Making the Invisible Visible

Tomosynthesis is a state-of-the-art imaging technology integrating cone-beam CT reconstruction and digital image processing.

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THA – Bone fusion without metal artefacts

Iterative Reconstruction (IR)
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Knees, Normal - Weight Bearing

Filtered Back Projection (FBP)

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Chest, Normal - Soft tissue

Filtered Back Projection (FBP)

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Ankle – Fixation without metal artefacts

Iterative Reconstruction (IR)
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    Spine –
Fixation without metal artefacts

Iterative Reconstruction (IR)
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Shoulder – No metal artefacts

Iterative Reconstruction (IR)

High quality multi-slice images are produced, visualizing anatomy, which may be difficult to see in conventional plain radiography, CT or MRI imaging.

Tomosynthesis multi-slice images are quickly and easily acquired using a low dose X-ray system similar to conventional linear tomography. However, unlike linear tomography, only a single acquisition run is needed to capture the multi-slice Tomosynthesis images.

The resulting multi-slice images are high resolution with low metal artifacts, providing key clinical advantages compared to other imaging modalities.

Tomosynthesis uses an automated acquisition process that acquires several images while the tube is moving in an arc across the region of interest, similar to linear tomography. However, unlike conventional tomography, only one acquisition arc is required to produce a series of image slices through the region of interest.

Slice thickness, range and centre can be optimised in post processing for further investigation, printing and DICOM storage.

Tomosynthesis images can be acquired in any position, including erect, resulting in weight bearing images. This is of particular interest when looking at knees, hips and spines.

A key clinical benefit is that Tomosynthesis images have minimal influence from the metal artifacts that are usually seen on CT images.

Therefore, Tomosynthesis is ideally suited to orthopedics for the follow-up diagnoses of patient with metal implants.

Tomosynthesis uses very low X-ray dose to achieve excellent clinical imaging. One Tomosynthesis exposure requires only a couple of seconds with a dose equivalent to approximately two radiography exposures of the same region of interest.

However, the acquired multi-slice images can provide far more clinical information compared to conventional DR or CR images.

In addition, low dose modes are available for select procedures where the dose rate is equivalent to a conventional AP or Lat exposure.

Tomosynthesis is well established as an imaging modality with a growing list of applications:

  •   • Fracture evaluation
  •   • Compression Fracture
  •   • Pre and Post surgery
  •   • Total Hip Arthroplasty (THA)
  •   • Total Knee Arthroplasty (TKA)
  •   • Extremities
  •   • Leg lengthening progression monitoring
  •   • Implant evaluation
  •   • Loosening of devices
  •   • Rheumatoid Arthritis – Bone erosion evaluation
  •   • Chest Examinations
  •   • Lung Cancer Screening - Nodule/Lesion visualization
  •   • Thorax - Follow-up exams with lower dose
  •   • Bronchoscopy - Biopsy position confirmation
  •   • Capsule Endoscopy - Location confirmation
  •   • Otology - Cochlear implants
  •   • Sinus
  •   • Etc.

Bariatric imaging

Tomosynthesis provides numerous key advantages including:

  •   • Low Dose
  •   • Weight Bearing or Recumbent
  •   • Low Metal Artifacts
  •   • High Spatial Resolution
  •   • Multi-slice imaging
  •   • High Quality Imaging in Plaster Fixation
  •   • High Quality Imaging with External Fixation
  •   • Easy Positioning
  •   • Fast Acquisition Time
  •   • Large FOV

Bariatric imaging Tomosynthesis is essentially a cone beam CT technique, perceived as part of CT scanning, and a reconstruction method resulting from the enhancement of Filtered Back Projection (FBP).

Bariatric imaging T-Smart is an advanced version of Tomosynthesis, using Iterative Reconstruction (IR). This results in superior image quality, clearly displaying trabecular detail and less metal artifacts.

T-Smart ideal for assessing:

  •   • Bone/Implant interface assessment
  •   • Hardware screw loosening
  •   • Fracture healing status adjacent to fixation plates

In addition, T-Smart can be used to make further reductions in X-ray dose while still producing excellent clinical imaging.

With the advent of Iterative Reconstruction (IR), it is now possible to provide oblique projections using the acquired Tomosynthesis imaging. Reconstructed images can be tilted laterally or vertically at up to +/- 20 deg.

This provides clearer imaging when examining the spine, pelvis and joints, or any other region that is not parallel to the tabletop.

Bariatric imaging Tomosynthesis and T-Smart are available on both our Sonialvision G4 and RADspeed Edge systems.

Remote controlled digital Fluoroscopy system incorporating Fluoro, DR, DSA, Tomosynthesis and Slot radiography.

    RADspeed Edge
Bariatric imaging General X-ray system including high end DR imaging with fully automatic positioning, Tomosynthesis and Stitching.

A selection of case studies performed using Tomosynthesis illustrating the flexibility of the modality, showing excellent special resolution and minimal metal artefacts.

Ankle, lateral with external fixation device.

Ankle, PA with external fixation device.

Scoliosis post surgery.

Hand, with pin in scaphoid.

Spine, AP post surgery.

Spine, Lat post surgery.

Total Hip Arthroplasty (THA).

Total Knee Arthroplasty (TKA).

  Clinical utility of T-smart TomoSynthesis for micro MAX stem THA
T-Smart imaging of the Revelation microMAX stem, a cement less short stem design allowing for proximal physiological load transmission..   Read more......

  Using Tomosynthesis images for measuring total spine alignment
Measuring total spine alignment on the Sonialvision system using a combination of Slot and Tomosynthesis imaging.   Read more......

  Use of Tomosynthesis for Total Hip Arthroplasty (THA)
Follow up observations using Tomosynthesis in THA imaging at the Iida Hospital allow assessment of bone fixation.   Read more......

  Applications of Tomosynthesis in Spine Surgery
Tomosynthesis has become more useful than traditional Tomography in a variety of different regions of interest.   Read more......

  Can T-Smart Tomosynthesis improve accuracy on THA stability?
T-Smart Tomosynthesis has greatly improved the quality of THA imaging by reducing the peri-implant artifacts.   Read more......

  Tomosynthesis for evaluating and treating painful shoulders
By creating multi-slice high-resolution images, was beneficial for evaluating the shoulder joint.   Read more......

  Tomosynthesis in Respiratory Medicine
A review of Tomosynthesis, CT and radiography in respiratory medicine at the National Cancer Hospital Takehiro Izumo.   Read more......

  User experience in Cochlear Implant Tomosynthesis
Tomosynthesis clearly shows the relationship between the electrodes and the cochlea senses fro each frequency band.   Read more......

  Experience in Cochlear Implant Tomosynthesis
Low metal artefacts in Tomosynthesis compared to CT and MRI imaging improve the visualization of the cochlear electrodes.   Read more......

  Gastrointestinal Tract using Patency Capsules
The use of Tomosynthesis to accurately locate and track the Patency Capsule within the abdominal cavity.   Read more......

  Tomosynthesis changes the evaluation of PLIF bone union
The low metal artefacts in Tomosynthesis imaging from pedicle screws and metal markers make it easier to evaluate the images.   Read more......

  Experience Using Tomosynthesis (T-smart) at Nara City Hospital
T-smart is a new reconstruction algorithm for Tomosynthesis, which reduces the metal artifacts while producing high spatial resolution images.   Read more......

  The use of Tomosynthesis at Aizawa Hospital
Because fluoroscopy can be used for accurate positioning, optimal imaging can be obtained for diagnosis.   Read more......

  The use of Tomosynthesis at Dokkyo Medical University
The use of Tomosynthesis for the observation of bone formation after fixation in trauma patients.   Read more......

  Orthopaedic Surgery Tomosynthesis Sumitomo University Hospital
Tomosynthesis is extremely useful for diagnostic imaging in orthopedic surgery since it is possible in the erect, sitting or recumbent position.    Read more......

  Lung Cancer Potential for Low Dose Tomosynthesis
An investigation into the application of Tomosynthesis in lung cancer screening with a focus on dose reduction.    Read more......

  Lung Cancer Possibilities Using Tomosynthesis
Low dose Tomosynthesis is a useful tool in lung cancer screening.    Read more......

  The Clinical Utility of Tomosynthesis in Lung Cancer Diagnosis
Tomosynthesis offers higher detection capacity for nodules in the lung field compared to general chest radiography.    Read more......

  Efforts to Reduce Exposure Dose in Chest Tomosynthesis
Tomosynthesis is a simple procedure that significantly enhances lesion visibility when compared to conventional chest X-ray imaging.    Read more......

  Applications of Tomosynthesis to Bronchoscopic Examinations
Tomosynthesis simplifies position confirmation for trans bronchial tumor biopsies and permits observations around the peripheral bronchial tubes.    Read more......

  Usefulness of Tomosynthesis for Orthopedics
Tomosynthesis enables clear observation of bone fractures, callus formation, fusing, synostosis status and bone and joint structures.    Read more......

  Clinical Applications to Orthopedics using Tomosynthesis
Tomosynthesis enables clear observation of bone tumors and bone structure that are difficult to observe in plain X-ray examinations.    Read more......

  Applications of Tomosynthesis for Colon X-ray Examinations
Tomosynthesis is extremely effective for colon X-ray examinations, especially in areas with complex topographies and lesions.    Read more......

   Tomosynthesis nearly equals MRI for rheumatoid arthritis
Tomosynthesis is nearly as good as MRI for detecting signs of rheumatoid arthritis, according to a new study in the February issue of the American Journal of Roentgenology.   Read more......

   Experience using the Sonialvision G4
The greatest strength of the Sonialvision G4 is the improvement in its fluoroscopic performance and its high quality radiographic images.    Read more......

   Tomosynthesis and Slot Advanced Imaging
Shimadzu provides advanced imaging on the Sonialvision G4, including Tomosynthesis and Slot radiography.   Read more......




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