Somatom confidence

Manufactured by Siemens

Sourced in Germany

The SOMATOM Confidence is a computed tomography (CT) scanner developed by Siemens. It is designed to provide high-quality, efficient imaging for a wide range of clinical applications. The system features advanced imaging technologies and is engineered to deliver reliable performance.

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Somatom definition as scanner, by Siemens (1 mentions)

8 protocols using somatom confidence

4DCT Imaging for Abdominal Region

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All measurements were performed on the SOMATOM Confidence helical multi‐slice CT scanner (Siemens Healthineers, Erlangen, Germany) which is used for the treatment planning CT simulation (Figure 1). The CT image sorting technique used for 4DCT studies is the phase‐based sorting algorithm
²³ (link) which supplies the image reconstruction at specific breathing phases according to the breathing patterns recorded by the RMS to reduce breathing‐induced motion artifacts and provide an explicit trajectory of the tumor in free breathing.
¹ (link) An example of 3DCT/4DCT parameters used in our institution for the abdominal region is presented in Table 1.

Qubala A., Shafee J., Batista V., Liermann J., Winter M., Piro D, & Jäkel O. (2023). Comparative evaluation of a surface‐based respiratory monitoring system against a pressure sensor for 4DCT image reconstruction in phantoms. Journal of Applied Clinical Medical Physics, 25(2), e14174.

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Radiodensity Calibration for CT Scans

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To obtain the RED information from the CT scan, calibration curves for 80, 100, 120, and 140 kVp tube voltage were generated with the Gammex 467 Tissue Characterization Phantom (Gammex, Giessen‐Allendorf, Germany) for the HU and the DD reconstruction. All scans were taken with a constant tube current of 250 mAs on the SOMATOM Confidence (Siemens Healthcare, Erlangen, Germany). The reconstruction with 3 mm slice thickness was executed with the B40s and E30s convolution filters. For the calibration, the mean CT value of each tissue mimicking insert was plotted against the RED of the material. The mean CT value for each insert was obtained in ImageJ (v1.50i, National Institutes of Health, Bethesda, USA). The CT values were averaged over a sphere of 2 cm diameter, centered in the middle of the insert. As the calibration curves in Fig. 2 show, the energy dependence vanishes when the DD reconstruction is applied. The right panel displays this implemented calibration given in eq. (1).

Flatten V., Friedrich A., Engenhart‐Cabillic R, & Zink K. (2020). A phantom based evaluation of the dose prediction and effects in treatment plans, when calculating on a direct density CT reconstruction. Journal of Applied Clinical Medical Physics, 21(3), 52-61.

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Hybrid Imaging-Guided Pulmonary Nodule Localization

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Under general anesthesia, intubation was performed in the two lumens, and the appropriate position was selected according to the location of the nodules. According to preoperative chest computerized tomography (CT) data, a fully covered metal localization grid was placed in the thorax, and a large-aperture sliding rail CT scan (Siemens, Germany; SOMATOM Confidence) was used in a hybrid operating room to confirm the skin puncture point of each nodule and measure the puncture depth and angle, as is shown in Figure 1.Figure 1

Localization of multiple pulmonary nodules in hybrid operating room. (A) Hybrid operating room and large-aperture sliding rail CT; (B) schematic diagram of simultaneous localization and puncture of pulmonary nodules 1 and 2 with full-coverage thoracic surface locating grid.

Zhang Q., Wang Z., Liu Y., Xing H., Xu J., Xu W., Cai H, & Jiang Y. (2022). Application of Simultaneous Localization of Multiple Pulmonary Nodules in a Hybrid Operating Room for Uniportal Video-Assisted Thoracic Surgery. International Journal of General Medicine, 15, 1429-1435.

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Comparative TBCT and Helical CT Imaging

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We performed TBCT scans on a mouse cadaver and a pig’s head, as shown in Figure 6. These scans shared the same system geometry with SAD = 500 mm and SDD = 700 mm. A total of 720 projections were acquired for each source in both scans.
Due to the small size of the mouse cadaver, only 30 sources in the middle of the array were used to sufficiently cover the FOV along the z-direction. For the same reason, a tube voltage of 50 kVp was applied.
The pig’s head was placed on the stage so that its eyes were level with the detector. The middle 9 sources were used to perform the scan using 80 kVp tube voltage. We compared the image quality of the transverse plane through the pig’s eyes between the TBCT and helical CT (SOMATOM Confidence, Siemens, Germany). The image acquisition parameters of these two scanners are listed in Table 1.

Chen Q., Zhou S., Tan Y., Yao H., Zhang Z., Mazur T, & Zhang T. (2021). Tetrahedron beam imaging with a multi-pixel thermionic emission x-ray source and a photon-counting detector – a benchtop experimental study. Medical physics, 48(11), 7250-7260.

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Left-Breast Cancer Treatment Planning

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A RANDO^® human phantom (Alderson Laboratory, New York, NY, USA) was used to implement the left-breast cancer treatment plan (Figure 1). It is an adult female phantom with a height of 175 cm and weight of 73.5 kg. A tilted wedge immobilization device at an angle of 15° was used. CT images for treatment planning were acquired using a CT simulator (SOMATOM Confidence, Siemens, Munich, Germany) with a slice thickness of 3 mm.

Kim H., Jung J., Jung H., Jeong J., Lee D., Jeong H.W, & Lee Y. (2022). Comparison of Jaw Mode and Field Width for Left-Breast Cancer Using TomoDirect Three-Dimensional Conformal Radiation Therapy: A Phantom Study. Healthcare, 10(12), 2431.

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Locally Advanced Cervical Cancer Imaging

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Locally advanced cervical cancer patients treated at Erasmus MC between December 2019 and January 2021 according to the EMBRACE II protocol were retrospectively selected for this study [22] 22. Pötter, R. ... . For each patient, a full-and empty bladder planning CT scan (Siemens Healthineers, SOMATOM confidence) was acquired in supine position with a 2.5 mm slice thickness and a pixel size of 0.98 x 0.98 mm 2 . The minimal field-of-view comprised 5 cm inferior of the ischial tuberosities to the first lumbar vertebra.

Kuipers S.C., Godart J., Corbeau A., Breedveld S., Mens J.W.M., de Boer S.M., Nout R.A, & Hoogeman M.S. (2024). Dosimetric impact of bone marrow sparing for robustly optimized IMPT for locally advanced cervical cancer. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 195.

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Quantifying Streak Artifacts in CT Scans

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The CT scans were acquired by a SOMATOM Confidence^® scanner (Siemens, Erlangen, Germany), using the standard protocol for head planning CT at HIT, with 120 kVP, 255 mAs, and 500 mm field of view. The transversal pixel resolution was 0.977 mm, and the scans were performed with 0.5 and 1mm slice thicknesses, with and without applying an iterative metal artifact reduction (iMAR) correction in the reconstruction. The images were later analyzed with the software ImageJ (26 (link)). A square of 2mm length was drawn at the marker position where the Hounsfield value was maximum. Square-shaped rings with a thickness of one pixel (~1 mm) and with an inner length as the one of the previous ring were then drawn around the marker (see Figure 3C). The streak artifacts, defined as the maximum and minimum values inside the different square-shaped rings, were computed as a function of the distance from the marker position.

Reidel C.A., Horst F., Schuy C., Jäkel O., Ecker S., Henkner K., Brons S., Durante M, & Weber U. (2022). Experimental Comparison of Fiducial Markers Used in Proton Therapy: Study of Different Imaging Modalities and Proton Fluence Perturbations Measured With CMOS Pixel Sensors. Frontiers in Oncology, 12, 830080.

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4D-CT and CBCT Imaging for Radiotherapy Planning

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For each patient CBCT, planning CT and repeat CT images were used. CBCT images were acquired with an IBA Proteus Plus (IBA, Belgium) and reconstructed with the clinically used protocol. Repeat 4D‐CT and planning 4D‐CT scans were acquired on a Siemens SOMATOM Confidence (Siemens Healthineers, Germany) and on a Siemens SOMATOM Definition AS scanner, respectively, using the same imaging protocol. For treatment planning and dose calculation, average 4DCTs were generated from the 10 breathing phases of pCTs and rCTs. More detailed imaging and reconstruction parameters for CBCT, rCT, and pCT are listed in the Supporting Information (Table S2).
Repeat CT scans were acquired on the same day as the CBCT, used for training of the DCNN and selected as reference for image quality and dosimetric evaluation. There was a time difference of a few weeks between the pCT acquisition, used within the patient specific correction workflow, and the rCT/CBCT acquisition. For all patients, the first available rCT‐CBCT pair (acquired in the first week of treatment) was chosen.

Thummerer A., Seller Oria C., Zaffino P., Meijers A., Guterres Marmitt G., Wijsman R., Seco J., Langendijk J.A., Knopf A., Spadea M.F, & Both S. (2021). Clinical suitability of deep learning based synthetic CTs for adaptive proton therapy of lung cancer. Medical Physics, 48(12), 7673-7684.

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