“The improved image quality provides us with clearer images of the coronary arteries of the heart”
“I’m so excited,” says Jess Lambrechtsen. Jess is Chief Physician of the Department of Internal Medicine and Cardiology at Odense University Hospital, Svendborg Hospital, Denmark, and he is excited about the improved image quality resulting from upgrading the department's cardiac CT scanner from Revolution™ CT to Revolution Apex Edition with TrueFidelity™ technology.
“The improved image quality provides us with clearer images of the coronary arteries of the heart. Noise is reduced in the images, and this will likely mean that it will become easier for us to provide a more accurate diagnosis,” he says.
Better image quality helps all patients
The Department of Cardiology is also a research department, and in October 2020, they were able
to upgrade the scanner they use for cardiac scans from Revolution CT to Revolution Apex Edition with TrueFidelity technology. The upgrade has been on the department's wish list for a long time, precisely because it was expected to significantly improve the quality of the images while also providing better quality when scanning overweight patients. The upgrade includes both a new X-ray tube and new image processing technology (TrueFidelity). The current upgrade with a new X-ray tube means that we get better images for patients with a high BMI, because the upgrade has made it possible to obtain images through a significant layer of fat.
An upgrade a few years ago made it possible to scan with lower doses, especially important for children who are more sensitive to radiation than adults.
“The CT upgrade enables us to image a more diverse group of patients; the new tube makes it easier to scan overweight people and patients more sensitive to radiation. The upgrade to TrueFidelity is good for all patients because it improves overall image quality. We have wanted this for a long time and now we have it” says Jess Lambrechtsen.
“With the improved image quality, we will probably be able to make a more accurate diagnosis at an early stage, which benefits the patient as well as the physician and the department.” Chief Physician Jess Lambrecthsen, Department of Internal Medicine and Cardiology, Svendborg Hospital, Denmark
Fast rotation and artificial intelligence
There are several attributing factors to the improved image quality. First, the entire heart is scanned in one rotation in less than 1 second. The fast rotation ensures less sensitivity to movement, just as fast shutter speed does in a camera. When scanning a moving object like the heart, it is essential to be able to perform the scan as quickly as possible.
But most of all, it is the use of artificial intelligence in the form of Deep Learning Image Reconstruction (DLIR) technology that improves image quality. GE Healthcare's DLIR technology TrueFidelity is “trained” using large, high-quality datasets to distinguish between noise and anatomical signals - and it can then intelligently suppress the noise without affecting anatomical and pathological structures in the image.
“A more accurate diagnosis means that the patient does not need additional examinations, so the patient benefits greatly because the process is less invasive over all. At the same time, we, as medical professionals, feel great professional satisfaction when we are able to make a more accurate diagnosis at an early stage. Finally, department costs are lower when fewer additional examinations are necessary,” says Jess Lambrechtsen.
“The improved image quality is based on, artificial intelligence technology, which utilizes computer capabilities to distinguish far more nuances than the human brain is capable of. Artificial intelligence helps us and is a natural next step in the development of diagnostics.” Chief Physician Jess Lambrecthsen
Testing the effect on diagnostics
The department at Svendborg Hospital scans, on average, 15 patients a day. Typically, patients are referred by their own doctor for the CT exam when they present with due to non-specific chest pain; an initial ultrasound examination has excluded other diagnoses and the cardiologist suspects there is a major narrowing of a coronary artery of the heart. Arteriosclerosis affects most people, but it only it creates symptoms when it narrows an artery by more than 50%.
Since cardiovascular disease is one of the most common causes of death in Denmark, there is great interest in non-invasive technology that can uncover problems at an early stage. The department at Svendborg Hospital is currently carrying out a study to determine what effect the upgraded scanner would have on diagnostics. The study is expected to be completed in January 2021.
“The image of the heart produced by the upgraded scanner is much clearer and it is comfortable to look at,” says Chief Physician Jess Lambrechtsen, who diagnoses up to 15 patients with heart problems every day.
TrueFidelity reconstruction technology is able to distinguish noise from anatomical structures and then suppress the noise so that anatomical structures appear much more clearly in the image. Below are CT images with (right) and without (left) TrueFidelity reconstruction from Svendborg Hospital.