36A79720Q0003-0001354.xlsx

Team A

Questions and Answers

1.a Fixed Wall Digital Detector, 1.b. Fixed Digital Detector, 1.c. Wireless digital detector Question: Please clarify When the wall stand and/or table detectors can be used as fixed or wireless do you still require a third wireless detector?

2.j. Minimum table height from floor [in] Question: Please change this requirement to 20 inches to allow for fair competition.

Workstation Requirements 4.b. LCD touchscreen acquisition workstation monitor Question: Please expand this requirement to touchscreen or mouse control to allow for fair competition.

Trade-In

1.g. Minimum SID range Question: Please change the minimum requirement 45 in.

Additional Specifications 2.o. Table and upright auto tracking package Question: Please change this minimum requirement to just Auto Tracking package.

2.s. Automatic tube crane, protocol-based movement Question: Please expand to automatic movement on the overhead suspension or fluoro tube.

2.x. Ability to send images directly from the control panel (no separate workstation required) Question: Please define “control panel” – is this requirement for the operator’s console?

2.aa. Auto tracking of the tube and detector during vertical adjustment at the wall stand and/or tube Question: Please remove this requirement to allow for fair competition

2.bb. Tilt-able detector holder with inherent grid (-20 degrees to 90 degrees) Question: Please remove this requirement to allow for fair competition.

2.ee. LCE In Room Monitor Ceiling Mounted Question: Please remove this as a minimum requirement or make it optional

Table Requirements 2.jj. Articulation Question: Please clarify this requirement.

2.rr. Ability to lower tabletop heights to at least 18” from the floor Question: Please change this requirement to a minimum of 18.5” from the floor to allow for full competition.

Software Requirements 3.a. Monitoring Dosage….reproducible with <2% deviation.

Question: In order to allow for full competition please change this requirement to 5% deviation.

Security/Connectivity Requirements 4.c. Encrypted hard drive

7.m Integration to third party Advanced Visualization System Question: Please clarify this specification and define “integration.”

7.n. Mobile Trailer Requirements Question: Please clarify this specification:

Trade-In Question: Please provide the following information to determine an accurate trade-in value: Software Level, List of Coils and Channels, Software Level, Year of Installation, and Projected De-Installation date. 7m. We need as a destination in DICOM section.

7n. Yes, it is for a interim solution, no more than 4 months. Yes, as an option not a requirement. Year of Manufacture: I don’t have the date of manufacture, but the startup date was 24-May-2010.

Gradient Strength: X, Y & Z 33Mt/m | Minimum Rise Time 330 µs | Slew Rate 100 T/m/s | Max Gradient Current 625 A | Maximum Voltage 1200 V

Channel count on System: 18

Quench History: I am not seeing any quenches in the service history.

Helium Level: 62.0 % this morning.

Coils: Please see list from inventory below:

• “Minimal footprint” – Suggest removal. Spec is too general. The requirement to have a typical drawing will allow the site to determine what footprint works best for them.

• “Grids and grid caps in various foci and radius”. The responses to this requirement will be very hard to evaluate “apples to apples”, as vendor A may provide 10 grid and grid cap combinations while vendor B may only provide 2 combinations, which will result in the value proposition not being evaluated equally.

1.a. Minimum wall detector size 17x17in Question: The 17x17 detector is an unduly restrictive requirement. Industry standard for systems with the same clinical requirements is a minimum of a 14x17 inches. Please change the minimum requirement to 14x17 inches.

2.r. Table and upright auto tracking package Question: Please change this minimum requirement to just Auto Tracking package.

2.v. Automatic tube crane, protocol-based movement Question: Please change this requirement to Automatic tube crane, protocol-based movement with fluoro tube.

2.ee. Automated movement for long axis stitching Question: Please change this requirement to Automated movement for long axis stitching at the table.

2.ff. Auto tracking of the tube and detector during vertical adjustment at the wall stand and/or tube.

Question: Please change this requirement to Auto tracking of the tube and detector during vertical adjustment at the table.

2.bbb. Ability to lower tabletop height to at least 18” from the floor in the horizontal position at stated maximum weight capacity.

Question: Please change the minimum specification from 18’ from the floor to 18.5” from the floor.

Software Requirements 3.a. Monitoring of dose…reproducible with <2% deviation Question: Please change the <2% deviation to a 5% deviation to allow for full and open competition.

3.b. Bone Suppression

1.j. Maximum system weight 2,090kg

1.b Minimum bore width 74cm Question: The minimum 74cm bore requirement is restrictive requirement, please change the minimum specification to 70cm to allow for full and open competition.

1.c. Minimum bore depth 160cm.

Question: The minimum 160cm bore depth requirement is restrictive requirement, please change the minimum specification to 145cm to allow for full and open competition.

1.e. Minimum slew rate 32 T/m/s Question: The minimum 32 T/m/s seems to be an error. Please change this requirement to a minimum slew rate of 200 to allow for full and open competition.

1.f. Minimum number of channels 550 lbs.

Question: The minimum 550lbs requirement seems to be an error. Please confirm that the minimum channel requirement should be 32 channels?

1.h. Minimum UPS time at full functionality is 5700 lbs.

Question: The Maximum Patient Weight Requirement seems to be an error. Please change this requirement to full or partial UPS. If you are requesting a full UPS (ability to scan patients without power) please confirm that the facility has the room, the correct HVAC and power to install this unit.

1.g. Maximum Patient weight withstood 120s Question: The Maximum Patient Weight Requirement seems to be an error. Please change this requirement to 500lbs to allow for full and open competition?

Additional Specifications 2.z. Uninterruptible power supply Question: Please clarify this requirement to full or partial UPS. If you are requesting a full UPS (ability to scan patients without power) please confirm that the facility has the room, the correct HVAC and power to install this unit. 1.b - changed to 70cm 1.c.- changed to 145cm 1.e.-changed to 200 1.f - changed to 32 1.g - changed to 500 lbs 1.h - changed to partial UPS 2.z. - partial UPS required

504B97003 Section B 1 E. Minimum slew rate? Need a number?

H. Minimum UPS time at full functionality [s] Is this for computer software only or entire system including gantry?

Section B 2

d. Uninterruptible power supply Is this for computer software only or entire system including gantry?

z. Uninterruptible power supply Is this for computer software only or entire system including gantry?

Section B 3 Workstation Requirements -What is the workflow and requirements for the workstation?

d. Uninterruptible power supply Is this for computer software only or entire system including gantry?

z. Uninterruptible power supply Is this for computer software only or entire system including gantry? 1.e.-changed to 200 1.h - changed to partial UPS B2.d - Partial system UPS 2.z. - partial UPS required B3.

d. - partial system UPS

z. - partial system UPS

Technical Requirements 1.b Minimum gantry aperture 75cm Question: The minimum 75cm gantry aperture is restrictive requirement, please change the minimum specification to 70cm to allow for full and open competition.

1.f. Maximum patient weight supported 250kg.

Question: The minimum 250kg patient weight supported is restrictive requirement, please change the minimum specification to 226kg (500lbs) to allow for full and open competition.

1.h. Maximum system weight is 250kg Question: The maximum system weigh of 250kg is restrictive requirement, please change the minimum specification to 2877kg for gantry only and table weight of 800 kg to allow for full and open competition.

Additional Specifications 2.c Dual Energy Imaging (either at the radiation source or in the detector).

Question: Please clarify this request for all vendors. Is a value-based specification desired (e.g., rotate-rotate) or would the VA like to see a premium-level option quoted (e.g., rapid switching).

Advanced Applications 4a.-e. Advanced applications integration to Tera Recon Question: The specification is requesting one post processing workstation, but then requests integration into TeraRecon. Please confirm that the request is for vendors to provide their own OEM advanced applications software for 4a. – 4.d. and then to confirm integration of the CT system (not the workstation) with TeraRecon? 1.b - changed to 70 cm 1.f - changed to 226 kg 1.h - spec removed 2c. - Dual Energy was moved to the value add section of the revised tech specs 4a-e - Both are required. Need a post processing workstation included and also need integration with TeraRecon

B3 - Both are required. Need a post processing workstation included and also need integration with TeraRecon B2- c - Dual Energy was moved to the value add section.

• Maximum pixel size of the detector is unduly restriction and clinically inconsequential. Request the minimum requirement be increased to 140 microns and allow vendors to exceed the minimum with whatever micron size they have.

1.d. Minimum Requirement 15.74 x 3.94cm Question: Some cardiac specific camera’s measure the field of view as spherical volume of interest (VOI) instead of a rectangular field of view. Please change the minimum requirement to 15.74 x 3.94cm (UFOV) or 19cm (VOI) to allow for full competition.

1.f. Minimum Workstation monitor Size 24 in Question: To allow for competition please change the minimum requirement to 23” 1.h. Maximum system dimensions (cm) 216cm x 173cm x190cm Question: Please change this specification to must fit in a specific room size. The dimensions above seem to be for a specific vendor.

1.i. Maximum System Weight 670kg Question: Please change the Maximum System weight to 1000kg to allow for full competition 1.j. Maximum Patient Weight 246kg Question: Please change the Maximum Patient Weight to 200kg (440lb) to allow for full and open competition

Additional Specifications 2.f. Open Gantry Question: Please change this requirement to Open or Ring Gantry to allow for full and open competition 2.g. Variable patient position (Upright to supine) Question: Please change this requirement to Variable Patient Position, Supine, Prone, or Dextra-cardia Imaging. While upright imaging is valid the ability to do supine and prone is clinically more relevant in its ability to identify diaphragmatic attenuation.

3.b. Minimum Workstation monitor Size 24 in Question: To allow for competition please change the minimum requirement to 23” Matrix provided 1.d - Specification has been removed.

1.f - Specification changed to 23 inches 1.h - Measurements of room added to the spec 1.i - Specification changed to Maximum floor loading 2.f - We have clinical justification for this and therefore this specification will remain as is.

2.g - We have clinical justification for this and therefore this specification will remain as is.

3.b - Specification changed to 23 inches

2.d. Removeable lead curtains with counter weights for when curtains not in use Question: To allow for full and open competition please change this requirement to Removable lead curtains with counter weights for when the curtains are not in use or portable radiation shield.

2.s. Head holder device for prone position Question: Please remove this requirement as this seems to be a unique offering from a specific vendor.

Software Requirements

3. a. Monitoring of Dosage- The system must be able to supply a technology that allows for monitoring and tracking of radiation dose provided to a patient; DICOM structured reporting is preferred. DAP accuracy must be 99% reproducible with <2% deviation.

Question: Please change this specification to <5% deviation to allow for full competition.

Security/Connectivity Requirements 4.d. Encrypted hard drive Question: Please expand this requirement to include a hard drive that this protected.

Trade-In

1.d. Minimum image reconstruction rate – 5 second acquisition to yield results in 20 seconds Questions: In order to allow for full competition, please change this minimum requirement to, the system is capable of fast rotational imaging that minimizes breathing artifact

1.h. Minimal rotation rate 45 degrees Question: In order to allow for full competition, please change this minimum requirement to, the minimum rotation rate is capable of fast cone beam CT acquisition to minimize artifact

Additional Specifications 2.ff. MedRad Ceiling mounted contract injector and interface Question: Most interventional suites use a table mounted injector. Please clarify what is requested.

2.ii. Intravascular Ultrasound system (IVUS) Question: Please clarify, do you want the IVUS to display on a large display monitor? 1d. Updating wording to 5 second acquisition. Rate can be met by multiple vendors.

1h. Updating wording to 30 degrees 2ff. Updating to remove ceiling/table specification and allow vendors to bid best option for table proposed.

2ii. Yes, would like monitor to be able to toggle views to display IVUS when it is in use.

534B92034 Technical Requirements 1.f. Minimum number of channels (coil elements) 204 Question: The industry standards is to measure the number of channels, not a vendor specific requirement of coil elements. Please change this specification to 16 channels.

1.g. Maximum Patient weight withstood 550 lbs.

Question: In order to allow for full competition, please change this specification to Maximum Patient Weight withstood 500 lbs. 1f. Updating to 32 channels. (Coil elements per application will be viewed on a value added basis).

1g. Clinical need, multiple vendors can meet requirement.

534B92036 Technical Requirements 1.d. Minimum gantry 30 degrees Question: Tilting gantries are an element in CT, but not PET/CT. Please remove this minimum requirement.

1.m. Minimum time of flight resolution 375 ps.

Question: The time of flight specification of 375 ps., is a restrictive requirement please change this requirement to 385 ps., to allow for full and open competition.

1.n. Minimum time of flight coincidence window 4.5ns.

Question: The time of flight specification of 4.5ns., is a restrictive requirement, please change this requirement to 5.25 ns, to allow for full and open competition.

1.s. Workstation operating system, Win 10 or above at time of delivery Question: Not all systems have a Windows Operating system, please change this requirement to Win 10, Linux or above at time of delivery. 1d. Removing requirement.

1m. Updating to 385 ps 1n. Updating to 4.9 ns 1s. Updating to Windows 10 or above, Linux equivalent generation or above, or other unique operating system of equivalent generation or above at time of delivery.

534B92037 Technical Requirements 1.a. Minimum number of slices 64 Question: Please confirm requirement that the CT must have a minimum of 64 independent detector rows?

1.j. Workstation Operating System Win10 or above at time of delivery.

Question: To allow for full and open competition, please change this requirement to Win10 (or above) or Linux Operating System at time of delivery Additional Specifications 2.r. 3D visualization and processing capabilities for reading Question: Please confirm that vendors should include independent 3d workstation capable of post processing 3D CT data? 1a. Confirmed as a 64.

1j. Updating to Windows 10 or above, Linux equivalent generation or above, or other unique operating system of equivalent generation or above at time of delivery.

2r. 3D post-processing is required, either on a independent workstation or included on primary workstation is acceptable.

534B92038 Technical Requirements 1.a. Minimum number of slices 64 Question: Please confirm requirement that the CT must have a minimum of 64 independent detector rows?

1.j. Workstation Operating System Win10 or above at time of delivery.

Question: To allow for full and open competition, please change this requirement to Win10 (or above) or Linux Operating System at time of delivery Additional Specifications 2.r. 3D visualization and processing capabilities for reading Question: Please confirm that vendors should include independent 3d workstation capable of post processing 3D CT data? 1a. Confirmed as a 64.

1j. Updating to Windows 10 or above, Linux equivalent generation or above, or other unique operating system of equivalent generation or above at time of delivery.

2r. 3D post-processing is required, either on a independent workstation or included on primary workstation is acceptable.

534B92039, 534B92040, 534B92042, 534B92043 Additional Specifications 2.b. Ability to accept multipower feeds from 110v to 440v Question: Please change this requirement to 3 phase, 480 volts to accommodate modern XR power requirements.

2.c. Floor mount tube with bucky tracking for wall stand Question: Section 1.n. identifies this requirement as a ceiling mounted system. Please remove, “Floor Mount” to the 2.c specification. 2b. Updated to ability to accommodate multi-phase, 480V 2c. Updated to remove floor mount

- This requirement is specific to the acquisition workstation that stores images. 250GB is insufficient for clinic need. Requirement will remain at 1 TB of hard drive space and requirement added of 16 GB of RAM.

534B92044 Technical Requirements 1.f. Minimum number of channels (coil elements) 204 Question: The industry standards is to measure the number of channels, not a vendor specific requirement of coil elements. Please change this specification to 64 channels.

1.g. Maximum Patient weight withstood 550 lbs.

Question: In order to allow for full competition, please change this specification to Maximum Patient Weight withstood 500 lbs. 1f. Updating to 32 channels. (Coil elements per application will be viewed on a value added basis).

1g. Clinical need, multiple vendors can meet requirement.

1.j. Maximum System Weight 12,000 lbs.

Question: In order to allow full competition please change this requirement to 17,000 lbs. or allow vendors to quote an extended installation proposal that may include additional structural support.

Trade-In Question: Please provide the following information to determine an accurate trade-in value: Software Level, List of Coils and Channels, Software Level, Year of Installation, and Projected De-Installation date. 1.j. We cannot raise the weight limit above 12,000 pounds. We also do not want the floor modified to provide structural support.

Trade In information:

Software version: 6.1V5 Release 3.2.3.5 Coil list:

1 8 channel Head 1 XL 16 channel Torso coil 1 15 channel Spine 1 16 channel NV coil 1 8 channel wrist coil 1 16 channel TR Knee coil 1 8 channel foot ankle coil 1 8 channel knee coil 1 6 channel CTL coil 1 6 channel cardiac coil 1 intera torso coil 1 6 channel breast coil 1 2 channel TR head coil 1 Sense flex large coil 1 Sense flex medium coil

Item 49 CVX-300 Excimer Laser System – This item is only available from one vendor and is unduly restrictive. Please remove this from the minimum requirements. Item 43: integration kit is required to connect the cardiac ultrasound and the echo interventional navigation tool for fusing live X-ray and live echo. Anatomical intelligence fusion imaging must be able to fuse live 3D transesophageal echo (TEE) and live X-ray in real time so care-giver can intuitively guide the device in the 3D space quickly. (facility will accept "removal of "model name")

Item 49: Excimer laser system and disposable catheters for the treatment of peripheral and coronary arterial disease. Photoablation is the use of light to break down, vaporize and remove matter. The excimer laser system facilitates photoablation via a variety of laser catheters to remove binding arterial plaques. (facility will accept "removal of "model name") 561B82013 • Wireless cardiac gating Question: To allow fair competition please remove this specification and permit all cardiac gating devices.

Minimum 32 channel 578B78022 Technical Requirements 1.d. Maximum Patient Weight Supported 295kg Question: Please clarify the maximum weight required, if the linear accelerator weight maximum is 227kg/500lb should this requirement be the same.

Additional Specifications 2.a. The CT scanner shall provide the ability for the user to independently operate the table, gantry and CT Fluoroscopy mode from the control room.

Question: Please clarify with the customer that CT Fluro is required or should be removed.

2.b. Modeled iterative reconstruction/Noise reduction. Vendors are encouraged to propose the greatest available noise reduction.

Question: Please clarify that the iterative reconstruction is a requirement. We understood that they customer does not plan to use this system for diagnostic CT and would, therefore, not utilize iterative reconstruction.

2.d. Full UPS Question: Please clarity this requirement, a full system UPS is very large and may not fit in the room. Does the customer want a full system UPS that will allow the facility to continue to scan if power is lost or a partial system UPS that will keep the scanner on and allow the therapist to get the patient off the table and save the data, but not continue scanning?

2.g. Wall or table mounted patient respiratory gating camera Question: Please update this specification to Wall mounted, Table mounted or Deviceless patient respiratory gating.

Question – We did not see Metal Artifact Reduction on the Generic Quote. Please ask this customer if this should be added to the minimum specifications 1.d. 500 lbs. is acceptable 2.a. CT Flouro should be included.

2.b. Iterative reconstruction should be included.

2.d. Provide a partial system UPS.

2.g. Metal artifact reduction should be included.

1.a Fixed Wall Digital Detector, 1.b. Fixed Digital Detector, 1.c. Wireless digital detector Question: Please clarify When the wall stand and/or table detectors can be used as fixed or wireless do you still require a third wireless detector?

Unit physical specifications 2.h. Maximum 2nd wireless detector [in x in] Question: Please change this requirement to 17inx17in to allow for fair competition.

2.m. Minimum tube height from floor when used with wall stand [in] Question: Depending on confirmation of type of tube mount please increase to 15.7 inches if Floor-Mounted tube or 11 inches if ceiling suspend tube.

2.n. Minimum image plate height from floor [in] Question: Depending on confirmation of type of tube mount please increase to 15.7 inches if Floor-Mounted tube or 11 inches if ceiling suspend tube.

Additional Specifications 3.n. Tube Mount: Floor-Mounted Question: Other specifications for this obligation would lean toward a ceiling suspended tube. Please confirm that a floor-mounted tube mount is indeed the requirement.

Workstation Requirements 4.d. LCD touchscreen monitor acquisition workstation monitor Question: Please remove the word, touchscreen, from the workstation monitor description to allow for full competition. 1.a. Only two detectors are required if the wall stand or table detectors can be used as fixed or wireless.

2.h. Changed in tech specs.

2.m. Changed in tech specs

2.n Changed in tech specs.

3.n Change to ceiling mount in tech specs.

4.d. Removed touchscreen. Changed in tech specs

Either would be fine. As long as the table holds a minimum of 550lbs.

1.a Fixed Wall Digital Detector, 1.b.