dank voor uw aandacht

Computed Tomography
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Computed Tomography
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