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Zenition 70

Manufactured by Philips
Sourced in Japan, Netherlands

The Zenition 70 is a medical imaging device designed for use in healthcare settings. It is a mobile C-arm system that provides real-time, high-quality imaging during surgical and diagnostic procedures. The Zenition 70 is capable of capturing fluoroscopic images and video to assist healthcare professionals in their clinical decision-making.

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5 protocols using zenition 70

1

Comparative Evaluation of Mobile C-arm and Hybrid Room X-ray Devices

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The X-ray device used on each procedure will be described as a dichotomous variable: Mobile C-arm (MCA) or hybrid room (HR). The MCA equipment is Zenition 70® (Philips, The Netherlands) with a 30 × 30 cm flat-panel detector. The C-arm is color-coded and fully balanced with ability to angulate from +90 to −50° [21 ].
Philips Azurion 7® is the X-ray equipment in a HR with a 20” flat detector and equipped with a workstation for image processing and fusion imaging (VesselNavigator, Phillips Healthcare, Best, The Netherlands). All compatible applications in the interventional lab via the central touch screen module and FlexVision Pro [22 ].
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2

Robotic-Assisted Pedicle Screw Placement

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Preoperative computed tomography (CT) images were obtained and used to plan pedicle screw placements. The spine surgery robotic system worked using the planning data.
The robot arm unit was attached to the operating table. Before the operation, the robot arm unit was equipped with a specific sterile drape, and the robot reference frame and arm guide were attached. A skin incision was made in the posterior midline of the planned fusion area. All surgeries were performed through a posterior approach, which included midline fascial incisions or midline skin and separate fascial Wiltse incisions.
All surgeries were done using “CT to Fluoro” registration. The C-arm (STX-1000A; Toshiba Medical Systems, Ohtawara, Japan or Zenition 70; Philips, Amsterdam, Netherlands) was used to acquire frontal and oblique X-ray images during surgery, which were matched with the planning data. Without Kirschner-wire guidance, pedicle screws were inserted under the robotic arm guide.
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3

Optimal Intraoperative Fluoroscopic Pelvic View

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From the AP view of the pelvis, the stepwise approach for obtaining an adequate OI view in the prone position is as follows: (Fig. 7)

Roll back towards the side of the hemiplevis being instrumented until the sciatic notch and the anterior inferior iliac spine can be clearly delineated.

In this view, the screw should be directed to the area between the proximal and distal aspects of the AIIS. Fig. 6D–F demonstrates the use of this view in guiding cranial and caudal trajectory.
Alternating between these 2 views can be done without interfering with the surgical instrumentation (Fig. 1B–C). As placement of screws in this corridor requires alternating between these views as corrections are made, functions of position memory in the fluoroscopy unit and a reliable fluoroscopy technician are incredibly valuable adjuncts.
Images and figures were generated using a cadaver specimen. Images were obtained using a C-arm (Zenition 70, Philips).
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4

CT-Fluoroscopic 3D2D Registration Protocol

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A baseline CT scan (Philips Brilliance 64 CT scanner, Philips, Best, Netherlands) was used to obtain 3D data (slice thickness 0.67 mm, contiguous slices, reconstruction matrix 512 × 512).
The (2D) fluoroscopic images for registration were acquired with a mobile C-arm system (Philips Zenition 70, Philips, Best, Netherlands). The imaging settings were set to the spine protocol (variable kV, typical dose-level 0.408 mGy 20 cm PMMA) to achieve optimal image quality of the vertebrae, which was part of the regular software (version 5.1.7: IQ NA HC R5.1.7).
All imaging data files were transferred to a secured portable computer in Digital Imaging and Communications in Medicine (DICOM) format.
The non-invasive marker model consisted of a randomly applied pattern of prototype hybrid skin markers (radiopaque and optical), which were an update of previously used optical markers [14 (link)]. The update consisted of a radiopaque sphere added to the marker’s center to make them visible on fluoroscopy (Fig. 1).

Examples of the hybrid skin markers. a Fluoroscopic image capturing nine markers containing a radiopaque sphere, b nine markers applied to the skin

The 3D2D registration was performed offline by running image data through a prototype algorithm (Philips Healthcare, Best, the Netherlands) on a regular computer (Intel® Core™ i7-9750H processor, NVIDIA Quadro® T1000 graphics card).
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5

Fluoroscopic Radiation Exposure in Ureteroscopy

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Intraoperative imaging was performed by a radiographer under the instruction of the operator using an image intensifier. The image intensifier used was a Philips BV Pulsera mobile C‐arm throughout the study time period and a second mobile C‐arm Philips Zenition 70 in 2022. Both had a Monoblock 80 Khz high frequency generator with a maximum output of 15 kW. Fluoroscopy data was collected from the electronic medical imaging records DICOM Radiation Dose Structured Report (RDSR) generated by the C‐arm. Radiation exposure was defined in the outcomes mGy, Gy/cm2 dose area product (DAP) and FT as per FLASH study9 reference outcomes. All members of the operating team in an operation wear RADsafe non‐lead gowns and thyroid collars with 0.50 mm equivalent lead protection. These are compliant with international radiation safety standards and are tested annually to ensure compliance.
Stone size was recorded based on the radiologist's report with the maximum dimension chosen. When multiple stones are present, the obstructing stone was selected. If ambiguity of stone size or location was identified, a consensus decision was made with two data coders and an external reviewer. Location within the ureter was divided into proximal, middle and distal using the anatomical landmarks of the sacrum's upper and lower border to divide the three segments.
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