Nottingham City Hospital have recently upgraded their existing Allura Xper FD10 EP Cockpit XL lab to AlluraClarity. Philips’ revolutionary new generation of interventional X-ray systems, the AlluraClarity family with ClarityIQ technology, introduces a comprehensive set of system-wide improvements that virtually ends the trade-off between X-ray dose and image quality. The team at Nottingham are delighted with ClarityIQ and have already noted a considerable drop in dose for all exams.
ClarityIQ dramatically reduces X-ray dose (typically by 73 percent in neuro, 50 percent in cardiac and 83 percent in vascular interventional procedures), while delivering equivalent image quality. The new technology pushes the boundaries of the ALARP (As Low As Reasonably Practicable) principle, so that patient and staff risks from radiation exposure are radically reduced, and longer, more complex procedures, can now be performed more safely. It incorporates powerful state-of-the-art image processing technology, developed by Philips Research, all working in real-time, enabled by the latest computing technology, to assure optimum image quality with noise and artefact reduction (also on moving structures and objects); image enhancement and edge sharpening, and automatic real-time patient and accidental table motion correction on live images.
ClarityIQ utilises a flexible digital imaging pipeline from tube to display that is tailored for each and every application area from cardiac to neuro studies. This gives the flexibility to select virtually unlimited application-specific configurations and obtain superb images at a fraction of the X-ray dose for every intervention. In addition, with ClarityIQ, over five hundred system parameters are fine-tuned for each application area, the result of years of Philips’ clinical leadership, so that it is now possible to filter out more X-ray radiation, and use smaller focal spot sizes and reduced pulses rates, thereby fully utilising the unique capabilities of the Philips MRC X-ray tube and Philips’ exclusive 2K imaging.
Philips will be collaborating with Andy Rogers, Head of Radiation Physics at Nottingham University Hospitals NHS Trust, over the next few months to optimise the system as required. The team are already routinely using EP Navigator and 3D ATG ( 3D atriography) for certain ablation procedures. EP navigator provides a fluoroscopy overlay of a 3D image of the heart, showing the catheter and 3D anatomy in real-time in one image, allowing the position of any catheter or lead to be instantly confirmed with respect to detailed 3D cardiac anatomy. An up-to-date view of this anatomy is vital but obtaining good CT scans is often difficult and time-consuming, requiring a high X-ray dose. With 3D ATG the team can create 3D images of the left atrium in the lab, and use this information to guide the catheter.
Chantel Brookes specialist radiographer, interventional radiology at Nottingham City Hospital says “we feel that we are learning each time we perform a 3D ATG, which is to be expected, and are very positive this will become routine for a lot of ablation procedures. It is now possible to transfer the 3D ATG data to St Jude Medical’s cardiac mapping system which quickens the workflow. We also plan to try to use the Clarity Cardiac procedures as well in future as an additional feature of Clarity Rel 8.1 is the ability to send a structured dose report to PACS”.
The upgrade comprised brand new state-of-the-art computer architecture fitted into the existing cabinet to replace the processing side of the system and new image processing software. The X-ray tube and remainder of the system remained the same. It only took two days, one day to install the hardware and then one day for all of the calibration.