2017/1/19

“MiX” Concept BRANSIST alexa series line-up

：Minimally invasive eXperience

Shimadzu Angiography Family
Minimize radiation dose

Minimize contrast media

Minimize procedure time

“Crossover” Angiography

“Crossover” Angiography system “Crossover” Angiography system It’s a whole new experience.

Feel next, Frontier of intervention

SCORE Imaging
1. For whole body : 12 x 12 inch FPD
1. For whole body : 12 x 12 inch FPD

2. Low dose x High IQ : Compact FPD cover 2. 5 alternative FOV : 12”/10”/8”/6”/4.5”

MiX
Changing the way, Making it possible Safety Design with your SMILE
3. For interventions : 4.5 inch FOV SMART Design SMILE Concept
TOP

It’s a whole new experience. Feel next, frontier of intervention Feel next, frontier of intervention

Feel next, Frontier of intervention

SCORE Imaging
SCORE Imaging
SCORE PRO Advance
• SCORE PRO Advance
• SCORE StentView+Plus • Significant radiation dose reduction
MiX • SCORE RSM
• Overwhelming high image quality
• SCORE MAP
• Halation less
Changing the way, Making it possible Safety Design with your SMILE • SCORE 3D/CT/CT-HR
SMART Design SMILE Concept • SCORE Navi/Navi+Plus
MiX

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Concept of SCORE PRO Advance

Image quality Motion Tracking Noise Reduction Motion Tracking Noise Reduction : Less Lag
High Image Quality • Less Lag & Less Noise w/o Lag • Conventional recursive filter • SCORE PRO Advance
in Low Dose Condition Motion Tracking Noise Reduction

Image Quality Up
with Lag
Reduce Dose
Conventional Recursive filter
Radiation Dose

Motion Tracking Noise Reduction : Less Lag Motion Tracking Noise Reduction : Less Lag Image enhancement with object detecting
• Conventional recursive filter • SCORE PRO Advance • Conventional recursive filter • SCORE PRO Advance • Enhance only vessels and devices
Line structure
・Direction
・Contrast

Edge enhance

Line detection Edge information

Original Image Enhanced Image

Image enhancement with object detecting Image enhancement with object detecting Total dynamic range control
• Conventional recursive filter • SCORE PRO Advance • Conventional enhancement • SCORE PRO Advance • Subphrenic area • Lung field (Less halation)

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Clinical cases：SCORE PRO Advance Clinical cases：SCORE PRO Advance Clinical cases：SCORE PRO Advance
• Rotational DA：LCA • Rotational DA：RCA • Tip Injection • Rotational DA • Fluoro (7.5pps) • DA (15fps)

Clinical cases：SCORE PRO Advance Clinical cases：SCORE PRO Advance Clinical cases：SCORE PRO Advance
• Fluoro (7.5pps/Low) • DA (15fps/Low) • Fluoro (10pps/Low) • DA (15fps/Low) • Fluoro • Fluoro

Clinical cases：SCORE PRO Advance Clinical cases：SCORE PRO Advance Clinical cases：SCORE PRO Advance
• 177cm / 85.5kg • 162cm / 96kg • Frontal • Lateral

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Clinical cases：SCORE PRO Advance Clinical cases：SCORE PRO Advance Concept of SCORE PRO Advance LowDose

Image quality
• Frontal • Lateral • Abdominal • Abdominal LowDose Mode

Image Quality Up

Reduce Dose

Radiation Dose

Clinical cases：SCORE PRO Advance LowDose Clinical cases：SCORE PRO Advance LowDose BRANSIST alexa MiX Dose comparison (LCA/CAUD)
Comparison of Fluoro Comparison of DA • BRANSIST safire • BRANSIST alexa MiX
54%down 65%down 78%down 26%down 38%down 50%down

100% 75%
※Measuring condition：SID:100cm, FOV:6inch, Acrylic:20cm, IVR point. Dose ratio is ratio of Fluoro 15pps to Fluoro 15pps LD. ※Measuring condition：SID:100cm, FOV:6inch, Acrylic:20cm, IVR point. Dose ratio is ratio of DA CAG15fps to DA 15fps LD. * Patient of these images are different. * X-ray dose per 1 frame is 100% (BRANSIST safire) vs 75% (BRANSIST alexa) on these images

Feel next, frontier of intervention Precise positioning of stent balloon Other companies : Post processing S/W

Case1 Case2 Case3

Confirming the stent Confirming the positioning Confirming the progress of
overlapped areas of stent post-dilatation stent dilatation
SCORE StentView+Plus Post Process

• PCI guidance in real-time

Viewed in
• Device display fixedly another WS monitor
• Auto timestamp record
Radiography image (30frames or more) Single Still image

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PCI guidance：SCORE StentView+Plus

PCI guidance：SCORE StentView+Plus PCI guidance：SCORE StentView+Plus
• Positioning stent accurately • Confirming Stent Strut clearly

Real time

Live monitor

DA SCORE StentView+Plus

Conventional SCORE StentView Evaluation

SCORE StentView+Plus：device positioning mode SCORE StentView+Plus：contrast mode
• Iｎ Vitro • Balloon Positioning • Contrast mode • Contrast mode Conventional SCORE StentView
Unsuccessful
case
unsuccessful case reasons
18%
• Devise operation during StentView
• Parallel usage with contrast media
Successful
Case • False detection of markers
82%
(Another device, Noise etc.)

• Multiple markers
•
(According to Shimadzu) (Kissing,IVUS)

SCORE StentView+Plus：ROI mode Conventional SCORE StentView Evaluation

Conventional SCORE StentView : Unsuccessful cases
• Set ROI using preceding fluoro/radiography images Conventional SCORE StentView
Unsuccessful
unsuccessful case reasons
MAP case
18%
• Devise operation during StentView
• Parallel usage with contrast media
Successful
Case • False detection of markers
82%
(Another device, Noise etc.)

• Multiple markers
False detection of markers Multiple markers •
(According to Shimadzu) (Kissing,IVUS)
1(one) ROI mode 2(two) ROI mode

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SCORE StentView+Plus Feel next, frontier of intervention

Weak point of DSA : motion artifact
• Abdominal • Peripheral
Challenge to
Unsuccessful
case
18%
Successful case SCORE RSM
100%!!! *Chasing angiography + Patent movement angiography
Successful
*Devise positioning mode
Case *Separation of blood vessel and bone
82%
*Contrast media mode
*Dose reduction + Reducing contrast media
* ROI mode

(According to Shimadzu)
SCORE

Contrast / resolution measurement

Principle of SCORE RSM Comparison of contrast
• Unique technology of multi frequency DSA 1.4 1.0 0.7 0.5 0.35 0.25(mm)

• Mask less DSA

ー ＝

Live Low frequency portion SCORE RSM 40mm Al + contrast or resolution chart DA DSA SCORE RSM

Comparison between acquisition mode

Comparison of resolution Comparison between DA and SCORE RSM

Contrast Contrast Radiation

Mode Resolution Panning
（EVT) (Tumor) Dose

DA △ X ○ 100% Available

DSA ◎ ◎ ◎ 300% NA

RSM ◎ ○ ◎ 150% Available

DA DSA SCORE RSM

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SCORE RSM DSA guidance : SCORE RSM DSA guidance : SCORE RSM
• DA • SCORE RSM • DSA • SCORE RSM • DSA • SCORE RSM

230mGy/min 120mGy/min

DSA guidance : SCORE RSM DSA guidance : SCORE RSM DSA guidance : SCORE RSM
• Peripheral Artery • Peripheral Artery • IPA • Celiac • Renal Artery

DSA guidance : SCORE RSM DSA guidance : SCORE RSM

DSA guidance : SCORE RSM
• Iliac • Shunt • Pendulum mode • Precession mode

SCORE

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Feel next, frontier of intervention Roadmap for neuro neuro-intervention

SCORE MAP : DSA-MAP
For improving image quality, individual LUTs are applied to both fluoroscopy • DSA-MAP • DSA-MAP (Live mode)
image and vessel (DSA) image.
SCORE MAP
3 types depending on the procedure
（S.I.MAP / Sub MAP / Trace MAP）
• Reducing contrast media
Live Roadmap image
fluoroscopy (Vessel and
• Reducing radiation exposure devices)

Mask for
• Shortening treatment time subtraction
Vessel image
(DSA )

SCORE MAP : FluoroMAP, BlankMAP SCORE MAP : Trace MAP SCORE MAP : Trace MAP
• FluoroMAP • BlankMAP (TAE with liquid material) Trace MAP
・Extract Vessel Edge （Auto/Manual）
・Annotation

Feature
・Registerable multiple MAPs
・Enable to switch showing or hiding
the edge synchronized with C-arm angle
(Auto/Manual)

Feel next, frontier of intervention 3D guidance : SCORE 3D

SCORE MAP : Sketch function

SCORE 3D applications
• SCORE 3D : 3D angiography
• SCORE CT /CT-HR : C-arm CT
• SCORE Navi : 3D-roadmap
1024 x 1024 matrix, 12bit, 30fps
• SCORE Navi+Plus : Multi-modality integration
MAX 60 deg/sec, around 3 sec acquisition
SCORE

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3D guidance : SCORE 3D
3D guidance : SCORE 3D 3D guidance : SCORE 3D
• Seamless communication of working angle • Clip • CAS • Coil • EVAR

C-arm 3D image DSA image

SCORE 3D : Vessel analysis SCORE 3D : Aneurism analysis

3D guidance : SCORE 3D
Result Straight View Single axis Diameter Volume
• Virtual endoscopy • AVF MPR

Reference Distance
line chart

C-arm CT : SCORE CT
C-arm CT : SCORE CT C-arm CT : SCORE CT

1024 x 1024 matrix, 12bit, 30fps

10 or 20dec/sec

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SCORE CT-HR
C-arm CT : SCORE CT SCORE CT-HR
• Axial • VR+Axial • Neuroform EZ（MIP） • Neuroform EZ（VR）

SCORE CT

SCORE CT-HR
SCORE

3D guidance : SCORE Navi MDCT integration

3D guidance : SCORE Navi
Raw Data

＋
MDCT

・Communicative C-arm angle

・Communicative FOV and SID
・Communicative table movement
(Panning, height adjustment) Angio Graphic View

Bidirectional integration (C-arm and MDCT) Synchronize for working angle

Slab MIP / Color MAP

1)Find working angle on WS

2)Send angle to C-arm

Coloring by CT value

Calcification Contrast medium Fibrous Fatty Soft

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Slab MIP / Color MAP

Display target lesion Vessel analysis

Long / short axis

Vessel route
Character of lesion

SCORE Navi / Navi+Plus

Virtual stent 2D registration

Virtual stent
Table movement and
image are synchronized

Synchronization of C-arm and image Synchronization of table and image SCORE Navi

SCORE

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It’s a whole new experience. Change the way. Make it possible. Lineup

Feel next, Frontier of intervention

SCORE Imaging
SMART Design

• SMART Access
MiX
• SMART Assist
Changing the way, Making it possible Safety Design with your SMILE • SMART Display
SMART Design SMILE Concept
Ceiling Floor-mounted
MiX

SMART Access SMART Access SMART Access

• Multiple approach • Whole body access

Dedicated C-arm for Crossover system

• Whole body access

190cm
• Multiple approach

• Radial approach, Best option for shunting

SMART Access SMART Access SMART Access

• Radial approach, Best for shunting option • Bedside console • Simple operation

210cm （Lever type）

Local console IVR NEO
C-arm console
C-arm setting Image adjustment
（Grip type）

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SMART Access SMART Access SMART Access

• 6 axis, Triple pivots • Multiple approach

Dedicated C-arm for Crossover system

• Whole body access 6

• Multiple approach
4 5

• Radial approach, Best option for 3

shunting 2
1

SMART Access SMART Access SMART Access

• Whole body access • Radial approach • Bedside console

140cm
（Lever type）
Local console IVR NEO
C-arm console
C-arm setting Image adjustment
（Grip type）

190cm

SMART Access SMART Assist SMART Assist

• Simple operation Feel the fastest operation system One action operation
in the world Assign your own tasks to function
keys
• Windows 7, 64bit
• SCORE StentView+Plus
• 2 min. boot up
• Selecting RAD/Fluoro program
• Completely parallel processing
• Selecting image for play back • Fluoro Record
• Back ground transfer
• Image analysis
• Road Map switching (ON/OFF)

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PCI View SMART Display It’s a whole new experience.

• 27ch/8ch simultaneous display

• MDCT WS Feel next, Frontier of intervention
• IVUS / OCT SCORE Imaging
• HIS / RIS / PACS / Dynamic image WS Monitoring
IVUS
LIVE MAP Monitoring
Monitoring
etc. Road Map
LIVE
LIVE
Ref.
• Dedicated touch panel console
MiX
LIVE Server
Ref.
Ref.
LIVE

Changing the way, Making it possible Safety Design with your SMILE

+ Dynamic image SMART Design SMILE Concept

Dynamic image Still image
SMILE SMILE MiX

Safety Design with your SMILE SMILE Dose-eye: 7 functions for dose control Fluoro record
4. Virtual collimation
1. MBH filter
Controlling the times of
Eliminate soft X-rays fluoroscopy exposure.
SMILE Concept by 4 types of filters
5. Image processing
• SMILE Dose-eye Realizing HD image
2. Pulse fluoroscopy
• SMILE Recovery Controlling the doses in 6. Fluoro record
10 levels
Controlling the time of
• SMILE Plus radiography exposure.

• SMILE Support 3. Grid control 7. Area dosimeter Realtime recording

(only 3M tube)
Measuring of actual doses Max. 1023 frames
For the most precise Former recording Direct recording
X-ray exposure

SMILE Recovery: Safety functions SMILE Support: On-line support New Angiography System

1) High speed booting up

- All applications is ready to be used
within 2 min. after switching ON.

2) Back up filament
- Filament is automatically switched
in case of tube failure during the cases.
Customer Maintenance center
3) Data mirroring
- Detecting the aging and the system condition only by pushing AUTO aging button.
- Clinical image data should be kept in safe.
- Periodical report of detected information is recorded at the server of maintenance “Crossover” Angiography
center by remote maintenance service.
SMILE

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Copyright(C)2010 Shimadzu Corporation. All Rights Reserved.

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