Image Quality, Increased Efficiency and Excellent Clinical Performance
09.27.04, 2:28 PM ET

Specialized CT Package, Allura Xper FD20, and New Allura 3D-Coronary Angiography Tool Allow Faster, More Confident Diagnoses and Better-Designed Treatment Planning for Clinicians and Patients

Royal Philips Electronics announced today the introduction of enhanced cardiovascular X-ray and computed tomography (CT) systems designed to meet the cardiovascular market's demanding clinical requirements for interventional procedures. Presented at the Cardiovascular Research Foundation's (CRF) Annual, Transcatheter Cardiovascular Therapeutics Scientific Symposium (TCT 2004), in Washington, D.C., the new systems include the Philips Allura Xper FD20, which captures and processes information at a resolution up to four times greater than that of conventional angiography systems. The company also introduced the customized, fast and reliable Philips Brilliance CT Private Practice CV configuration, targeted toward cardiologists, and the Philips Allura 3D-Coronary Angiography (3D-CA) tool, which obtains three-dimensional images of the coronary arteries. Both technologies were recently cleared by the Food and Drug Administration (FDA).

Both the Allura Xper FD20 and the Allura 3D-CA tool provide unparalleled detail representation of the condition of the heart's coronary vessels. The Allura Xper FD20 is the first cardiovascular system on the market empowered with Philips unique 2k x 2k imaging chain, which enables physicians to see the vasculature at up to four-times the resolution of other systems. It also includes StentBoost, Philips exclusive interventional tool providing a clear view of stent deployment in coronary arteries, which allows clinicians to immediately take corrective action, potentially eliminating the need for additional costly procedures.

"In the last 10 years, procedure rooms have transitioned from film to digital-based technology, and Philips has been focused on leading that transition while continuing to partner with our customers to develop cutting-edge medical technology for better patient care," said Richard Fabian, director, cardio/vascular X-ray, for Philips Medical Systems. "The introduction of products like the Allura Xper FD20 and Allura 3D-CA are a result of that vision and reinforces Philips commitment to continually improving patient care."

Philips newest interventional tool, the Allura 3D-CA, was created in collaboration with scientists at the University of Colorado Health Sciences Center. The 3D images of coronary vessels from multiple viewpoints and angles produced by the system will enable clinicians to make faster decisions, more clinically confident diagnoses and design better treatment-planning methods. This can result in enhanced care, potentially shorter procedure times and less contrast and radiation exposure for patients.

"Traditionally, cardiologists have relied on their own expertise in visualizing the coronary artery tree in order to determine severity of lesions and vessel lengths, which are unique to each patient," said John Carroll, M.D., chief of cardiology, director of Cardiac & Vascular Center at University of Colorado Hospital. "Philips Allura 3D-CA is a breakthrough interventional tool that will now deliver 3D images of the heart's complex anatomy, which are unavailable with 2D imaging. By viewing the heart's arteries in 3D, cardiologists can better understand its true structure, which benefits patients not only in treatment, but also shortens exam times, reduces the need for additional invasive procedures and lowers potential exposure to radiation and contrast agents."

Philips will also showcase the Brilliance CT Private Practice CV configuration, which assists cardiologists in the examination and treatment of cardiac patients with fast, noninvasive, highly accurate insight. Specifically designed for, and restricted to, the analysis of cardiac and peripheral vasculature, the Brilliance CT Private Practice CV configuration can non-invasively assess heart disease and help reduce reliance on and expense of other tests. The user-friendly system provides an exciting new tool for cardiologists, while preserving the clinical practice of traditional CT for radiologists.

"Our new specialty system gives cardiologists a fast and consistent CT unit to help determine within minutes if the correct treatment approach is medication, catheterization lab examinations or surgery," said Phil Prather, director, global cardiology CT, for Philips Medical Systems. "With the potential time savings, cardiologists can increase patient volume, increase efficiency and provide better, more precise patient care."

Additionally, the clinical advantages of Philips Rate Responsive(TM) CVCT technologies are currently being confirmed through a landmark comparative study of cardiac CT imaging versus Quantitative Catheter Angiography (QCA). Coronary Assessment by Computed Tomographic Scanning and Catheter Angiography, called CATSCAN, is currently in an advanced stage of patient enrollment. As a large, international multi-center, prospective and double-blind study, CATSCAN is intended to substantiate that CT systems employing Rate Responsive(TM) CVCT technologies are a suitable alternative for many patients previously sent for a diagnostic catheterization procedure. Results of this study are expected at this year's American Heart Association (AHA) and Radiological Society of North America (RSNA) annual meetings.

Other Philips interventional tools on display at this year's TCT meeting include:

-- Electrophysiology (EP) software - Empowers electrophysiologists with knowledge of the heart's complex anatomy, offering detailed insight into a patient's left atrium, pulmonary veins, coronary sinus and cardiac veins. This will allow doctors to pre-plan the EP study, thereby having the potential to shorten the procedure time.

-- RapidView 20 - The RapidView 20 feature helps efficiently manage the multislice CT data explosion by reconstructing images at up to 20 images per second. This unique feature can save precious time during trauma evaluation - when every second counts.

-- Improved Cardiac Review(TM) - Provides a comprehensive set of CT user tools that allow quick visualization of one or more multiple cardiac phases, and adding a quick measurement of cardiac output and ejection fraction. Globe View, a new feature within Cardiac CT Angio, enables better visualization of the coronary arteries.

-- 2k(2) imaging - The Allura Xper FD20 is the first cardiovascular system on the market to provide a 2k x 2k imaging chain up to four-times the resolution of currently marketed systems.

-- StentBoost - A simple, quick, and cost effective tool to improve visualization of stents in coronary arteries, StentBoost helps the clinician to enhance stent visibility during interventions and improves clinical outcomes.

-- Xper - Xper integration provides advanced functionality that boosts the efficiency of procedures and workflow before, during and after the intervention. Users can easily personalize the system to access any type of medical image or patient information - from CT to MR and Ultrasound - during the intervention while Xper settings make it easy to combine all relevant clinical images for PACS or CD archiving.

-- Xres - Philips award-winning real-time imaging algorithm, Xres reduces noise in clinical images, producing sharp, accurate images

I DO hope the BRILLINCE CT comes on-line very soon and it's as good as Phillips says. I'd love an annual look at my vasculature without catheterization.
Philips will also showcase the Brilliance CT Private Practice CV configuration, which assists cardiologists in the examination and treatment of cardiac patients with fast, noninvasive, highly accurate insight. Specifically designed for, and restricted to, the analysis of cardiac and peripheral vasculature, the Brilliance CT Private Practice CV configuration can non-invasively assess heart disease and help reduce reliance on and expense of other tests. The user-friendly system provides an exciting new tool for cardiologists, while preserving the clinical practice of traditional CT for radiologists.

Yes sir Zip, I am purely excited myself. If I find a horsepistol that has bought one a deeze gizmos, I will post it. Trouble is, how many years will it take for medical insurance to cover the test? I read last night that fast ct scans aren't covered, but it may be old info. Insurance pays for a $16-20k cath, but....It appears that the University of Pennslyvania Hospital, may be one of the institutes leading in noninvasive coronary artery imaging, or at least they are making information available to the public. The Minnesota Heart Institute, and it's affiliate organizations, appear to be using ctscans and mri's in a new fashion. They have developed a stronger magnet for the MRI. Info is hard to get, though. Stanford University received $175,000,000 from the federal gov for MRI research. I emailed one of the research fellers and asked about the best noninvasive imaging available to date. Will let you and all know if I get a response.

You realize this could hurt the cardio interventionalist, until they adapt. It could also make the ole stress test obsolete. So there are a lot of forces at play out there. (I'm paranoid)

I'm considering a fast ct (EBT) scan. A couple of arguments among the docs are; con-it don't see soft plaque, or vulnerable plaque. Pro-In older more advanced stages of CAD, calcium almost always predicts blockages. It may not be a good test for screening younger, asymptomatic folks, but for old geezers like myself, it may be a good thing. See's ya round.

Jack,

I'm due to have a CT coronary angiogram soon which I think is what you have just posted about. I seem to remeber somewhere reading that it does pick up soft plaques. I'm somewhet concerned however that it won't be sensitive enough and an equivocal result would be worse than no result.

On a more personal note I think I saw somewhere were you said that you had angins for 10 years on fast excercie. I wondered
how you were being treated ?
Did you have drugs?
Have you had angioplasty?
How dibilitating is it.

I'm 42 and am really concerned that there may not be a fix for this. I get back/shoulder aches and neck aches after large meals and sometimes after excercising (though I don't do a lot of that anyway and at the moment I'm too scared to do much at all). It was suggested that these might be angina symptoms (complicated coz they also think I have esophageal reflux) for 4 weeks and I'm waiting on this test for a definitive diagnosis.

Eeeean! I just copied the name of your upcoming test, CT Coronary Angiogram, pasted it into google and the first return was GREAT news. Thank you so much :) Before I forget, and if you don't mind, where are you having this done, and will your insurance cover it?

To answer your questions, I had one type of angina for many years (don't think it was 10) before I had a heart attack last May (minor heart damage), and a light stroke. It was pressure in my chest, no pain, just a tightness that covered my chest. It happened while at rest, so my cardiologist didn't think that it was heart related. Most angina happens after exertion, and goes away after rest or nitro.

I take 30 mg Imdur daily, which is a time released nitroglycerine. I also have the fast acting nitro for under the tongue. The Imdur decreased the frequency and magnitude of the angina that I have (that's what it is for). It is a vasodilator. It expands all of the arteries. If I stopped taking it, my angina might come back like it used to be, which was not debilitating, but very uncomfortable. I think that theoretically, Imdur helps to grow new, collateral arteries. I have never read this though. I still have angina, but seldom to the point of having to take the fast acting nitro. These days it is just an ugly reminder of heart disease/CAD. It does get painful at times when I exercise on my treadmill. I still get 3 types of angina. Tightness in the chest, burning pain in the center of my chest along with an achy left arm, and a numb, burning type in my back, directly behind my heart (only after exercise).

I have had 3 cardiac catheterizations, and no angioplasty. The 1st cath showed that my ramus artery went totally closed, and caused my heart attack. It was too small for a stent or angioplasty, plus it was too late to reopen it. The damage was done. My coronary arteries are different from 90% of the rest of you folks. I have a left dominant heart. My rca is tiny and ~45% blocked. My left main coronary artery supplies most of my heart. It has a blockage at the top that worries me everyday. The last cath I had, showed it was ~45% blocked. Stents are not usually inserted until the blockage is >70% or so, and the artery must be large enough, to get a stent into.

I have super high cholesterol, and cannot take statins. I take beta blockers, ace inhibitors, plavix and a host of supplements, including fish oil, folic acid, b12, and b6. (all doctor recommended).
I have read that it is not uncommon for angina to occur after a large meal. As a matter of a fact, many have had heart attacks after a large meal. I suppose it may be due to all the blood that travels to the stomach and intestines after we eat, in order to digest our food. While in school, we never ate before a test, because we wanted the blood to stay in our brains, lol. You need to take the meds for GERD or acid reflux, so as to rule out this condition being the cause of your pain.

Don't be so worried about not being able to get "fixed". If you have any blockages, looks like this new test you are about to have, will find them. Good doctors and medicine can do amazing things nowadays. Just don't let a heart attack sneak up on you, because then you either die, or have some damage to your heart to live with.
Thanks so much for your information. Here is some info I found on this new test :

Baylor Jack and Jane Hamilton Heart and Vascular Hospital
New CT Coronary Angiogram

The new high-resolution scanner available at the Baylor Jack and Jane Hamilton Heart and Vascular Hospital can produce images so detailed that blockages or plaques can be visualized just as in an invasive coronary angiogram.

In a brief outpatient procedure, physicians can use the scanner to acquire three-dimensional images of the area being studied. The CT coronary angiogram takes pictures of the blood flow within the arteries after a dye is injected into a peripheral vein. Compared to invasive coronary angiography which involves placement of a catheter in the groin or arm and injecting dye into an artery, this approach is more patient-friendly. In approximately 30 seconds, hundreds of pictures or “slices” of the artery are produced with one revolution of the camera.

CT angiography is most appropriate for patients who are at risk for developing cardiac disease. This can include patients who smoke, have high cholesterol, experience chest pain, or have a family history of cardiac disease.

The CT scanner also performs calcium scoring, allowing physicians to detect calcium buildup in the arteries. Unlike traditional CT and chest x-ray, which only show calcification, the new scanner can identify soft, non-calcified plaque. By identifying plaque at an early stage, aggressive preventive treatments may help stop the development of heart disease.

The CT angiogram may be used to rule out pulmonary embolism, identify aneurysms in the aorta or other major blood vessels, identify dissection in the aorta or its major branches, and detect narrowing or obstruction of arteries. In the future, physicians may also use the scan to monitor patients with previous bypass surgery or stent placement.

“The feasibility of non-invasive coronary artery imaging opens up the possibility of imaging patients earlier in the course of coronary artery disease when their condition may be more treatable,” said Kevin Wheelan, M.D.*, co-chief of cardiology and chief of staff at Baylor Hamilton Heart and Vascular Hospital.

its worth remembering modern CT scans are still highly radioactive and not without their own risks

public health warning for all the hypocondriacs out there

actually 'highly radio active' is a bit exagerated.dont want to stress anyone unduely