R/F Development of the OPESCOPE ACTENO Medical Systems Division, Shimadzu Corporation Shouji Takamura, Takeshi Okamoto, Shinsuke Kanazawa, Go Takayanagi, Shinichiro Mori, Yoshiaki Tanaka, Yoshihiro Atsumi, Tatsuya Shimizu, Atsuhiro Hattori 1. Introduction The OPESCOPE Series Surgical Mobile C-Arm System offers: • C-arm cart construction with no protruding cables • Fully manual positioning, including vertical movements • Pulsed fluoroscopy at 15 fps This leads to following points that contribute to the popularity of the system: • Sterile and compact • Rapid positioning operations • High image quality but low X-ray exposure dose 2. Basic Specifications and Development Topics Shimadzu has developed the new OPESCOPE ACTENO range that further builds on the previous functions. In this paper, we introduce the range of advanced functions offered by ACTENO, including: • Fluoroscopic image display functionality added to the C-arm cart for all models • Extended distance from X-ray tube to I.I. • Narrower C-arm cart body • More compact monitor cart • Folding monitors to save space • 1-megapixel TV camera as standard for higher image quality • Boost-pulsed fluoroscopy as standard is a powerful tool for imaging thick objects, such as lateral radiography of the lumbar spine • Virtual collimation further reduces X-ray exposure • Realtime dose and cumulative dose monitor display functions (the demand for which is likely to grow in the future). Table 1 summarizes the ACTENO basic specifications. The most important factors in the field of orthopedics, in particular, are quick operation and high image quality. The features and functions of ACTENO are described below. X-ray tube capacity 100 kHU fixed anode (0.6 mm focal point) Image intensifier 9/6-inch, 2 field of view switchable, or 6/4-inch, 2 field of view switchable Continuous fluoroscopy, or Pulsed fluoroscopy (15 fps max.) C-arm operation Fully manual positioning, including vertical motions (Fully counterbalanced) Virtual operation Image rotation, collimator operation (Operations from C-arm cart) IBS (Image Brightness Stabilizer) Fixed at center of region of interest, or Predicted region of interest Table 1 OPESCOPE ACTENO Major Specifications

2.1 Improved C-arm Operation C-arm positioning follows the popular fully counterbalanced manual positioning method, including vertical motions. This method ensures rapid positioning. The greater 780 mm distance from the X-ray tube cover surface to I.I. (previously 700 mm) and the wider 670 mm C-arm depth (previously 660 mm) enhance the freedom of positioning. The width of the C-arm cart body has been reduced from 880 mm to 800 mm, making it more maneuverable. An optional handle with C-arm lock-release button is available at the I.I. side to exploit the benefits of the fully counterbalanced OPESCOPE...

2.4 New Communications Control Method Improvements have also been made to the cart cable that connects the C-arm cart to the monitor cart, which has to be installed, cleaned, and stored for each procedure. The cart cable handles power supply and transmission of image data and other data. It contains multiple cables for different applications combined in a complex manner. In the past, this inevitably resulted in a thick and heavy cable which was difficult to route. In addition, data traffic is now significantly heavier than previous systems to support the realtime display of exposure dose and...