A Diagnostics & Imaging Week
As it often does at such gatherings, GE Healthcare (Waukesha, Wisconsin) has highlighted its presence at last week’s annual meeting of the Radiological Society of North America (RSNA; Oak Brook, Illinois) with a wave of product introductions and other announcements.
One key product unveiled on the McCormick Place exhibit floor was the Discovery VCT, which GE characterized as “the world’s first true 64-slice combination positron emission tomography and volume computed tomography (PET/CT) system for cardiac imaging applications.”
The company said the Discovery VCT system “has the potential to transform the way physicians diagnose and treat heart disease and other life-threatening illnesses.”
GE said the system marries the high-speed, high-resolution capabilities of the company’s volumetric CT with the metabolic and physiologic capabilities of its PET system, which it said is the industry leader.
“By combining these scanning technologies,” GE said, “the Discovery VCT provides the tools to enable physicians to more accurately diagnose and identify heart disease and other conditions, including cancer and neurological disorders.” Using PET technology, a physician can assess areas of the heart that are not getting sufficient blood supply. To determine the root cause, the physician can look for stenosis in the coronary arteries using the volumetric CT technology.
“The Discovery VCT will enable physicians to access essential functional and anatomical patient data, including perfusion map at rest and peak cardiac stress, CT angiography and cardiac calcium score, all in one setting,” said Dr. Marcelo Di Carli, director of nuclear medicine/PET and co-director of cardiovascular imaging at Brigham and Wom-en’s Hospital (Boston). “The information made available through Discovery VCT images will help physicians quickly and accurately diagnose cardiovascular patients, eliminating unnecessary invasive diagnostic procedures while guiding more appropriate treatment decisions.”
GE originally designed the LightSpeed VCT, the world’s first volume CT system (introduced in 2004), to integrate with its PET technology. The company recently reported the 500th installation of the LightSpeed VCT, making it the fastest-selling product in GE Healthcare history.
“Developing the world’s only volumetric, 64-slice PET/ CT is a logical extension of our success with the Light-Speed VCT,” said Gene Saragnese, vice president and general manager of GE Healthcare’s global molecular imaging and CT business. “The speed and resolution of the LightSpeed VCT, combined with the functional capabilities of PET, will keep [us] at the forefront of diagnostic cardiovascular care.”
In another major push at RSNA, GE Healthcare introduced three new imaging technologies across different modalities to enhance breast cancer detection:
- MR BREASE (breast spectroscopic examination), a new technique using spectroscopy to improve specificity.
- A new collaborative agreement with the Ethicon Endo-Surgery (Cincinnati) unit of Johnson & Johnson (New Brunswick, New Jersey) to integrate biopsy and portable ultrasound technologies.
- A new digital mammography workflow module for the company’s Centricity picture archiving communication system (PACS).
GE said these advances augment its Senographe, which it said is the world’s leading digital mammography system. Since Senographe’s introduction as the world’s first full-field digital mammography (FFDM) in 2000, more than 1,500 of the GE systems have been installed worldwide.
“We’re taking a holistic, multi-modality approach to breast cancer by looking at all of GE’s capabilities and how they will impact the whole spectrum of the disease, from screening and early diagnosis through treatment,” said April Dorcas, strategic marketing manager at GE Healthcare.
GE said MR BREASE improves the ability to distinguish benign breast lesions from cancerous ones by showing elevated concentrations of choline, a product of membrane synthesis that rises in rapidly reproducing cancer cells and is a strong indicator of malignancy. It potentially reduces the number of benign biopsies indicated by MR, according to Robert Lenkinski, PhD, head of MRI research at Beth Israel Deaconess Medical Center (Boston).
“The potential for adding spectroscopy to the standard breast MRI exam is that it can greatly improve a radiologist’s ability to distinguish benign breast lesions from cancerous ones,” said Lenkinski. “Spectroscopy adds another measure to improve the overall accuracy of MR scanning of the breast.“
MR BREASE is a new enhancement to GE Healthcare’s VIBRANT (volume imaging for breast assessment) high-definition technology that enables a non-invasive imaging procedure of both breasts simultaneously, in a single patient visit. The company said VIBRANT–XV “further expands the capability to acquire high-resolution images at high speed, providing both exquisite anatomical detail as well as critical kinetic information.”
GE has more than 400 VIBRANT installations worldwide.
Ultrasound has become a standard and important tool in the detection and diagnosis of breast cancer. The GE/Ethicon Endo-Surgery collaborative sales/marketing agreement is aimed at launching a new solution that could reduce the number of open surgical breast biopsies performed each year. Of the 1.6 million women who will have breast biopsies this year, more than 500,000 will undergo the open surgical procedure.
Through their collaboration, Ethicon Endo-Surgery and GE will offer compatible products that can operate together as part of an integrated biopsy system to help enable breast surgeons to provide a less-invasive, more accurate method of diagnosing breast cancer compared to open surgical biopsy.
The companies will promote two technologies working in tandem – the Mammotome EX Biopsy System from Ethicon Endo-Surgery and the GE Logiq Book XP compact ultrasound system. When used together, the companies said, “these technologies give patients and surgeons immediate access to a highly accurate diagnostic procedure for patients undergoing breast biopsy.”
GE said the integration of a new digital mammography workflow module to its Centricity PACS product “offers customers the ability to read digital mammography images on their PACS workstation while providing efficient access to historical multi-modality exams. These advanced applications are aimed to facilitate the earliest detection of breast cancer, giving a woman the best potential clinical outcome through early treatment.”
GE also is offering a Personalized Breast Cancer Management program designed to provide physicians with the tools to develop a comprehensive end-to-end breast cancer protocol that tailors screening, the latest technology diagnostic tests and treatments according to individual risk factors and pathology.
The program also offers an operational excellence and integrated multi-specialty care coordination and optimization program that GE said “significantly reduces the cycle time from detection to diagnosis and treatment.”
The program is being developed at Virtua Health (Marlton, New Jersey), and is planned for development at University Community Health System (Tampa, Florida).
Also at RSNA, Eastman Kodak (Rochester, New York) displayed a broad portfolio of new digital imaging and information products that it said can perform a wide range of functions in hospitals, outpatient imaging centers and medical specialty practices.
The space-efficient Kodak Directview DR 3000 System, shown for the first time at this year’s meeting, is a works-in-progress solution designed to capture and enhance X-ray images with improved efficiency. Kodak said the DR 3000 system’s flexible floor mounted design is an ideal single detector solution for hospitals and diagnostic imaging centers.
Another works-in-progress solution will enable Kodak’s computer-aided detection (CAD) system for mammography to also run bone mineral density tests. Since the same women who are screened for breast cancer often are at risk for osteoporosis, the company said having a “two-in-one” CAD system “can be a great benefit for women’s healthcare centers.” Special CAD software from Kodak will be able to analyze an X-ray of a woman’s hand to produce a report that will indicate bone density.
Kodak also showed its new CR Long-Length Portable Imaging System, a small, portable, lightweight medical imaging accessory for capturing images of bones up to 33 inches long. The company’s stitching software provides a nearly seamless long-length image that is ready for diagnosis without any need for manual intervention by technologists or radiologists. The new system can capture erect and supine medical images in hospital X-ray rooms, surgical suites and orthopaedic clinics, and can easily be moved to conduct patient bedside exams.
The company also featured its Kodak Carestream Solutions, complete image and information systems that enhance communication of patient data across the continuum of care. These solutions, which include Kodak Care-stream Radiology Solutions and Kodak Carestream Infor-mation Management Solutions, are designed to improve care delivery, patient safety and efficiency while delivering cost savings for radiology departments, healthcare organizations and communities.
Kodak also announced availability of the Kodak Directview DR 7500 System, a premium digital radiography system that “offers outstanding image quality and is scalable to meet the space and budget requirements of a wide range of healthcare facilities,” Kodak said in a statement.
R2 Technology (Sunnyvale, California), a developer of computer-aided detection (CAD) technology for the earlier detection of breast cancer and other medical conditions, unveiled its new Citra Mammography Applications Suite, for use with Sectra’s (Linkoping, Sweden), multi-modality, vendor-neutral, universal breast imaging workstation.
The company said Citra is the first system to “CAD-enable” digital mammography reading workflow, offering the radiologist “unique decision support tools and superior productivity during review of mammography cases.”
“R2’s CAD systems already offer physicians a ‘second set of eyes’ to help improve the earlier detection of cancer,” said John Pavlidis, R2’s president and CEO. “With Citra, we now also offer physicians a universal and ‘CAD-intelligent’ system for reviewing digital mammography images and comparing them with digitized prior film images.”
The Citra Mammography Applications Suite works in conjunction with the Sectra IDS5/mx.net Breast Imaging Workstation and R2 ImageChecker D Mammography CAD System. The company said it is compatible with all FDA-approved full-field digital mammography (FFDM) systems, including those from GE Healthcare, Hologic (Bedford, Massachusetts), Fischer Imaging (Denver) and Siemens Medical Solutions.
Key features include RightSize Optimized Temporal Comparison, an exclusive R2 package that equalizes the size of all displayed images to facilitate the efficient comparison of prior and current images; EmphaSize Variable Size CAD Marks, R2’s new marker technology which provides variable-size CAD marks that correlate to lesion significance; PeerView Digital CAD Display, which enhances the suspicious region in order to help the radiologist understand the specific features detected by R2’s algorithm; and LesionMetrics CAD-Enabled Decision Support, which provides additional information, including lesion size, distance to chest wall and nipple; R2 CAD score and other characteristics of detected masses and calcifications.
R2 also noted that five independent prospective clinical studies from academic and community practices showed that the use of the company’s mammography CAD resulted in 6.6% to 19.5% more cancers detected. Studies comparing CAD performance on architectural distortions, cases graded by difficulty, and small invasive breast cancers all demonstrate the advantage of R2’s CAD algorithm, the company said.
Siemens Medical Solutions (Malvern, Pennsylvania) and BrainLAB (Munich, Germany) introduced NaviVision, a platform combining a surgical C-arm and an optical 2-D/3-D navigation unit. The new system allows more room for the operating room team and helps facilitate workflow, the companies said, adding that the presence of fewer cables “may increase safety during typical OR situations.”
Describing NaviVision as “the first integrated optical navigation platform with automatic recording for surgery that is supported by an image receptor,” the companies said the combination of Siemens’ ARCADIS family of mobile C-arms and BrainLAB’s optical 2-D/3-D navigation unit “helps provide the operator with great freedom of action at the OR table.”
NaviVision’s adjustable swivel arm can be set in either the horizontal or vertical direction. Its navigation screen can be attached directly to the C-arm’s workstation or to the OR table to meet the surgeon’s needs. A DICOM interface allows for easy documentation of image data.
The NaviVision system is expected to be available in January, together with new models of Siemens’ ARCADIS Orbic, ARCADIS Orbic 3D and ARCADIS Varic C-arm systems.
Siemens Medical Solutions also highlighted new CT Clinical Engines at its booth, addressing four key clinical fields – acute care, cardiology, neurology and oncology. The company said this new clinical workflow concept “maximizes the clinical performance of computed tomography imaging by combining CT technology with its established syngo solutions.
CT Clinical Engines offer improved image acquisition and quality, Siemens said, resulting in “exceptional visualization as well as comprehensive evaluation, robust quantification and flexible reporting.” Available on the Somatom Definition, Sensation and Emotion CT scanners, these new CT Clinical Engines provide synergy benefits across the entire clinical workflow in each field, according to the company.
“[Our] new-generation CT Clinical Engines offer clinical configurations that can simplify any facility’s workflow,” said Scott Goodwin, vice president, CT Division. “These engines provide a total, customizable CT solution that can meet the demands of any clinical environment, whether it is a large research facility or diagnostic imaging center.”
In other Siemens Medical news, Schering (Berlin) and Siemens said they would join forces to explore the potential of Siemens’ Dual Source computed tom-ography technology implemented for the first time on Somatom Definition in combination with Schering’s CT imaging agent, Ultravist.
The new Somatom Definition is the world’s first dual-source CT system and is faster than any existing CT technology, the company said. It employs two X-ray sources and two detectors at the same time, while traditional CT systems use only one source and detector. Ultravist is an intravascular, non-ionic contrast medium suitable for all common X-ray examinations. It is approved in more than 100 countries worldwide and used in more than 10 million procedures per year, the companies said.
Through this technology, numerous advantages will be offered to physicians and patients such as clearer, more detailed images and a wider range of clinical applications. It is designed to set new standards in non-invasive diagnosis of the heart and the coronary arteries. It is capable of imaging patients with high or irregular heart rates, or arrhythmias, without beta-blocker medications that are often used today. At the same time, radiation exposure can be reduced by up to 50%.
Also at RSNA:
• Confirma (Kirkland, Washington) reported the addition of new features to its CADstream system, which it referred to as “the standard in CAD [computer-aided detection] for breast MRI.”
An expanded version of SureLoc, CADstream’s interventional guidance tool, is now compatible with all interventional guidance methods and equipment. In addition, CADalog, the company’s new study library that provides efficient storage and retrieval of studies, and z3D Contrast Acuity by Clario, a new visualization tool for the evaluation of study enhancement patterns, were introduced at RSNA. CADalog and z3D Contrast Acuity are currently under clinical investigation.
Bruce Porter, MD, medical director of First Hill Diagnostic Imaging (Seattle), said, “Breast MR has been significantly hindered in the past by the time-consuming, laborious task of processing and interpretation of the study. CADstream markedly reduces processing and interpretation time, and there is increasing evidence suggesting that CAD may also improve the accuracy of breast MR studies.”
• Connect Imaging (Honolulu), a provider of picture archiving and communication systems (PACS) for small- and medium-sized hospitals and imaging centers, is displaying two product enhancements at its booth on the McCormick Place exhibit floor.
The upgraded Distribution Manager module forwards studies to radiologists according to flexible and comprehensive rules, whether the radiologists are on site or logged in remotely via DSL or cable modem. It includes a monitor panel that displays the current status of all routing connections and allows other staff to quickly determine whether the radiologist has received all images in the study.
The company’s new ViewBox features several upgrades such as a background study preloading thread that allows the user to display and manipulate large studies with more than 1,000 slices from new multislice CT scanners almost as quickly as two-view chest X-rays.
The ViewBox user interface also has been enhanced to allow users to reorder images and series on the display, link multiple series (including prior studies) for simultaneous scrolling, and perform normal image manipulation without having to look away from the image.
• Terason (Burlington, Massachusetts), a producer of high-performance Laptop Ultrasound imaging systems, reported the launch of the Terason t3000 Ultrasound System.
The company said that unlike solutions that rely on modified off-the-shelf components, “the Fusion Processor is the only fully custom-designed, integrated ultrasound chip set in the world.” It enables what Terason characterized as “unprecedented ultrasound image processing power in a small system.”
The t3000 Ultrasound System is based upon proprietary Teratech Architecture, which combines a front-end Fusion Processor with PC- based back-end data processing. The system runs as a Windows application on a standard laptop computer, and can be instantly converted from a portable unit to a cart-based system.
Terason was established in 1994 as a spin-off of the Massachusetts Institute of Technology’s (Cambridge, Massachusetts) Lincoln Laboratory.
• Toshiba America Medical Systems (TAMS; Tustin, California) introduced two new coils, one designed for long bones such as the humerus and femur, the other a 32-channel head/spine coil designed for brain, cervical, thoracic and lumbar imaging in trauma or immobile patients.
The latter coil is especially beneficial when imaging the spine on hard-to-move patients or those suffering from spine disorders such as kyphosis, a permanent curvature of the spine, TAMS said. The coil delivers high-resolution images without the need to change coils or move the patient.
Available on any of TAMS’ Vantage MRI systems, the new coils were exhibited as works-in-progress.
• Zonare Medical Systems (Mountain View, California) reported new upgrades to the company’s z.one ultrasound system. The upgrades include two new transducers, calculation packages and a program for automatically recognizing and adjusting for the differences in body sound propagation, which the company said is possible only due to its Zone Sonography technology.
Donald Southard, president and CEO, said, “The new transducers greatly expand the imaging capabilities and applications of the z.one system, whether used as a full-featured, cart-based system or a premium compact system.” He said the Zone Sonography technology “has allowed us the ability to automatically adjust for each individual’s unique body sound propagation and fully optimize the ultrasound image – something never before achieved.”
The Zone Sonography architecture retains all the raw data obtained in the ultrasound signal, enabling such advances as automatic sound speed compensation. Zonare said it also has allowed “superb image quality at a substantial price-to-value ratio.”