General Medical Merate S.p.A.

Infotec
www.gmmspa.

Symbol
Mobile C‐arm radiological unit
• C‐arm with wide dimensions and displacements
• Patient and operator Dose Reduction, innovative 4 levels programme in
continuous fluoroscopy

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MEAN FEATURES
• C‐arm with wide dimensions and displacements
• Patient and operator Dose Reduction, innovative 4 levels programme in continuous
fluoroscopy
• C‐arm with wide dimensions and displacements; easy transport and movement with
reduced weight and dimensions
• User‐friendly display, streamlined workflow management
• Stationary and rotating X‐ray tube anode
• 9”, 12” and 13” image intensifier
• High performance digital system with 14 bit CCD 1k x 1k camera
• DICOM services (optional)
• Wide series of standard and optional accessories

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 INFOTEC
THE WIDE Symbol MOBILE SURGEY UNITS RANGE
The Symbol arm range is composed of a series of X‐ray systems for digital fluoroscopy and
radiography with wide C‐arm dimensions and double LCD monitors. The monitors are
perched on workstation’s trolley with digital memory for images archive, management and
images documentation.
MODELS 4F9 5R9 5R12 5R13 10R9 10R12 10R13
Anode type Stationary Rotating Rotating Rotating Rotating Rotating Rotating
Power 4 kW 5 kW 5 kW 5 kW 10 kW 10 kW 10 kW
Image intensifier 9” 9” 12” 13” 9” 12” 13”
Iris collimator and
opt. opt. opt. opt. Standard Standard Standard
semitransparent
6000
Images storage 6.000 6.000 6.000 6.000
500.000 with dynamic module
Measures and
opt. opt. opt. opt. opt. opt. opt.
Marker Module
Dynamic Digital
// // // // opt. opt. opt.
Cine 15 f/s Module
Dynamic Digital
// // // // opt. opt. opt.
Cine 30 f/s Module
Vascular module // // // // opt. opt. opt.
DICOM service opt. opt. opt. opt. opt. opt. opt.

Symbol is a radiological imaging intensifier, suitable for all applications in the field of surgical
trauma, orthopedic, neurological, urological, cardiology, and gastroenterology.

Thanks to a wide range of software modules, it can be configured up to an innovative

angiography mobile unit, ideal for vascular surgery procedures.
The ergonomic and mechanical structure makes the unit displacement extremely easy, even
in very small places.
The C‐arm innovative design is extremely important since it is able to reduce the patient and
operator X‐ray dose to as minimum as possible, whilst maintaining an excellent image
quality. Furthermore, the procedures documentation is completed with clinical images and
patient X‐ray dose rate.

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MECHANICAL STRUCTURE, DIMENSIONS AND POSITIONING

The mechanical structure, the highly ergonomic design and compactness, are the main
features of Symbol arm, ensuring the safety of the operator at all time, during each
operative situation.
The C‐arm is designed with optimized values well counterbalanced providing width and over‐
scan dimensions for an excellent handling and efficiency in reaching the various projections
needed.
The optimal C‐arm patient positioning flexibility makes the system particularly suitable for
vascular procedures.
The arm is made of anodized aluminium, to have a lighter, steady handling in displacement
along with maximum hygiene thus avoiding oxidation risks.
Additionally, the wheels are blocked by a proper pedal positioned on both sides with push
cable deflectors.
The compact double LCD monitor workstation trolley is designed to facilitate the equipment
use and displacement even in small places. The workstation connection cable is equipped
with a double connector for cost saving. In fact, the cable replacement can easily be carried
out by the operator.

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 INFOTEC
USER INTERFACE
The C‐arm operator interface is based on a user‐friendly ergonomic touch screen display,
with intuitive icons to perform easily the activities in an operation theatre.

TOUCH SCREEN DISPLAY FUNCTIONS

y Focus spot
y X‐ray “exposure preparation”
y X‐ray generation functions *
y Anode rotation status
y Power supply voltage status
y Anode thermal status
y Image rotation adjustment
y Iris diaphragm adjustment
y Position adjustment and semi‐transparent blades rotation
y Digital Image rotation and vertical/horizontal image flip
y Image Intensifier field input
y Exposition mode
y Exposition parameters control (manual/automatic)
y Indicator/selector of exposure parameters
y C‐arm vertical displacement

*Generator’s function display: Real X‐ray exposition Fluoroscopy Time; Acoustic signal with
manual reset after 270 fluoroscopy seconds; Automatic stop with manual reset after 300
fluoroscopy seconds; X‐ray exposition luminous and acoustic signals.

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 Standard accessories
• Fluroscopy double foot switch

• X‐ray push button

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 INFOTEC

THE X‐RAY GENERATOR AND TUBE

The Symbol arm offers the possibility to be configured with three different generators
models:

• Stationary anode generator of 4 kW

• Rotating anode generator of 5 kW
• Rotating anode generator of 10 kW.

The 10 kW version is more suitable for vascular surgery, it features a high thermal capacity
and low power dissipation.
The exposition adjustment in fluoroscopy mode can be controlled by the operator in
automatic or manual mode.
The automatic use is based on adjusting algorithms that are able to minimize the dose while
maximizing the quality of the images. The operator will reach an optimal result with any
anatomical district and in any operating mode.
The ABS adjusts the current, voltage and the chamber gain parameters automatically and set
the Iris camera.
The system is equipped with dynamic digital indicator on the C‐arm touch screen, displaying
the thermal X‐ray tube status and the accumulated heat.
To guarantee the safe use by the operator or for the patient, the generator has a thermal
safety system to ensure the proper unit functioning up to a temperature of 60 ° C + / ‐ 5 ° C.

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COLLIMATION SYSTEM
Symbol can be configured with two different collimator models.

• Circular collimator which automatically adjusts itself in function of the Image intensifier
magnification selected.
• Iris collimator with semitransparent copper blades and automatic diaphragm with
octagonal Iris. Additionally, to enhance the cardiological X‐ray application performance,
the C‐arm offers the opportunity of a semi‐lunar blades shape system (optional).
To reduce the X‐ray dose as much as possible, it is available a digital pre‐view optional
function, which allows the monitor display of any anatomical part, without the need of X‐
ray exposition.
In Radiography mode, the X‐ray beam is automatically collimated to the cassette size
dimensions.

TV CHAIN
Symbol arm combines the higher mechanical quality structure and the excellent radiological
performance to the high quality image standard and efficiency in management process.
The digital TV chain is assembled with high technology components. Each element is
designed to produce images at real high level definition, 1k x 1k thus resulting in an excellent
image quality but reducing the dose as much as possible.

IMAGE INTENSIFIER
The peculiar image intensifier features make the intensifier an excellent component to
create a very high image quality level, low noise, minimal distortion and low dose.

CCD CAMERA SENSOR

The CCD camera is based on a sensor, designed to obtain the maximum image quality with
the lower dose level.
The digital image rotation allows the operator to have the image displayed on the monitor
correctly, whatever is the C‐arm position.
The CCD camera is directly connected to a memory without a middle frame grabber board;
what follows is an extremely fast, dynamic and constant quality of acquired images.

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 INFOTEC
WORKSTATION TROLLEY
The Workstation is equipped with two monitors; TFT of 19” (colour and monochrome) for
optimal fluoroscopic image display.
The monitors of large dimensions allow the operator optimum vision, both in terms of size of
the displayed images and in terms of definition of the details.
The two monitors’ dimensions and the images’ high definition offer the opportunity to keep
the workstation trolley at a distance from the operation theatre, assuring sterility, without
compromising the images viewing comfort or penalize the diagnostic capability.
The monitors are integrated with an innovative TV chain, providing a suitable result for any
clinical procedure.

IMAGES PROCESSOR
The C‐arm’s images processor is configured with Windows operative system and has an
innovative acquisition system developed with a wide functions range.
The sequence or the static acquired images are saved on local system memory with an
archive capability of 6.000 images for models 4F9, 5R9, 5R12 and 5R13, or 500.000 images
for models 10R9/10R12/10R13.
The archive is organized on sections with multiply researching keys.
The images acquisition parameters are saved with the post‐processing functions available
for further images modification and images management.
The C‐arm’s image processor remarkable performances could be furthermore enhanced with
the optional applicative modules integration.

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APPLICATIONS MODULES (OPTIONAL)
The processor performances can be further integrated with a series of applications module
to adapt the C‐arm equipment to the clinical application. Symbol‐arm can be provided with
the following optional modules:

• MEASURES AND MARKER MODULE

The Measures and Marker module is a dedicated module for further operator image
enhancement with digital marker insertion.

• DIGITAL DYNAMIC MEMORY MODULE WITH DIGITAL CINE

Application module for images acquisition, storage and digital sequence images
management (“movies”) without external connection.
• Pulsed DIGITAL CINE acquisition mode
The DIGITAL CINE function is an additional acquisition mode that allows the images
sequence recording in pulsed mode with extreme high quality.
The dynamic module comes with two images’ sequence versions:
y 15 frames/s image sequence
y 30 frames/s. image sequence

• VASCULAR MODULE (available only with 30 f/s)

Applicative module dedicated to the vascular procedure, add two operative modes to the
digital dynamic memory module:
y DSA operative mode
y ROAD MAPPING operative mode

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 INFOTEC
OPTIMIZATION OF THE EXPOSURES AND DOSE REDUCTION
The system allows the automatic dose levels adjustment through an innovative programme
of work:
y The continuous fluoroscopy offers innovative possibility to optimize the radiological
exposures automatically by choosing from four mA levels, depending on the
examination type.
y The pulsed fluoroscopy is characterized by the wide frequency range choice and impulse
levels.
y The angiography in DIGITAL‐CINE allows the possibility of choosing the most appropriate
work program.

PROCEDURES DOCUMENTATION
Symbol offers a complete set of tools for images and dose rate.
The archived images exportation is by DICOM 3.0 (optional) and in formats supported by
Windows, (.AVI, .BMP) for most popular images editing programme compatibility.
The image export and the documentation procedures are performed at the operator
discretion through various available standard tools.

The CD/DVD writer can be completed with the implementation of any ‘burning software’ in
DICOM 3.0 format (optional).

X‐RAY DOSE DOCUMENTATION, DOSE/RATE AND DAP (OPTIONAL)

When using the system, the C‐arm touch screen displays the AK (mGy) and AK rate
(mGy/min) simultaneously and automatically.
With the optional DAP device integration, the X‐ray dose used during the procedures is
measured directly in an automatic way using an integrated ionization chamber.
Whilst the digital processor monitor displays the DAP (μGym2) value automatically.
At the end of the procedure, the system creates an Exposition Report (DAP) automatically. It
contains information relating to the total patient X‐ray exposure which is displayed
according to the different working modes (continuous/pulsed fluoroscopy, radiography).

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The report can be printed through the local medical printer (optional), to include this
documentation in the medical record to the patient. Furthermore, it is also available in PDF
export file.

LOCAL PRINTER (OPTIONAL)

Symbol can be configured with the medical thermal printer, Sony UP TO 970, enabling the
image printing on paper and on transparent film for printing and reporting all the exposures.
The image printing is very easy to use with the "Film Composer" function which allows the
operator to manage the documentation format, select the quantity and the image
placement in each module to be printed.
LASER LIGHT LOCALIZER (OPTIONAL)
In compliance with the patient safety instructions and the operators’ regulations in force,
there is a centering system to guide the laser light which can be easily installed or removed,
placed aside image intensifier.
The laser light localizer allows the correct positioning of the device without the need of X‐ray
expositions, as the light indicator shows the central X‐ray beam axis to make easy the image
centering.
DICOM CONNECTION MODULE (OPTIONAL)
Symbol supports all DICOM 3.0 functionalities based on the specific needs of the users.
Various options for post processing archive and documentations are also available.
Additionally, a CD/DVD digital images WRITER is available completed with a software to read
the DICOM system protocol on either the DICOM station viewer or a standard PC.
Automatic interface for Medrad injector (optional)
It is possible to install the interface for the automatic contrast high pressure Medrad Mark V
ProVis® injector exam connection. During vascular (DSA and RM) mode, the injector rightly
equipped, activates the contrast injection at the best time automatically.

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 INFOTEC
MAIN FEATURES
DIMENSIONS AND MECHANICS
Motor‐driven vertical travel 40 cm
Horizontal travel 20 cm
Horizontal axis arm rotation ± 210°

Orbital rotation 146° (‐56°/+ 90° )

Vertical axis arm rotation ± 10,5°

C‐arm vertical free space 80 cm (9”) [83]*
76,8 cm (12”) [80,3]*
77,8 cm (13”) [80,8]*
C‐arm Depth 72 cm
Source Image Receptor Distance (SID) 99,8 cm (9”)
96,7 (12”)
97,6 (13”)
Focus‐Skin Distance 20 cm
BRAKES AND WHEELS
Steering rear wheels with operator manual control. Resin wheels with
“bombé” profile to increase manoeuvrability and both sides stop
pedals with push cable deflectors.

Weight and Dimensions

Description 9” (II) 12” (II) 13” (II)
Weight 338 kg 346 kg 342 kg
Width 78 cm 78 cm 78 cm
Depth in movement 212 cm 213,5 cm 213,5 cm
position
Height in movement 178,5 cm 185,7 cm 185,7 cm
position
*Value without spacer

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 OPERATOR’S INTERFACE
C‐arm display touch screen
TFT display touch screen Monochrome 7”
Intuitive icons for easy use
Resolution 800 x 480 Pixels
Multi‐lingual interface
Workstation monitors Color monitor Monochromatic monitor
Standard with R4 and R5 models Standard with 10R models
Optional Monochromatic monitor
Dimension 19” 19”
Technology TFT TFT
Maximum resolution 1280 x 1024 pixel 1280 x 1024 pixel
Input DVI‐I e VGA DVI‐I e VGA
Viewing angle 178° 170°
Horizontal and vertical Horizontal and vertical
Contrast 800:1 900:1
Brightness 270 cd/m2 1000 cd/m2

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 INFOTEC

GENERATOR 4F9 5R9/5R12/5R13 10R9/10R12/12R13

Nominal power 4 kW 5 kW 10 kW
High frequency inverter 40 kHz
High tension 40 – 110 kV 40 – 120 kV
Maximum thermal 1.000 kJ
capacity (1.333 kHU)
Maximum thermal 75 W
continuous dissipation (6.000 HU/min)
Continuous fluoroscopy 0,2 – 4,0 mA 0,2 – 4,0 mA
Focus 0,5 mm Focus 0,3 mm
Pulsed fluoroscopy Up to 6 mA Up to 8 mA Up to 12 mA
0,5–1–2–4–7,5–15 fr/s 0,5–1–2–4–7,5–15 fr/s 0,5–1–2–4–7,5–15 fr
Impulse duration 38 ms Impulse duration 38 ms Impulse duration 38 ms
Focus 0.5 mm Focus 0.3 mm Focus 0.3 mm
Boost pulsed fluoroscopy Up to 8 mA Up to 12 mA Up to 20 mA
0,5–1–2–4–7,5–15 fr/s 0,5–1–2–4–7,5–15 fr/s 0,5–1–2–4–7,5–15 fr/s
Impulse duration 38 ms Impulse duration 38 ms Impulse duration 38 ms
Focus 0,5 mm Focus 0,3 mm Focus 0,3 mm
Digital Spot Up to 8 mA Up to 12 mA Fino a 20 mA
(single impulse) Focus 0,5 mm Impulse duration 38 ms Impulse duration 38 ms
Focus 0,3 mm Focus 0,3 mm
Digital CINE // // Up to 100 mA
15/30 fr/s
Minimum impulse
duration 14 ms
Focus 0,6 mm
Direct radiography 25 – 80 mA 25 – 100 mA
0,02 – 3,00 s 0,02 – 3,00 s
Focus 1,5 mm Focus 0,6 mm
X ray Tube Stationary anode Rotating anode
Model CEI OX‐110‐5 IAE X20P
Anode rotation speed // 3000 round/min
Focal spot dimension 0,5/1,5 mm 0,3/0,6 mm
Anodic power 0,78/4,2 kW 5/17 kW
Anode material W RTM
Anode angle 12° 10°
Anode diameter // 64 mm
Inherent filtration 0,5 mm Al eq.(IEC522) 0,7 mm Al eq. (IEC522)
Thermal anode capacity 30 kJ (40 kHU) 150 kJ (200 kHU)
Thermal anode 270 W (21.600 HU/min) 300 W (24.000 HU/min)
dissipation

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 CIRCULAR COLLIMATOR SYSTEM
Circular Collimator Automatic IB adjustment
IRIS COLLIMATOR SYSTEM (OPTIONAL)
Iris Collimator with semi transparent Automatic diaphragm with octagonal Iris
blades Semi‐transparent double copper blades
system
Semi‐lunar copper blades shape system
(optional) for cardilogical performance
Virtual collimation without radiation
(optional)

TV CHAIN
TV matrix 1kx1k
CCD CAMERA
Matrix 1024 (H) x 1024 (V) pixel
Pixel dimension 5.5 µm x 5.5 µm
Frame rate 30 fr/s
Signal/noise ratio 61 dB
Scan mode Progressive
Acquisition system 14 bit
Lens Integrated

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 INFOTEC

IMAGE INTENSIFIER
9” 12” 13”
TH9438QX TH9432QX HIDEQ 33‐4 ISX
Nominal input screen 23 32 33
Enlargement 1 16 21,5 21,5 cm
Enlargement 2 12 16 16 cm
Enlargement 3 // // 12
Out put screen size 25 mm
DQE (Standard IEC) 65 %
Conversion factor 260 320 418 cdxm /mRxs‐1
‐2

Central resolution
Normal 56 48 40 pl/cm
Enlargement 1 62 54 50 pl/cm
Enlargement 2 70 62 56 pl/cm
Enlargement 3 // // 60
Contrast ratio 10% 36:1 36:1 30:1
Contrast ratio (10 mm) 23:1 22:1 18:1
I.I. Grid 60 blades cm 14:1 SID 100cm

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 DIGITAL IMAGE PROCESSING
Digital images acquisition frequency 30 images/second.
LIH function (Last Image Hold) To keep displayed on the monitor the last
image acquired at the exposition end
Greyscale inversion (B/W). In real and post processing time displaying
Windowing and images levels To optimize the images quality based on
clinical applications
Brightness values adjustment In real and post processing time adjustment
Digital Zoom with edge enhancement Zoom can be activated on real‐time images or
factors selectable by the operator. stored ones
PAN function. To select the area to be enlarged, it can be
activated on both, real‐time images and
stored images
Digital image rotation Real‐time and high‐low/left‐right image
inversion
Digital recursive filter for noise reduction. It can be activated on four levels and with an
algorithm realized to reduce at the minimum
the images dragging
Edge enhancement Adjustable on several levels to improve
details visibility
APPLICATIVE MODULES OPTIONAL
MEASURES AND MARKER MODULE Image measurements functions:
(optional) distances/angles,
Marking, image annotation and comment

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 INFOTEC

ONLY AVALABILE WITH 10R9 10R12 E 10R13 MODELS

DYNAMIC CINE LOOP • Acquisition and direct archiving on Hard Disk with
15 frames/s MODULE minimum images sequence of 15 frames/s with
manual and automatic CINE LOOP
• 500.000 images archive
DYNAMIC CINE LOOP • Acquisition and direct archiving on Hard Disk with
30 frames/s MODULE minimum images sequence of 30 frames/s with
manual and automatic CINE LOOP
• 500.000 images archive
DIGITAL CINE ACQUISITION The DIGITAL CINE function uses all the dynamic
DETAILS acquisition module features and integrates them with
a pulsed radiological technique with high frequency
and resolution:
• Pulsed frequency generator :
15pps and 30pps selectable by the operator,
Range kV: 40 – 120 kV,
Range mA: up to 100 mA,
Pulse duration: 14 ms.
With the DIGITAL CINE pulsed technique, the operator
can obtain digital movies with a very high images
quality level and low X‐ray dose.
VASCULAR MODULE DSA operative mode (Digital Subtraction
(possible only with a Dynamic Angiography) & Road Mapping
module 30 frames/s) The package includes:
• Hard Disk archiving;
• Automatic Cine Loop after acquisition
• Automatic Mask
• Low dose DSA or H.Q. mode;
In H.Q. mode it is possible to select 15 frames/s
or 30 frames/s ;
• PIXEL SHIFT in real time
• LAND MARK in real time
• SUBTRACTION in real time, with 6 levels of
enhancement.
• ROAD MAPPING in real time, with mask
acquisition
• ROAD MAPPING in real time, with the previous
acquired mask.

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 ARCHIVING
Archive • Local archives (on hard disk) of static or images
sequences in automatic or manual mode
• Storage mode changeable at any time by the
operator
Storage capacity on Hard Disk • Models 4F9, 5R9, 5R12 and 5R13: 6.000 images
• Models 10R9/10R12/10R13: 6.000 images
500.000 images with optional dynamic module
Images archives organized for • Patient personal data;
operative sections with multiple • Operator name,
keys for images research • Examination date
• Procedure type
Images displaying • Inside the archive in form of icon marked with a
sign for an easy research.
Image deleting • To select or delete a single or a complete
images section.
Archived images exportation • DICOM 3.0 (optional) and in formats supported
by Windows (.AVI, .BMP)

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 INFOTEC

CASSETTE HOLDER
Format 24x30
PROCEDURES DOCUMENTATION
Networking interface board, for direct For direct connection, through standard TCP/IP
connection connection or any kind of computer connected
to the net.

C‐arm touch screen displays “live” the AK

(mGy) and AK rate (mGy/min)
DAP DOSE REPORT (optional) • DAP (μGym2) value digital processor
monitor displays.
• Exposition Report (DAP) automatic system
creation. The report collects the total
patient X‐ray exposure data displayed
according to the different working modes
(continuous/pulsed fluoroscopy,
radiography).
• Local medical printer (optional) patient
record print.
• Pdf export file.
USB port For external devices connection

CD‐ROM and DVD WRITER (optional) Exportation mode:

• Selection of the most relevant single patient
images
• Full session of all the images stored for a
single patient

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 LOCAL PRINTER (OPTIONAL) Sony UP 970 AD
LASER LIGHT LOCALIZER (OPTIONAL)
DICOM CONNECTION MODULE • DICOM STORE
(OPTIONAL) • DICOM WORKLIST
• DICOM PRINT
• DICOM MPPS
• DICOM STORAGE AND COMMITMENT
• DICOM CD/DVD WRITER (with SW DICOM
viewer)
• DICOM on USB flash drive (with SW
DICOM viewer)

Automatic interface for Medrad injector • Interface for automatic contrast high
(optional) pressure Medrad Mark V ProVis® injector

ENVIROMENTAL
Operating temperature +10°C / +40°C
Storage temperature 0° C/ + 40°C
Operating humidity 20% / 80% non condensing
Storage humidity 10% / 80%
Pressure 700/1100 hPa
Vibration 10 – 150 Hz, 0.35 mm peak
Power supply Monophaase neutral to ground
220‐240V ± 10%; 50Hz
Connection to the mains supply With power supply 16 A EN60309.
external isolation transformer

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 INFOTEC

OPTIONAL ACCESSORIES
MEASURE AND MARKER SOFTWARE
LASER LIGHT LOCALIZER FOR I.I. 9"/12”/13”
CASSETTE HOLDER FOR I.I. 9"/12”
DAP DOSE WITH PDF EXPORT FILE
CD WRITER BMP FORMAT
DICOM STORE
DICOM WORKLIST
DICOM PRINT
DICOM MPPS
DICOM STORAGE COMMITMENT
DICOM CD/DVD WRITER
DICOM ON USB FLASH DRIVE
VIDEO SONY UP970AD PRINTER
VIDEO SONY UP990AD PRINTER
STERILE TOWELS

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Symbol mobile unit overall measures with IB 9”

Symbol mobile unit overall measures with IB 13”

Symbol mobile unit with vertical axis arm rotation

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 INFOTEC
Work station overall measures

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 GENERAL MEDICAL MERATE S.p.A.
Via Partigiani, 25 ‐ 24068 Seriate (BG) ITALIA
tel (0039) 035 4525311 ‐ fax (0039) 035 297787
http: www.gmmspa.com e‐mail: [email protected]
In compliance with the essential requirements of MEDICAL DEVICES DIRECTIVE 93/42EEC and supplements
Conforme ai requisiti essenziali della DIRETTIVA DISPOSITIVI MEDICI 93/42CEE e sue integrazioni

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