Vantage Orian Opens New Perspectives in all Fields

Dr. Thorsten Leibecke
At the Schön Klinik Neustadt – situated right on the Baltic Sea coast between Kiel and Lübeck – 1,150 employees care for around 20,000 inpatients from Germany and other countries. From a medical perspective, the academic teaching hospital of the University of Lübeck offers highly skilled specialised services in eight medical expert centres. One of these is the Clinic for Diagnostic and Interventional Radiology. Next to their focus on musculoskeletal radiology for orthopedics trauma surgery and spinal surgery, the clinic also provides quality radiological services in the fields of oncology, cardiology, gastroenterology, neurology vascular and abdominal surgery. “We provide our clinical partners a broad spectrum of radiological investigations,” said Dr. Thorsten Leibecke, Senior Radiologists in the Clinic for Diagnostic and Interventional Radiology, “including whole-body imaging and guideline-based multiparametric prostate imaging as part of tumour diagnostics.”
His team have been using the Vantage Orian from Canon Medical since the end of November 2018. “We opted for this machine following an intensive selection process in July 2018,” says Dr. Thorsten Leibecke. “In addition to the strong gradients required for the neuro- and cardio-imaging frequently performed in our clinic, it needed to be a 1.5 Tesla system due to e.g. the long implants in scoliosis surgery.” Spinal surgery is – next to arthroplasty - a key focus in the medical work done in the Schön Klinik Neustadt. “We are very pleased with the Vantage Orian, equipped with cutting-edge technology.” The Senior Physician and his colleagues were also impressed with the reduced energy consumption thanks to the ECO Mode. “When purchasing new equipment, we consciously support any opportunity to save energy,” said Dr. Leibecke.

Patients and staff are now benefiting from the Vantage Orian in their day-to-day clinical work. The dockable patient couch and the wider gantry opening allow personnel to move all patients into position without any problem. This applies particularly to patients with ankylosing spondylitis or pronounced kyphoscoliosis. “For the roughly 1,500 bedridden patients who are examined by MRI each year, it makes a big difference whether we need to move patients twice or four times, as was previously the case with an MR Compatible trolly,” said Dr. Leibecke. “The Vantage Orian’s Dockable Table means we can avoid 3,000 repositioning procedures per year, which also places considerably less strain on our personnel.”

The patients themselves are also much more comfortable. Overweight patients and those with claustrophobia also find the wider opening to be significantly more pleasant. “I would not have thought that an 11 cm wider opening would make much of a difference,” said Dr. Leibecke.

Performing MR studies in Vantage Orian also impresses in a number of technical aspects. For example, the use of flexible coils ensures that the image quality is at least as good as when dedicated coils are used. The coils can be used for any area of the extremities, and are therefore flexible in use. The Pianissimo and Pianissimo Zen technologies make the Vantage Orian one of the quietest MRIs available. “Some sequences, such as 4D angiography of the head, can be performed without any of the typical loud MRI noises,” said Dr. Leibecke. He also highlights the benefit of being able to pause the measurements without having to restart the entire sequence. “This spares the patients from having to lie down for so long,” he said. He adds that the homogeneous magnetic field, even in the off-centre areas, allows the arm to be positioned beside the body for wrist Imaging.

Dr. Leibecke’s assessment after the first period with the Vantage Orian is that the training, service and application were and remain outstanding. “So far, the whole operation has run smoothly and we haven’t had any unexpected downtimes whatsoever,” he enthuses. “And this has also represented a significant expansion to our portfolio.”
MSK Images - UTE - Depiction of the tendons.
For example, radiologists at the Schön Klinik Neustadt are increasingly performing angiograms without contrast agent. Amongst others, techniques such as FBI (Fresh Blood Imaging), Time-SLIP, 3D PCA, 3D TOF, mASTAR (time-resolved), and FSBB (Flow Sensitive Black Blood) are routinely used here. The cerebral 3D TOF angiography often carried out in daily clinical practice impresses with its excellent depiction even of peripheral arterial vessels. Arterial Spin Labelling (ASL) also offers a native method for illustrating cerebral perfusion on the Vantage Orian.

In musculoskeletal radiology, the range of features has also been expanded with “cartilage mapping” and Ultrashort Echo-time (UTE) imaging. The so-called UTE sequences help to identify even very discrete findings of pathologically altered tendon and ligament structures which would not vbe clearly shown by conventional sequence with longer echo-time (TE). This is possible with the Vantage Orian because UTE sequence allows for ultra-short TE’s with a spoiled gradient echo sequence. In addition, thanks to its EasyTech CardioLine+ technology, the system can independently detect a total of 14 different heart axes in line with the Society of Cardiology guidelines. This significantly simplifies and speeds up cardiac MRI investigations.

For abdominal diagnostics, free-breathing protocols in particular make the investigations easier, both for the technician and the patient.

Regardless of which Vantage Orian technology the radiologist has used until now, whether working in a specific team or between disciplines, the high expectations for MRI are met in all fields. “In Canon Medical we have a reliable and forward-thinking partner that we can trust,” said Dr. Leibecke. “We look forward to continuing our excellent working partnership.” //
Cartilage Imaging of knee: Color-coded T2 Map axial / color-coded T2 Map sagital / Pd-Fatsat axial / T2-map greyscale.
Multistation imaging with automated stitching: T1w 3D fatsat / T1W 2D / T2w 2d fatsat.
MSK, excellent off-center homogeneity: axial, para-coronal and para-sagital PD fatsat of the shoulder.
MSK, excellent off-center homogeneity: axial, para-coronal and para-sagital PD fatsat of the shoulder.
MR-Angiography: 3D TOF axial and sagital projection.
MR-Angiography: 3D TOF axial and sagital projection.
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