Robot CT

Equitom's equine clinic puts into operation a highly advanced robot, EDAMIS, for making standing CT images of the horse: a revolution in medicine.

INTRODUCTION 

This very futuristic-looking robot allows doctors to take CT images of the upright horse. The technique is so innovative that it has yet to be used even on humans. 

Thanks to this unique device, a CT scan can be made while the horse is standing up, thus avoiding a general anaesthetic. In addition, this robot is extremely powerful and fast. The room where the robot was installed has also been converted into an operating theatre so that certain surgical procedures can now be performed with very high precision under the robot's control. The use of the robotic CT-scanner to control surgical interventions is unique in the world and puts the Lummen Horse Clinic back on the world map! 

WHAT IS A CT SCAN 

A classical CT-scan is a tunnel-shaped device in which you, as a human being, have to lie down for examination. It uses X-rays and is able to obtain 3-dimensional images of the body. It mainly provides very precise information about the bones and bone structure. The CT scan is very frequently used to detect pathologies/diseases that cause pain or lameness in the horse. These can include chronic bone inflammation, arthrosis, cracks and micro-fissures, bone cysts, but also sinus and tooth problems, tumours, etc. By using a contrast medium, additional information can be obtained about soft tissue (tendons, ligaments, cartilage, menisci, etc.). 

The classical CT-scanner, which originates from human medicine and has been used in our clinic for several years, usually requires a general anaesthetic and is not without risks for the horse.  Both the anaesthetic and waking up are and always will be delicate moments for horses. Horses can hurt themselves or even break their legs when waking up. Sport horses have besides their emotional value also a high economic value (sometimes several millions of Euros), which makes their owners try to avoid anaesthesia.  

The robot-CT is the solution to this problem and sport horses from Belgium and surrounding countries come for a robot examination precisely because a general anaesthetic can be avoided. 

UNIQUE IN EUROPE 

The robotic scanner at Equitom is the first on the European continent. There are currently 3 in the world: one at Equitom, one at Dubai Equine Hospital and one at the University of Pennsylvania.  

The robotic scanner at Equitom is similar to the two others in the world. It is more modern and the generator is even more powerful, which improves the quality of the images. 

With the arrival of the robotic CT scanner, Equitom therefore has one of the best-equipped equine medical imaging departments in the world. Besides already advanced radiography and ultrasound, there is an MRI-scan (Magnetic Resonance Imaging), a scintigraphy (bone scan), and a classic CT-scan (Computer Tomography) with an extra large tunnel of up to 90cm (Large Bore CT). 

Our medical imaging specialist Zoë Joostens (Diplomate ECVDI) works closely with the American company that developed the robot and Equitom has become the European research centre to further develop the robot. 

ADDED VALUE FOR HORSE AND OWNER 

The robotic CT scanner allows three-dimensional CT imaging of bone and soft tissue structures of the horse without general anaesthesia.  

The scanner consists of two robotic arms and several cameras that register the horse's movements. The arms of the robot rotate around the sedated horse taking a series of images. These images are converted by a computer system into a detailed three-dimensional image, as in a conventional CT scan. The cameras allow movement correction to be made. Mild movements can thus be filtered out in order to guarantee razor-sharp image quality. 

The major advantage over a conventional CT is that a general anaesthetic is avoided. General anaesthesia of a horse always entails a certain risk because of their size, weight and their possible panic reactions in the event of danger. As a result, horses can seriously injure themselves during the awakening phase, in exceptional cases resulting in a broken leg.  

For the owner of the horse, the standing CT can also be of golden value. The standing CT can allow extremely advanced imaging in a low-threshold manner. CT images are obtained under mild sedation and so diagnoses can be made before, during or after the competition season without the need for general anaesthesia. This is a special and exceptional benefit for every animal and every owner, but especially for valuable sport horses. 

ADDED VALUE FOR VETERINARY MEDICINE 

The robotic CT scanner is also a true revolution in veterinary medicine. Certain conditions that were previously impossible to diagnose with conventional radiography and ultrasound on a standing horse are now easy to detect thanks to the robot. Thanks to the robot, we can make more diagnoses at a very early stage so that preventive action can be taken in time. 

Moreover, the standing CT examination can be combined with a standing MRI examination. Both imaging techniques have different characteristics and can therefore be used complementarily in complex and multiple pathologies. As a result, the doctors have very detailed information that helps them to make a correct and complete diagnosis. If necessary, the horse can be treated and followed up optimally. 

Thanks to our specialised team, the neck and back region and intra-venous/arterial contrast studies are also being developed on the standing horse. 

The slight sedation of the horse allows this examination to be carried out in a day clinic. The referring colleague can thus very quickly start the appropriate therapy after the diagnosis has been made and after consultation with our imaging specialist. 

Surgical interventions, such as complex fractures, can be prepared in advance thanks to the information from the standing CT scan. This allows the surgeon to determine the optimal surgical technique and significantly reduce anaesthesia time. In addition, the robot room is equipped with all the necessities to allow a general anaesthesia and to be used as operating room.  A mobile operating table can be used to wheel a horse into this room under general anaesthesia. The robot can thus also be used to accompany complex surgical procedures (e.g. neurosurgery). 

Furthermore, the device can be used not only for the diagnosis and therapy of existing medical problems. Due to its low-threshold character, the standing robot-CT can also be used for preventive medicine. Horses can be screened after an intense training period, even before the final competition season, to see if there are any abnormalities present that could develop into serious and even life-threatening pathologies.  This can be important and even life-saving for racehorses. Prevention is better than cure! 

TECHNICAL DATA OF THE ROBOT-CT 

The robot, also called EDAMIS (Equine Dual-Arm Multi-modality Imaging System), was developed in the United States by Orimtech LTD. 

The robot arms rotate around the horse and scan the region in as little as 30 seconds. A series of cameras continuously records the slightest movement of the horse and makes a movement correction to obtain razor-sharp images. The robot is more than 3 metres tall and weighs almost 6 tonnes.