Xperience live 3D guidance. Philips Allura Xper FD20 functional description

Transcription

1 Xperience live 3D guidance Philips Allura Xper FD20 functional description

2 Opening up new fields of treatment The Allura Xper FD20 is perfectly suited to your changing needs. The evolution of interventional applications will open up new fi elds of treatment that will require new X-ray imaging technologies. Philips is committed to delivering those solutions to you today. Philips Allura Xper FD20 system is unique. It integrates the latest technologies in high resolution fl at detector imaging with advanced 3D applications. Its proven and stable C-arm geometry with the intelligent Xper table, plus its intuitive user interface with customizable settings make your Allura a true Xper system. It is designed to optimize your interventional workfl ow. In fact, it is everything your interventional department needs today and tomorrow. Xperience live 3D guidance with the Allura Xper FD20. 2 Allura Xper FD20 functional description

3 Contents 4 Your open door to advanced interventions 8 Xper Module 8 Xper in the examination room On-Screen Display Xper Geometry Module 9 Xper Imaging Module Xper Pedestal 9 Xper in the control room Xper Viewing Console Xper Review Module 9 Xper provides excellent customization to meet your needs 10 The image quality you want with low X-ray dose Dynamic Flat Detector Philips 2K Imaging Chain Xres MRC tube SpectraBeam fi ltration Monitors Fluoro storage Xper Beam shaping Rotational Angio SmartMask 11 Xper DICOM Image Interface Continuous autopush RIS/CIS DICOM Interface Xper Workspace 11 Integration features that enhance workflow 12 Technical information - Geometry C-arm Stand BodyGuard Patient Protection 14 Automatic Position Controller Xper table Patient mattress Xper table tilt 15 Xper table cradle Xper table pivot Xper table swivel 16 Monitor Ceiling Suspension Optional accessories 17 Ceiling Suspended Radiation Shield Table Mounted Radiation Shield Examination Light 17 Technical information - Geometry Options 18 Technical information - User Interface Xper User Interface in the Examination Room 19 Xper Module Xper Geometry 20 Xper User Interface in the control room Xper Review Module Xper Module 21 Xper data monitor 22 Xper review monitor 23 Second Xper Imaging Module Second Xper Geometry Module Second or third Xper Module Contrast Injectors 23 Technical information - User Interface Options 24 Technical information - Integration MultiSwitch Lab Reporting 25 Continuous autopush DICOM Print Intercom RIS/CIS DICOM Interface Standard Line Rate Video Output 25 Technical information - Additional Communication Options 26 Technical information - Image Detection Dynamic Flat Detector Fluoroscopy Grid-switched pulsed fl uoroscopy Double wedge fi lters Trace-subtract fl uoroscopy 27 SmartMask Dual Fluoroscopy Digital Acquisition Acquisition frame rates Storage capacity 27 Technical information - Viewing 28 Technical information - X-ray Generation X-ray generator: Xper Beam Shaping MRC-GS 0407 X-ray tube SpectraBeam 29 Anatomical fi lters X-ray On indicator light Real-time dose information at tableside X-ray dose information in the control room X-ray dose information in the examination report 30 Monochrome LCD monitor Color LCD monitor Second Reference Monitor 2k display 31 MultiVision Physio Viewing 32 Subtracted Bolus chase Rotational Angiography Allura 3D-RA 33 Dynamic 3D Roadmap XperCT 34 Xperguide StentBoost Allura 3D-CA 35 CT TrueView EP navigator Quantitative Analysis Packages 36 CO2 view trace Customer Services 37 Technical information - Dimensions 38 Technical information - Room Layout Allura Xper FD20 functional description 3

4 Your open door to advanced interventions Today, new interventional treatments and applications are constantly being pioneered. And although this expansion is exciting, it means that you must be more versatile than ever before. You must be equipped with an X-ray system that is capable of performing an increasingly wide variety of complex procedures. That is why Philips introduces the next generation Allura Xper FD20 system. It is optimized for all these new and future procedures, and it combines superb image quality with the most advanced diagnostic and interventional tools, seamlessly integrated in the clinical workfl ow. For example, the Allura Xper FD20 offers a broad range of unique Live 3D guidance tools for both vascular and non-vascular procedures, including XperGuide for needleguided interventions such as biopsies and drainages. This dramatically expands the range of interventional procedures that you can perform, helping you to grow your practice. Your Allura Xper FD20 can also come with XperCT to provide you with soft tissue imaging right in your own angio suite. It also offers advanced stent positioning and placement in cardiology procedures, and advanced navigation for electrophysiology procedures. These ground-breaking tools have all been developed in close cooperation with our worldwide clinical network. This has ensured superb imaging performance, instant availability of results, seamless integration, and full tableside control - all for better clinical insight and enhanced navigation. Moreover, you can deploy any of these tools quickly and effi ciently, since they are fully integrated into the Allura Xper FD20 workfl ow. The intuitive Xper user interface makes it even easier to operate the system where you need it. And, thanks to the innovative Xper settings, any of the different procedures you need to perform can be set-up according to your preferences. The system remembers your personal settings and implements them automatically. Also, because complex procedures and new devices are making image quality more important than ever, the Allura Xper FD20 incorporates the unique 2k x 2k imaging chain for accurate visualization of the small details. And importantly, the Philips DoseWise program ensures maximized image quality at a low X-ray dose, thanks mainly to the powerful MRC tube with spectrabeam fi ltration. 4 Allura Xper FD20 functional description

5 The increased complexity of procedures is also demanding faster and easier access to all relevant information and clinical data. That is why the Allura Xper FD20 provides Xper Workspace, an integrated environment bringing together all information at tableside or elsewhere, so you can manage your procedures and department better than ever. In total, the Allura Xper FD20 sets new standards in clinical performance, ease of use, tool integration, and extreme versatility. Quite simply, it is the next generation in interventional imaging. Allura Xper FD20 functional description 5

6 Ceiling suspended High output FD20 Flat Detector Xper table C-arm stand MRC X-ray tube with Xper Access 6 Allura Xper FD20 functional description

7 Optional examination light Flexible monitor ceiling suspension with height adjustment 18-inch LCD monitors (optional color LCD monitor) Xper Module with Xper Viewpad attached Xper Geometry and Imaging Module Xper data monitor (LCD) Xper review monitor (LCD) Xper Review Module Optional Xper Module Allura Xper FD20 functional description 7

8 Xper in the examination room On-Screen Display On the reference monitor, the On-Screen Display provides information including X-ray indicator, radiographic parameters, rotation and angulation stand positions, table position, Source Image Distance, Air Kerma (both rate and accumulated dose), frame speed and fl uoroscopy mode. On the examination monitor, the On-Screen Display contains the user interface of the Xper ViewPad, which is used to carry out functions like run and image selection, review speed, active fi le selection and digital zoom. The Allura Xper FD20 features Xper technology, which is designed to improve your personal and departmental effi ciency: Xper settings provide an advanced level of customization so users can create an interventional lab that directly meets individual needs and preferences The Xper User Interface provides intuitive system controls and all relevant functionality at the tableside to enhance ease of use Xper Integration provides bi-directional information exchange Xper Geometry Module To make operation as convenient as possible, the Xper Geometry Module can be positioned on all sides of the patient table. The Geometry Module can be adjust to the position to retain the intuitive button operation. It controls tabletop fl oat, table height, pivot lock, Source Image Distance, stand positioning and, optionally, isocentric tilt and cradle functionality Xper Module Available in both the examination and control room, the Xper module communicates user preferences for acquisition settings, automatic position control and processing. Optional tableside controls enable clinicians to control quantitative analysis, interventional tools, Xcelera Pacs, ViewForum and hemodynamics with Xper IM. The Xper Module can be operated via touch screen controls or an integrated joystick. 8 Allura Xper FD20 functional description

9 Xper provides excellent customization to meet your needs Xper Imaging Module Like the Xper Geometry Module, the Xper Imaging Module can be positioned on all sides of the patient table, while retaining intuitive button operation. The Xper Imaging Module allows the user to activate shutter and wedge positioning, fl uoroscopy mode as defi ned via Xper settings, roadmapping functionality, detector fi eld size and beam width. Shutters and wedges can be positioned on Last Image Hold for X-ray dose saving. Both Xper Modules have a removable protection bar that prevents unintended activation of system. Xper Pedestal The Xper pedestal creates an additional fl exible workspot for operating the system in the examination room. The pedestal is equipped with additional Xper Geometry and Imaging modules and can also hold the X-ray footswitch. Optionally, an additional Xper module can be mounted on the pedestal. The Xper pedestal can be positioned freely around the patient table and can be stowed away when not used. Xper in the control room Xper Viewing Console All parts of exam workfl ow have been greatly optimized with Xper technology, from scheduling to archiving. Just by selecting patient and clinical application, the system is completely set and ready for the procedure. When you close the examination, images are automatically archived and exam patient data is sent to the user s preferred destination, while the next procedure is being started. Examination management is task-oriented and includes exam Scheduling, Preparation, Acquisition, Reviewing, Reporting and Archiving. The various windows allow real multi-tasking for better lab effi ciency. The Xper Viewing Console comprises a color data monitor for patient data and system information management, including radiographic parameters. The review monitor and the Review Module enable effi cient exam viewing and post-processing. Optionally, an additional Xper Module can be installed in the control room for procedural support. Xper Review Module The Xper Review Module provides direct control of key viewing functions, like exam and run cycle, contrast, brightness, edge enhancement and viewing speed (tagarno wheel) to further enhance workfl ow effi ciency. Allura Xper FD20 functional description 9

10 The image quality you want with low X-ray dose The Allura Xper FD20 features advanced algorithms, a next generation fl at detector and Philips renowned imaging chain to ensure superb image quality at a low patient X-ray dose. Dynamic Flat Detector Philips 14-bit virtually distortion-free dynamic fl at detector offers 154 micron pixels for higher resolution and a DQE(0) of more than 73% for better image quality, especially for low X-ray dose fl uoroscopy. Its 8 fi elds of view offer the optimal size for vascular and cardiovascular imaging. It also offers a refresh light that provides temporal virtually artifact-free imaging by blanking the detector, eliminating image glow during dynamic studies. Philips 2K Imaging Chain The Allura Xper FD20 platform includes the ground breaking 2K digital imaging chain and is designed to process up to 2048 x 2048 pixels as acquired by the fl at detector to increase detail resolution. The 2k imaging chain can be completed with an additional 2k display for evaluating the small clinical details in native resolution. Xres Xres is a real-time image processing algorithm that is applied to each clinical image in real-time. Xres provides excellent image quality through improved contrast and sharpness. It exploits the benefi ts of the fully digital detector to reduce noise in clinical images and can be applied to cardiac fl uoroscopy and exposure runs, as well as vascular fl uoroscopy and trace subtract fl uoroscopy. MRC tube The Allura Xper FD20 is equipped with the legendary high power MRC-GS 0407 tube. The tube s exceptional design provides long life and allows it to withstand high continuous loads, while maximizing heat dissipation. This enables virtually unlimited X-ray sessions without forced cool down delays. SpectraBeam filtration The MRC tube works in tandem with SpectraBeam fi ltration to allow increased X-ray output with better fi ltration of soft radiation. SpectraBeam offers three levels of fi ltration - up to one mm Cu equivalent to reduce patient X-ray dose, while maintaining image quality. The fi ltration level can be programmed via Xper settings. The fl uoroscopy mode can be selected at tableside. Monitors Three 18-inch LCD monitors are standard with the Allura Xper FD20. The LCD monitors offer high contrast, high brightness, virtually fl icker and distortion free imaging. The control room monitors include a 19-inch LCD color monitor for patient data and a black and white LCD monitor for image viewing and processing. In the exam room, two height adjustable 18-inch LCD black and white monitors are available for live and reference imaging. Fluoro storage Xper fl uoro storage captures the last 20 seconds of fl uoroscopy (up to 600 images). Fluoroscopy runs can then be stored, processed and archived like regular run exposures. Xper Beam shaping Xper Beam shaping allows the wedges and shutters to be positioned without using X-ray radiation. Rotational Angio Rotational Angio saves time, contrast medium and X-ray dose by creating real-time 3D impressions of complex vasculature with multiple projections and just one contrast injection. A contrast run can be followed up with a mask run to allow image/run subtraction. The rotational scans can be reconstructed automatically for 3D visualization. SmartMask SmartMask simplifi es roadmapping procedures by overlaying live fl uoroscopy with a selected reference image. Using the previously acquired high quality images reduces the amount of contrast injections and X-ray dose for patients and staff. The reference image can be faded in/out for enhanced visualization and guidance. 10 Allura Xper FD20 functional description

11 Integration features that enhance workfl ow The combination of advanced integration features combined with Xper settings, which personalize image archiving and printing, make the Allura Xper FD20 an excellent workfl ow-friendly system. Now your department can run the way you want it to, with effi ciency enhancers that give you more time for patient care. Xper DICOM Image Interface The Xper DICOM Image Interface provides fast export of clinical images in DICOM XA Multi Frame or DICOM Secondary Capture. Images can be sent in background to any DICOM-compatible device, and can be sent to several destinations, as confi gured via Xper settings. In addition, with DICOM Query/Retrieve, older DICOM studies can be uploaded into the system. Continuous autopush With the continuous autopush option, cases can be archived while you proceed with procedures, so that you do not have to wait for the system after each case or delay archiving until the end of the day. RIS/CIS DICOM Interface This RIS/CIS DICOM interface option uses DICOM Worklist Management (DICOM WLM) and Modality Performed Procedure Step (DICOM MPPS) standards to enable two-way communication between the system and a local Information System. Xper Workspace The Allura Xper FD20 can be provided with a broad range of integrated solutions in the control and exam room, advancing information management in the intervention suite. ViewForum provides a multi modality work environment that enables you to review and control multi modality information (e.g. MR, US, CT). Furthermore it allows parallel viewing and processing of previously acquired X-ray images to increase patient throughput and procedural effi ciency. MultiVision allows images from different image sources to be viewed on the LCD color monitor in the exam room, eliminating the need for multiple monitors. With Xper MultiSwitch, the Xper Viewing Console can be shared with external IT systems to make workfl ow effi cient and save space. Access to any type of information system, like PACS, RIS, CIS, Allura 3D-RA and StentBoost can be provided. Allura Xper FD20 functional description 11

12 Technical information - Geometry C-arm Stand C-arm angulation speed: - Up to 25 /s Focal spot to iso-center: 81 cm Source Image Distance: cm C-arm depth: 90 cm Motorized fl at detector movement including SID and Xper Access Xper Access allows re-positioning of the fl at detector from portrait to landscape. Rotation of the fl at detector is performed in 3 seconds Ceiling mounted C-arm stand Floor mounted C-arm stand Specifi cations: Allura Xper FD20 Ceiling stand: Ceiling carriage with motorized L-arm and C-arm - Iso-center to fl oor: cm Manual and motorized longitudinal movement of 300 cm at 15 cm/sec. It includes auto stops at the park position, cardio position, neuro position and lower peripheral position Allura Xper FD20 Floor stand: Floor mounted C-arc with motorized L-arm and C-arm - Iso-center to fl oor: cm L-arm rotation, motorized and manual movement, over 180 with snap positions at 90, -0, -90 to allow patient access from three sides of the table C-arm rotation: - In head-end position: 120 LAO, 185 RAO - In side position: 90 LAO, 90 RAO C-arm rotation speed: - Up to 25 /s C-arm angulation: - In head-end position: 90 cranial, 90 caudal - In side position: 185 cranial, 120 caudal - Full angulation capability: only restriction is patient position BodyGuard Patient Protection The Philips; exclusive BodyGuard patient protection mechanism uses capacitive sensing to determine patient location and prevent collision, while allowing stand positioning at up to 25 /s. BodyGuard has an override function to allow full stand positioning control at all times. BodyGuard 12 Allura Xper FD20 functional description

13 The C-arm can be parked away easily and can be positioned freely over the table. The C-arm can be positioned at the head end an both sides of the table. Full angulation and rotation fl exibility in any stand postition. Allura Xper FD20 functional description 13

14 Automatic Position Controller Automatic Position Controller (APC) functionality for the stand is accessed through the Xper Module at the patient tableside. The APC provides two modes of operation: Preset Position Sequence: The projection sequence can be defi ned by Xper settings for every clinical procedure. Every procedure can contain up to 10 different stand positions. Positions can be recalled in sequence or selected individually. The projection sequence parameters include rotation, angulation, SID and orientation of the detector. Reference-driven positioning: Stand positions can be recalled by referring to the images at the reference monitors, which means that the rotation, angulation, SID, and detector orientation are restored to the original settings of the reference image. Xper table The Xper table is a dedicated cardiovascular table with a free-fl oating tabletop. This table has very high patient loadability and can make a large longitudinal fl oating movement. Cables are incorporated in the table to allow maximum operation fl exibility. Patient mattress The special design and composition of the patient mattress ensure high patient comfort. The mattress is made of slow recovery foam, with a density of 58 kg/ m3 and a thickness of 7 cm that adapts to the patient body shape. The mattress foam divides the pressure of the body equally, which helps patients feel at ease and lie still. This is especially useful for long interventional procedures. The especially designed cover is easy to clean. Xper table tilt The tilt option enhances the effi ciency of gravity-oriented procedures. The tilt option is ideal for interventional and head-down procedures because it provides more precise imaging of contrast medium, blood or objects in the body. As the table tilts, the X-ray beam automatically coordinates to the movement to keep the region of interest in the iso-center. The table fl oats even when tilted, and the region of interest can be followed by panning the tabletop in a motorized movement. Specifi cations: Radio translucent carbon fi ber tabletop Tabletop length: 319 cm Tabletop width: 50 cm Motorized tabletop height adjustment: 79 to 107 cm Tabletop metal free overhang: 125 cm Longitudinal fl oat: 120 cm Transversal fl oat: 36 cm Maximum allowable patient weight: 250 kg with additional force of 500 N, allowed in case of CPR. CPR can be performed while the tabletop is set in any longitudinal position The Xper Module, Xper Imaging, and Xper Geometry Modules can be positioned on three sides of the patient support Max. 17º head-up Max. 17º head-down 14 Allura Xper FD20 functional description

15 Specifi cations: Maximum tilt range: -17 head-down to 17 head-up Automatic safeguarding system with manual override Iso-centric tilt movement synchronized with the stand Xper table swivel The swivel option allows total body coverage for the Allura Xper FD20 Floor without the need to change the patient s position on the table. Xper table cradle In addition to the tilt functionality, this option lets you move the tabletop around the point of interest in a side-to-side cradle movement. This enables optimal positioning of the patient, for instance, for more invasive or guided puncture procedures. Specifi cations: 76 cm translocation of the whole patient support assembly in the direction of the fl oor-mounted C-arm Pivot of table base allows rotation of the table base over a range of 90 to the right side and 90 to the left side of the patient Specifi cations: Iso-centric cradle Maximum cradle range: -15 to +15 Cradle speed: 3 /s Xper table swivel Xper table - cradle Xper table pivot The pivot option provides improved table access for patient transfer and is designed for use during angiographic and interventional procedures of the upper peripherals. It allows pivoting of the table base around its vertical axes. Pivot range: -90 to +180 (or -180 to +90 degrees). Table can be locked at any position and indents at 0, -13 and +13.(to support arm angiography) Xper table automatic position control The table automatic position control provides auto iso-center positioning. The tabletop position will be adjusted automatically to the pre-defi ned default point of interest. This saves time and X-ray dose at the start of an exam or when setting up the system for rotational scans. In addition it contains store and recall functionality of the height, longitudinal and lateral position of the tabletop. This allows you to return to a previous position without using X-ray dose. Allura Xper FD20 functional description 15

16 Pan handle The Pan handle is an additional tabletop fl oat control extension, which can be attached to any side of the table. This additional PAN handle is a master/slave confi guration with the standard Xper Geometry Module. Ergonomic Pan handle Monitor Ceiling Suspension The Monitor Ceiling Suspension allows fl exible, freely rotating positioning of two, three, four or six monitors. Monitors rotate freely on the ceiling suspension over a range of 350º Move transversally over a distance of 300 cm (118.1 in.) and longitudinally over a distance of 330 cm (129.9 in.) Motorized height adjustment and concave set-up of the monitors for optimal viewing angle. Optional accessories Peripheral X-ray fi lter Cath arm support (adjustable) Ratchet compressor Pulse cath arm support Table mounted radiation shield MCS bracket ceiling radiation shield Ceiling mounted radiation shield Dripstand Arm support Mattress Neuro Mattress Set of arm supports Table clamp Patient straps Head support Set handgrips & clamps Cerebral fi lter Neuro wedge Cable holders (15 pieces) Add-on OP-rail Monitor Ceiling Suspension 16 Allura Xper FD20 functional description

17 Technical information - Geometry Options Ceiling Suspended Radiation Shield The ceiling suspended radiation shield protects against scatter radiation to the eyes and the upper body of the physician and staff. The shield is mounted on the ceiling monitor carriage with a two section suspension arm to allow free positioning of the shield. It can be used in combination with the table mounted lower body radiation shield. Examination Light An examination light enables the optimal visualization of the examination region under daylight conditions. This light intensity is 30,000 Lux. The handgrip is removable and can be sterilized for use with a disposable cover. Ceiling Suspended Radiation Shield Examination light Table Mounted Radiation Shield The table mounted radiation shield provides additional protection for physician and staff against scatter radiation. The shield consists of two protective parts: a lower shield and an upper shield. The shield is specially designed for use with the Xper table. Specifi cations: Can be mounted on either the right or left table accessory rails Can be pulled into the required working position and parked underneath the tabletop to facilitate patient preparation The upper shield can be positioned upright for optimal protection or can be folded down to allow free access to the patient Table Mounted Radiation Shield Allura Xper FD20 functional description 17

18 Technical information - User Interface Xper User Interface in the Examination Room Xper stands for X-ray Personalized, and refl ects the expert nature of the Allura Xper FD20 system. The three components of Xper are: Xper settings, which customize the system to each physician s preferred settings Xper User Interface, which provides intuitive system controls in both the examination and control room Xper Workspace, which includes highly advanced integration functionality, such as DICOM Query/ Retrieve and Multi Switch functionality In the examination room, the Xper User Interface comprises the On-Screen Display, the Xper Module, and the Xper Imaging and Geometry Modules. The On-Screen Display is on the left side of the reference monitor. The following system information is displayed: X-ray indicator X-ray tube temperature condition Radiographic parameters: kv, ma, ms Rotation and angulation of the stand positions Source Image Distance (SID) Table height Detector fi eld size display General system messages Selected frame speed Fluoroscopy mode Integrated fl uoroscopy time Air Kerma dose (both rate and accumulated dose) Dose Area Product (both rate and accumulated X-ray dose) - Graphical bars for body zone specifi c dose rate and accumulated Air Kerma levels related to the 2Gy level for cardiac procedures Stopwatch The On-Screen Display on the exam monitor in the examination room contains the Xper Viewpad, which stores the pre-programmed function settings. The Xper Viewpad controls the following: Run and image selection Exam and run cycle Review speed Run and exam overview Active exam sub fi les (exposure image/runs, reference images, print fi le) Flagging exam and run for storage Subtraction and image mask selection Digital zoom Storing reference run or image to reference monitors Select reference monitors for review and/or processing of previous run exposures 18 Allura Xper FD20 functional description

19 Xper Module cursor control Xper Module The Xper Module can be positioned both at the tableside and in the control room. Up to three Xper Modules can be connected to the system. The Xper Module contains the following functionality: Acquisition setting Selection of preprogrammed procedures and acquisition parameters. Procedures are programmed in the Xper settings. This is also where the specifi c Xper procedure for the Allura 3D-RA / Allura 3D-CA / Stentboost and XperCT option(s) can be selected. Automatic Position Control (APC), optional Selection of the sequence of preprogrammed positions. Up to 10 single plane or biplane projections can be preprogrammed via Xper settings per clinical procedure. Via APC, the geometry can also be steered to the projection as displayed on the reference monitors or the optional 3D-RA color monitor. Image Processing To adjust image processing parameters, like contrast, brightness, edge enhancement, subtraction, zoom, pixel shift, landmarking and image invert. Quantitative Analysis (QA), optional If QA packages are available on the system, the analysis can be performed on the Xper Module. Interventional tools, optional. Allows control of interventional tools like Allura 3D-RA, Allura 3D-CA, CT TrueView, 3D Roadmapping, StentBoost, XperCT and XperGuide ViewForum and Xcelera (optional). Integrates the ViewForum multi modality review application and/or the Xcelera network application in the Allura Xper system. It allows these viewers to be used via the Xper Module in the examination room during the examination. Hemo on Xper Module (optional) Integrates Xper IM Physiomonitoring 5 system in the Allura Xper system It allows the physician and procedure staff to perform a complete hemodynamic study from tableside Xper Geometry The Xper Geometry Module can be positioned on all sides of the patient table. The Module adjusts to the position to retain the intuitive button operation. The Xper Geometry Module provides the following functionality: Tabletop fl oat Table height position Table tilt angle (if the tilt option is selected) Table cradle angle (if the cradle option is selected) Source Image Distance (SID) selection Flat detector portrait/landscape position Stand positioning Longitudinal movement of the stand along the ceiling Stand rotation in an axis perpendicular to the ceiling Store and recall of two scratch stand positions including SID and detector orientation Emergency stop button Accept button of the Automatic Positioning Control Geometry reset button, which resets stand and table to a default starting position Xper Geometry Module Allura Xper FD20 functional description 19

20 Xper Imaging Module Xper imaging Module The Xper Imaging Module can also be positioned on all sides of the patient table, while retaining intuitive button operation. The Xper Imaging Module provides the following functionality: Fluoroscopy mode selection as defi ned via Xper settings Positioning of shutters and wedges without radiation Manual or automatic wedge including position on the last image without radiation Xper fl uoro storage to record up to the last 20 seconds of fl uoroscopy Selection of the detector fi eld size Preferred beam width Reset of the fl uoroscopy buzzer Selection of trace subtract fl uoro function Selection of SmartMask function Xper Review Module The Xper Review Module is a review station for basic cardiovascular viewing needs. The most often used functions can be controlled by the touch of a button. The Xper Review Module comprises the following functionality: Power on/off of the system Tagarno wheel to control the review of a patient exam File and run cycle Adjustment of contrast, brightness, and edge enhancement File, run and image stepping Run and fi le overview Basic review functionality, such as image invert and digital zoom Go to default settings Reset fl uoroscopy timer and switch X-ray on/off Xper Review Module Both the Xper geometry and imaging Modules have a removable protection bar that prevents unintended activation of system. Xper User Interface in the control room In the control room, the Xper User Interface comprises an Xper Review Module, two monitors, a keyboard and a mouse. The monitors have shared screens: the color screen is the data monitor; the black and white screen is the review monitor. Xper Module The optional Xper Module can be connected in the control room. The functionality of this Xper Modules is equivalent to the functionality on the Xper Modules connected in the examination room. When multiple Xper Modules are connected to the system, this Xper Modules operate independently. Images and movies can be exported in a PC-compatible format via the USB interface. 20 Allura Xper FD20 functional description

21 Xper data monitor The data monitor is a 19-inch LCD color monitor. It shares a screen with the review monitor. A standard keyboard and mouse control the user interface. The data monitor is intended as the patient data interface. Workfl ow is divided into Scheduling, Preparation, Acquisition, Review, Reporting and Archiving. System information is displayed on the bottom of the data monitor: Stopwatch and Time System guidance information Dose Area Product (DAP) and Air Kerma Dose (both rate and accumulated dose) Frame speed settings, fl uoroscopy mode and accumulated fl uoroscopy time Exposure and fl uoroscopy settings, such as Voltage (kv), Current (ma) and pulse time (ms) Stand position information, such as rotation, angulation and SID number, so that new exams can be appended to an earlier patient fi le. Furthermore, each patient folder can contain multiple examinations to allow for split billing and split administrative purposes. Each examination contains multiple fi les, such as acquisition, reference and print fi les. Patient information can also be sent from the modality to the information systems using DICOM Modality Performance Procedure Step (DICOM MPPS). Preparation The preparation page provides the room and patient preparation preferences of each individual physician, eliminating the need for hard copy protocols. Physicians preferences are Xper settings programmed, and the information resides permanently in the system, unless a change is made. Acquisition The acquisition page contains information on the currently selected patient. The page shows a full overview of all acquired runs. The history fi le of the patient can be reviewed at the touch of a button. Review The review page lets you review: Previous exams Exams from other modalities Xper data monitor Scheduling On the scheduling page, new patient data can be added manually or loaded from the RIS, CIS or HIS via DICOM Work List Management (DICOM WLM). Patients can be listed and selected by date, physician or intervention type. Older DICOM patient studies can be uploaded using the DICOM Query/Retrieve function. Patient management protocols are exceptionally fl exible and allow for multiple exams to be selected under one patient identifi cation Report For systems with the Lab Reporting option, the report page lets you create a patient report. The report contains information on patient X-ray dose, written text from the intervention and appended clinical images. It can be printed or sent by electronic mail. Archive Clinical studies can be archived to a CD with the optional Xcelera DICOM Recorder (IDR) or to a PACS, like the Xcelera PACS, or the ViewForum workstation. The archive process - including multiple destinations, archive formats, and background transfer - can be completely automated and customized with Xper settings. Allura Xper FD20 functional description 21

22 Xper review monitor The review monitor is an 18-inch black and white LCD monitor that shares a screen with the color data monitor. The graphical user interface on the black and white monitor has the following features: Step through file, run or images File and run overview Image processing features such as contrast, brightness and edge enhancement Flagging of runs or images for transfer Image annotation Automatic printing Quantitative Analysis Packages if available Subtraction Move or renew mask Landmarking (increase/decrease of degree of subtraction) Video invert Zoom and pan image View trace Pixel shift Electronic shutters Toggle switch physio Store/delete images/runs Store fluoro Xper review monitor 22 Allura Xper FD20 functional description

23 Technical information - User Interface Options Second Xper Imaging Module Extension of the imaging controls with a second module in the control room in a master-slave confi guration. Second Xper Geometry Module Extension of the geometry controls with a second module in the control room in a master-slave confi guration. Second or third Xper Module The Allura Xper FD20 can be extended with additional Xper Modules. One Xper Module can be connected in the control room. In the examination room one Xper Module can be connected at the table and a second one at the Xper Pedestal. The specifi cations and information on the Xper Module are similar for all Xper Modules connected to the system. If more than one Xper Module is connected to the system, each Xper Module can be operated independently. Contrast Injectors The following contrast injectors are optimized for use with the Allura Xper FD20 system: Liebel- Flarsheim - Angiomat Illumena Medrad - Mark V ProVis - Avanta Acist - Voyager Allura Xper FD20 functional description 23

24 Technical information - Integration The Xper DICOM Image Interface enables clinical images to be exported to a destination, such as ViewForum, Xcelera PACS, Xcelera DICOM Recorder or any third party PACS. The system exports clinical studies in DICOM XA Multi Frame or DICOM Secondary Capture formats. The Xper DICOM Image Interface speeds up image transfer through its fast Ethernet link, making images available on-line within seconds. The archiving process can be confi gured via Xper settings: Image archiving is done in the background during or after the procedure The images can be archived automatically in the background with the continuous autopush option The export format is confi gurable in 512 2, , or 2k 2 (unprocessed) matrix The Xper DICOM Image Interface can distribute the examination images to multiple destinations for archiving and reviewing purposes The Xper DICOM Image Interface provides DICOM Store and DICOM Store Commitment Services The Query/Retrieve function allows older DICOM studies to be uploaded in the system The Xper data monitor can be switched to Radiology Information Systems via the web-based browser (HTML) or X-window (Exceed). It makes full use of the RIS facilities and existing support for automatic handling of logistic tasks (e.g. automatic tracking, purchasing of supplies and billing) that are available. Lab Reporting This option allows the clinical user to generate and print a report in modality stand-alone situations. The user can incorporate free text, clinical images and X-ray dose information. The report is printed or sent by . Part of the report is generated automatically from administrative data (e.g. patient/exam data, hospital name) and acquired data (e.g. run log, X-ray dose information and event log). MultiSwitch Xper MultiSwitch enables the Xper workspot in the control room to be shared with other applications that are loaded on separate PC modalities. The MultiSwitch option lets you switch the color LCD data monitor, keyboard and mouse that are normally connected to the Allura Xper system. This saves signifi cant space in the control room by enabling only one monitor and keyboard to be used for multiple applications, like Allura 3D-RA, Stentboost, Allura 3D-CA, XperCT, ViewForum and Xcelera Dicom Recorder. 24 Allura Xper FD20 functional description

25 Technical information - Additional Communication Options Continuous autopush This option provides an additional processor board that is dedicated to archiving. This minimizes interruptions that are caused by other functions that require the image processor, such as patient review. Using the continuous autopush option speeds up archiving and availability of clinical images for review at other PACS destinations. Standard Line Rate Video Output The standard line rate video output option is 625 (525) lines for a 50 (60) Hz video output unit. This option is required to connect a medical DVD/VCR or an additional TV monitor. This option lets you automatically start/stop a medical DVD/VCR, while X-ray is being generated during fl uoroscopy and exposure. DICOM Print DICOM Print provides an interface to any DICOM Printer. It provides Print Preview, Print Compose, Print Manual Overrides, Print Job submission, and Print Job management via automated printing protocols. Intercom The remote Intercom is used for communication between the examination and control room. RIS/CIS DICOM Interface This interface option enables two-way communication between the system, a local Information System (CIS or RIS) or hemodynamic system. The interface uses the DICOM Worklist Management (DICOM WLM) and Modality Performed Procedure Step (DICOM MPPS) standards. If an information system is present, it is possible to receive patient and examination (request) information and to report examination results. This option provides the following benefi ts: Eliminates the need to retype patient information on the system Prevents errors in typing patient name or registration number, which ensures consistency of information throughout the department to prevent problems in archive clusters Provides information to and from the information system about the acquired images and radiation dose. Upon request from the system, the complete worklist with all relevant patient and examination data is returned to the system. Allura Xper FD20 functional description 25

26 Technical information - Image Detection The Allura Xper FD20 is equipped with a next generation dynamic fl at detector, whose compact size can easily handle complex projections. Image quality and X-ray dose reduction are further enhanced by SPIRIT image processing. Pulse rates: system-customized at 3.75, 7.5, 15 and 30 pulses per second Frame grabbing of static fl uoroscopy images or Xper Fluoro Store to store the last 20 seconds of fl uoroscopy for reference or archiving Dynamic Flat Detector Philips next generation dynamic fl at detector provides excellent image quality at a low patient X-ray dose. Specifi cations: Size of detector housing, including BodyGuard: 42 x 52 cm Maximum fi eld of view: 30 x 38 cm Image matrix: 2480 x 1920 pixels at 14 bits depth Detector zoom fi elds: 30 x 30 cm, 26 x 26 cm, 22 x 22 cm, 19 x 19 cm, 16 x 16 cm, 13.5 x 13.5 cm, 11 x 11 cm square formats Pixel size: 154 μm Detector bit depth: 14 bits Nyquist frequency: 3.25 lp/mm Detector quantum effi ciency: more than 73% at 0 lp/mm Digital output: 2k 2 and 1k 2 and at 14 bit depth resolution Modulation at 1 lp/mm > 60% Modulation at Nyquist frequency: 10% Fluoroscopy Three fl uoro modes are available at tableside and these can be programmed via Xper settings. Each mode can be programmed with a different composition of X-ray dose rate, digital processing and fi lter settings. Specifi cations: SpectraBeam fi lters for MRC-GS 0407 tube: 0.2, 0.5 and 1.0 mm Copper equivalent pediatric fi lter Fluoroscopy image processing: recursive fi ltering, localized contrast-adaptive contour enhancement, SPIRIT fi lters and Xres algorithm Pulsed X-ray modes with a Fast Fluoro Reset function, which quickly returns the system to fl uoroscopy if there is an unexpected system reset Grid-switched pulsed fluoroscopy Pulsed fl uoroscopy can reduce X-ray dose and improve image quality. Conventional pulsed fl uoroscopy, however, has a ramp-up and trail effect of soft radiation that does not contribute to image quality, leading to unnecessary X-ray dose exposure for patients and staff. With Philips unique grid-switched pulsed fl uoroscopy, this effect is eliminated. This signifi cantly reduces X-ray dose compared to conventional pulsed fl uoroscopy. The MRC-GS 0407 X-ray tube of the Allura Xper FD20 has grid switching capabilities, allowing you to take full advantage of the X-ray dose reduction capabilities of the system. Double wedge filters Double wedge fi lters provide optimum image quality in all projections. The wedge fi lters ensure that optimal exposure and hence optimal image quality is maintained (with minimal patient entrance X-ray dose). Trace-subtract fluoroscopy Trace-subtract fl uoroscopy provides top quality reference images for accurate positioning of a catheter, guidewire or other interventional devices. The peak bolus is automatically traced over the area in view when contrast is administered under fl uoroscopy. The resulting image shows a vascular structure as if it were completely fi lled: the reference image or roadmap. Subsequent fl uoroscopy shows the progress of the intervention over this reference image. The roadmap image can be faded in/out for optimal visualization. Run exposure can be performed without losing the roadmap image, saving contrast and X-ray dose. In addition, the subtracted fl uoroscopy can be re-masked to compensate for movement. 26 Allura Xper FD20 functional description

27 Technical information - Viewing SmartMask SmartMask simplifi es Roadmapping procedures by overlaying fl uoroscopy with a selected reference image on the live monitor. The reference monitor can be faded in/out for optimal viewing. Dual Fluoroscopy The dual fl uoroscopy mode allows side-by-side display of digitally processed non-subtracted fl uoroscopy and trace-subtract fl uoroscopy for improved visualization and catheter guidance during complex procedures. The dual fl uoro option offers live digital zoom capabilities. Images can be zoomed by a factor of two to en large the display of the region of interest. With the second reference monitor option, an additional reference image can be displayed next to the two live monitors. Storage capacity The table below lists the maximum number of images that can be stored in the standard or extended confi guration. Standard confi guration 50,000 12,500 Storage extension 100,000 25,000 Digital Acquisition The Allura Xper FD20 can be customized with a virtually unlimited number of acquisition programs for digital angiography and digital subtraction angiography. Image resolution is up to 2048 x 2048 pixels for vascular imaging and 1024 x 1024 pixels for cardiovascular imaging. Acquisition frame rates For maximum frame rates (images/second) in standard or optional confi guration(s), see table below. Standard confi guration 0,5 to 6 fps 0,5 to 6 fps Frame rate extension 15 and 30 fps 0,5 to 6 fps 60 fps acquisition at a 512 x 512 matrix is optionally available Allura Xper FD20 functional description 27

28 Technical information - X-ray Generation X-ray generator: The Velara generator is optimized for the latest cardiovascular needs. Specifi cations: Microprocessor-controlled, 100 kw high frequency converter generator Quartz-controlled power-switch, with a minimum switching time of 1 ms Voltage range: 40 to 125 kv Maximum current: 1250 ma at 80 kv Maximum continuous power: 2.5 kw for 0.5h, 2 kw for 0.8h Nominal power (highest electrical power): 100 kw (1000 ma at 100 kv) With Xper settings, different exposure protocols can be customized for every clinical application. They can be selected on the Xper Module during procedures. Xper Beam Shaping Xper Beam Shaping allows for virtual collimation of the shutters and wedges on the last X-ray image, eliminating additional X-ray dose during collimation changes. MRC-GS 0407 X-ray tube The Allura Xper FD20 is provided with the legendary high power MRC-GS 0407 X-ray tube. In the last seven years, Philips has installed more than 5000 MRC X-ray tubes with customers around the world. Data shows that on average, the MRC X-ray tube lasts signifi cantly longer than conventional tubes. The powerful MRC- GS 0407 X-ray tube allows very high heat dissipation, enabling SpectraBeam fi ltration to reduce the patient X-ray dose signifi cantly. Specifi cations: 0.4/0.7 mm nominal focal spot values with maximal 30 and 65 kw loadability Grid-switched pulsed fl uoroscopy Fluoro power for 10 minutes: 4500 W Max. fl uoro power for 20 minutes: 3500 W Max. anode heat dissipation: 11,000 W Max. heat dissipation of assembly heat: 3500 W SpectraBeam dose management with 0.2, 0.5, and 1.0 mm Copper equivalent SpectraBeam Filters: Oil cooled X-ray tube with thermal safely switch Direct anode oil cooling system with 200 mm anode diameter SpectraBeam The combination of SpectraBeam with the MRC-GS 0407 tube allows increased X-ray output with better fi ltration of soft radiation. This reduces patient X-ray dose for cardio and vascular applications, while maintaining the same excellent image quality. Specifi cations: Copper fi lters: 0.2, 0.5, and 1.0 mm copper equivalent The fi lters can be programmed via Xper settings The fl uoroscopy mode can be selected at tableside SpectraBeam minimizes soft radiation with unique beam fi ltration 28 Allura Xper FD20 functional description

29 Anatomical filters Filters designed to compensate for large absorption differences in the object. There are special fi lters for cerebral angiography and lower peripheral angiography. X-ray On indicator light It is important that everyone entering or already inside the examination room knows when X-ray is being applied so that they can take the necessary precautions. The Allura Xper FD20 has an integrated X-ray On indicator light located above the LCD monitors that is clearly visible from virtually anywhere in the room. Real-time dose information at tableside Relevant dose information is integrated in the on-screen user interface of the LCD exam room monitors of the Allura Xper FD20 system. It provides the user with all relevant dose information, including accumulated and rate values of patient Air Kerma and X-ray dose area product. In addition, body zone specifi c dose rates are displayed for cardiac procedures. Dose rates can be controlled by the user at tableside, by choosing a different fl uoro mode. X-ray dose information in the control room Dose information is also available in the control room. Cumulative dose is displayed on the Xper data monitor. The displayed dose information is based on actual generator and geometry parameters. X-ray dose information in the examination report A dose report can be printed (in background) at the end of each examination at the touch of a button. This includes data, such as patient demographics, cumulative fl uoroscopy time, cumulative fl uoroscopy, acquisition and total examination dose, the amount of runs and X-ray parameters. Examination report data can be provided via the RIS/CIS DICOM two-way interface to the RIS/CIS (MPPS protocol). Allura Xper FD20 functional description 29

30 Technical information - Viewing Color LCD monitor Ceiling suspended LCD monitors in the exam room The system is delivered standard with two black and white 18-inch LCD monitors in the examination room. A 19-inch LCD color monitor and an 18- inch black and white LCD monitor are standard in the control room. Monochrome LCD monitor Specifi cations: 19-inch Color TFT-LCD display Native format 1280 x 1024 SXGA Wide viewing angle (approximately 160º) Controlled brightness (200 Cd/m2) with ambient light dependent brightness control On screen display of control functions operated via push buttons. Second Reference Monitor A second reference monitor in the examination room can display both reference images and reference runs. The User Interface on the second reference monitor is accessed via the remote control on the Xper ViewPad. LCD monitors in the control room Specifi cations: 18-inch monochrome TFT-LCD display with a native format of 1280 x 1024 SXGA 10 bit grey-scale resolution with grey-scale correction Wide viewing angle (approximately 160º) High brightness (max 600 Cd/m2, default 500 Cd/m2) with ambient light dependent brightness control On-screen display of control functions operated via push buttons Examination room LCDs include protection screen and motorized height adjustment 2k display The 2k display is an additional high quality display for viewing clinical images in full resolution as acquired. The 2k display can be confi gured in the control or exam room. It displays high resolution clinical information for both acquisition and fl uoroscopy images. In the control room the 2k display is confi gured as a slave of the review monitor. In the exam room the display is confi gured as a slave of the exam monitor. The main characteristics of the monitor are: 21 inch monochrome TFT-LCD display Native format 2560 x 2048 matrix Wide viewing angle Brightness: max. 700 cd/m2 Contrast ratio 600:1 On-screen display Weight: 8.6 kg Dimensions: 495(W)x425(H)x108(D)mm 30 Allura Xper FD20 functional description

31 MultiVision The MultiVision video switch is the integrated video switch for high quality, progressive display video sources on the color LCD monitor. It can switch either black and white or color signals, and supports up to four inputs to one output. MultiVision enables an extra color monitor in the ceiling suspension in the examination room to be shared between the system and other sources, such as a DICOM viewer, StentBoost, Allura 3D-RA interventional tool, etc. The switch is controlled via the acquisition menu on the Xper Module. Physio Viewing PhysioViewing provides acquisition, storage and display of physiological signals on the Allura Xper FD20 system. Four physiological data signals can be acquired and stored. One signal can be displayed when reviewing images. Allura Xper FD20 functional description 31

32 Technical information - Additional Options Subtracted Bolus chase Bolus Chase provides more fl exibility for lower peripheral vasculature imaging with Xper Access. Xper Access lets you change the detector position from portrait to landscape for ideal image coverage. Routine examinations can be performed quickly and confi dently with Bolus Chase. A hand-held speed controller is used to constantly match table speed to the speed of the contrast run-off, which is displayed in real-time on the monitor screen. After the contrast run, the recorded speed profi le can be used to acquire mask images with the most accurate subtraction results. The result is effi cient, accurate run-off studies that eliminate the need for repeat exposures. Bolus Chase gives fast, accurate results for increased patient throughput and improved patient management. Automated exposure control and precise speed control assure high quality images and excellent subtracted studies. Rotational Angiography Rotational Angiography acquires a range of projections to create real-time, 3D impressions of complex vasculature and coronary arteries. A contrast run can be followed up with a mask run to allow image/ run subtraction. Rotational Angiography can save considerable time and contrast, while providing the image detail required for diagnostic and therapeutic decisions. A rotational scan can be done in both the head and side positions. The high speed acquisition decreases the amount of contrast medium, while the wide rotation range provides a complete evaluation of anatomy. The stand s excellent stability enables precise positioning and high reproducibility, resulting in the high quality images that are required for 3D-RA. Specifi cations: C-arm in head position - Maximum rotation speed: 55 /s - Maximum rotation angle: 240 C-arm in side position - Maximum rotation speed: 30 /s - Maximum rotation angle: 180 Frame speeds: 15, 30 and 60 fps. Users can designate speed, as well as a start and end position, through Xper settings The clinical images from the rotational scan can be sent automatically to a 3D-RA interventional tool for a reconstruction of static vasculature Allura 3D-RA Allura 3D-RA is designed to provide three dimensional (3D) images of brain and peripheral vessels to facilitate endovascular interventions in neuro and vascular radiology. Allura 3D-RA assists physicians in decision making for treatment strategy in endovascular procedures, neuro or vascular surgery or even radiotherapy. Allura 3D-RA reduces the number of DSA acquisitions and fl uoroscopy time needed to perform an examination. This means less X-ray dose for both patient and medical staff and a reduced quantity of contrast medium, leading to reduced procedure costs. Image acquisition is performed with the Rotational Angiography feature of the Allura Xper FD20 system with the fl exibility to position the C-arm in either head or side position. The Allura Xper FD20, in combination with Allura 3D-RA, provides optimal workfl ow via the following workfl ow enhancers: Complete automated 3D-RA process from 2D acquisition to 3D viewing When the acquisition of the rotational run is performed the images are sent automatically to the Allura 3D-RA interventional tool, where the reconstruction is started automatically and the reconstructed volume is shown automatically on the display. This means no user interaction is needed during the complete 3D process. 3D reconstructions can be made available real-time with the optional real-time digital link. 3D at Xper Module, optional With the Xper Module the physician has all 3D functionality available at tableside. Features like rotating, panning, zooming, AVA, Virtual Stenting, 3D-APC and 3D Follow C-arc can all be performed 32 Allura Xper FD20 functional description

33 with the touch screen module. There is no need for the physician to leave the examination room. Via the Xper Module the physician also has access to the following innovative functionality: - 3D Automatic Position Control (3D-APC) When the optimal working position has been chosen via the Allura 3D-RA interventional tool, the C-arc will automatically steer to this position. - 3D Follow C-arc When the position of the C-arc (not using X-ray) is changed, the 3D volume will automatically follow the position of the C-arc. This means the position of the C-arc (and therefore the 2D projection) and the 3D volume are always aligned. The Allura 3D-RA interventional tool itself gives you access to a wide range of innovative functions including: Reconstructive Zooming Technique, SpineView, CalciView, a complete measuring package including Automated Vessel Analysis (AVA), the unique Computer Assisted Aneurysm Analysis (CAAA), Virtual Stenting, Catheter tip shape simulation and Automatic Voxelshift. 3D multimodality matching is designed to integrate 2D and 3D morphological or physiological MR or CT datasets with 3D angiographic information; providing an integrated view of patient data. Dynamic 3D Roadmap Dynamic 3D Roadmap adds unique functionality to the integrated 3D product by providing a dynamic 3D roadmap to support interventional procedures. The 3D Roadmap option matches the real-time 2D fl uoro images with the 3D reconstruction of the vessel tree, so that the physician can see the advancement of the guide wire, catheter and coils on the 3D volume in real-time, on one monitor. The dynamic 3D roadmap remains displayed if the user changes the C-arm position, the SID and/or the Field of View of the fl at detector. The 3D volume will also automatically follow the orientation of the C-arc in real-time, so that users can choose the optimal position of the C-arc. The clinical advantages for this technology can be signifi cant for applications, such as real-time catheter navigation and monitoring coil delivery. XperCT XperCT provides CT-like imaging capabilities in the interventional suite - without transporting the patient. This opens up a new area of clinical applications that aid interventions. Applications include the evaluation of soft tissue information before and immediately after the intervention, as well as the detection of bleeding areas and calcifi cations. In addition, XperCT provides high quality bone images that are useful for spinal procedures. The imaging process is fully automated in the Xper system. The 3D XperCT volume is displayed automatically. No user interaction required. The 3D volume can be viewed in the control room and in the Allura 3D-RA examination room. Slice view is performed to visualize the soft tissue and to scroll through the volume. Slice thickness and ww/wl can be varied. In addition the XperCT volume can be matched with Allura 3D-RA. This view combines soft tissue information with high-resolution vessel information. The optimal view can be chosen with the orientation of the 3D volume: the C-arc follows automatically. Dynamic 3D Roadmap XperCT Allura Xper FD20 functional description 33

34 Live 3D Guidance of needle placement through fl uoro overlay on XperCT Xperguide XperGuide supports percutaneous needle interventions with live 3D guidance. It brings percutaneous needle interventions back to the interventional suite. XperGuide is a navigational tool that supports the physician during these interventions. The physician can use XperGuide in a wide range of clinical procedures, ranging from biopsies and drainages to RF ablations. StentBoost StentBoost is a simple, quick, and cost-effective tool to enhance visualization of stents in the coronary arteries. It shows the stent in relation to the vessel wall. StentBoost uses markers on the balloon or stent delivery catheter to better visualize objects in the direct environment of the markers. It improves: Stent positioning in lesions and bifurcations Stent deployment Stent-in-stent placement Assessment of stent artifacts (like fractures) XperGuide is based on an XperCT dataset. With XperGuide, virtual needle paths are created on an XperCT dataset. This volumetric dataset can be viewed in any slice direction. You can use a wide range of gantry projections to defi ne the needle path. XperGuide automatically calculates the optimal gantry projections for viewing needle insertion and monitoring progress. The virtual needle paths can be viewed on the XperCT slices, to verify if the path is feasible. XperGuide is fully controlled from tableside. Pressing the foot peddle to acquire fl uoro images, will automatically match the Live 2D image with the XperCT volume and it is automatically displayed on the Monitor Ceiling Suspension. The gantry can be positioned in the predefi ned gantry positions or controlled manually. The XperCT or XperGuide images will follow the gantry projections After StentBoost Before StentBoost Allura 3D-CA Allura 3D-CA creates a 3D model of 2D coronary artery images. It can help improve diagnosis by providing: Optimal insight into the structure of the coronary tree Improved assessment of lesions and bifurcations Insight into the optimal working angles Allura 3D-CA 34 Allura Xper FD20 functional description

35 Enhance interventional preparation: Select the right stent length Select optimal view of lesion or bifurcation with TrueView map Enhance interventional execution: Work with optimal viewing angles of lesions and/or bifurcations Place the right stent with the right length in the right place Via the real-time link and seamless integration with the Allura Xper system. Quantitative Analysis Packages Vascular Quantifi cation software package This is a clinically validated analytical software package for quantitative analysis. It includes the following functions: Vessel diameter and stenotic index. This program measures vessel size and calculates the degree of stenosis. Automated Vessel Analysis. This program uses contour detection to calculate vessel dimensions and subsequently analyzes stenoses. Calibration routines to enter the scale into the programs (based on the size of the catheter visible in the image). CT TrueView CT TrueView connects the Cath lab to the CT room. It provides all the benefi ts of Allura 3D-CA based on a CT diagnostic image. It offers: Optimal C-arc positioning on Philips CT data sets to minimize foreshortening when assessing lesions or bifurcations Full integration with Philips products. This option is available in the extended Brilliance workspot in the CT Room and it can be controlled from tableside or from the control room in the Cath Lab. It is one easy to use user interface on the EBW and interventional hardware. Ventricular Quantifi cation software package This software package calculates the ejection fraction and local wall motion parameters from left ventricular angiograms in different formats. The functions are: Various LV volumes Ejection Fraction Cardiac Output Centerline Wall Motion Slager Wall Motion Regional Wall Motion Calibration routines EP navigator EP navigator shows the catheter and the 3D anatomy in real-time in one image, allowing electrophysiologists to instantly confi rm the position of any catheter or lead with respect to detailed 3D cardiac anatomy in the EP intervention lab. This information can support the electrophysiologist in performing complex EP procedures with greater confi dence, in a more intuitive way. During the procedure, EP navigator helps the electrophysiologist: Guide mapping procedures with more confi dence Get to ablation points that are diffi cult to reach more confi dently Perform complex procedures when you don t have access to mapping Right Ventricular Quantifi cation software package This software package is used to assess ejection fraction and right ventricular volumes. It enables you to perform right ventricular analysis from angiograms. The calculations can be executed from single plane or biplane projections. The package is intended especially for pediatric cardio applications and focuses on easy and effi cient wall contour detection. Allura Xper FD20 functional description 35

36 The functions are: Calibration routines Various Right Ventricular volumes Ejection Fraction Cardiac output Centerline Wall Motion Slager Wall Motion Regional Wall Motion Biplane Ejection Fraction automatic Biplane Ejection Fraction manual Coronary Quantifi cation software package This software package provides quantifi cation of stenosis measurements in the coronary arteries. The functions are: Diameter measurement along the selected segment Densitometric information Cross sectional area Percentage of stenosis Pressure gradient values Stenotic fl ow reserve Calibration routines Customer Services Philips Customer Services support you in every season of system ownership from Planning through Start-up, Peak Usage and Renewal by helping you simplify your operations in ways that let you spend more time focusing on what s most important: the needs of your patients. Philips Customer Services is service that works for you in all the seasons of ownership. CO2 view trace This software package enables tracing (stacking) of images acquired with CO2 injections. This package can be used during post-processing, next to View Trace images acquired with iodine injections. Full Autocall The Full Autocall option can be used in conjunction with the quantitative analysis packages. When the object to be analyzed (e.g., Left Ventricle, Vessel Segment) is placed in the iso-center, full autocall avoids the need to: Acquire an additional image series containing a sphere or grid for calibration purposes, or Calibrate manually on a calibration object (e.g., catheter) displayed in the image or image series to be analyzed 36 Allura Xper FD20 functional description

37 Technical information - Dimensions All dimensions in mm 350º Allura Xper FD20 functional description 37