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An Image-Guided Tour Through BWH


Title: Slide 1 Author: Mallika Last modified by: Tina Kapur Created Date: 6/24/2011 12:15:45 PM Document presentation format: On-screen Show (4:3) Other titles – PowerPoint PPT presentation

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Title: An Image-Guided Tour Through BWH

An Image-Guided Tour Through BWHsAdvanced
Multimodality Image Guided Operating (AMIGO) Suite
  • Image Guided Therapy Program
  • Department of Radiology
  • Brigham and Womens Hospital

Operating Room
MRI Room
Supported by
  • National Center for Image Guided Therapy (NCIGT)
    P41 RR019703 (Jolesz, Tempany) 2005-2015

  • This presentation researched and created by
    Mallika Winsor
  • Photographs by Junichi Tokuda and Dan Kacher

From Conceptualized Sketch
...To Completed Suite
Advanced Multimodality Image Guided Operating
(AMIGO) Suite P41 RR019703 National Center for
Image Guided Therapy (NCIGT) 2005-2015 Ferenc
Jolesz, MD Clare Tempany, MD
The OR and MR rooms of AMIGO
Advanced Multimodality Image Guided Operating
(AMIGO) Suite P41 RR019703 National Center for
Image Guided Therapy (NCIGT) 2005-2015 Ferenc
Jolesz, MD Clare Tempany, MD
Imaging Equipment in AMIGO
  • Room 1 MRI Room
  • Siemens 3T Verio MR scanner that moves along a
    ceiling track between the MRI room and the OR
  • Room 2 PET-CT Room
  • Siemens PET-CT
  • Room 3 Operating Room
  • BK Medical Pro Focus UltraView Surgical
    Ultrasound with Prostate Transducer
  • Siemens S2000 Ultrasound
  • Siemens Artis Zee ceiling mounted X-ray
    Fluoroscopy system with Navigation Package and
  • Zeiss Pentero surgical microscope
  • Navigation
  • BrainLAB navigation system
  • Sentinelle Medical (Hologic) Aegis Navigation
  • St Jude Medical mapping and navigation system
  • IntraMedical Imaging Node Seeker and Beta Probe
  • Robin Medical Endoscout

The OR and MR rooms of AMIGO
Advanced Multimodality Image Guided Operating
(AMIGO) Suite P41 RR019703 National Center for
Image Guided Therapy (NCIGT) 2005-2015 Ferenc
Jolesz, MD Clare Tempany, MD
Magnetic Resonance Imaging (MRI)
Goal Highly detailed anatomical images
  • What Does It Do?
  • Strong magnetic field is applied, causing the
    nuclei within the patients body to rotate and
  • Scanner detects, records, and combines the
    different rotating fields into a single image
  • Gradients in all directions are combined to
    create a 3D image
  • Strong contrast between different soft tissues
    within body
  • Better at producing images of brain, muscles,
    heart, cancers than CT or x-rays
  • Applications
  • Used to distinguish pathological tissue from
    normal tissue
  • Comparable resolution, much better contrast
    resolution (between arbitrarily different but not
    identical tissues) than CT
  • Advantages
  • Harmless to patient
  • What it uses
  • Strong magnetic fields
  • Non-ionizing radiation

Magnetic Resonance Imaging (MRI)Terminology
  • Parameters of Image Acquisition
  • Edema
  • TE echo time
  • TR repetition time
  • TI inversion time
  • Time between inversion and excitation pulses
  • Abnormal accumulation of fluid beneath the skin
    or in cavities of the body
  • Caused by increased secretion of fluid into the
    interstitium or impaired removal of fluid

Magnetic Resonance Imaging (MRI)Basic Scans
  • T1-weighted MRI scan
  • T2-weighted MRI scan
  • Highlights fat deposits
  • Water dark fat bright
  • Good grey v. white matter contrast
  • Commonly run clinical scan
  • Short TE short TR
  • Highlights fluids
  • Fat dark water light
  • Good for imaging edema
  • Heavily used for clinical scans of cerebral
    spinal fluid
  • Long TE long TR

T2-weighted MRI scan
Spin density weighted MRI scan
  • Gradient Echo (GRE) sequence
  • Additional loss over T2 decay
  • Air/tissue boundaries susceptible
  • Increases contrast of specific tissues
  • Long TE long TR
  • No contrast from either T1 or T2 decay
  • Uses spin echo (sometimes gradient echo)
  • Short TE long TR

Magnetic Resonance Imaging (MRI)Specialized Scans
  • Diffusion MRI scan
  • Fluid Attenuated Inversion Recovery (FLAIR)
  • Diffusion tensor imaging (DTI) enables diffusion
    to be measured in multiple directions
  • Make brain maps of fiber directions
  • Examine connectivity of different regions of
  • Examine areas of neural degeneration and
  • Inversion-recovery pulse sequence that nulls
    fluid signals
  • Free water dark edematous tissue bright
  • Most sensitive way to evaluate brain for
    demyelinating diseases
  • Carefully-selected TI allows signal from any
    particular tissue to be suppressed
  • Conversion of T2-weighted sequence via additional
    radio frequency pulse and manipulation of
    magnetic gradients

Functional MRI (fMRI)
  • Measures signal changes in the brain due to
    changing neural activity
  • Low resolution, rapid rate scans
  • BOLD (Blood-Oxygen-Level Dependent) effect
  • Increases in neural activity cause changes in MR
    signals via T2 changes
  • Increased neural activity increases demand for
  • Vascular system overcompensated, increasing
    oxygenated hemoglobin
  • High resolution 3D maps of venous vasculature
    within neural tissue

Real-Time MRI
  • Continuous monitoring ("filming") of moving
    objects in real time
  • Should help provide information about diseases of
    the joints and heart
  • May make MRI examinations easier and more
    comfortable for patients

Magnetic Resonance Imaging (MRI)Medical
  • Interventional Therapy
  • Radiation Therapy Simulation
  • MRI images used to guide minimally invasive
    procedures both intraoperatively and
  • No ferromagnetic instruments used
  • Some specialized systems allow imaging concurrent
    with surgery
  • Usually, surgical procedure is temporarily
    interrupted so MR images can be acquired to
    verify success/guide subsequent surgical work
  • MRIs used to specifically locate tumors within
    body in preparation for radiation therapy
  • Patient placed in specific, reproducible, body
    position and scanned
  • MRI system computes precise location, shape and
    orientation of the tumor mass, correcting for
    spatial distortion inherent in the system
  • Patient is marked/tattooed with points that, when
    viewed in specified, reproducible body position,
    permit precise triangulation for radiation therapy

Magnetic Resonance Imaging (MRI)
  • What is MRI Compatibility?
  • Safety Concerns
  • MR-Safe device or implant that is completely
    non-magnetic, non-electrically conductive, and
    non-RF reactive
  • Titanium and its alloys
  • MR-Conditional device that is safe, provided
    the safety conditions are defined and observed
  • MR-Unsafe objects that are significantly
    ferromagnetic and pose a clear and direct threat
    to persons and equipment within the magnet room
  • Patients always asked for complete information
    about all implants prior to entering the MRI suite
  • Radio frequency energy
  • Powerful radio transmitter can heat the body to
    the point of risk of hyperthermia in patients
  • Peripheral Nerve Stimulation
  • Rapid switching on and off of the magnetic field
    gradients may cause nerve stimulation
  • Acoustic noise
  • Appropriate ear protection is necessary for
    anyone inside MRI scanner room during examination
  • Cryogens
  • Cryogenic (extremely cold) liquids enable
    superconducting capabilities of the
    electromagnetic coils
  • MRI support rooms should be equipped with
    pressure relief mechanisms and an exhaust fan in
    case of a quench (shut-down of superconduction
  • Pregnancy
  • Increasingly important for diagnosing and
    monitoring congenital defects of the fetus (no
    contrast agents used)
  • Fetal tumors (primarily teratomas)
  • Facilitating open fetal surgery
  • Other fetal interventions
  • Planning to safely deliver and treat babies whose
    defects would otherwise be fatal

Siemens MAGNETOM Verio 3T
  • Who Can It Accommodate?
  • How Does It Help BWH?
  • Patients up to 550 lbs
  • Pediatric and elderly patients
  • Claustrophobic patients
  • Intensive Care Unit patients
  • Patients dependent upon medical equipment
  • Minimizes scan rejections due to claustrophobia
  • Reduces necessary sedations
  • Capture sharper images (due to reduced
    anxiety-related movement)
  • Early access in interventional MRI
  • Opportunities to perform more kinematic studies

  • Features ?
  • Why this machine?
  • VQ engine
  • Ultra-light (6.3 tons) magnet with zero helium
  • Total Imaging Matrix (TMI)
  • TrueForm design
  • Larger imaging volume, higher image quality,
    better fat saturation
  • Whole body imaging up to 6' 4
  • Shortest 3T system available
  • 70 cm Open Bore
  • Moves along ceiling into OR
  • Higher speed, increased image quality
  • Safer scanning environment
  • Increase flexibility, accuracy and speed
  • Enhanced image quality for a wide range of
  • Ensures uniform RF distribution in all body
    regions (optimizes homogeneity)

Bottom Line Exceptional diagnostic
capabilities, patient comfort, and efficient
A view of OR table and the MR through the PET/CT
Advanced Multimodality Image Guided Operating
(AMIGO) Suite P41 RR019703 National Center for
Image Guided Therapy (NCIGT) 2005-2015 Ferenc
Jolesz, MD Clare Tempany, MD
Positron Emission Tomography-Computed Tomography
Goal Precise localization of metabolic functions
  • What Does It Do?
  • How Does It Work?
  • Hybrid modality of PET and x-ray CT
  • Takes both types of images sequentially, in the
    same session
  • Images can be combined into a single 2D or 3D
    superposed image
  • Detecting changes in molecular activity
  • Reveal primary tumors
  • Detect metastases
  • Quantify uptake
  • Improves accuracy in oncology, surgical planning,
    radiation therapy, cancer staging
  • Increased image quality, speed, and accuracy of
  • Patient fasts for 4 hours or more
  • Intravenous bolus (tracer) injected patient's arm
  • 1-2 hours later, patient placed into PET-CT,
    usually with arms at the sides or above the head
  • Automatic bed moves head first into the gantry,
    first obtaining a topogram (whole body flat
    sagittal section)
  • Operator uses PET-CT console to identify patient
    and examination, selects the scanning parameters
    and starts image acquisition period
  • Patient automatically moved head-first into CT
    gantry, where x-ray tomogram is acquired
  • Patient automatically moved through PET gantry,
    parallel to CT gantry PET slices acquired
  • Software reconstructs/aligs PET and CT images
  • Whole body scan (mid-thigh to top of head) takes
    5-40 min

Positron Emission Tomography-Computed Tomography
  • Positron Emission Tomography
  • X-ray Computed Tomography
  • Uses radionucleotide decay to generate 3D image
    of functional processes in the body
  • Detects gamma rays emitted by a positron-emitting
    radionucleotide ("tracer")
  • Tracer enters patient's body via a biologically
    active molecule
  • FDG is a tracer used to display metabolic
    activity of tissue in terms of regional glucose
  • Computer analyzes location/concentration of
    tracer within patient to construct 3D images
  • Uses computer processed tomography to generate 3D
    images from a collection of 2D x-ray images taken
    around a single axis of rotation
  • Tomography imaging by sections
  • Supplements x-rays and medical ultrasonaography
  • Used in preventative/screening medicine

TIME Magazine declared PET-CT "Medical Invention
of the Year" in 2000
AMIGOs PET-CTSiemens Biograph TruePoint
  • Features ?
  • Benefits
  • World's first HD PET platform
  • 190 cm patient scan range
  • 6-, 16-, 40- or 64- slice CT
  • 0.33 second rotation time on 64-slice CT
  • Customizable
  • Multisclice CT configurations,
  • High or standard resolution options
  • Clinical configuration options
  • 21.6 cm axial PET field of view with TrueV
  • Best NEMA spatial resolution in the industry
  • 2 mm uniform PET resolution
  • 2x improvement signal-to-noise
  • Distortion-free throughout entire field of view
  • More accurate visualization of fine detail at all
  • Extremely sharp, highly-detailed images
  • Wide range of performance options
  • Largest PET field of view in the industry,
    increasing count rate performance by over 70
  • 10 minute whole-body PETCT imaging with TrueV
  • Exceptional lesion detectability
  • More accurate visualization of fine detail at all
  • Enhanced detectability and highest level of
  • Sharper images
  • Greater distinction within image

AMIGOs PET-CTSiemens Biograph TruePoint
  • Technological Features
  • Lutetium Scintillator Oxyorthosilicate (LSO)
  • Faster scans
  • HI-REZ
  • Exceptional resolution
  • TrueV
  • Longest axial field of view available
  • TrueC
  • Model-based scatter correction
  • Ultra-Fast Ceramic (UFC) detector
  • Stunning CT image quality
  • SureView
  • Maximum image quality at any scan speed
  • CARE Dose4D
  • Real-time dose modulation
  • z-Sharp
  • Highest spatial resolution available

Siemens Artis Zee Ceiling-Mounted C-Arm,
Operating Table and MRI in OR of AMIGO
Advanced Multimodality Image Guided Operating
(AMIGO) Suite P41 RR019703 National Center for
Image Guided Therapy (NCIGT) 2005-2015 Ferenc
Jolesz, MD Clare Tempany, MD
AMIGOs AngiogramSiemens Artis Zee
Ceiling-Mounted C-Arm
  • Features
  • 56" full-color medical-grade screen
  • Large flat detector
  • Easy patient access
  • Full body coverage
  • Ergonomically designed controls
  • View multiple inputs simultaneously
  • Get the "whole picture" directly, at tableside
  • Change layout according to individual workflow
  • Extremely high resolution (4x that of standard
  • 8 megapixel resolution at 4 x HD (3840 x 2160
  • Over 200 layout combinations
  • 21 video source inputs
  • Fully integrated tableside control

Siemens Artis Zee Ceiling-Mounted C-Arm
AMIGOs AngiogramSiemens Artis Zee
Ceiling-Mounted C-Arm
  • CARE program
  • Reduces patient and operator radiation dose to a
  • Addresses broader patient base of dose-sensitive
    patients (ex children)
  • Provides dose monitoring during procedure
  • Enhances in-house reporting
  • Standard with all Artis Zee systems
  • Imaging
  • Improved visualization of therapeutic devices
  • Advanced 3D applications, allow greater speed and
  • Workflow
  • Ergonomically designed controls
  • Streamline workflow, increased efficiency

  • What is Ultrasound?
  • Applications
  • Cyclic sound pressure with a frequency (20 kHz -
    200 MHz) greater than the upper limit of human
    hearing (typically 20,000 hertz in healthy young
  • Uses many different fields to penetrate a medium
    and measure the reflection signature or supply
    focused energy
  • Reflection signature can reveal details about the
    inner structure of the medium
  • This property is used by bats to locate prey
    while hunting
  • Most well-known application is use in sonography
    to image a fetus in a human womb
  • Diagnostic sonography (AKA ultrasonography)
    ultrasound-based diagnostic imaging technique
    used to visualize subcutaneous body structures
    such as tendons, muscles, joints, vessels and
    internal organs for possible pathology or
  • Able to determine size, structure, and any
    pathological lesions using real-time tomographic
  • Soft tissue imaging
  • Cardiac (heart)
  • Renal (kidney)
  • Hepatic (liver and gallblader)
  • Muscuko-skeletal (muscles, ligaments, tendons)
  • Ophthalmic (eyes)
  • Superficial (just under the skin) structures
  • Ex testicles, thyroid, salivary glands, lymph
  • Guiding interventional procedures in real time
  • Fine needle aspiration/biopsy (FNA/NAB)
    diagnostic procedure
  • Biopsy of masses for cytology or histology
    testing in breast, thyroid, liver, kidney, lymph
    nodes, muscles, joints

  • Obstetric Imaging
  • Emergency Ultrasound
  • Used to identify many conditions harmful to both
    mother and fetus
  • Risk of leaving such conditions undiagnosed is
    far greater than the small risk associated with
    undergoing the actual US scan
  • Primary uses
  • Assess gestational age
  • Confirm fetal viability
  • Determine location of fetus, intrauterine v.
    ectopic (displaced anywhere besides uterine wall)
  • Check the location of the placenta in relation to
    the cervix
  • Detect multiple pregnancies
  • Detect major physical abnormalities
  • Assess fetal growth for evidence of intrauterine
    growth restriction (IUGR)
  • Check for fetal movement and heartbeat
  • Determine the sex of the baby
  • Specialized application by emergency responders
    to guide immediate first aid care
  • Pros
  • Images muscle, soft tissue, and bone surfaces
    well particularly good at delineating interfaces
    between solid and fluid-filled spaces
  • Renders "live" images, helps narrow down problem
  • Determines severity and sources of trauma within
  • Portable, narrowly-focused, easy to use
  • Cons
  • Cannot penetrate bone
  • Depth of penetration limited, especially in obese
  • Operator-dependent (high skill needed for good
    quality images and accurate diagnoses)
  • Scanning methodologies
  • Focused Assessment with Sonography for Trauma
  • Detects internal bodily fluid in between organs
    in cases of blunt abdominal trauma
  • Screening test for blood around the heart or
    abdominal organs after trauma
  • Detects blockages/clots/penetrations of the heart

  • Biomedical Applications
  • Detection of pelvic abnormalities, involving
    abdominal/vaginal/rectal US
  • Break calculi (stones formed in the body) into
    fragments small enough to be passed without
    excessive difficulty via lithotripsy
  • Ablate tumors non-invasively via High Intensity
    Focused Ultrasound (HIFU)
  • Magnetic Resonance-Guided Focused Ultrasound
    (MRgFUS) guided by MRI, a lower frequency
    (250-2000 kHz) than medical diagnostic ultrasound
    is applied in significantly higher time-averaged
  • Acoustic Targeted Drug Delivery (ATDD) enhanced
    transportation of molecules across specified
    tissues via high frequency ultrasound (frequency
    1-10 MHz sound intensity 0-30 watts/cm2)
  • Cataract treatment via phacoemulsification
    (surgery in which the eye's internal lens is
    emulsified with an ultrasonic handpiece and
    aspirated from the eye aspirated fluids replaced
    with balanced salt solution)
  • Low-intensity pulsed ultrasound used to stimulate
    bone and tooth regeneration, disrupt blood-brain
    barrier for drug delivery
  • Ultrasound-guided sclerotherapy and endovenous
    laser treatment
  • Ultrasound-guided sclerotherapy ultrasound is
    used to visualize the underlying vein, allowing
    the physician to deliver and monitor the
    injection of the vein-shrinking drug
  • Endovenous Laser Treatment (ELT)
    minimally-invasive ultrasound-guided technique
    used to treat varicose veins with laser energy
  • An optical fiber is inserted into the vein to be
    treated, a laser light is shone into the interior
    of that vein, causing the vein to contract
    optical fiber is slowly withdrawn
  • Elastography non-invasive method in which
    stiffness or strain images of soft tissue are
    used to detect and classify tumors
  • When a mechanical compression or vibration is
    applied, the tumor deforms less than the
    surrounding tissue (strain in the tumor is less
    than that in the surrounding tissue)
  • Elasticity can discern health from unhealthy
    tissue in specific organs/growths
  • Ultrasound Identification (USID)
  • Real Time Locating System (RTLS) or Indoor
    Positioning System (IPS)
  • RTLS used to wirelessly track and identify the
    location of objects in real time
  • Does not include speed, direction, or spatial
  • IPS network of devices used to wirelessly
    locate objects or people inside a building
  • Nonlinear propagation effects
  • US waves usually display nonlinear propagation
    (distortion) due to their high amplitude to
    wavelength ratio
  • Safety Concerns
  • Occupational exposure to ultrasound in excess of
    120 dB may lead to hearing loss
  • Exposure in excess of 155 dB may produce heating
    effects harmful to the human body
  • Exposures above 180 dB may lead to death
  • Recommended to avoid routine use of ultrasound
    scans in low risk pregnancies

AMIGOs Ultrasound 1BK Pro Focus UltraView
  • Capabilities
  • Features
  • Locate and map lesions, evaluate blood flow,
    biopsy suspicious areas
  • Easy-to-create images for accurate diagnosis
  • Full line of specialized transducers
  • Breast, abdominal, vascular, cardiac, obstetric,
  • Compatible with many other contrast-enhancing
  • Monitor therapeutic interventions
  • Breast biopsy, cyst drainage, radioactive seed
    implantation, other therapies (RFA, cryotherapy,
    microwave, laser)
  • Guide tip of catheter during RF ablation and
  • Intuitive keyboard and simple user interface
    makes scanner simple to learn and use
  • Compact, mobile design
  • High contrast imaging
  • HistoScanning interface
  • IQPAC technology (for abdominal imaging)
  • Angular Compound Imaging (ACI) organ definition
  • Reduced presence of artifacts, shadowing and
  • Compounds images from up to 5 different angles
    into a single, enhanced image
  • Enhances anatomical structures (tissue structure,
    vessel borders) during acquisition
  • Enhanced Tissue Definition (ETD) reduced speckle
  • Smooth out potential irregularities in an image
  • Speckle suppression algorithm continuously
    analyzes ultrasound image for irregularities,
    then smoothes them out without loss of frame rate
  • Improved anatomically correct continuous border
  • Improved ability to visualize lesion margins

AMIGOs Ultrasound 1BK Pro Focus UltraView
  • Specifics

Scanning Modes B- and M-mode CFM, PW and CW Doppler Tissue Harmonic Contrast imaging
Display 19 LCD flat screen
Features IQPAC Coded excitation Auto Doppler Auto Gain CHI acc. Split screen 3D DICOM Palm Control
Dimensions (approx) Height 1475-1565 Width 525mm Depth 765mm
Weight 70kg
Ultrasound Transducer 1BK 8818 Triplane
  • Features
  • Applications
  • Images all three prostate planes
  • Switches between planes at the click of a button
  • Increases diagnostic value with 3D, Contrast and
  • Sterile single-use needle guides
  • Individually sterile-packed, pre-assembled and
    ready to use
  • UA1322-S Biplane guide
  • Simultaneously biopsy the peripheral, transition
    and central zones
  • UA1323-S Endfire guide
  • Apical biopsies
  • UA1329-S Dual guide
  • Minimal manipulation
  • All are suitable for 17G needles
  • Transrectal prostate scanning
  • Transrectal puncture and biopsy
  • Transperineal puncture and biopsy
  • Transvaginal scanning
  • Spectral and CFM Doppler examinations
  • Tissue harmonic imaging
  • Contrast imaging

Ultrasound Transducer 1BK 8818 Triplane
  • Specifications

Frequency range 4 - 12 MHz
Contact surface (acoustic) 34.4 x 5.5 mm
Focal range 3 - 60 mm
Scanning modes B, M,BCFM, Doppler, Contrast, Tissue Harmonic
Frame Rate 60 Hz
Image field (expanded) Triplane / 140
Dimensions 36 x 39 x 323 mm
Weight 230 g
Disinfection Immersion STERIS SYSTEM 1 STERIS SYSTEM 1E STERRAD 50, 100S and 200
Ultrasound Transducer 2BK 8838 Endocavity 3D
  • High Resolution Color and 3D Imaging
  • World's first electronic transducer, for
    endovaginal, endoanal and transrectal imaging,
    with built-in high resolution 3D
  • Built-In 3D Acquisition
  • Built-in linear array rotates 360 inside the
  • No need for additional accessories or mover
  • No moving parts come in contact with the patient,
    for excellent patient comfort
  • Unsurpassed Image Quality
  • For both dynamic 2D and 3D scanning
  • Wide frequency range 12- 4 mHz, excellent imaging
    capabilities across all frequencies
  • Enhanced focus capabilities for prostate 3D and
    pelvic floor imaging
  • Premium Ease
  • Slim 16mm diameter for more comfortable patient
  • Easy to hold and manipulate
  • 2D scanning plane controlled remotely from the
    system keyboard
  • Silent operation

Ultrasound Transducer 2BK 8838
  • Specifications

Frequency range 12-4 MHz
Focal range (typical) 3-60 mm 0.1-2.4 in
Frame rate gt150
Disinfection Immersion STERIS SYSTEM 1 STERIS SYSTEM 1E
Scanning modes B,M,CFM, Doppler,Power Doppler, Tissue Harmonic Imaging, Contrast Imaging
Contact surface (acoustic) Transverse 65 x 5.5 mm 2.6 x .2 in
Image field (expanded) 65 mm/2.6 in wide acoustic surface able to rotate 360º
Weight (approx.) 450 g 1 lb
Ultrasound Transducer 3BK 8848 Intracavity
  • A resolution revolution in image guided prostate
    therapy. Resolute, clear and detailed images of
    the prostate, for accurate volume studies and
    source dose planning
  • Image guided prostate therapy
  • Sagittal scanning of any size prostate from base
    to apex
  • Resolute, clear, detailed image for accurate
    volume studies and source dose planning
  • Customizable sagittal grids and preferences for
  • Clear visualization of seminal vesicles
  • Clear view of needle placement
  • Pelvic Floor scanning
  • Best broad view of anterior and posterior
    compartments for functional and anatomical
  • Reproducible 3D studies with external mover
  • Detailed high-resolution biplane with 6.5 cm
    linear and convex views
  • Applications
  • Prostate brachytherapy
  • Transrectal scanning
  • Transperineal puncture
  • Transvaginal scanning
  • Prostate cryotherapy
  • Spectral and CFM Doppler
  • Contrast imaging

Ultrasound Transducer 3BK 8848 Intracavity
  • Specifications

Frequency range 5-12 MHz
Focal range (typical) 3-60 mm
Frame rate gt150
Disinfection Immersion, STERIS SYSTEM 1 STERIS SYSTEM 1E STERRAD 50, 100S and 200
Scanning modes B,M, Doppler, BCFM, Tissue Harmonic Imaging
Contact surface (overall) Transverse 127 mm2 Sagittal 357 mm2
Image field (expanded) 180(transverse)
Weight (approx.) 250 g
AMIGOs MicroscopeZeiss OPMI Pentero
  • Features
  • Intraoperative Fluorescence technologies (enhance
    efficiency via vital info)
  • Intra-operative fluorescence
  • Integration of entire digital video chain
  • Integration of surgical microscope into
    hospital's information and communication
  • User-friendly solutions for OR staff
  • INFRARED 800 Fluorescence-based angiography
  • Immediately visualize and interpret
    intraoperative blood flow
  • Delivers critical information quickly and
    conveniently to surgeon
  • No procedural disruption
  • Specially tailored to requirements of
    neurosurgery for management of vascular diseases
    (Ex cerebral aneurysms, arteriovenous
    malformations (AVM, and bypass procedures)
  • Button activates INFRARED and guides it
    automatically to the point of interest
  • Digital videos saved automatically
  • Still images easily taken and transferred to
  • AutoRecord synchronous video of white light and
    infrared view
  • AutoGain brightness of infrared image
    automatically adjusted to respective application
  • AutoReplay repeat function jumps directly to
    start of inflow on video, skips over blank
  • Picture-in-Picture direct comparison of white
    and infrared recordings on touch screen
  • Completely integrated into OPMI Pentero
  • FLOW 800 Visual analysis of vascular blood flow
  • Analytical visualization tool for rapid and
    reliable interpretation of fluorescence video
    sequences generated using INFRARED 800
  • Supports an in-depth interpretation of
    fluorescence videos by creating objective
    evaluation of results visually and in color
  • BLUE 400 Fluorescence-guided tumor resection
  • Visible differences
  • Excellent aid for visualizing tumors clearly at
    any time during the procedure

AMIGOs MicroscopeZeiss OPMI Pentero
  • State of the art apochromatic optics
  • Crystal-clear images, sharp details, natural
  • Variskop provides a larger working range and
    comfortable conditions
  • 17 field depth increase
  • Convenience
  • Ergonomically correct design for cranial, spinal
    and posterior fossa procedures
  • Surgeon can be standing or seated
  • Design is 30 more compact
  • Allows for freedom of hand and instrument
    movement, short distance to surgical field
  • Overhead design
  • Suspension system can be placed in any position
    (even behind surgeon)
  • Several different configurations available
  • Stereo co-observation tube remains in same
    position as microscope is repositioned
  • Light
  • 20 more light for surgeons (more for assistants)
  • Spot illumination
  • Precisely adjusts light cone without reflections
  • Two-channel illumination system
  • Higher-contrast images in narrow and deep canals
  • Integrated digital visualization immediately
    produce and process digital video
  • Simply Unique (user-friendly solutions for OR
  • AutoBalance one-touch button
  • AutoDrape air evacuation to precisely fit
    sterilization drape over microscope
  • FlexiTrak easy transportation
  • Superlux 330 easy to change lamps and modules
  • Workflow Integration
  • Fast and easy connection to all leading
    navigation systems without external components
    and wiring
  • Open interface system
  • Use same workstation and cable with other ZEISS
    surgical microscopes
  • Binocular, color injection and superimposition of
    navigation data
  • Robotic X/Y design with three motorized axes
  • Provides real tool tracking for viewing every
    point in working and tilting range of OPMI
  • Laser-guided, high-speed autofocus system
  • Delivers precise navigation by focusing to a
    fraction of a millimeter
  • Precisely identifies displayed point
  • MultiVision
  • Enables surgeon to inject information and data
    into the eyepiece
  • Touchscreen interface can be injected into
    MultiVision display and controlled using the

AMIGOs MicroscopeZeiss OPMI Pentero
  • FDA cleared for any MRI-guided intervention on
    MRI scanners
  • Clinical procedures on open scanners
  • Prostate brachytherapy and cryotherapy, RF
    ablation of liver tumors, cryotherapy of renal
    cancer, breast biopsy, brain surgery
  • Research on close-bore scanners
  • MRI catheterization and endoscopy, motion
    artifact elimination
  • Clinical Applications
  • Many MR-guided diagnostic and therapeutic
  • Biopsy and aspiration (breast, brain, liver,
  • Tumor RF/laser ablation (liver).
  • Brachytherapy (prostate, kidney).
  • Image-guided neurosurgery.
  • Pain management (nerve blockage).
  • Specifications
  • Realtime 6 degrees-of-freedom tracking during MR
    imaging with FSE, FGRE, SPGR, SSFSE.
  • Number of Tracking Devices 2 out of 4 ports.
  • Tracking Accuracy Location 2mm, Orientation 1
    degree (values represent 2 standard deviations of
    the tracking error population).
  • Tracking Range Up to 30cm from the center of the
  • Tracking Angle Unlimited (360 degrees).
  • Tracking Rate Up to 16Hz.
  • Input Power 120VAC/0.8A (60Hz) or 230VAC/0.4A
  • Comes with a set of mechanical tools that help
    the physician navigate a needle to a specific
    location inside the patient
  • Sensors
  • Acquires the location and orientation of a sensor
    during an MRI scan
  • Sensor is a 3 dimensional magnetic field sensor
    made by 3 orthogonal pick up coils
  • Comes in different sizes and shapes, to fit the
    specific application
  • Most popular
  • Basic cube sensor for hand held guided tool
  • Micro sensor with about 1.5 mm diameter for small
    tools, catheters and more

To be continued