Pulsera versus 9900

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wscott

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We are in the market for a new or refurb C-arm at our ASC. I have used Philips BV Pulsera in the past 2007-2011; current ASC has an old OEC 9600. Budget is around 100-120K.

Are you CURRENTLY a Pulsera or OEC 9900 fan? Why?
Do you have DSA?

Thanks for your input.

The article below is interesting

Spine (Phila Pa 1976). 2013 Jul 15;38(16):1401-4. doi: 10.1097/BRS.0b013e318294e27d.
Comparison of image quality and radiation exposure from C-arm fluoroscopes when used for imaging the spine.
Prasarn ML1, Coyne E, Schreck M, Rodgers JD, Rechtine GR.
Author information
1
Department of Orthopaedics, University of Texas, Houston, TX 77030, USA. [email protected]
Abstract
STUDY DESIGN:
Cadaveric imaging study.

OBJECTIVE:
We sought to compare the fluoroscopic images produced by 4 different fluoroscopes for image quality and radiation exposure when used for imaging the spine.

SUMMARY OF BACKGROUND DATA:
There are no previous published studies comparing mobile C-arm machines commonly used in clinical practice for imaging the spine.

METHODS:
Anterior-posterior and lateral images of the cervical, thoracic, and lumbar spine were obtained from a cadaver placed supine on a radiolucent table. The fluoroscopy units used for the study included (1) GE OEC 9900 Elite (2010 model; General Electric Healthcare, Waukesha, WI), (2) Philips BV Pulsera (2009 model; Philips Healthcare, Andover, MA), (3) Philips BV Pulsera (2010 model; Philips Healthcare, Andover, MA), and (4) Siemens Arcadis Avantic (2010 model; Siemens Medical Solutions, Malvern, PA). The images were then downloaded, placed into a randomizer program, and evaluated by a group of spine surgeons and neuroradiologists independently. The reviewers, who were blinded to the fluoroscope the images were from, ranked them from best to worst using a numeric system. In addition, the images were rated according to a quality scale from 1 to 5, with 1 representing the best image quality. The radiation exposure level for the fluoroscopy units was also compared and was based on energy emission.

RESULTS:
According to the mean values for rank, the following order of best to worst was observed: (1) GE OEC > (2) Philips 2010 > (3) Philips 2009 > (4) Siemans. The exact same order was found when examining the image quality ratings. When comparing the radiation exposure level difference, it was observed that the OEC was the lowest, and there was a minimum 30% decrease in energy emission from the OEC versus the other C-arms studied.

CONCLUSION:
This is the first time that the spine image quality and radiation exposure of commonly used C-arm machines have been compared. The OEC was ranked the best, produced the best quality images, and had the least amount of radiation.

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That is significant lower radiation with the OEC. I have a 2009 Pulsera and am very happy with the image quality, much better than the OEC 9800s I use at the surgery center. However, I do not compare the radiation outputs of the machines so cannot comment on that. You can get a very nice used Pulsera for around $42k that will give comparable image quality to a new 9900 or new pulsera so keep that in mind.
 
FWIW, I have lead drape on side of bed. State radiation physicist told me that my Pulsera had the lowest readings she had seen. I have not read details of study as posted but settings on pulsar i.e. pulsed mode, etc. will change radiation output significantly.

I find image quality of Pulsera better than what I had with 9900 at hospital and as pointed out price savings is very significant.
 
I just got a brand new OEC 9900 to replace a 2002 Phillips Pulsera (not a misprint, yes, 2002) and the image quality is fanf#ckingtastic.
I knew the image quality on the Pulsera had degraded over time, but the change feels like swapping a 1950s black and white TV with bunny ears, for a 2017 60 inch high def flatscreen. Man, is it brutally expensive, but the pictures are amazing. Uses much less radiation, too.
 
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