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#20 – Revolutionary Limb Prostheses

First X-Ray Exam in a Standing Position

The new Multitom Rax (Courtesy of Siemens AG, Munich/Berlin)

The new Multitom Rax X-ray scanner from Siemens Healthineers enables, for the very first time, full radiographic 3-D-imaging of patients in their natural standing position, thanks to two robotic arms that move around the person. Dr. Lars Hofmann is a physician and is the head of global marketing & product management of X-ray products at Siemens. He talked to us about what he considers a revolutionary product.


MedicalExpo e-magazine: When was the Multitom Rax launched?

Dr. Lars Hofmann: The Multitom Rax was a huge multi-year project that was unveiled at RSNA [Radiological Society of North America] last November in Chicago and was also presented at ECR [European Congress of Radiology] in March 2016 in Vienna.

The system already has EC and the FDA clearance and is commercially available. It’s been extremely exciting to be able to launch a new product in the radiography and radiology environment that is beyond what people might have expected.

If you look at standard radiography, there has been, of course, evolution—but not necessarily a revolution. The Multitom Rax is something completely new and we are the only ones to offer such a solution.

ME e-mag: What are the most innovative aspects?

Dr. Hofmann: We can do full 3-D tomography in weight-bearing position, meaning that the patient is standing and does not need to move. The robot can revolve around him or her. It’s the first of its kind. In the case of someone with back or joint pain, whether ankle or knee, you often have to ask the patient to move, which can be quite painful. Now, you can select the standing or sitting position and the system automatically moves where it has to move. The adjustment is done by the technician and there is no need to reposition the patient.

The system automatically moves around the patient (Courtesy of Siemens AG, Munich/Berlin)

The system automatically moves around the patient (Courtesy of Siemens AG, Munich/Berlin)

To have 3-D tomography in a natural weight-bearing condition is a huge benefit. The human anatomy does not look the same in a lying position than it does in a standing position. If you have a patient lying, there is no pressure on the joints or on the spine. If they’re standing, you can see what they experience in their everyday life, which gives you a different scenario. We are gaining new information from the natural weight-bearing position. It’s of real interest in orthopedics and trauma, for example.

Also, the Multitom Rax can do both 2-D and 3-D exams. So, if there are any medical questions arising from the 2-D X-ray, you can immediately examine the patient again in 3D using the same scanner in the same room. This allows flexibility, for example in an emergency department.

ME e-mag: What about the two robotic arms?

Dr. Hofmann: The two robotic arms are both ceiling-mounted, freely movable and totally flexible, moving around the room and around the patient. One is the X-ray tube and one is the unique RAX detector. They are completely, independently robotic and are able to be precisely aligned. The alignment is within 0.1 mm accuracy—as fine as a human hair.

The human anatomy does not look the same in a lying position than it does in a standing position.

The capabilities that you have with a detector and an X-ray tube are extremely well aligned—thanks to robotic technology—and give you a lot of freedom. Not only do they increase the flexibility, they are also extremely simple to use. You push a button and the system goes automatically to the correct position.

By freedom, I also mean that we are able to do fluoroscopy procedures, selected angiography procedures and, of course, tomography—meaning full 3-D imaging. If you can do CT exams in a room where you also can perform fluoroscopy and radioscopy, you have the possibility of saving a room, which can be of great benefit.

ME e-mag: Do you use the same amount of radiation than with conventional machines?

Dr. Hofmann: For fluoroscopy and radiography exams, the radiation dose is exactly the same as with any other radiography system. We are focused on radiation safety, and the technology we use and the radiation dose we achieve are industry-leading. If you look at 3-D exams, the dose is pretty much comparable to CT.

The Multitom Rax can do both 2-D and 3-D exams (Courtesy of Siemens AG, Munich/Berlin)

The Multitom Rax can do both 2-D and 3-D exams (Courtesy of Siemens AG, Munich/Berlin)

About the Author

Celia Sampol has been a journalist for more than 15 years. She worked in Brussels and Washington for national medias (Agence France Presse, Liberation, Europolitics). She's the editor-in-chief of NauticExpo e-magazine and MedicalExpo e-magazine.

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