We evaluated the scalar location of the electrode array postoperatively in all patients by CB-CT (DynaCT-equipped Axiom Artis dTA angiography unit; Siemens Co., Erlangen, Germany) [2 (link), 3 (link)]. All included electrode arrays were fully inserted. Two physicians analyzed the scans regarding scalar electrode position (ST versus SV insertion, intracochlear dislocation, insertion angle) and cochlear size (diameters in length and width referring to Escudé et al. [11 (link)] see Fig. 1 ) independently, and used Impax 6 by Agfa Healthcare for reconstruction. The insertion angle has been evaluated between distance A and the bloom artefact of the apical electrode as described before by Ketterer et al. [24 (link)] (see Fig. 1 ).![]()
Impax 6
Manufactured by AGFA HealthCare
Sourced in Belgium, Germany
Impax 6 is a medical imaging software solution developed by AGFA HealthCare. It is designed to manage and distribute digital medical images and patient information across healthcare facilities.
Automatically generated - may contain errors
Lab products found in correlation
Magnetom verio, by Siemens (3 mentions)
Gadovist, by Bayer (2 mentions)
1.5 t mri, by Siemens (1 mentions)
Traumacad, by Brainlab (1 mentions)
Plt 604 at, by Toshiba (1 mentions)
Aplio xg, by Toshiba (1 mentions)
Pvt 375bt, by Toshiba (1 mentions)
Magnetom skyra fit, by Siemens (1 mentions)
Magnetom avanto fit, by Siemens (1 mentions)
Magnetom avanto, by Siemens (1 mentions)
Slice o matic software version 4, by Tomovision (1 mentions)
40 protocols using impax 6
1
Assessing Cochlear Implant Electrode Position
2
Comprehensive Evaluation of Calcium Deposits in Shoulder
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All patients included into the study received a CT scan using a dual-source-64-channel multi-detector-computed-tomography-scanner (Somatom-Defintion, Siemens, Germany) of the affected shoulder. A 3D dataset was obtained from the acromioclavicular joint to the diaphysis of the humerus (Protocol: 120 kV, 143 mA, TI 1 s, cSL 0,6mm). Image post-processing was carried out using the medical DICOM viewer (IMPAX 6, Agfa HealthCare NV, Belgium). Total count of the deposits was determined. In case of multiple deposits small ones with a distance <5 mm to a larger deposit were defined as satellite deposits. 3D reconstructions were used for determination of the morphology of the CDs looking for septations. In all cases the average Hounsfield units of the calcium deposit was determined. In case of multiple localizations the biggest deposit was chosen for investigation. Using the 3D Reconstruction also the localization of the calcium deposits was carried out. Therefore the acromion was also divided into 4 equal sectors, according to the technique from Ogon et al, used for the sonographic investigation (Figure 1 ).
3
Identifying MET exon 14 Lung Cancer
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Under an institutional review board-approved protocol (Partners Human Research protocol number 2019P000198), we identified patients who presented to our thoracic medical oncology clinic between January 2013 and December 2018, who met the following criteria: (1) confirmed non-small-cell lung cancer by histology; (2) confirmed METex14 skipping found in the primary tumor or a metastatic lesion; and (3) availability of pre-treatment imaging data for review, obtained either at our institution or at another institution, with the images uploaded into our picture-archiving and communication system (AGFA Impax 6, Mortsel, Belgium). We collected clinicopathologic data, including age, sex, smoking history, tumor histology, and stage of disease at the time of diagnosis.
4
Randomized and Anonymized MRI Study
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All cases were randomised using the Microsoft Excel randomisation function and identifiers were removed from each MRI examination. The cases were subsequently networked to the PACS workstation (IMPAX 6 AGFA Healthcare) under an allocated post-randomisation case number. When one or more comparison studies were available, the most relevant comparison was selected and was similarly de-identified and stored on the workstation under the same case identifier.
5
MRI Evaluation of Head and Neck Anatomy
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MRI of the head and neck were performed on 1.5T and 3.0T systems using standard ENT protocols. Available sequences were T1 with and without contrast, T2, and Short-TI Inversion Recovery (STIR) imaging, and the slice thickness was between 4 and 6 mm. The MRI data were evaluated by the same head and neck radiologist (ML) and measurements were carried out upon visibility on the axial, coronal, and sagittal planes. An average value was calculated if the depth of invasion (DOI) was visible on two planes. In cases where DOI could not be determined on MRI, the depths were set to 0 mm for analysis. Images were viewed in the PACS system (IMPAX 6, AGFA).
6
Radiographic and MRI Evaluation of Rotator Cuff Arthropathy
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Pre-operative plain radiograph focused on three parameter measurements to evaluate rotator cuff arthropathy which include osteoarthritic change, acromiohumeral distance, and inferior glenohumeral distance. Further pre-operative MRI evaluation focused on mediolateral (ML) tear size, anteroposterior (AP) tear size, tendon retraction, fatty infiltration and muscle atrophy. Radiographic parameters were evaluated by one experienced orthopedist and one senior orthopedic resident. A 1.5-T MRI (Siemens Healthcare, Germany) was used in this study. All measurements were made on a PACS workstation using Agfa IMPAX 6 (Waterloo, Canada) software technology—this software uses data within the DICOM (NEMA, VA, USA) header on all MRI (whether from our institution or from outside institutions) to allow referenced measurements to be made.
7
Cervical Spine Fractures in Ankylosing Trauma
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Töölö Hospital, a part of Helsinki University Hospital, is the only level-1 trauma center for a catchment area of 1.67 million people, where emergency whole-body CTs for blunt trauma are routinely performed. Patients with serious trauma such as cervical spine fractures and injuries are frequently transferred to our institution from general hospitals both outside of and within the same health care district for further evaluation and treatment. All patients over the age of 15, both primary and referrals with any blunt trauma and ankylosis of at least three consecutive cervical spine vertebrae were included. To our knowledge, studies in the literature have not established a cut-off value for significant ankylosis that predisposes patients to fractures. Patients under 16 years or without ankylosis of at least three consecutive cervical vertebrae, as well as patients with penetrating trauma were excluded. The Impax Picture Archiving and Communications System (Impax 6, Agfa Healthcare NV, Mortsel, Belgium) allowed manual retrieval and reassessment of all CTAs between October 2011 and March 2020.
8
MRI Evaluation of Posterior Tibial Tendon Pathology
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MR images were read in consensus by two radiologists (MR1, MR2; both with over 7 years of experience in reading MRI of the musculoskeletal system) at a workstation with the Impax 6 (Agfa Healthcare, Mortsel, Belgium) picture archiving and communication system (PACS). The presence of tendon abnormality including tendinosis, tenosynovitis, low- and high-grade partial tear, and complete tear was registered after evaluation of the full length of the tendon. Tendinosis was defined as irregularity of the tendon contour and/or intrasubstance intermediate signal in fluid-sensitive sequences (in multiple planes) and/or thickening of the PTT tendon (greater than twice the size of the flexor digitorum longus tendon), and tenosynovitis was defined as the presence of circumferential fluid within the synovial tendon sheath greater than 2 mm in maximal width. Low-grade partial tear was defined as an intrasubstance area of high signal in fluid-sensitive sequences, with or without extension to the tendon surface. High-grade partial tear and complete tear were defined as near full thickness or full thickness discontinuity of the tendon fibers, respectively. Based on these findings the PTT appearance was classified according to four different classification methods.
9
MRI Prostate Tissue Contrast Analysis
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The SNR and contrast-to-noise ratios (CNR) were measured using our institutional Picture Archiving and Communication System (Impax 6, Agfa Healthcare).
Regions of interest (ROI) were systematically drawn on T2WI at approximately the same location in all patients. This was done to minimize the impact of the distance between the ERC and the ROI in group B. The signal intensities (SI) of the whole prostate, peripheral zone (PZ), and transition zone (TZ), as well as of urine in the bladder were measured in all patients. The standard deviation (SD) of the SI of the urine was defined as image noise, assuming a homogenous composition and, therefore, SI of the urine.
In patients with histologically proven prostate cancer, the signal intensities of the MRI lesions that were positive on MR-TRUS guided fusion biopsy were also measured.
Calculation of SNR and CNR was performed as follows [19 (link), 20 (link)]:
Note – SI = signal intensity, SD = standard deviation, BT = benign tissue in the respective intraprostatic zone, PCA = prostate cancer, PZ = peripheral zone, TZ = transitional zone.
Regions of interest (ROI) were systematically drawn on T2WI at approximately the same location in all patients. This was done to minimize the impact of the distance between the ERC and the ROI in group B. The signal intensities (SI) of the whole prostate, peripheral zone (PZ), and transition zone (TZ), as well as of urine in the bladder were measured in all patients. The standard deviation (SD) of the SI of the urine was defined as image noise, assuming a homogenous composition and, therefore, SI of the urine.
In patients with histologically proven prostate cancer, the signal intensities of the MRI lesions that were positive on MR-TRUS guided fusion biopsy were also measured.
Calculation of SNR and CNR was performed as follows [19 (link), 20 (link)]:
Note – SI = signal intensity, SD = standard deviation, BT = benign tissue in the respective intraprostatic zone, PCA = prostate cancer, PZ = peripheral zone, TZ = transitional zone.
10
Prone Spiral Breast CT Imaging
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All women were placed in prone position in a spiral breast CT (nu:view; AB-CT [Advanced Breast CT] GmbH). Each breast was examined separately starting with the left side. The detector is equipped with telluride crystals and the detector area has a total size of 280 × 500 mm. A fixed x-ray tube voltage of 60 kV and a tube current of 32 mAs were used for all patients (at the beginning breast CT examinations at our institution were performed with 25 mAs, later changing the settings to 32 mAs for better depiction of microcalcifications). All examinations were performed with the nu:view reconstruction software, which utilizes a Feldkamp-type filtered back-projection algorithm for image reconstructions. A voxel size of 300 μm3 and 4 × 4 detector binning were used for the standard image reconstruction, whereas a kernel of 150 μm3 voxel size with 2 × 2 detector binning was used for a high-resolution image reconstruction. Images were reconstructed to a size of 0.3 mm for the standard and 0.15 mm for the high-resolution images. The images were analyzed on a picture archiving and communication system workstation equipped with a customized breast imaging display software (AGFA Impax 6), enabling sagittal and coronal reformations as well as maximum intensity projections (MIP).
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