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EH 1_2015

WE HAVE A MINDSET, CREATING NEW PERSPECTIVES. 5G, high technology which rewrites the rules of radiology. • Multiple FOV and different scan modes, selected via the software, can be adapted to a wide range of applications. • Nothing is safer for patient health than the new EcoScan protocol and SafeBeam™ technology. • Unbeatable image accuracy thanks to the market’s smallest available focal spot and single flat panel sensor. • Proprietary NNT software facilitates image sharing and analysis. • The revolutionary bed enables practitioners to perform exams in various fields of application. Precursor in the field of CBCT imaging, NewTom is the unrivalled benchmark in radiology thanks to highly effective research standards, flawless reliability and sheer quality. These ingredients make 5G the best way to explore new fields of application. NewTom - Via Silvestrini, 20 - Verona, Italy 37135 T +39 045 8202727 +39 045 583500 - - NewTom Booth #20 Extension Expo A NT5GmEuropeanFebMar15.indd 1 17/02/15 14:02 25EH @ ECR Liver Fibrosis of a few months old child measured simul­ taneously in kPa (4.7kPa & 5.1kPa) and m/s (1.2m/s & 1.3 m/s). No fibrosis corresponding to a F0 Metavir score UltraFast Doppler displays multiple spectrums in a single image in this neonatal liver with cholestasis. Full display achieved in a single acquisition Subscription rate 6 issues: 42 Euro, Single copy: 7 Euro. Send order and cheque to: European Hospital Subscription Dept Printed by: WVD, Mörfelden-Walldorf, Germany Publication frequency: bi-monthly European Hospital ISSN 0942-9085 Representatives China & Hongkong: Gavin Hua, Sun China Media Co, Ltd. Phone: +86-0755-81 324 036 E-Mail: Germany, Austria, Switzerland: Ralf Mateblowski Phone: +49 6735 912 993 E-Mail: France, Italy, Spain: Eric Jund Phone: +33 493 58 77 43 E-Mail: GB, Scandinavia, BeNeLux: Simon Kramer Phone/Fax: +31 180 6200 20 E-Mail: Israel: Hannah Wizer, International Media Dep. of El-Ron Adv. & PR Co., Ltd. Phone: +972-3-6 955 367 E-Mail: South Korea: CH Park, MCI Phone: +82 2 730 1234 E-Mail: USA & Canada: Hanna Politis, Media International Tel: +1 301 869 66 10 E-Mail: Ultrasound system sharpens paediatric hepatic imagingHigh quality B-mode with advanced functions makes UltraFast the “go-to” device for paediatricians Ask about UltraFast ultrasound and you might expect a technical answer explaining why the ultrasound is fast- er. However, for Stéphanie Franchi- Abella MD, fast means just fast, an ultra-quick acquisition she can take of a squirming, agitated new-born in the blink of an eye. ‘These babies are small and breathing rapidly, the organs are moving fast in the image and it’s sometimes difficult to record Pulsed Wave Spectral Doppler in their vessels that are small. ‘UltraFast facilitates Doppler acqui- sitions. It only takes two seconds to record all Doppler data in an image and you can obtain all conven- tional Pulsed Wave Spectral Doppler measurements retrospectively and assess the blood flow in these vessels recorded in the image. This is inter- esting in young patients because one acquisition may be sufficient to assess arterial and vein patency. ‘In liver disorders it is very interest- ing in showing transient inversion of peripheral portal blood flow that we would not be able to see with a Doppler. For us, this can be a sign of portal hypertension,’ explained Dr Franchi-Abella, who is a paedi- atric radiologist at Bicêtre Hospital in Paris, the leading tertiary centre for paediatric liver disease and liver transplantation in France. At this year’s ECR she is pre- senting a lecture on ‘The Benefits of Using UltraFast Ultrasound Imaging in Paediatric Patients’ dur- ing the SuperSonic Imagine Satellite Symposium (4 March). In 2012,her clinic was first equipped with an Aixplorer ultrasound plat- form from SuperSonic and the fol- lowing year the group presented at JFR (the French meeting of Radiology and ESPR European Congress of Paediatric Radiology) preliminary findings from a study of 98 children, half of whom were healthy while the others had liver fibrosis. The study compared the metrics reported by the ShearWave Elastography function on the Aixplorer with histological staging of biopsies from the same tis- sue. ‘In 90% of cases the ShearWave Elastography (SWE) matched the liver fibrosis staging obtained from biopsy,’ Dr Franchi-Abella said. An article reporting these prelimi- nary findings is now in press with the journal Radiology. Meanwhile these results caught the interest of the French ministry for health, which is co-sponsoring an expanded study that will enroll over 200 children to establish and validate SWE as a non- invasive tool for the diagnosis of liver fibrosis. ‘I would not want to promote any findings ahead of the definitive results; but, what is clear, and what we can say, is that the preliminary findings are very encouraging. There may be a possibility that we can bet- ter decide when to perform biopsy in certain indications,’ she said. While the primary endpoint of establishing a correlation between histology reports and SWE remains the same, the method for analys- ing the histological samples calls for a computer-assisted assessment. ‘In other words, instead of having only a visual assessment, where the patholo- gist looks at a slide, we will scan the slide for an additional and more objective assessment with software analysis,’ Dr Franchi-Abella explained. ‘We expect to be able to complete this study next year.’ In her ECR symposium presenta- tion, the expert said she will discuss specific applications of Aixplorer, both for its advanced UltraFast func- tions and elastography, as well as for its B-mode, ‘although I plan to show examples of how we apply the Ultrafast ultrasound in clinical practice, notably for liver disorders,’ she said. ‘We have had high-end ultrasound systems with complicated keyboards and so many buttons eve- rywhere that there is nothing natural about learning how to use them. The Aixplorer has proven to be so much simpler to use that most radiologists in our service have taken it up eas- ily and rapidly. It quickly became the preferred system for everyone in our clinic. It is the “go-to” ultrasound system because of the high-quality imaging.’ The multi-task Aixplorer can cover routine clinical assessments of mor- phology, whether for a neo-natal brain, or the hips, and notably for the digestive anatomy, she added. ‘We have improved our diagnostic perfor- mance in some disorders since using the Aixplorer. For example in biliary atresia – a progressive biliary fibrosis leading to biliary obstruction in new- borns – the presence of a microcyst (<0.5 mm) next to the portal bifurca- tion is quasi pathognomonic of this disorder. The quality of the SL10-2 probe improved the detection of such microcysts a lot, and that is helpful in assessing this pathology. For this diagnosis we don’t want to lose any time. Babies who have surgery before 40 days have a better outcome with a greater chance to resolve the pathol- ogy and avoid liver transplantation, so it is essential to make a diagnosis as early and as quickly as possible. ‘The fact that we have advanced functions for measuring liver stiffness, or to better see microvasculature, helps us to understand certain pathol- ogies better. For children receiving liver transplants, the first month can be complicated with many things that could happen (rejection, infection, vascular disorders and so on). ‘Sometimes the ability to link a morphological image with elastomet- rics helps to understand what is happening better and make a much more precise diagnosis. I’ll be sharing examples from such cases of children with a liver transplant in my ECR presentation.’ Paediatric liver imaging expert Stéphanie Franchi-Abella MD, Department of Pediatric Radiology, Bicêtre Hospital, Paris, France T +390458202727 +39045583500 - - NT5GmEuropeanFebMar15.indd 117/02/1514:02 Phone: +86-0755-81324036 Phone: +496735912993 Phone: +33493587743 Phone/Fax: +31180620020 Phone: +972-3-6955367 Phone: +8227301234 Tel: +13018696610

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