Interventional Radiography

Trinias provides advanced Interventional Radiography

The Trinias concept focuses on:

  •   • Solutions for imaging: New concept image processing with SCORE OPERA AI and intuitive protocol control
  •   • Solutions for management: Collation and visualisation of procedure information in SMART Record
  •   • Solutions for operators: Intuitive operability and stress-free C-arm movement including New C-Arms and Dose Eye.


The most important feature of any Vascular Lab is Image Quality.

Building on the success of the SCORE PRO Advance image processing of our previous generation systems as used at The Austin Hospital, Score Opera AI is a new image processing engine using machine learning artificial intelligence to provide further enhancement in image quality and reduction in X-ray dose.

Using advanced image processing techniques, including Score Opera AI Deep Learning and Pattern Recognition, the images are well-defined, and devices are easily discernible.

With a focus on capturing all the information available during a procedure, SMART Record provides an intuitive platform in which to record, edit, review and archive procedures. This includes:

  •   • Recording of the system display
  •   • Voice recording
  •   • Image System information (Gantry & table position, acquisition parameters, dose etc.
  •   • Video capture from a CCTV video feed for live video capture.

Thumbnails and Timelines are provided for easy selection of the required information in playback. This platform provides an excellent solution for a video feed into a lecture theatre or training room and/or for staff review and training post procedures with a focus on improved efficiency.


The new C-arm design is faster, more flexible and features a new slim line elegant design:

  •   • Available in either floor or ceiling mounted configuration
  •   • Multiple positions providing excellent patient access for all procedures
  •   • Isocentric rotation maintaining alignment with the region of interest (ROI)
  •   • Faster than a conventional C-Arm for improved workflow
  •   • 3D/CT acquisition at the head-end and both side positions affording full patient coverage in advanced imaging
  •   • Heads up display ensuring that the image is always displayed with the correct orientation


In addition to the multiple working positions of the flexible C-arms, Automatic Femoral Access is provided for the Head end position of the C-Arm. With Automatic Femoral Access activated, if the patient table is panned in the head-wards direction towards the C-arm. The C-arm will automatically swing to the side maintain the detector in the current imaging position, allowing the table to be panned beyond the normal position for head position, providing femoral access without the need to manually move the C-Arm.

Conscious of the importance of dose management within an interventional lab, Dose-eye Live provides real-time dose information in a clear and easy to interpret display.

Operators can make real-time decisions in how to proceed with procedures based on this information, ensuring the best possible dose management while maintaining the highest possible clinical care and outcomes.

In addition, the cumulative dose information is captured and presented in a comprehensive dose report for further analysis and record keeping

SCORE StentView+Plus is advanced software developed to support PCI procedures based on real-time image processing technology.

SCORE StentView+Plus displays an enhanced image of stents in a fixed position in real-time which is particularly effective in assessing positional relationships between overlapping stents, or when re-expanding a stent using a balloon.

In cases with more than 2 markers, the region of interest (ROI) may be selected in order to provide improved automatic detection and to reduce procedure times.

SCORE StentShot provides a detailed stent enhanced image which is highly effective for observing more detail, such as checking for broken stents. Working with both StentView and StentShot will help improve PCI procedures.

  Flex-APS and New SCORE StentView

  Using Dynamic StentView Effectively

SCORE RSM is a motion tolerant DSA technique achieved through Shimadzu’s high-speed, real time digital image processing technology.

SCORE RSM is particularly effective in bolus chasing in extremities and abdominal examinations when patients have difficulty remaining still.

When used in conjunction with the C-arm Procession or Pendulum modes, a reduction in radiation dose and contrast medium to the patient can be achieved.

Acquired images using SCORE RSM are automatically stitched together into a single overview image. Interactive positioning between the image and patient position facilitates improved patient care.

(Note: SCORE Chase requires the SMART Table option)

SCORE Navi/Navi+Plus is an application that utilises preprocedural images to support minimally invasive interventions.
By synchronizing the C-arm projections to pre-procedure MDCT images, the system enables these MDCT images to be used as a reference during interventions, reducing contrast media usage and X-ray dose.
Registration of the MDCT images and the fluoroscopy images is easily achieved, and the software can overlay images onto fluoroscopy, providing a map function.
The Navi+Plus application includes a virtual stent feature that allows you to simulate the stent size and placement position before carrying out a procedure.

SCORE MAP includes the new TraceMAP function. TraceMAP is easy to operate, creating an overlay image on fluoroscopy by automatically tracing the contours of vessels from the DSA image. This makes it possible to recognize bifurcation and control devices quickly and easily in various vascular interventions such as EVT etc.
In addition, manually drawn lines or guides can be used to provide further flexibility.

The SCORE 3D application allows rapid display of the 3D reconstructed images automatically after rotational radiography.
High image quality is achievable through high acquisition speed, reducing movement artifacts and the quantity of contrast medium required.
Operability is further improved through the user friendly and customisable GUI.


SCORE CT provides cross-sectional imaging of low-contrast regions during procedures. With a 10s and a 20s mode to choose from to best match your procedure, axial, coronal and sagittal images are automatically displayed after acquisition.


The Trinias SCORE OPERA system increases the image processing grey scale from 14-bit to 16-bit, significantly improving image quality for SCORE CT where low-contrast resolution is of particular importance.

The system has been designed for single-action performance, making control in the examination and control rooms as intuitive as possible.

The all-new SMART Touch bedside digital console enhances the physicians experience with one-touch customisable functions available for selection.

The intuitive DirectMemory graphics controller provides direct access to registered clinical angles and easily set position memories during procedures.

The multi-functional SMART Table is designed for complex case throughput, including cardiac, neurological, abdominal, and peripheral procedures.

The procedure table provides Tilting and Cradle functionality as well as conventional Panning with motor assist selectable when horizontal and provided while tilted.

Full integration into the imaging system, provides advanced imaging including 3D/CT, fusion with preprocedural imaging and peripheral synchronised acquisition and intervention.

With the optional large 58-inch high-resolution colour LED monitor, the operator can select the optimal display of images to best suit the current procedure.

Multiple video inputs are available for selection through the customisable menu.

Flex-APS and New SCORE StentView (PDF 2.1MB)
Dynamic real time StentView and enhanced StentShot provide advanced interventional imaging tools.
Flexible Active Pixel Shift (Flex-APS) in DSA imaging further enhances image detail, especially when patient movement is present.

Making the best use of Trinias applications for lower extremities (PDF 2.3MB)
Department of cardiology, the Fraternity Memorial Hospital
Dramatic progress has been made in lower extremity interventional procedures in recent years.

Contrast agent-free endovascular treatment using 3D imaging (PDF 0.8MB)
Osaka Saiseikai Nakatsu Hospital
Incorporation preprocedural 3D CT imaging and angiograms to reduce contrast medium burden to the patient.

Cerebral interventional procedure on Bi-Plane system (PDF 2.6MB)
Neurosurgery, Yamaguchi University Facility
The Shimadzu Trinias has resulted in substantial dose reduction without sacrificing image quality.

Achieving minimally invasive procedure in practice (PDF 1.1MB)
Mimihara General Hospital
Using StentView and C-arm rotation to confirm the positional relationship of guide wires and IVUS catheters.

Achieving minimally invasive procedure in practice (PDF 1.6MB)
Kokura Memorial Hospital
Using SCORE-RSM to confirm ascertain the hemodynamics of the entire lower extremity.

Achieving minimally invasive treatment (PDF 2.6MB)
Osaka Nakatsu Hospital
Using SCORE StentView+Plus and SCORE Navi+Plus with preprocedural CT to achieve minimally invasive treatment.

Minimally invasive EVT with SCORE RSM (PDF 5.1MB)
Toyohashi Heart Centre
Low radiation dose, high image quality and low contrast medium imaging is achievable using SCORE RSM.

Optimal C-Arm angle during DCA (PDF 8.5MB)
Toyohashi Heart Centre
High image contrast and low lag make it easier to determine DCA catheter cutter movement and orientation of cutter housing.

Usefulness of Trinias MiX (PDF 4.5MB)
Dr. Toshiyuki Konishi, M.D., PhD.
Clear imaging with low dose rates while providing the opportunity to implement more rigorous patient treatment.

Development of the Trinias MiX Package (PDF 5.5MB)
Keiichi Goto
Medical Systems Division, Shimadzu Corporation

New SCORE PRO Advance X-Ray Image Processing Unit (PDF 9.5MB)
Kazuhiro Mori
Medical Systems Division, Shimadzu Corporation

Enthusiasm of doctors and new-generation imaging technology (PDF 3.36MB)
-Part one-
Dr. Kazuya Kawai, Chief Director
Dr. Shuichi Seki, Director
Dr. Satoshi Yamamoto, Chairperson
Chikamori-kai Group, Chikamori Hospital Department of Cardiovascular Medicine

-Part two-
Dr. Masami Sakurada, Hospital Director
Tokorozawa Heart Center

-Part three-
Dr. Shozo Ishihara, Director
Dojinkai social medical corporation, Mimihara General Hospital Department of cardiovascular medicine

Development of the Trinias Flat Panel Detector-Equipped Angiography System (PDF 2.07MB)
Yoshiaki Miura
Medical Systems Division, Shimadzu Corporation

Dynamic StentView: Cardiovascular Intervention Support Software (PDF 2.07MB)
Yoshiaki Miura
Medical Systems Division, Shimadzu Corporation

PCI with SCORE StentView on the Trinias Angiography System (PDF 11MB)
Shozo Ishihara, M.D.
Department of Cardiology, Mimihara Gereral Hospital

Using Dynamic StentView Effectively - Tokorozawa Heart Center (PDF 5.0MB)
Masami Sakurada, Director
Tokorozawa Heart Center