Scientific Paper Presented at RSNA 2009 :
CT Exprés™ injector benefits over dual-syringe

Comparison of Dual-Syringe and Syringe-Less Power Injector in the Outpatient MDCT Practice:
Impact on the Operator’s Performance, Work-flow, and Contrast Media Utilization

Ma, Xiaozhou; Sing, A; Fay, J.; Haboub, I; Saini, S. Sahani, D. Massachusetts General Hospital, Boston, MA
(Wednesday, December 02 2009)

Presenter : Xiaozhou Ma MD

Abstract Co-Author : Anand Singh MD, Joseph Fay,
Ibrahim Haboub, Dushyant Sahani MD

PURPOSE

The purpose of this study is to compare the performance efficiency and technologists’ satisfaction with two different power injectors (PI) in an outpatient setting.

METHOD AND MATERIALS

In the IRB approved prospective study, 275 outpatients (M: 133; F: 142) scheduled for CECT were randomized and scanned on either of the two 16- adjacently placed MDCT (GE) fitted with dual-syringe (Bracco) or syringe-less (CT Express III, Swiss Medical Care) PI. The equipment preparation time (CM, saline loading), releasing time (unloading of saline and CM), and CM wastage incurred for each PI were recorded by a single operator. The technologists’ satisfaction was rated on a 10-point scale. The statistical analysis was performed using student’s t-Test.

RESULTS

Total 140 patients were performed using dual-syringe and 135 with syringe-less system. The equipment preparation time and releasing time per exam for dual-syringe and syringe-less PIs were 139±39, 32±14 seconds and 48±31, 8±3 seconds respectively (p< 0.001). Approximately 11mL CM wastage/exam was observed with dual-syringe and 0 mL for syringe-less PI (p<0.001). The technologist rated higher satisfaction with the use of syringe-less PI than the dual-syringe system (9.3 vs. 6.3; p<0.01). Due to improved efficiency, 2.6 additional patients per day were scanned in the room using syringe less PI.

Comparison of the efficiency of two PIs:

	Syringe-less PI	Dual-syringe PI	P value
CM Loading Time (sec)	39 ± 30	135 ± 40	P < 0.001
CM Unloading Time (sec)	6 ± 2	30 ± 14	P < 0.001
CM wastage (mL)	0	11	P < 0.001

Comparison of technologists’ satisfaction:

	Syringe-less PI	Dual-syringe PI	P value
Overall attitude	9.3	6.3	P < 0.01
User friendly	9.2	6.3	P < 0.05
Easiness of patient preparation	9.8	4.5	P < 0.001
Easiness of PI setup	7	7	> 0.05

Setting up time: 39 seconds versus 130 seconds:

Syringe-less PI

Dual-syringe PI

Setting up steps: Set up of day sets (daily) Take two CM bottles and connect them to the docks (1000mL CM for about 8 pts) Connecting tubing for IV Insert the cassette into the injector The injector automatically primes the line Choose a program and start

Setting up steps: Take two syringes from two blisters Insert the 1st syringe into the injector Forward plunger into the 1st syringe Take the cm bottle and connect to the 1st syringe Draw contrast into the 1st syringe Insert the 2nd syringe into the injector Take the saline bottle and connect to the 2nd syringe Forward plunger into the 2nd syringe Draw saline into the 2nd syringe Attach the y-connector and the patient tube Prime the two syringes and the line Program and start

Releasing time: 6 seconds versus 35 seconds:

Syringe-less PI	Dual-syringe PI
Releasing steps: Unlock the patient set Take it out and discard it	Releasing steps: Remove the piston from the 1st syringe Remove the piston from the 2nd syringe Unlock the syringes Release the 2 syringes from the injector with the y-connector and the patient tube attached and discard them

CONCLUSION

The syringe-less power injector is more user friendly, improves the outpatient CT workflow, and allows 11 mL CM saving per exam over dual-syringe injector in average.

CLINICAL RELEVANCE/APPLICATION

Syringe less PI allows simultaneous loading of 2 contrast medium bottles of 500mL and a 1000mL bag of saline therefore enabling scanning several patients after the initial set up.

For additional information please contact: SMC – Swiss Medical Care SA Le Portique, Av. De Sévelin 28 CH 1004 Lausanne Switzerland Tel: +41 21 623 60 30 Fax: +41 21 623 60 31 Web: www.swissmedcare.com Email: info@swissmedcare.com