More Time for Patient Care with INSTINX and Aquilion Serve

Canon Medical’s new Aquilion Serve CT scanner was specially designed to support busy imaging departments that face challenges in time and staffing. With a host of brand-new features, the new system delivers better image quality, lower radiation dose and optimised workflow to enable healthcare professionals to focus more on patient care.

The Royal Bournemouth Hospital is a large and busy general healthcare facility in the South of the UK. Facing increased demands for consistent high quality scanning, the Hospital opted for an Aquilion Serve, which has already helped to improve efficiency and bring greater confidence to its 28 radiographers. Matthew Benbow, Superintendent Radiographer, manages the CT and MRI Departments. He explains to VISIONS how the new system has dramatically reduced training time and workflow.

The Royal Bournemouth Hospital is a general (723 beds) hospital in Bournemouth, Dorset, UK, managed by the University Hospitals Dorset NHS Foundation Trust. It already houses three Canon Medical CT scanners: Aquilion ONE ViSION Edition, Aquilion ONE GENESIS Edition, and now, an Aquilion Serve.

Matthew has worked at the Hospital for over 23 years. During this time, he has experienced the growth in demand for CT imaging, as well as its technological evolution.

“When I first came to Bournemouth, we were scanning around 15 patients per day on one CT scanner, due to lower demand and much lower scanner capabilities,” he said. “Now, we've got three CT scanners and we're imaging around 100 plus patients per day. So, each of those scanners is doing at least twice as much as the original one used to do.”

Alongside increasing workloads, the available staff changed drastically at the hospital.

“The turnover of radiographers is now high and there is a shortage of radiographers. It's hard to get them. They come and go quicker than they used to years ago, when they used to stay around for 15-20 years,” he remarked. “Now, sometimes, we train someone and they move on again really quickly. The key thing is that we want new people trained as quickly as possible, so that they can take part in the full rota, including the night work, the evening work, and the shift work.... as a full member of the team and in a position that doesn’t require supervision by somebody else."

The Aquilion Serve features INSTINX - Canon Medical’s new, holistic, ultra-efficient workflow solution. INSTINX was specially designed to enhance every aspect of imaging - from patient positioning, right to patient scanning and reporting. It features many advanced technologies and innovations from Canon Medical. Wherever possible, automation is employed to make operation easier, faster and provide a more consistent workflow experience.

The Aquilion Serve is suitable for all routine examinations. It features a new 80-cm wide bore gantry with two easy-to-use touch panels and inbuilt cameras that enable automated, one-touch patient positioning. It also introduces Canon Medical’s unique INSTINX workflow solution. which combines AI-enabled automation with innovative hardware and an intuitive user experience to support fast, easy, and safe CT exams. The new workflow also dramatically reduces training time for operators.

“The User interface of the Aquilion Serve is state of the art which makes building protocols much easier and much more straightforward, as well as in scanning. People are getting to grips with it a lot quicker,” said Matthew. “It also includes some automation that didn’t exist previously. Canon Medical have brought some innovative features and some clever automation into the software, which we are taking advantage of.”

“There are two cameras built into the gantry for automated positioning during initial setup. They help ensure that the patient is in the iso-center of the gantry,” added Matthew. “that's important, because you get a better scan quality and you get a better dose profile if the patient is in the middle. So, the cameras ‘look for’ the patient and moves them to the correct start position, the correct height and adjusts the left-right positioning when needed before you start acquiring any images. That was a manual process before, now the Aquilion Serve is doing that for you."

“The touch panels on the gantry are very straightforward and clear,” he said. “You make a body part selection, then you press a single button and the scanner carries out the task that you just asked it to do. The touch panels are on both sides of the gantry - left and right. Obviously, different rooms will be designed in different ways. So you might want one side or the other, but it works on both sides which is very straightforward.”

Many of the new features of the Aquilion Serve enhance the safety of all procedures for the patients, as well as staff.

“It’s always better to have the patients in the middle of the gantry. They are less likely to knock their arms and their elbows because they are centrally positioned,” said Matthew. “With the scanner’s lateral table movement, it saves anyone having to pull the patient manually across on the mattress, or dragging them across on a slide sheet. Some patients are really heavy. So, manually pulling the patients into position is not only less comfortable for the patient, but is also risky for the radiographer that's performing that. A motorised tabletop offers some reduction in the risk of manual handling incidents or accidents, which is great.”

Using SilverBeam technology, the Aquilion Serve’s 3D Landmark Scan, provides an ultra-low dose 3D scanogram. The dose of the 3D scanogram is the same as frontal and lateral 2D scanograms.

“The advantages of 3D Landmark Scan are that it allows the scanner to perform automatic landmark detection of scan ranges and accurate fields of view,” said Matthew. “So, you can use, not just the frontal and lateral image that's generated from the helical scanogram, but you can also use the axial slices to ensure your field of view is optimum. So, you effectively get it for free compared with what you did before, i.e. for the same dose you now get extra functionality.”

Matthew is the Superintendent Radiographer of CT and MRI at the Royal Bournemouth Hospital in Bournemouth. He joined the Hospital 23 years ago. Prior to this, he was a Senior Radiographer at Southampton General Hospital (UK) for five years. And before this, he has worked in Brighton (UK) and Treliske Hospital in Truro, Cornwall (UK) where he originally trained. When he is not working, Matthew plays bass in a hospital band called ‘On the NASH’.

“Based on your scan protocol, Automatic Landmark Detection (ALD) automatically adjusts the scan range, Field of View, kV and mA for each individual patient.” he continued. “It speeds up the operation that the radiographer has to do and gives them more time to focus on other important issues, like the patient. We are using ALD for all our examinations.“

Canon Medical’s Advanced intelligent Clear-IQ Engine (AiCE) deep learning reconstruction algorithm provides high quality low noise images with low dose levels according to Matthew.

“AiCE is another successful example of where clever reconstruction techniques have come along. We use it on all reconstructions.”

As the Aquilion Serve is so intuitive and easy to operate, training time is significantly reduced.

“After a fortnight of applications training, around 10 of our radiographers were happily performing scans with the system,” said Matthew. “That’s unusual for that number of people in that short time. Everybody just took to it so intuitively. It is great news if we can shorten training time. There are 28 radiographers here, who have all got to learn to use it. It makes that process simpler.”

Matthew also recognises that the more straightforward and intuitive equipment is, the less likely it is that errors are made.

“With the simplified and more intuitive software that we have on the Aquilion Serve, I believe that the probability of anyone making an error or requiring assistance is reduced because it's more obvious when the operator is doing the right thing,” he said. “It gives them confidence that they are not looking at a cluttered screen with several different options, any of which could be the right one. They’re working on a very clear screen, which is intuitive as to where they're going next. The software is structured such that they are guided in the right direction.”

“The Serve is enjoyable for our operators to use, because they feel not only supported by training, but without even realizing it, they feel supported by the person who designed the software,” added Matthew. “It enables them to feel comfortable and confident that they’re doing the right thing.”

For around 22 of the 23 years that Matthew has worked at the Royal Bournemouth Hospital, he has been collaborating with Canon Medical.

“Some of the Canon people are still there after all these years. I’ve got to know them really well. It’s a great team to get on with and work with,’ said Matthew. “They know what we need and are only too keen to try to support that, and make it happen, which is probably why the relationship has gone on so long and continues to go on.”

“I look forward to where INSTINX is going. It is great to have one of the first Aquilion Serve CT scanners and to be at the forefront with INSTINX. It’s a brand new software platform which undoubtedly will be developed further for many years. The developments that will come along with that will be quite exciting,” he continued. “We’re certainly keen to push it as hard as we can and see what we can do with it, but, so far, so good. And we are enjoying it very much.”

“The Serve is very much a workhorse scanner. It's used for a mixture of inpatients and outpatients and works through big numbers of patients every day. It's capable of doing that,” he said. “That’s what we're going to expect of it. And I’ve got every confidence that that is what it’s going to deliver.”