Medical Device Daily

As heart and circulation ultrasound specialists gathered this week in Washington for ASE 2009, the American Society of Echocardiography's (Morrisville, North Carolina) 20th annual scientific sessions, a few dozen diagnostic and imaging companies were eager to show off their latest gadgets. Among them, GE Healthcare (Chalfont St. Giles, UK) put the spotlight on its latest solution for the assessment of heart failure, the Vivid E9.

According to GE, the Vivid E9 expert series is an entirely new class of 4-D cardiovascular ultrasound that features advanced, quantitative tools for assessing treatment and therapies for heart failure management. It brings the dream of true 4-D imaging and stress testing to life for the first time in a GE ultrasound system. Driven by a new processing engine, eight times more powerful than conventional systems, it enables the clinician to view a full-volume 4-D image for each heartbeat, the company said.

"We've had a really great conference, it's actually been really exciting to be in our booth, customers just can't get enough of [Vivid E9]," Ruth Fleming, commercial marketing for GE's cardiovascular ultrasound business, told Medical Device Daily.

Fleming said the Vivid E9 is the first commercially available system that offers 4-D cardiovascular ultrasound. "It isn't something that our traditional competitors are readily available with, so the Vivid E9 has been an exciting story for us and it's been well received [at ASE]," she said.

GE launched the Vivid E9 at the end of 2008 and has been shipping the system to customers since December.

"Any opportunity you have to assess a full volume gives you an accurate picture of what you're looking at," Fleming said. She added that 4-D echocardiography enables physicians to get a better look at the shape and size of the patient's heart.

GE says its accelerated volume architecture drives the engine and enables Flexi-Volume acquisition; a full volume in one, dual or multiple heart cycles, individually selectable based on the patient. Flexi-Volumes and RV Volumes help clinicians diagnose heart failure by evaluating the shape and size of the chambers, the company said. In addition, 4-D color flow provides data on valve function and 4-D Auto LVQ and tissue velocity imaging quantifies systolic and diastolic function. AFI and 4-D stress echo are on board for differentiating ischemic and non-ischemic heart failure, while tri-plane TSI and 2-D strain help to assess the treatment and therapy options for heart failure management, GE noted.

The company said its new M5S transducer takes the matrix array technology and marries this with single crystal technology to provide better endocardial definition, texture, and crisper valves across a wider range of frequencies than traditional transducers.

Though this represents GE's fifth 4-D "breakthrough," the company says it hasn't come at the expense of the 2-D imaging most clinics will rely upon while transitioning. The new D-series transducers work with the new engine to deliver enhancements in 2-D, 4-D and shared service image quality across the entire patient population, GE said.

"The 4-D is very easy to incorporate into an everyday routine," said Marti McCollough, director of Cardiac and Vascular Imaging at Methodist Hospital (Houston). "We grab a few 4-D volumes prior to picking up the 2-D transducer and then incorporate the 4-D throughout the rest of the 2-D study."

To make the transition simple, GE said it includes the "Easy 4-D" feature package to help improve workflow, reduce the learning curve, and make the 4-D exam protocol more reproducible from patient to patient. With the new One-Touch 4-D feature, users simply touch one button and the system automatically crops away the full volume and displays the requested view. Management of large data sets 4-D provides is simplified with the 4-D Virtual Store, which uses image pointers to refer back to the original full volume data set, rather than saving multiple large data sets for every new crop view or measurement.

"With 4-D, you know precisely where you are and can cut 30% to 40% of errors from 2-D imaging on a routine basis," said Aasha Gopal, MD, associate professor of medicine, advanced echocardiography at St. Francis Hospital (Roslyn, New York).

Behind its new Scan Assist technology, the Vivid E9 also marks GE's first exploration into true 4-D stress echo, according to the company. It allows users to acquire single cycle or multi-cycle full volumes in any variation of traditional, multi-dimensional or full volume views. Vivid E9's templates for both exercise and pharmacologic stress tests are all fully customizable, GE said.

The company also said the Vivid E9 is 40% smaller and 30% lighter than the Vivid 7 while boasting front and rear handles for easy transport. One touch accesses the electronic keyboard and touch panel and another touch adjusts the height and position, instantly, according to GE. A new 17" all Digital LCD monitor tilts and swivels for optimum viewing and data management choices are conveniently located with multiple USB ports, DVR recorder, and DVD drive, the company noted.

"As a diagnostic tool, Vivid E9 breaks down virtually any barrier that had been limiting [the] field of 4-D echocardiography," Al Lojewski, VP and general manager of GE's Cardiovascular Ultrasound business. "We've been able to open up the world of 4-D imaging for use in almost every echo exam without sacrificing our 2-D roots and it didn't happen without our best efforts and our top design teams. It's all worthwhile, though, if it helps even one our customers predict and prevent patients being hospitalized for heart failure. That's why we're in this business."