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349 protocols using aquilion one

1

Comprehensive Urinary Tract Imaging in Children

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During the last 6 years (2011-2016) we have performed 276 CTUs in 249 children. This number includes standard indications, mentioned above (renal trauma, tumors, complicated infections and nephrolithiasis), but also suspected CAKUT.
CTUs were performed with two different multidetector CT scanners (64-row Philips Brilliance and 320-row Toshiba Aquilion ONE).
CTU was performed in 4 different protocols:
Whenever possible, low acquisition parameters were used, to meet ESPR and ESUR criteria [1 (link), 2 (link)] and our guidelines described in previous publications [4 (link)].
CTU protocol evolved in time, and in some cases it could slightly differ from mentioned above - this concerned especially doses of CM per phase and time intervals between CM bolus injections (i.e. it could be elongated in some patients with severe hydronephrosis).
Examinations performed due to suspected CAKUT and follow-up studies performed after surgical repair were chosen to the final analysis − that is 226 CTUs in 205 patients (190 CTUs performed on Philips Brilliance, 36 – on Toshiba Aquilion ONE). In most cases, CTU was performed if no correlation was observed between the results of different imaging studies (especially ultrasonography and dynamic scintigraphy) or before qualification for surgical repair of the abnormality. Whenever possible, CTU was performed as a one-phase study.
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2

Coronary Calcium Scoring and CCTA Protocols

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All participants underwent coronary artery calcium scoring and CCTA using 64-multidetector (Brilliance 64, Philips Healthcare, North Andover, Massachusetts; or Biograph mCT, Siemens, Erlangen, Germany) or 320-multidetector (Aquilion One, Toshiba Medical Systems, Tochigi, Japan) row scanners at one of three imaging sites in Scotland. CCTA was performed following intravenous injection of 50 to 70 mL of iodine-based contrast medium at a flow rate of 5.5 to 6.5 mL/sec. The Toshiba Aquilion One scanner used wide volume collimation, 0.75 sec gantry rotation and tube current based on body-mass index. The Philips 64 Detector Row Brilliance CT utilised 0.625 mm collimation, gantry rotation varied with heart rate − 0.42 sec to 0.5 sec and tube current based on body-mass index. The Biograph mCT scanner used wide volume collimation, 0.30 sec rotation time and tube current based on body-mass index. Based on heart rate and rhythm, prospective or retrospective gating were utilised.
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3

Motion-Sensitive Projection Imaging Protocol

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For each time point t = 0 : (NP-1), forward projections were acquired from the corresponding phantom volume. To investigate the effect of gantry position relative to the motion direction on motion sensitivity, 5 projections were acquired at each time step where i = 1 : 5 is the gantry position.
Sinograms were obtained via a ray-based forward projector modified for a curved detector geometry and implemented in Gadgetron (NIH, Bethesda, MD) with 20-fold oversampling in the detector plane (u,v)23 (link)–25 (link). Oversampled sinograms were integrated to simulate the sampling achieved by a single-source Toshiba Aquilion ONE clinical scanner geometry (896 detectors per row, 320 detector rows with 0.5 mm effective detector length in the z-dimension at the isocenter, 1072 mm source-to-detector distance and 600 mm source-to-isocenter distance, quarter detector offset, and no flying focal spot)26 using Matlab (Mathworks, Natick MA). Although not a feature of the Toshiba Aquilion ONE scanner, we implemented in-plane focal spot deflection (FSD) to evaluate the potential improvement in performance for our task27 . In this case, twice the number of volumes (and projections) were generated to account for the increase in acquired projections and the detector offset was modified from one-quarter to one-eight.
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4

Coronary CTA Imaging Protocol

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All participants in the current serial coronary CTA study underwent ≥ 64 slice coronary CTA at baseline (Lightspeed VCT, GE Healthcare, Milwaukee, WI; Somatom Sensation and Definition CT, Siemens, Forchheim, Germany; Aquilion One, Toshiba, Otawara, Japan) and follow-up (Lightspeed VCT or REVOLUSION, GE Healthcare, Milwaukee, WI; Somatom Sensation and Definition CT, Siemens, Forchheim, Germany; Aquilion One, Toshiba, Otawara, Japan) and non-contrast CT for coronary artery calcium (CAC). If required, an oral and/or intravenous beta-blocker or a calcium channel blocker was administered in order to reach a target heart rate <65 beats/minute. Sublingual nitroglycerin was also administrated prior to IV contrast injection, unless contraindicated.
Scan parameters for non-contrast CT are obtained as follows: prospective electrocardiogram-triggering, 512×512 matrix size, and peak tube voltage of 120 kVp. The contrast cardiac CTA scanning protocols have been previously reported 1 (link), 12 (link). Scanning parameters included: < 1mm slice thickness, ≤ 20mm field of view, 512×512 matrix size, and tube voltage of 120, 100 or 80 kVp (100 or 80 kVp used in participants with a body mass index <25kg/m2). Prospective or retrospective electrocardiogram-triggering is employed.
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5

Semiautomated Spleen Volume Analysis

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CT scans were performed on SOMATOM Definition AS (Siemens, Erlangen, Germany) or Toshiba Aquilion ONE (Toshiba Medical Systems, Tokyo, Japan) with a slice thickness of 1–3 mm. All CT images were analyzed using semi-auto spleen segmentation software (MM Research Frontier Syngo-Via, VB20, Siemens Healthineers, Germany). Two abdominal radiologists with 6 and 8 years of experience in abdominal imaging manually verified the spleen region of interest (ROI) on each slice to avoid discrepancy. The total spleen volume was calculated by multiplying the overall ROI area with slice thickness (Figure 1).
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6

Computed Tomography Perfusion Imaging for Acute Stroke

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CTP for all cases was performed on a 320-Slice Toshiba Aquilion One (Toshiba Medical Systems, Otawara, Japan). A 50 mL bolus of contrast agent (Ultravist 370; Bayer HealthCare, Berlin, Germany) injected in the cubital fossa using a 18 Gauge cannula at a rate of 6 mL/s was used to acquire CTP images. The first CTP acquisition was acquired 7 seconds after the start of contrast injection, followed by another 18 time points over 72 seconds. MIStar (Apollo medical imaging, Melbourne Australia) was used to generate the CTP maps, using semiautomatic processing of infarct core and penumbra volumes. A model-free singular value decomposition is used to deconvolve the tissue enhancement curve and the AIF with automated delay and dispersion correction. 22, 23 Brain magnetic resonance imagings were performed on either a 1.5 or 3 Tesla magnetic resonance imaging (Siemens Aera/Siemens Verio, Siemens AG, Healthcare Sector, Erlangen, Germany). Previously validated thresholds were applied to measure the volume of the acute perfusion lesion (relative Delay Time ≥3 seconds) and acute ischemic core (relative cerebral blood flow ≤30% within the perfusion lesion). 13 (link) MIStar uses DT maps for penumbra definition whereas some other software uses Tmax.
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7

Coronary Artery Calcium Quantification Protocol

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All examinations were performed using a 320‐row computed tomographic system (Aquilion ONE; Toshiba Medical Systems, Tokyo, Japan) with patients in the supine position on a table, and images were acquired during a single breath hold, which allows image reconstruction in a single cardiac phase. Dual scanograms were used for planning the examination and determining the anatomical range to be covered. A nonenhanced prospective ECG‐gated scan was performed to measure the coronary artery calcium score (CACS) with the following parameters: rotation time, 275 ms; slice collimation, 0.5 mm; slice width, 3.0 mm; tube voltage, 100 kV; and automatic tube current modulation (SURE Exposure 3D standard, Toshiba Medical Systems Corporation, Otawara, Japan). Images were analyzed in a core workstation using dedicated software (TeraRecon version 4.4.11.82.3430.Beta, Foster City, CA). Agatston calcium scores were calculated to quantify the extent of coronary artery calcification.13, 14
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8

Cardiac CTA Scanning Protocol

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All scans were performed on a Toshiba 320-row computed tomography scanner (Aquilion ONE, Toshiba, Tokyo, Japan). A prospective ECG gating protocol was used for the CTA scan with the following scan parameters: tube voltage was 100 or 120 kV; tube current was determined by body mass index (300–500 mA); and time resolution was 275 ms. Prior to contrast injection, the control heart rate was <80 beats/min, and patients with high heart rates underwent CTA after heart rate stabilization or were considered for beta blockers at the discretion of the treating physician. Then, 60–70 mL of iodine contrast medium (350 mg/mL iodine-containing ethanol solution) was injected at a flow rate of 4.5–5 mL/s. The reconstructed image matrix was 512*512 with a layer thickness of 0.5 mm and increments of 0.25 mm.
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9

Radiofrequency Catheter Ablation for Atrial Fibrillation

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The subjects consisted of 48 consecutive patients with symptomatic drug-refractory AF (mean age, 57.2 AE 10.5 years; 47 males) undergoing an initial radiofrequency catheter ablation. All patients gave their written informed consent to the electrophysiologic study (EPS), ablation procedure, and this protocol. The group comprised 20 patients with paroxysmal AF (spontaneous termination within 7 days), and 28 patients with persistent AF (AF lasting over 7 days). Adequate oral anticoagulation was given for at least 1 month before the procedure. All antiarrhythmic drugs were discontinued for at least 5 half-lives prior to ablation. Upon admission, transesophageal and transthoracic echocardiograms were performed. The conventional echocardiographic measurements, left atrial dimension (LAD) at the end systole in the parasternal long-axis view, maximum left atrial volume (LAV) by the prolate-ellipsoid method, and left ventricular ejection fraction (LVEF) by the Teichholz's method, were calculated [8] . All patients underwent multi-detector computed tomography (320-row detector, dynamic volume computed tomography scanner; Aquilion ONE, Toshiba Medical Systems, Tokyo, Japan) for 3-dimensional (3D) visualization of the left atrium (LA) and pulmonary veins (PVs).
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10

Coronary Artery Calcium Scoring

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A 320-detector-row scanner (Aquilion ONE, Toshiba Medical Systems, Otawara, Japan) was used to evaluate the CAC score of each lesion; the left main, left anterior descending, left circumflex and right coronary arteries were calculated with the Agatston method. A radiologist who was blinded to the participant’s age, sex and name performed the scoring of the CAC. The total Agatston scores (TAS) > 400 was defined as severe CAC [19 (link)].
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