UK’s first photon-counting CT scanner installed at John Radcliffe Hospital
09/02/2022
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A radically new imaging technology, the photon-counting CT (computerised tomography), has arrived at the John Radcliffe Hospital making it the first in the UK to benefit from the system's high resolution and dose reduction technology.
The NAEOTOM Alpha from Siemens Healthineers is also the first in the world to sit within a hybrid catheterisation laboratory. This will support Oxford University Hospitals (OUH) NHS Foundation Trust in optimising diagnostic and treatment pathways for patients, as well as facilitating ground-breaking research at the Oxford Acute Vascular Imaging Centre (AVIC), part of the Radcliffe Department of Medicine at the University of Oxford, to help pave the way for photon-counting CT to be rolled out across the NHS.
The new technology forms part of the University's Academic Cardiovascular CT programme, supported by OUH and the British Heart Foundation.
The system uses cadmium telluride crystals, a new type of material, converting X-ray photons directly into electrical signals before being counted, overcoming the loss of information encountered in conventional CT. The better the input signals, the better the resulting images at the end of the processing chain that the radiologist can use for diagnosis.
As well as obtaining valuable new clinical information and supporting earlier diagnoses, the new system also means patients benefit from lower exposure to radiation: equipped with highly sensitive photon-counting detectors, the scanner can achieve up to 45 per cent dose reduction for ultra-high resolution.
The new photon-counting CT replaces an existing MRI at the AVIC, which took up to an hour to complete a single cardiac study. Clinicians now expect to reduce cardiac scanning time to just a few minutes, enabling the expansion of services to include vascular imaging for acute patients and the provision of a routine cardiac CT service.
The implementation of photon-counting CT into clinical practice at the John Radcliffe Hospital has the potential to transform patient pathways for those presenting with symptoms of a heart attack, identifying patients who can be treated at home and those who require targeted intervention.
With conventional CT imaging, the calcified arteries of these patients compromise image quality, often necessitating further, invasive investigations. The NAEOTOM Alpha allows the visualisation of coronary vessels to clearly assess whether obstructions are present, helping to avoid unnecessary hospital admissions.
Dr Bruno Holthof, OUH Chief Executive Officer, said: "It’s wonderful to see this cutting-edge CT technology coming to Oxford, keeping us at the forefront of medical imaging research. This new scanner will have huge direct benefits for our patients, thanks to quicker and better diagnoses and access to the very latest treatments.
"The Trust showed its commitment to this clinical-academic partnership with a £11.5 million grant last year to the University of Oxford to support the development of major clinical research facilities, including the refurbishment of AVIC."
Research in this area is ongoing at AVIC, where the location of the photon-counting CT within a unique hybrid facility means plaques can be visualised concurrently to intervention, providing data that has never been captured before.
For the first time, doctors are able to visualise plaques before they are disturbed, allowing researchers to identify the plaques causing a heart attack and apply this knowledge to identifying vulnerable plaques before they rupture.
This data will also be used to optimise artificial intelligence models at the big data facility within AVIC, with the goal of helping to predict heart attacks in the future. The combination of photon-counting CT and AI for the first time will also help to optimise heart attack diagnosis and prognosis ahead of the technology being adopted by the NHS. Additional research will be conducted with international collaborators, including the Semmelweis University, Hungary, who have just obtained similar technology.
"The photon-counting CT scanner is game changing for UK healthcare provision and will enable us to streamline our patient pathways. It will act as a gatekeeper, reducing hospital admissions and scanning patients with symptoms of a heart attack before they are admitted," said Professor Charalambos Antoniades, British Heart Foundation Chair of Cardiovascular Medicine at the Radcliffe Department of Medicine, and Director of the Oxford AVIC.
"We will be able to identify patients who can undergo medical therapy as an outpatient or send patients directly for revascularisation procedures without the need for an invasive diagnostic angiogram, freeing up hospital beds and avoiding unnecessary hospitalisation.
"This is the first system in the UK and the first in the world within a hybrid setting, making us pioneers for a technology that will soon help transform diagnostic provision across the NHS."
Peter Harrison, Managing Director at Siemens Healthineers GB&I, said: "The introduction of photon-counting CT is a development that could be compared with the move from pixelated black-and-white images to HD colour. We are proud to be the first to introduce the photon-counting CT to the market and pleased to see this technology arrive in the UK for the first time at the University of Oxford.
"With its advanced visualisation capabilities, the system will be central to studies striving to reduce burden on the NHS and transform patient pathways. We hope the NAEOTOM Alpha will go on to inspire further breakthroughs in healthcare and support ground-breaking research taking place at the University of Oxford today and into the future."
Find out more about the NAEOTOM Alpha on the Siemens website.
This YouTube video shows a time-lapse of the Photon Counting CT scanner being installed at the John Radcliffe.
Pictured: Peter Harrison, Managing Director of Siemens Healthineers GB&I (left), with Professor Charalambos Antoniades, Director of the Oxford Acute Vascular Imaging Centre, oversee the delivery of the UK’s first photon-counting CT