Top Siemens Medical exec details strategy behind Somatom Definition

Siemens embraced customers 10 years ago as integral to its operations. When developing new technologies, engineers turn to customers early on to make sure their ideas have clinical value. This has led to some risk-taking, as evidenced by the introduction at the RSNA meeting of the Somatom Definition, a unique CT scanner that boosts speed and data collection by using dual detectors and tubes.

Since the advent of multislice CT, vendors have touted machines on the basis of how many slices they deliver. In 2004, Siemens took a step away from that idea, introducing the Somatom Sensation 64, which doubled the slices per detector array. Competitors framed the development as a weakness, arguing that Siemens was resorting to engineering patchwork to cover shortcomings in its detector development. Siemens said the technology was designed to improve spatial resolution.

This year the curtain opened on a new kind of CT, using last year's pioneering developments built into two imaging chains. It would have been more characteristic of a multibillion dollar enterprise to stay on the single-source, multislice track. And yet Siemens diverged.

"Certainly, there is a risk component," said Erich R. Reinhardt, president and CEO of Siemens Medical Solutions. "One has to be careful when leading innovation. But we were convinced that this technology would contribute to what we were trying to achieve."

In an interview with DI SCAN, Reinhardt explained the thinking that went into developing the Somatom Definition and where he expects this technology to lead.

SCAN: With the release of the Sensation 64, you began diverging from the usual path in CT, generating 64 slices from a 32-detector-row array. This made you vulnerable to claims that you didn't have a true 64-slice scanner.

Reinhardt: We do have a 64-slice scanner and it is better than any competitor's. Who needs to have a 64-slice detector? We have a very strong presence in the market, and it is more important how the market feels than our competitors.

Which leads to the Somatom Definition. In the mid-1990s, one might have thought that CT was a mature technology. With multislice, it started again - new clinical applications went into development that later justified this technology. With the Somatom Definition, we are doing the same thing. We are entering a new era, adding a second x-ray source in the same gantry, and this is giving us higher temporal resolution, which is important for cardiac or any application in which time is of the essence.

Dual-source CT allows us to apply dual energy. There is the probability that one can improve specificity. This needs a lot of R&D work. But it has a great chance.

Third, (Somatom Definition allows a) dose reduction - which is a big surprise. One would assume with two x-ray sources there would be a higher x-ray exposure. That is not so for cardiac applications, which is of great interest, because the scan time is shorter. Altogether, this will make CT technology more robust, maybe replacing the more interventional procedures for diagnostic purposes.

SCAN: Large companies tend to be risk-averse. But you have diverged from the conventional approach of adding more detector rows and more slices. Why?

Reinhardt: We apply criteria in order to set our priorities - to assess risk as well as opportunity. We see that there is a real demand to improve efficiency, and we are trying to meet it. It is a market-driven strategy. It is not technology driven. The technology is the enabler, and if you try to lead the innovation, set the trend, for sure you have to deal with risk.

SCAN: The last time you did this was in 1989 in CT, when you introduced spiral scanning in place of the step-and-shoot approach. The rest of the industry followed you then. Do you think the same thing will happen this time?

Reinhardt: That depends on the clinical applications. If the market is asking for this technology, our competitors have to follow. Otherwise, it is great for us.

SCAN: What does the launch of the Somatom Definition mean for future Siemens offerings?

Reinhardt: In the different market segments that exist today, we have a broad spectrum of multislice systems - dual-slice CT up to 64 slices - and for sure we will continue to develop multislice technology and tune the specifications of the system to different needs in different market segments. CT will have different needs and requirements. We do not see a situation where only dual-source CT will be of use.

SCAN: Wide area detectors are coming down the road. Will there be a time when you have wide area detector products with single-source x-ray and others with dual-source x-ray?

Reinhardt: We can speculate on those topics. We have large-scale detectors in use in CT for research work to understand the advantages (of this technology). The key advantage is high spatial resolution, and that is under evaluation. The question is not whether it is feasible from a technological point of view. We have to find out if there is a clinical need to go in this direction, and what is the benefit for the clinical examination. Is this required in order to answer any medical questions? What does it mean to clinical workflow? If it increases the quality of the diagnosis, provides more specific diagnostic information, and is more cost efficient, then definitely we will go into this.

SCAN: Are your research prototypes aimed at answering some of those questions?

Reinhardt: It is in the research phase for sure. The task of this research is to find out the potential.