c-arm ct with siremobil iso-c3d a new dimension of care in ... · c-arm ct with siremobil iso-c3d a...

C-arm CT with SIREMOBIL Iso-C3DA New Dimension of Care in the OR

Used and Refurbished C-Arms are Available from www.SharpMedical.com - Call us at 800-969-9800 An Independent C-Arm Service Provider. This PDF provided for research / historical purposes only.

If you are involved in trauma and orthopedic surgeryyou know the importance of precise control whenrepositioning dislocated bone fragments, placingpedicle screws in the spine, or positioningosteosynthetic material. Placing a screw too closeto a joint, for example, can lead to extremely painfuland debilitating complications that may require furthersurgical intervention. The 2D projection imagingof conventional mobile C-arms often leaves youwanting more spatial information to assess andconfirm outcomes of the interventional procedure.

In the past, the search for additional information inthe OR led to the use of CT or MR systems. Howeverin practice, these units come with a high cost, largefootprint, limited mobility, patient transport concerns,and many extra logistical requirements.

With SIREMOBIL® Iso-C3D, Siemens Medical Solutionsoffers C-arm CT, a revolutionary new solution tothe problems faced everyday in today’s demandinghealthcare environment. You gain the full advantagesof intra-operative 3D imaging without increasingspace requirements, long preparation times foroperations or the need to reposition the patient forbetter access. Furthermore, SIREMOBIL Iso-C3D alsoallows you direct surgical navigation based on intra-operatively generated 3D images.

SIREMOBIL Iso-C3DC-arm CT brings intra-operative 3D imaging

2 Used and Refurbished C-Arms are Available from www.SharpMedical.com - Call us at 800-969-9800 An Independent C-Arm Service Provider. This PDF provided for research / historical purposes only.

3Used and Refurbished C-Arms are Available from www.SharpMedical.com - Call us at 800-969-9800 An Independent C-Arm Service Provider. This PDF provided for research / historical purposes only.

190º

~115º

SIREMOBIL Iso-C3DC-arm CT: Precisely how it works

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Truly isocentric design:

• Object remains centered,no readjustments

• Image displayed in the same scalefor all projections

• Unparalleled positioning flexibilityof 190º (+/-95º)

• Required for 3D imagingin an orbital movement

• Dose- and time-savings

Non-isocentric design

• X-ray beam moves off center, making readjustments necessary

• Image changes in scale when projection is modified

• Limited positioning flexibility of ~115º (+90º,-25º)

3D imaging with a mobile C-arm:A whole new dimension

SIREMOBIL Iso-C3D now providesthe ability to generate a 3D volumedataset along with 2D imaging.The addition of a motor drive bringscontrolled orbital movement of theC-arm throughout the 190º scan.A powerful workstation allows 3Dreconstruction of the automaticallyacquired isotropic data set.

Isocentricity: What does it meanexactly?

The intra-operative 3D imagingcapabilities of SIREMOBIL Iso-C3D

are based on SIREMOBIL Iso-C, thefirst truly isocentric mobile C-arm.The isocentric design keeps theX-ray beam centered on the regionof interest throughout the 190ºscanning range of the C-arm.

Isocentricity: How does it affectmy practice?

For applications demanding frequentchanges of the projection angle,conventional C-arms requiresubsequent vertical and horizontalcorrections. With an isocentric C-arm,such repositioning is no longerrequired. The results are pronouncedsavings in time and dose.

Furthermore, an isocentric designpaves the way for 3D imaging ona C-arm …


C-arm CT: The scanning process

Using SIREMOBIL Iso-C3D in yourclinical routine is remarkably simple:

• The anatomic region of interestis centered within the isocenterof the C-arm with laser localizers

• A manual non X-ray collisionavoidance test follows to ensurethat objects do not block the pathof the C-arm during the automatedscan

• The integrated electric motorautomatically drives SIREMOBILIso-C3D through a 190º scan

• During this automated scan,SIREMOBIL Iso-C3D acquires50 or 100 2D frames in one ortwo minutes

• The 3D dataset, a cube of 123 cm3,is generated simultaneously to theautomated scan

C-arm CT: What else is required?

Because of the CT-like reconstructionprinciple of SIREMOBIL Iso-C3D, theoperating table and the positioningaccessories must be metal-free.Metal parts would be visualizedin the individual frames and causecorresponding artifacts in thereconstructed 3D dataset. Nearlyall well-known manufacturers offercarbon fiber and standard operatingtables with metal-free positioningaccessories.

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• The 3D images are immediatelyavailable after the scan

• The 3D images are displayed in theform of multiplanar reconstructions(MPR’s) which depict the scannedbony anatomy in the coronal,sagital, and axial planes

Immediately following the scan,you can view, and manipulate the2D fluoroscopic images and CT-likesectional images. All three spatialplanes are simultaneously displayedon the image monitor of the monitortrolley, and it is also possible to viewthe images in a SSD (Surface ShadedDisplay) format. Thanks to a specialsterile mouse, the system can becontrolled directly from the operatingtable.


SIREMOBIL Iso-C3DDelivering uncompromised safety in the OR

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A broad range of applications

SIREMOBIL Iso-C3D has beendeveloped for intra-operative usein the radiographic imaging ofthe following anatomical regions:

• bones and joints of the upper and lower extremities

• cervical, thoracic and lumbar spine

SIREMOBIL Iso-C3D will support andoptimize clinical procedures involvingother anatomical regions. Togetherwith our customers we are currentlyworking in clinical trials for approvingfurther applications.

Maximum safety for minimallyinvasive procedures

The system’s intra-operative 3Dimaging capabilities are ideally suitedfor minimally invasive interventions,that now account for a significantpercent of all operations. Higherpatient comfort, shorter recoverytimes and cost effectiveness can beimproved with the use of SIREMOBILIso-C3D.

Bringing peace of mind to thesurgeon and patient

SIREMOBIL Iso-C3D brings additionalradiographic information that hasthe potential to significantly improvequality and safety levels whenreconstructing joint surfaces orpositioning screws or implants.

If the surgical intervention requiresnew data, you can use SIREMOBILIso-C3D to obtain the most recentanatomic imaging for higher qualityand safety of the intervention. Repeatprocedures can be largely avoided,yielding potential time savings andreduced liability and risk.

Furthermore, you can use SIREMOBILIso-C3D as a post-operative controlwithin the OR to confirm anddocument the proper placementof anatomy and any relatedhardware. Thus, there is a reducedreliance on busy radiologydepartments for post-operativeconfirmation and documentation.

Intra-operative


Post-operative

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SIREMOBIL Iso-C3DAdvanced user and patient comfort

Sterile conditions

With 190º of orbital rotation for 3D data acquisition,parts of the C-arm will travel from underneath theOR table to above the table. Two possible methodsto help maintain sterility:

• Creating a sterile tunnel with drapes. The C-arm,covered by a sterile drape, rotates through thetunnel.

• Covering the patient with two additional overlappingsterile drapes before the scan. The C-arm is usedwithout sterile draping and the potentiallycontaminated drapes are rolled down with steriletowel clips after the scan.

Excellent results at minimum dose

SIREMOBIL Iso-C3D is optimized for maximum imagequality at minimum dose. Thanks to the CARE*initiative, product features like laser localizers, pulsedfluoroscopy and Last Image Hold functionalityguarantee low dose treatment.

The SIREMOBIL Iso-C3D design requires the physicianto apply radiation only when necessary. Unit-specificadjustments like lens aperture or camera positioningcan be accomplished without radiation. The applieddose is optimized accordingly – a 3D scan with 50or 100 projections corresponds to a 2D fluoroscopyof 20 or 40 seconds.

* Combined Applications to Reduce Exposure


SIREMOBIL Iso-C3DNew dimensions in networking

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SIREMOBIL Iso-C3D speaks syngo® –the comprehensive software fromSiemens Medical Solutions formedical imaging with intuitive userinterface and integrated networking.The unique software solution forvirtually all medical tasks providesa uniform working environmentthroughout clinical networks and canbe easily upgraded to the currentstate-of-art software versions.

The intuitive user interface has thesame look and feel at virtually allclinical workstations, whether it’s anMR, CT, Ultrasound, etc. offering easydata exchange without limitations.Your clinical routine benefits fromincreased staff flexibility, improvedefficiency across all modalities andenhanced productivity.

CT-imaging of an internal spine fixator


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SIREMOBIL Iso-C3D provides thefollowing DICOM 3.0 functionalities:

• DICOM SendIt is possible to transfer images tothe hospital network or the centraldigital patient image archive.

• DICOM PrintImages can be printed out onthe network printers via lasercameras.

• DICOM Query & RetrieveAllows the physician to call up,display, and even post-processpre-operative images fromother modalities directly at theSIREMOBIL Iso-C3D monitor trolley.

Your workflow is further simplifiedby an integrated CD writer, whichallows direct storage of imagesacquired by the C-arm or from otherimaging modalities.

MR-imaging of a knee

Lateral X-ray imaging of a lumbar spine


SIREMOBIL Iso-C3DFinishing touches that complementyour needs

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CD writer KeyboardMonitor trolley with3D componentsSterile mouseMotor drive

Horizontallaserlight localizer


• syngo – the revolutionary softwarefor medical imaging with intuitiveoperator‘s interface

• Ergonomic control panelwith intuitive symbolic

• Special sterile OR mousefor central operation

• Compact monitor trolley thataccommodates printer, videorecorder and workstation withintegrated CD writer

• Electromagnetic brakes andcable deflectors for streamlinedworkflow

• Integrated cabling for simplecleaning and unobstructed orbitalmovement

The surgical environment demandsquick and accurate decisions.

That’s why it’s crucial that yourC-arm comes equipped with featuresthat support your individual needs:

Monitors: 2D/3D mode

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Hand-heldfluoro switch Electromagnetic brakesRotable operator‘s panel


SIREMOBIL Iso-C3DC-arm CT convinces experts worldwide

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From the first clinical tests inGermany to numerous successfulinstallations worldwide, SIREMOBILIso-C3D has proven to be a realinnovation for clinical outcomeand workflow optimization.

Some of our enthusiastic customersexplain why C-arm CT revolutionizestheir daily work:

More predictable screw & implantplacement

”We have found that image-guided3D navigation with SIREMOBILIso-C3D provides more predictablescrew-placement and allowsfor immediate verification ofthe construct, anatomy, anddecompression. We believe thatthis will provide benefits to thepatients, treating physicians, andhospitals with regards to improvedsafety, efficacy, accuracy, and cost.“

Larry T. Khoo, MD,UCLA Comprehensive Spine Center,Los Angeles, USA


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”We have found that SIREMOBILIso-C3D gives excellent fluoroscopicimages and the 3D images are veryuseful in the percutaneous fixationof intra-articular fractures. Currentlywe are using this C-arm in thedevelopment of fluoro-navigationprocedures and combining 3Dimages in the fluoro-navigation.”

Professor Kwok-Sui Leung,Department of Orthopedicsand Traumatology,The Chinese Universityof Hong Kong, China

Intra-operative ”revision“ –second surgery not necessary

“SIREMOBIL Iso-C3D allows intra-operative three-dimensionalimaging of osseous structureswithout significantly increasingcosts. This enables a direct checkof the procedure and results ofthe reconstructive surgery, whichallows the physician to reactintra-operatively.”

Paul Alfred Gruetzner, MD,BGU Ludwigshafen, Germany

No post-operative CT-scan required

”C-arm CT with SIREMOBIL Iso-C3D

promises routinely performed intra-operative 3D imaging at considerablygreater cost-savings than was thecase with the previous post-operativeCT procedures.“

Ekkehard Euler, MD, et al.,Clinic of the University of Munich,Germany

Highly increased accuracyin complex surgery

”SIREMOBIL Iso-C3D provides theneurological and spinal surgeonan unprecedented ability to easilyacquire and view multi-planar 3Dimages of intra-operative anatomy.This technology coupled with an intra-operative navigation system ushersin a true paradigm shift in our abilityto perform complex surgery with ahigh degree of accuracy and safety.“

Stephen M. Papadopoulos, MD,Barrows Neurological Institute,Phoenix, USA


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SIREMOBIL Iso-C3DA safe investment in the future

The C-arm CT capabilities of intra-operative 3Dimaging with SIREMOBIL Iso-C3D bring addedassurance during interventions in trauma andorthopedic surgery and have the potential tosignificantly raise your standard of care.

The improved quality of care can potentially resultin better patient outcomes, reduced need for repeatprocedures, and reduced risk and liability.

Since post-operative assessment of the interventionis possible right in the OR, the need for controls inthe radiology department is virtually eliminated,leading to additional time and cost advantages.Furthermore, SIREMOBIL Iso-C3D functions as anOR workstation, allowing pre-operative images fromother modalities to be called up, displayed, and post-processed directly at the monitor trolley.

Digital networking together with revolutionary3D C-arm CT directly in the OR offer you significanttime and personnel savings, cost optimization anda streamlined clinical workflow.


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The perfect partners:C-arm CT & Surgical 3D Navigation

And there is still more to revolutionize your clinicalroutine: With SIREMOBIL Iso-C3D the direct 3D surgicalnavigation has become reality. NaviLink™, the directinterface for 3D navigation, has been especiallydeveloped for SIREMOBIL Iso-C3D and is compatiblewith navigation systems of leading manufacturers.

The 3D information generated in the OR by SIREMOBILIso-C3D, including all spatial coordinates, is directlytransferred to the connected navigation system thatcan immediately start the navigation procedure.

For more information about this fascinating surgicaltechnique please consult our brochure ”NaviLink –Direct 3D Navigation Interface for SIREMOBIL Iso-C3D“or have a look at the Internet:www.SiemensMedical.com/surgery.


Order No. A91100-M1320-F632-02-7600

Printed in Germany

CCA 64077 WS 04034.

The information in this document contains general

descriptions of the technical options available, which

do not always have to be present in individual cases.

The required features should therefore be specified in

each individual case at the time of closing the contract.

Siemens reserves the right to modify the design and

specifications contained herein without prior notice.

Please contact your local Siemens Sales representative

for the most current information.

Original images always lose a certain amount of detail

when reproduced.

Siemens AG · Medical SolutionsHenkestr. 127, D-91052 ErlangenGermanyTelephone: ++49 9131 84-0www.SiemensMedical.com


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