A Diagnostics & Imaging Week

Most of what happens in the field of diagnostic imaging involves prevention – or at least discovery of disease in its early stages. That has once again been a key point of emphasis at this year's Radiological Society of North America (RSNA; Oak Brook, Illinois) scientific assembly, being held this week at Chicago's McCormick Place convention center.

GE Healthcare (Chalfont St. Giles, UK) kicked off its participation in this year's RSNA event by showcasing technologies that help providers transform a healthcare delivery model focused on treating late disease to one with a focus on "Early Health," or prevention and pre-symptomatic disease detection.

"Healthcare providers are looking for ways to find disease sooner to help people live longer, fuller lives," said President/CEO John Dineen. He said GE Healthcare "is the only healthcare organization with the strength to bring together the best in science, technology, and business to help providers redefine the frontiers of discovery, diagnosis, treatment and information management and transform healthcare."

In a Monday news conference, the company demonstrated what it labeled "Radiology Re-imagined" by highlighting three new diagnostic imaging product lines it said were inspired by customer needs and developed in response to changing market dynamics.

"Customers around the world have clearly told us that they want medical technologies designed to help them achieve the specific clinical and operational objectives of their department or institution," said Mark Vachon, president/CEO of GE Healthcare's Global Diagnostic Imaging business.

"Their feedback inspired us to re-imagine radiology, from technology development to product offerings, in a way that is new and unique in the radiology field," Vachon said. "Through this effort, we have developed the Optima, Discovery and Brivo product lines around specific customer needs."

Among the new products on display in the GE Healthcare booth:

The Optima XR640, developed to deliver digital productivity with flexibility by providing the same configuration as a digital fixed detector RAD room with the flexibility of a single, shared digital detector, and features a moveable detector that mimics traditional patient exam workflow.

The Discovery MR450, GE's new 1.5T MR scanner, offering what the company said are "the most advanced capabilities available on any 1.5 Tesla system," including real-time cardiac imaging, single-acquisition, multi-contrast abdominal images with outstanding fat/water separation and ultra high-resolution musculoskeletal exams with high patient throughput.

The Discovery PET/CT 600, delivering "a powerful combination of the highest sensitivity in the industry, next generation of MotionFree technology, high-definition imaging, and fast reconstruction."

The Discovery XR650, featuring GE's fixed-flat-panel digital detector, delivering what GE said is one of the industry's highest detective quantum efficiency of 77%, with a new portable detector, offering further flexibility in the comprehensive radiographic room compared to previous generations."

The LightSpeed VCT XTe, a new generation of scanners built from GE Healthcare's proven LightSpeed VCT platform and enhanced with HD technologies.

The Senographe Essential Interventional, GE's latest innovation for breast biopsy, "designed to improve clinical confidence, accuracy and comfort with your biopsy system."

The LOGIQ E9, a new ultrasound system for radiology and vascular applications that merges real-time ultrasound images with images from other imaging modalities like CT and MR.

The OEC 9900 Elite C-arm, a new fluoroscopy device that the company said "allows for superb images during surgery with radiation dose control dependability and versatility."

The Advanced Workstation (AW) Server, which GE said is capable of expanding the boundaries of the clinical office and the potential of 3-D image-based diagnosis.

Philips, UCMC aim to improve efficiency

As is usually the case, the "big guys" in the medical imaging space have cranked up their marketing machines for this week's 94th annual meeting of the Radiological Society of North America (RSNA; Oak Brook, Illinois) in Chicago to take advantage of their sprawling exhibits in the McCormick Center exhibit space, and their PR machines are equally busy cranking out press releases on each firm's "newest and best."

One of those big players, Royal Philips Electronics (Amsterdam, the Netherlands), unveiled two new solutions at RSNA to help radiologists save time and improve patient diagnosis.

Philips reported that it is partnering with the University of Chicago Medical Center (UCMC) on what the company said is a "first-of-kind" closed-loop imaging research trial.

The purpose of the ongoing trial is to take a holistic view of radiology workflow and integrate information systems together with imaging systems to remove inefficiency at all points within the imaging loop. The "imaging loop" clock starts when the physician decides to order an imaging exam and ends when the results of the test are communicated to the doctor and eventually the patient.

Led by Paul Chang, MD, medical director of enterprise imaging for UCMC, the institution has initiated this study with the goal of reducing errors and improving quality of care and patient outcomes.

Together with Philips, UCMC is integrating the technologies used throughout the radiology suite so they "talk" to each other across an automated and open platform, seeking to streamline imaging procedure steps to save minutes, not seconds, during the entire imaging loop.

The medical center said helping to improve efficiency of radiology workflow may help it reduce patient waiting time, repeat scans and the time needed for appointments.

"To stay relevant in healthcare, we simply can't keep using the same workflow model," said Chang. "Radiologists need to provide the highest-quality diagnostic results to the patient's physician while obtaining the best images on the first scan, every time, without compromising patient care."

This, he said, "requires an orchestrated workflow that can only be achieved if all systems used in the imaging loop are integrated and provide an interface allowing information to flow seamlessly from one step to the next, minimizing inefficient and potentially distracting busy work for the radiologists and technicians."

As a first step of the research trial process, Philips and UCMC have identified major bottlenecks and non-essential steps in the imaging loop, and have determined the right Philips technologies to help solve the inefficiencies facing radiologists and technologists.

During this initial phase, UCMC replaced the current paper-based CT protocol system — manual entry of a list of images requested, as well as contrast and dose requirements — with an automated electronic patient protocol system that uses a Philips tablet PC for wireless access to relevant patient and scanning protocol information.

Protocol settings are automatically communicated to the CT scanner, simplifying CT scanning by sending all relevant clinical information and protocol definition without requiring manual entry. Event-driven alerts provide updates throughout the entire imaging process and notify radiology staff when images are ready for processing.

Overall, the UCMC radiology department was able to eliminate non-essential work and paper trails. The medical center and Philips said upcoming iterations of this project would seek to incorporate additional, customized solutions that directly address the bottlenecks identified in the imaging process.

Probe-based solutions pushed by Hitachi

Hitachi Medical Systems America (Twinsburg, Ohio) is demonstrating advances for the HI VISION 900 system, along with what it said are "unique probe-based solutions," which allow radiology departments to utilize the equipment in their department more efficiently.

Highlighting its RSNA exhibition are new developments in the company's Real-time Tissue Elastography (E-mode) feature. With more than 800 units delivered to date, E-mode is now being used for applications other than just breast imaging.

Hitachi is displaying images of its use in thyroid, prostate, musculoskeletal and colorectal applications. The company said its new Strain Ratio tool allows radiologists to quantify the relative differences in stiffness between a mass and any surrounding tissue.

Also featured for the HI VISION 900 are the recently released Version 2.5 software and 7-Series transducers. Version 2.5 software adds support for new probes and new features such an onboard DVR that can record clips continuously for up to four hours, DICOM Structured Reporting and HIPAA compliance support.

Hitachi's new 7-series probes feature Expanded Layer Transducer (ELT) technology for clearer, cleaner images at increased depth. The 7-series high-frequency probes incorporate Hitachi's Micro Piezo-composite Transducer technology, which the company said is "the culmination of more than 40 years of Hitachi transducer research and development," and "which provides superb superficial and peripheral vascular imaging."

The company also is demonstrating the potential economic and workflow advantages of switching some biopsy procedures from CT to ultrasound. It says that increased penetration and unique probe designs, such as its through-crystal dedicated biopsy and therapy probe, are enabling its customers to overcome limitations used to necessitate CT guidance.

Move into CT, MRI for iCAD

iCAD (Nashua, New Hampshire), a provider of advanced image analysis and workflow solutions for the early identification of cancer, has unveiled several innovations at its exhibit space.

"This year we have expanded our portfolio of image analysis and workflow solutions beyond mammography CAD into the imaging modalities of computed tomography (CT) and magnetic resonance imaging (MRI), extending our reach," said President/CEO Ken Ferry. "This enables us to help clinicians find the most prevalent cancers including breast, colon and prostate, earlier, faster and with greater confidence."

iCAD launched several new CAD analysis and clinical decision support solutions that work in combination with CT and MRI imaging modalities:

SpectraLook and VividLook use algorithms that generate colorized MRI images and enhancement curves on a pixel-by-pixel basis, providing radiologists with wat iCAD terms "timely and efficient contrast kinetic assessment of lesions in the breast and prostate."

CADvue is a complete MRI image review, analysis and BI-RADS compatible reporting solution providing contrast enhancement curves, dynamic 3-D images and quantification of key lesion parameters. The company said CADvue's automation of critical manual steps provides a significant reduction in the time required to generate curves and streamlines radiologist's work flow and diagnosis.

VeraLook is a "revolutionary" CAD solution for virtual colonoscopy (CTC), iCAD said, designed to aid radiologists in the detection of polyps during their review of CTC exams. It said early clinical evidence suggests that CAD for CTC will enhance radiologist effectiveness in interpreting CTC studies.

iCAD also is demonstrating elements of its next-generation SecondLook Digital CAD solution, currently under development. Advances shown include performance improvements, software enhancements, and new "lesion metrics" that provide insight into CAD's decision-making process.

S-GYN offers answers quickly

SonoSite (Bothell, Washington), whose focus is on hand-carried ultrasound for the point of care, introduced the S-GYN ultrasound tool, which it refers to as "a streamlined, custom-designed solution" for gynecologists who want to perform imaging for diagnosis and procedural guidance right in the patient exam room.

SonoSite has engineered the S-GYN system to enable gynecologists to provide answers to their patients quickly. It integrates the company's SonoHD and SonoMB technologies to provide clear imaging of common gynecologic problems and to guide interventional procedures.

With the system's SonoAdapt technology, the clinician need only adjust two controls — Depth and Gain — to quickly acquire the optimum image. SonoSite said the small footprint of the S-GYN fits easily beside the patient examining table and it can be ceiling- or wall-mounted to save space.

The S-GYN tool is configured to use the company's C60x abdominal and ICTx transvaginal transducers.

The S-GYN system joins the family of other S Series systems, which include the S-Nerve for anesthesiologists, the S-Cath for interventionalists, the S-ICU for intensivists, the S-FAST for emergency medicine physicians and S-MSK for musculoskeletal specialists.