Additional Resources ❯ Clinical Concerns ❯ Current Clinical Concerns in CT: Hardware2

Current Clinical Concerns in CT: Results : CT Scanner Hardware

Specific manufacturers/models

1. I have the Sensation 16 v70. How do you rate and compare with Lightspeed Burst Plus?

Answer: We also have a 16 slice scanner, and have been very satisfied with its performance across a range of clinical applications. The scanner has been especially valuable in CT angiography studies across a range of applications from coronary imaging to run-off studies to renal imaging. I have not used the Lightspeed scanner, so I can't compare the 2.

2. I am in the process of buying a CT, considering either the Siemens Sensation 10 vs. GE Ultra Lightspeed 8 slice. At the present moment, I have a single slice GE CTI Pro. It has been wonderful. We have done 331,000 slices without any tube change. I am told that Siemens sensation has got a low HU of 5.3 compared to GE 6.3 HU. At the same time, Siemens Inspace, I am told, is very good. Could you please advise?

Answer: Inspace is great. I do not know the specifics of the GE 8 slice, but will look into it ASAP and get back to you. For the record, we have helped develop inspace.

3. I understand that your facility has Toshiba 16 slice scanners. What is your opinion of the Toshiba scanners?

Answer: Toshiba makes a very good 42 inch flat screen TV. I think the Samsung model is better, and at home, I bought the 50 inch Samsung. It has a great picture.

At work, I use a Siemens 19 inch flat screen monitors. They are really good monitors because the images I see on them are incredible, especially the CT angio and virtual imaging. I guess the fact that the monitors are hooked up to a Siemens Sensation 16 may have something to do with that. At Hopkins, we have 4 Siemens Sensation 16 scanners. All images on the website are done on these systems. All our cardiac work is done on these systems. All our clinical work is done on these systems. All our academic work is done on these systems. I spend 16 hours a day using these systems. What was the question? Enough said…

4. I was surprised to learn that Toshiba introduced a 32 slice CT and said the first unit was to be installed at Johns Hopkins in January (2004). Is this for Radiology? What's going on with Siemens-according to Diagnostic Imaging's Brad Tippler's report (see below), they made a fool of themselves, and appear to have stolen a page from the GE with their marketing spin tactics…Diagnostic Imaging reports: "Siemens introduced a 64-slice scanner, but the paint on it was still wet. I think it was a 16 when it was delivered to McCormick Place last week."

Answer: Brad Tippler is a terrific writer, but if you follow his monthly DI articles for many years, his approach to radiology focuses on the human side of medicine and people and not the technical side of CT, MR or mammography. Perhaps he gave Siemens the ultimate compliment---that their technology is so new and so hot, that it is improving by the day. If you look at the specs for the 64 slice to be delivered next summer, it is awesome. The Siemens 64 and the Philips 40 slice systems blew everything else away. I will print the exact spects of these systems later this week, but I left them at work. We look forward to these new systems as well as the new Straton tube, which is available now and seems to be of major value for coronary CTA. As for Brad, let me wish him a happy and healthy 2004.

5. We heard that Hopkins has a 16 slice Toshiba scanner. We're wondering how you like it, and if it has met the potential that you expected. We're in the market for some new multi-slice scanners and were hoping you could enlighten us on which direction we should go.

Answer: Neuroradiology has a Toshiba scanner and you might contact Dave Yousem et al for any info. In body imaging (chest-cardiac-abdomen-msk, etc) we use the Siemens Sensation 16 scanners, and all of the material on www.ctisus.com is from that system or its predecessor. If you have any specific questions please give me a call or email me.

6. What are the pros and cons regarding the 16 slice scanners by these 2 companies: Siemens vs. Phillips 16 Slice.

Answer: I have 4 Siemens 16 slice MDCT's, so you know my vote. I have not seen the Philips us it up close, nor do I know anyone who owns it, so I can not give an opinion on it. Our experience with the Siemens has been great, and they have the premier 3D software package-Inspace. You can view some of what can be done at www.insideinspace.com. Good luck on your decision. Let me know how it works out.

7. I saw your Siemens v. Philips comment. Toshiba tells us that Johns Hopkins has made a multiple purchase of Toshiba CT's to do cardiac angiography. ("in a Siemens stronghold"). Have you seen any comparison or have a comment?

Answer: Toshiba gave Neuroradiology at Hopkins a free scanner. We do all our cardiac CT, including CTA of the coronaries, on one of our 5 Siemens Sensation 16 scanner and never have used the Toshiba. My experience and information is that the Toshiba has inferior technology, inferior software and is not used by any major university or medical center for body CT work at the highest levels. In regards to CT angiography of the coronary arteries, you will note that nearly every published article is from a Siemens scanner with a couple from GE systems in the work. The Toshiba salesperson is telling you a fairytale and misleading you. We will be posting a section on cardiac CT soon, but in the meantime, look at www.insideinspace for some cardiac work. For cardiac references, there are a number of articles by Becker C. and Flohr T. If you have any questions, give me a call or email me.

8. Like to know more of why you do not care for Toshiba CT scanners. I was told I can ask you here. I know you like Siemens, but why not Toshiba. It seems that they have a good tech, and I just spoke with a sales person last week.

Answer: Answer: Let me not focus on a specific company, but let me explain to you my rules for choosing a CT scanner. The rules are simple, and are a matter of fact, and not of great philosophy. Also, these rules do not take into account a practical point-your budget for a scanner. Let's then assume that the financing was in order, and so here is my advice:

(1) Do not believe anything a salesman tells you-BUYER BEWARE.
(2) All scanners will break at some point-what is the repair record of you potential vendor? More importantly, how good will they be in your city and town. Geography does matter. Get some guarantees.
(3) Football teams need a good quarterback to lead them, and the same is true with a scanner company. Who is the boss-and what is his/her track record? Do they lead or simply follow?
(4) What scanners are the leaders in CT using? What is (in no special order) Stanford, Duke, NYU, Penn, Cleveland Clinic, Mass General, etc. using? Leading institutions typically choose the best technology. If they won't buy a system from company X, why should you?
(5) What is the long term plans of your vendor? Will they be around in 5 years? Will they continue to grow, so that your scanner can be updated or will they welter?
(6) What is the total package? If I buy a scanner, the workstation becomes critical. Does the manufacturer have their own development team for the new workstation, or do they simply sell a black box solution. My opinion is that I need to be with the technology leaders, not the pretenders. The next wave of CT will truly separate the haves from the have nots.
(7) Beware manufacturers who have claims but no substance. Publications in throw away journals, or supplements or infomercials may seem real first glance, but ask this question-if things were so good, why was it not published in a peer reviewed journal. Look at AJR, Radiology, Radiographics, JCAT, etc, and you will see that the articles published are typically done on GE or Siemens systems. Perhaps there is a reason, the systems are better. Remember, academics relies on career promotions through publication and so hardware is critical. That is why you will Siemens scanners at NYU and Penn, etc. and GE scanners at Duke, Mass. General, etc.
(8) Go with companies with proven leadership. There is a reason why they are successful. A Klaus Hambuchen or Richard Hausmann at Siemens, or a Stan Fox or Jeff Immelt at GE are worth far more than promises from paper tigers. I have always found that in technology, success will follow leaders. Think computing and think Steve Jobs, Bill Gates, Michael Dell. I always was a sucker for people with a vision of future not merely focusing on the present.
(9) Beware the salesman with the half truths or half lies. When in doubt call a user of the system of your choice, not someone selected by the vendor.
(10) Make sure your potential scanner can do the applications you need, not the applications the vendor wants to sell.
(11) I could give you some more rules, but I think this will do for now. Plus I have to finish up some work for ctisus. Email me back if I did not answer the question (or if I did).

References
Ryberg J, Buckwalter KA, Caldemyer KS et al. Multisection CT: Scanning Techniques and Clinical Applications. Radiographics 2000; 20: 1787-1806.
Summary: This Radiographics article reviews MDCT technology. Detector rows, detector array design and acquisition protocol parameters are discussed. In addition, the detector design differences among various manufacturers are reviewed. This is an excellent source of technical information for those practicing multislice CT.