Does premium obstetrical care belong only in the “premium” cities of the world? In Vigo, world-leading expertise and technology is brought to the people. As of August 2015, the largest municipality in Galicia is home to the new Hospital Álvaro Cunqueiro. Here, Professor Doctor Carlos López Ramón y Cajal leads the obstetrics and gynecology department in the largest university hospital in northern Spain.

Professor López spends three to four days a week on clinical work and the rest of his time on his duties as head of the department and teaching students. His passion is exploring the fetal world through ultrasound. For this, he stresses that Philips EPIQ 7 o� ers two incomparable values: reality and security.

Reality and security

EPIQ 7 ultrasound

Customer story

Prof. Dr. Carlos López Ramón y CajalHead of Obstetrics and Gynecology, Vigo University Hospital Álvaro Cunqueiro, Vigo, Galicia, Spain

Tertiary obstetrical care, research, teaching• 45 specialists, 12 residents• 4,000 - 4,500 births per year• 500 - 600 patients seen

every day• 22,622 ultrasound scans in 2015 EPIQ 7 with xMATRIX• Main transducers used:

C5-1, C9-2, X6-1, L12-5• OB/GYN department also

equipped with Philips Affi niti and other Philips ultrasound systems

“Welcome to the real world”

It was the “jump in technology” that attracted Professor López to try Philips EPIQ 7. He says the new xMATRIX and high frequency technologies are much, much better than Philips iU22. “It’s another level, another universe of possibilities,” he says. “Using volumes, it’s possible to study the surface of structures and inside structures – like a scanner.”

Unlike mechanical transducers, electronic transducers do not require algorithm software to reconstruct multiple pictures into volumes. Instead, volumes are immediately available in real time. Virtually eliminating movement artifacts, Professor López says xMATRIX images are “not reconstructions, not science fiction… welcome to the real world.” He captures one to five volumetric studies in every examination, but can just as easily work with twenty volumes, “because xMATRIX is very fast: two seconds for one volume.”

Collaborating with Philips

Service and maintenance are very important topics for Professor López. While it may be difficult, he can rely on Philips to obtain the same image quality after service updates.

He also collaborates closely with the Philips “engineer dream team” in Bothell, Washington. “The work of the engineer is very important to translate so much information to the screen and to the clinician to interpret.” Professor López helps filter what information is interesting or not. “It’s necessary to connect the clinician with the engineer to get good information.”

This process of testing and checking can uncover information hidden in the system that’s especially useful for the clinician. One example is the Doppler sound, which Professor López uses to confirm or exclude cardiac adaptations. He beams: “The sound is a fantastic tool in EPIQ.”

New perspectives in ultrasound require new mindsets in clinicians. Professor López explains that images from mechanical transducers can seem aesthetically pleasing, but “Photoshop-like” rendering softens reality. By contrast, EPIQ with xMATRIX processes industrial amounts of pure, raw data so “the picture is real,” he says. “What you see is real, true. That’s the difference.” He urges clinicians to reconsider their image quality expectations and compare images from the same patient using different systems.

But is a volumetric transducer helpful for diagnosis in most patients? Professor López says with mechanical trandsucers, “it’s only possible to get to the best image in two to three patients per week.” But he says, “With xMATRIX, I find clinical help in most patients. This difference is very important. I want a good resolution for at least 80% of patients.”

Premium peace of mind

Professor López only uses EPIQ, in all his patients. “I need to be sure that this is bone, muscle, skin, lung, cardiac tissue, blood,” he says. EPIQ provides “clear differentiation of gradient tissue with security – so you can rest assured.” He stresses that these subtle differences are only possible to achieve in a premium system. He cites a recent example where using EPIQ he could detect small vessels with arterial flow which other systems could not detect. “In the last year, we tested many systems in this hospital, and we always finished with the same conclusion. This is faster, exceptional quality, and we’re happier!”

While top-level ultrasound systems may seem similar, Professor López emphasizes the impact of Philips transducers. “The result: you work on all patients with security. The reason for your security is using these tools.” In addition to a thorough anatomical exploration, he always performs a functional examination. For this, EPIQ is essential, “because pulse Doppler, color Doppler, with the possibility to use xMATRIX only exists with this premium system.”

Reality and security may be the priorities for tertiary centers, but what about workflow? Professor López says: “If you use [transducers] C5-1, C9-2, and volume, the throughput in one morning is faster. The resolution in each patient is excellent. The diagnosis: faster. The security is higher, the highest. The work in one patient probably takes five to ten minutes. With other systems, I tested it – 15, 20 minutes are necessary to get very similar results.”

The EPIQ difference

Professor López’s delight in the technology retains very practical purposes. Recently, he used color Doppler to detect a blood vessel in a patient’s uterine scar from a cesarean section. The patient now lives in another city though, where her practice does not have EPIQ and cannot detect the blood vessel. Professor López says it’s difficult to get agreement with colleagues about the situation and therefore management of this patient. But he concludes: “If you want reality and security, it’s necessary to have a premium ultrasound system.”

“For me the difference is that it’s possible to confirm the same diagnosis in different moments throughout the pregnancy. Repeat the exploration and you get the same diagnosis, because the picture is real.” Furthermore, while these days all systems must for example be able to image obese patients, EPIQ delivers a unique “wow effect.” He says xMATRIX taught him that the fetal heart can be normal – without defects – but that there may be tiny modifications marking the beginning of a new adaptation. He says it’s easy to detect a normal heart, “but with this new system, it’s possible to detect very small adaptations.” EPIQ is an outstanding system for training, he says, “Because the real world exists in the premium system.”

Importantly, high resolution enables Professor López to conduct groundbreaking research. He uses the L12-5 lineal transducer to explore the bones of the middle ear, fetal pupil response, vocal cord behavior, the fetal auditory cortex at only 18 weeks, and more. He states his target with wonder and determination: “The black box of obstetrics is response – neurological behavior.”

© 2016 Koninklijke Philips N.V. All rights reserved.Specifications are subject to change without notice.

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4522 991 20521 * AUG 2016

“Come with me and sit down in this chair. This is the patient, this is EPIQ. Begin to perform an exploration. And now I perform the exploration for you. Is it the same? Yes. If you want to get a premium system – use it. Sit down and use it. Test, test, test, test, test.”Prof. Dr. Carlos López Ramón y Cajal, Head of Obstetrics and Gynecology, Vigo University Hospital Álvaro Cunqueiro, Vigo, Galicia, Spain