Diagnostics & Imaging Week and Staff Reports

Siemens (Erlangen, Germany) won a landmark contract for medical imaging in the UK with a multi-million pound purchase of 11 top-of-the-line scanners by the University Hospitals Birmingham National Health Service Foundation Trust (UHB).

It is the single biggest contract to be awarded using the NHS Supply Chain procurement system introduced in November 2007 that gives public hospitals an accelerated and streamlined process for purchasing.

"The UHB shopping list was quite wide, so the usual suspects were presenting for a variety of modalities," said Steve Holmes, UK sales manager for Siemens Healthcare, who led the bid that bested GE Healthcare (Chalfont St. Giles, UK), Royal Philips Electronics (Eindhoven, the Netherlands) and Toshiba Medical (Tokyo).

"Philips won angiography X-ray units and Carestream was awarded general X-ray units," said Holmes, but Siemens took the big-ticket scanners, "and they are buying state of the art," he added.

UHB currently runs the Queen Elizabeth Hospital and Selly Oak Hospital, located 1-1/2 miles apart in south Birmingham, and is consolidating 40 specialties into a new 545 million ($812 million) hospital to be called the Queen Elizabeth Hospital Birmingham that is scheduled to begin opening in June 2010.

"To say this is a quantum step is actually an understatement, if you could see our department today," Dr. Peter Guest, clinical service lead radiology at UHB, told Diagnostics & Imaging Week.

"The importance for us . . . is the increase in capacity, allowing for a rapid turn-around for both inpatient and outpatient services, which we can not do today," he said.

"Then clearly there is a significant increase in not just the quality of imaging but an entirely new set of technological capabilities for scanners that we simply do not have today."

UHB is purchasing four MRI scanners, four computed tomography (CT) scanners and three single photon emission computed tomography (SPECT/CT) systems.

Among the CT scanners is a Somatom Definition AS+ 128-slice CT scanner that will be dedicated to the emergency department.

"I have the impression this capability is routine in the United States, but it is new for us and quite new for the UK," said Guest, adding that the benefits of full body scans for trauma cases is well-established.

He said UHB currently uses CT in trauma cases but that the scanner is located in a separate facility where the new CT will be located in a new accident and emergency assessment and reporting center for QEHB fully loaded with new imaging equipment.

Beyond trauma, he said the 128-slice CT will be used for diagnoses of acute abdominal and chest pain and "it will be cardiac capable for triple rule-out assessments" of coronary artery disease, pulmonary embolism and aortic dissection.

Holmes said the zero-heat tubes for the AS-series CT scanner, which eliminates downtime for cooling off periods, "is terrific for throughput, which is a sensitive issue in the UK as everyone has waiting lists on their mind."

Guest mentioned improved waiting lists for radiology three times in an interview to contrast the service, as well as capabilities, for the new QEHB radiology group.

An open MRI platform will be new for the hospital's radiology group, and QEHB will also feature Siemens' Magnetom Verio 3 Tesla MR scanner which will be used for complex imaging. He said UHB currently has access to a 3 tesla scanner only for research purposes at another center.

"The Verio 3T sits on the footprint of a 1.5 scanner with a short and open bore," said Holmes, in contrast to 3T research scanners that patients find uncomfortable enough to refuse to return for follow up scans.

UHB is the leading teaching and research hospital trust in the Midlands and is a regional center for organ transplant, trauma, burns, plastic surgery, cardiology and neurosciences.

Paul Brettle, imaging X-ray group manager at UHB, said, "The new hospital will be a flagship site in terms of the services we will be able to provide for the community and we also want to ensure such innovative technology will assist us in not only keeping waiting lists down, but in tackling conditions that are increasing in an ageing population."

Presentations among the "usual suspects" in UK medical imaging begin in early May for another hospital consolidation underway by Mid Yorkshire Hospitals NHS Trust that is constructing two brand-new hospitals, the Pinderfields Hospital in Wakefield and the Pontefract Hospital in Pontefract.

Procurement of scanners and other medical imaging modalities is being conducted through a NHS Supply Chain tender.

Multiplex to boost biochip assays for pathogens

Biochip diagnostics developer Randox (Crumlin, Northern Ireland) said it is licensing multiplex polymerase chain reaction (PCR) technology from SeeGene (Rockville, Maryland/Seoul, South Korea) to develop high-throughput screening panels that will simultaneously detect a broad range of infectious pathogens.

Randox, which has recently expanded into molecular biology diagnostics developing its Biochip Array Technology (BAT) for multi-analyte assays for gene expression profiles, said the new capability with SeeGene technology broadens market potential even further.

"The Seegene application has massive capability for simultaneously detecting a large number of pathogens in a highly specific and sensitive fashion," Martin Crockard of Randox told Medical Device Daily from Seoul, where he was coordinating work with SeeGene.

Crockard said using the PCR platform allows even faint traces of a pathogen in a patient sample to be amplified to detectable levels for the Randox BAT readers.

The BAT panels are run through one of the Randox analyzing units that include the high throughput, fully automated Evidence, the medium throughput semi-automated Investigator and a near-patient automated redare called Multistat.

"This has huge implications in healthcare practice," he said, "it will facilitate precise identification of the implicated pathogenic organism causing the symptoms presented, ensuring correct treatment is given at the correct dose at the correct time."

Where diagnostic assays typically are used to test for a single pathogen, simultaneous testing for multiple pathogens eliminates the need to perform a sequence of tests to find the cause of infection.

The companies are focusing their first efforts to combine the proprietary technologies on tests for sexually transmitted infection (STI) and respiratory infections.

With the amplified samples, Randox's biochip array placed in the analysis platform can simultaneously detect up to 10 pathogens, viral and bacterial, from a single sample, including those that may not present symptoms.

"While asymptomatic infections may seem harmless, if unchecked, they may be passed on and many have implications, using the example of sexually transmitted diseases, for fertility both male and female," Crockard said.

"As more than one STI may be present in an individual, which is quite often the case, it makes sense to test for as many as possible at once, so that the treatment given completely removes any infections, rather than only those detected using single assays," he added.

"In the case of respiratory pathogens, the need is greater still for an effective multiplex assay, as rapid determination of infection may save lives, through immediate and correct treatment," Crockard said.

For the respiratory assay panel, the Radox BAT assesses 18 pathogens simultaneously. "This provides a very powerful tool in the fight against debilitating respiratory disorders," he said.

The terms of the agreement between the two privately held companies were not disclosed.

U.S.-based companies organize group in Japan

A group of U.S.-based med-tech companies has launched the American Medical Devices and Diagnostics Manufacturers' Association (AMDD; Tokyo), representing the Japanese operations of more than 60 U.S. firms.

AMDD was established as of April 1 as an independent organization to foster speed and efficiency when addressing the common advocacy interests of companies formerly represented by the Medical Devices and Diagnostics Subcommittee of the American Chamber of Commerce in Japan (ACCJ).

Advocacy activities include providing policy recommendations related to regulatory issues, national health insurance reimbursement payments, and healthcare system reform in Japan, in order to provide global-standard advanced medical technology to Japanese patients.

"The AMDD will conduct activities to establish an environment where the value of advanced medical technology is fully appreciated, with the aim of improving patient quality of life, saving lives and reducing medical expenditure," said Dr. Huimin Wang, chairman of AMDD and corporate vice president, Japan and Intercontinental, for Edwards Lifesciences (Irvine, California).

"This will be achieved through the adoption of advanced medical technology; that is, minimally or non-invasive diagnostics and treatment," Wang said.

David Powell, vice chairman of AMDD and president, Johnson & Johnson KK, said, "The AMDD will work with Japanese and European industry associations when submitting recommendations to the government to address the delay of approval of advanced medical technology, also known as the device lag, and innovative product pricing."

The AMDD's 62 member companies account for roughly 13,000 jobs in Japan and generate some $8.5 billion in sales, representing 40% of the Japanese medical technology market.

Polish distributor accord renewed

Imaging Diagnostic Systems (IDSI; Fort Lauderdale, Florida) said it has renewed its distribution agreement with EDO-MED as its exclusive distributor in Poland.

EDO MED will continue to market and provide technical service support for the CT Laser Mammography (CTLM) system throughout that country, as well as to assist with and promote the ongoing research efforts utilizing CTLM technology at the Comprehensive Cancer Center in Gliwice, Poland, and other institutes and research centers.

IDSI said it will continue to collaborate with EDO MED to develop the CTLM clinical research program in Poland, providing support for hospitals using the system as part of their routine practice and research to further investigate additional usage of the system. The company also will provide assistance for EDO MED's sales and marketing initiatives.

1st RapidArc treatments in India

Clinicians at Yashoda Cancer Institute (Hyderabad, India) have carried out that country's first treatment using a new, faster form of radiotherapy that extends more advanced care to more patients. A 72-year-old bladder cancer patient received the treatment using RapidArc radiotherapy technology from Varian Medical Systems (Palo Alto, California).

Varian said the RapidArc technology makes it possible to deliver image-guided IMRT (intensity modulated radiotherapy) two to eight times faster than is possible with conventional IMRT.

Srinivas Chilikuri, MD, said RapidArc delivers a precise and efficient treatment in single or multiple arcs of the treatment machine around the patient and offers several advantages over traditional approaches.

Yashoda Cancer Institute is a 200-bed comprehensive cancer research and treatment center operated by Yashoda Hospitals. The institute provides care to 7,000 cancer patients every year.

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