Top technologies at RSNA 2010 drive personalized medicine.
(Conferences, meetings and seminars)
Radiologists (Conferences, meetings and seminars)
|Publication:||Name: Applied Radiology Publisher: Anderson Publishing Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 Anderson Publishing Ltd. ISSN: 0160-9963|
|Issue:||Date: Jan, 2011 Source Volume: 40 Source Issue: 1|
|Product:||Product Code: 8622000 Medical Associations NAICS Code: 81392 Professional Organizations SIC Code: 8621 Professional organizations|
|Organization:||Organization: Radiological Society of North America|
|Geographic:||Geographic Scope: United States Geographic Code: 1USA United States|
Radiologists are playing an increasingly important role in
delivering personalized care, a development emphasized by the theme of
the 96th Scientific Assembly and Annual Meeting of the Radiological
Society of North America (RSNA 2010)--Personalized Medicine: In Pursuit
"Radiology can play a central role, helping evolve and shape this emerging vision for the benefit of cancer patients," noted Sanjiv S. Gambhir, MD, PhD, Molecular Imaging Program at Stanford (MIPS), Department of Radiology and Bio-X Program, Stanford University. In his presentation, Strategies for the Earlier Detection of Cancer, Dr. Gambhir identified new imaging strategies for studying basic cell and molecular biological events to identify disease at earlier stages.
Helping to drive radiology's evolution toward personalized care are several new advances in medical imaging and imaging informatics (IT), which were on display at RSNA 2010 in Chicago.
Computed tomography (CT)
GE Healthcare (Chalfont St. Giles, U.K.) highlighted Veo, its latest solution to CT radiation dose reduction. As a model-based iterative reconstruction (MBIR) technology, Veo's new modeling techniques are designed to deliver lower noise and artifact suppression, provide resolution gain, and improve low-contrast detectability. The technology is available in Europe and is 510(k) pending at the FDA. GE also emphasized its dose-reduction innovations with its Adaptive Statistical Iterative Reconstruction (ASiR) solution, a low-dose reconstruction technology engineered to reduce dose by as much as 40% to 50% while maintaining image quality (Figure 1).
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Ingenuity CT is a new platform from Philips Healthcare (Andover, MA) designed to enable clinicians to reduce dose by up to 80 percent while maintaining diagnostic image quality and improving spatial resolution. The system is engineered to generate low-dose diagnostic images with detailed visualization of bones at the same quality as full-dose images.
As part of its goal to reduce radiation exposure to 2 mSv in typical CT exams, Siemens Healthcare (Malvern, PA) announced it will soon release FAST CARE, a solution to shorten exam times and lower dose. Fully Assisting Scanner Technologies (FAST) is a new processing support program. Combined Applications to Reduce Exposure (CARE) is a new dose reduction solution that automatically displays dose distribution for the planned examination. Together, FAST CARE will be available for use on the SOMATOM Definition AS and the SOMATOM Definition Flash scanners in 2011. CARE adds to the company's initiatives to provide CT dose reduction solutions, including Iterative Reconstruction in Image Space (IRIS), a new method for the reconstruction of CT images designed to reduce dose.
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Toshiba America Medical Systems (Tustin, CA) introduced 160-detectorrow helical scanning, which is the helical scan mode with the largest number of detector rows. Designed for the Aquilion One, the CT system can image the entire chest, abdomen, and pelvis in less than 5 seconds, or 2.5 times faster than 64-detector-row imaging. This technique is designed to reduce motion artifact to produce quality images.
Magnetic resonance (MR)
GE Healthcare (Chalfont St. Giles, U.K.) introduced the redesigned Discovery MR750w with a 3.0T magnet, zero-boil off technology, 70 cm X 130 cm patient bore with dual-flared 78-cm aperture openings, and a 50 cm X 50 cm X 50 cm field-of-view volume. Also on display at the GE booth was the Optima MR430s, a compact 1.5T system; the Optima MR360, a 1.5T whole-body MR with two detachable and one fixed table; and the Brivo MR355, a 1.5T wholebody MR with a fixed table. The systems have a super-conducting CXK4 magnet with zero boil-off technology.
The company has several 510(k) pending MR coils within its GEM Suite, which includes a set of receive-only radio frequency (RF) surface coils designed for use with the Discovery MR750w 3.0T system and the Optima MR450w 1.5T system.
Of its non-contrast solutions, GE demonstrated 3D arterial spin labeling for quantitative brain perfusion assessment. The technique can be used on pediatric patients and those with reduced renal function.
Lantheus Imaging (N. Billerca, MA) touted the release of ABLAVAR (gadofosveset trisodium), an FDA-cleared MRA blood pool imaging agent used to evaluate aortoiliac occlusive disease in adults with known or suspected peripheral vascular disease. The agent is administered in a single, low dose--in line with the recent update to the ACR manual.
The Ingenia MR system from Philips Healthcare (Andover, MA) is a digital broadband MR system, which supports digital signal acquisition and processing directly in the RF receive coil nearest to the patient. By providing a consistent digital connection throughout the entire MR scanning process, the system is designed to generate up to a 40% improvement in signal-to-noise ratio. The system is pending 510(k) clearance.
Siemens Healthcare (Malvern, PA) highlighted productivity enhancement technologies on its MR systems with Tim 4G and Dot (day optimizing throughput). Tim 4G combines ultra high-density coils with 48 RF channels. The Dot engine offers a customizable framework for patient personalization, user guidance, and exam automation. Both technologies are available in the MAGNETOM Aera 1.5T and Skyra 3T MR systems.
Toshiba America Medical Systems
(Tustin, CA) introduced a new Vantage Titan 3T MR system designed to improve patient compliance and comfort and to enable advanced techniques. The open bore has a 71-cm aperture designed to reduce claustrophobia in bariatric patients. Toshiba's Pianissimo noise-reduction technology works to reduce exam noise by up to 90%.
With the Vantage Titan, radiologists can perform several contrast-free MRA techniques, including fresh blood imaging (FBI) for evaluating peripheral vascular diseases of the lower legs and extremities; contrast-free improved angiography (CIA) for easier visualization of smaller vessels; time-spatial labeling inversion pulse (Time-SLIP) for evaluating hemodynamic, functional assessments, and visualization of vascular structures; and time space angiography (TSA) to create non-contrast time-resolved imaging with high temporal resolution (Figure 3). The Vantage Titan 3T MR is pending 510(k) clearance.
GE Healthcare (Chalfont St. Giles, U.K.) announced the installation of a positron emission tomography (PET)/ CT and MR imaging (MRI) platform called PET/CT +MR. The integrated sequential two-room PET/CT, MR scanners can be used in parallel or patients can be scanned on independent systems. An image registration application runs on GE's Advantage Workstation, allowing a patient to be moved from one device (PET/CT) to the other device (MR) without changing positions on the table.
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GE also announced its first shipment to the United States of the Discovery NM/CT 670, a single photon emission computed tomography (SPECT/CT) system. It combines nuclear medicine detectors, a newly designed SPECT gantry for greater positional flexibility, and GE's BrightSpeed Elite 16-slice CT. The system is engineered to shorten acquisition times and to improve dose management.
Philips Healthcare (Andover, MA) presented its approach to whole-body PET/MR with a system that integrates the molecular imaging capabilities of PET with the soft tissue contrast of MRI. A rotating table maintains patient position as the patient undergoes an MRI study and a PET study. The system is pending 510(k) clearance.
Another molecular imaging advance from Philips is the Ingenuity TF PET/ CT. The hybrid system is designed for studies in oncology imaging, cardiac perfusion, and diagnostic CT. The system includes the same features of the Ingenuity CT platform, including dose-reduction technologies.
Siemens Healthcare (Malvern, PA) introduced Biograph mMR, the first integrated whole-body molecular 3.0T MR system with simultaneous data acquisition technology. Clinical applications include identifying neurological, oncological, and cardiac conditions and planning therapies. Initial research suggests the system can scan the entire body in as little as 30 minutes for the combined exams (Figure 4).
The Biograph mMR system requires 510(k) review by the FDA. Due to regulatory reasons its future availability in any country cannot be guaranteed.
Barco's (Kuurne, Belgium) Coronis Fusion 10MP display system for diagnostic grayscale imaging aims to enhance precision in reading grayscale images. With 4096 X 2560 resolution for grayscale studies, clinicians can read chest, bone, and breast imaging exams. IPS WideView LCD technology enables viewing from several angles and is designed for multi-user viewing (Figure 5).
Carestream Health (Rochester, NY), introduced eHealth Portal Services, a new cloud-based service that allows healthcare providers to remotely access medical data. eHealth Archive Services users are able to share data and collaborate with imaging centers, radiologists, referring physicians, and other healthcare providers.
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InDex Image PHR by InSite One (Wallingford, CT) took center stage at RSNA 2010 by operating as a clearinghouse in a patient medical record exchange demonstration, which is part of a 2-year, NIH-funded project developed by the RSNA and the National Institute of Biomedical Imaging and Bioengineering (NIBIB).
As cloud solutions integrate radiology systems with the healthcare enterprise, MedWeb (San Francisco, CA) touted the ease-of-use of its Medweb Cloud, a cross-enterprise, cross-platform archive that supports the creation of a master patient index (MPI). The cloud archive is designed for use with specialty-based telemedicine and information management applications, including teleradiology, PACS and RIS, and uses industry standards, such as DICOM, HL7, IHE, and XDS, to share patient data across healthcare facilities and systems.
Nuance Communications (Burlington, MA) launched PowerScribe360, a platform that combines the speech recognition engine Dragon Medical, and is designed for core radiology reporting with options for critical test result management (CTRM), external data capture, multisite workflow support, and structured reporting.
Radiologists, referring physicians, and specialists can review imaging exams simultaneously on the IntelliSpace Portal by Philips Healthcare (Andover, MA). The new platform offers Collaborator, a medical networking solution that allows multiple users to share images and data, and discuss cases in real-time through a chat feature.
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Siemens Healthcare (Malvern, PA) showcased syngo.via, a RIS/PACS platform with advanced visualization tools. Distinctive in syngo.via is automated case preparation functionality, which loads images into the appropriate application and sorts them into the corresponding disease-specific layout, thus eliminating the need to manually choose the application, load data, and select corresponding layouts. (Figure 6).
TeraRecon (Foster City, CA) launched iNtuition CLOUD, a cloud-computing solution for providing advanced visualization as an Internet-based service. Customers can upload their scans to the iNtuition CLOUD site, and then log in from any Mac or PC to access the full suite of thin-client iNtuition tools. iNtuition is also available for the iPhone, iPad, and iPod Touch.
Vital Images (Minneapolis, MN) upgraded Vitrea Enterprise Suite (VES) with Version 6.0. The new version separates rendering, processing, and data storage to sustain quality service. Clinical features include Dynamic MR, XA 3D Angio, and Oncology Fusion, which allows users to visualize, quantify, and track tumors using fused CT, MR, PET, and SPECT images (Figure 7).
Ziosoft Inc. (Redwood City, CA) introduced its PhyZiodynamics solution, an advanced visualization technology with superconducting algorithms that clinicians can automatically apply to the analysis of internal organs, vessels, tumors, and other regions of interest. It also enables radiologists to read from 2-dimensional to 5-dimensional views.
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Canon Medical Systems (Lake Success, NY) debuted its new wireless cassette-size digital radiography (DR) sensor system, the CXDI-70C, at RSNA 2010. The 510(k)-cleared device includes a standard 14-in X 17-in image area and wireless transfer capabilities. Weighing less than 8 lbs, the system is designed to be easy to handle and to fit into existing Bucky trays.
Carestream Health (Rochester, NY) announced the integration of its wireless, cassette-size CARESTREAM DRX-1 detector with Quantum Medical Imaging's Q-Rad Floor Mounted system. The cesium iodide-based CARESTREAM DRX-1C is engineered to produce high image quality and improved DQE (detective quantum efficiency).
FUJIFILM Medical Systems U.S.A. (Stamford, CT) rolled out the new FCR Go 2 at RSNA 2010. The system is equipped with a higher output x-ray generator designed to improve imaging of dense areas, such as the abdomen and spine, and bariatric patients. The new system features a full-size, 15-inch image display at the onboard workstation, enabling technologists and radiologists to preview a full-size image at the patient bedside, using a familiar platform.
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New tools for interventional radiologists being highlighted at the GE Healthcare (Chalfont St. Giles, U.K.) booth included the Innova 4100-IQ. The x-ray imaging solution is designed for image-based diagnosis and minimally invasive therapy for peripheral, oncological, and neurological imaging procedures. It uses CT or MR 3D image data to create a vascular map to better visualize complex anatomy images in fluoro mode.
Addressing the need for flexible x-ray imaging in the emergency departments and intensive care units, GE also introduced FlashPad, a wireless detector that features two handles for easy positioning. The detector provides up to 8% more coverage for key applications and maintains high image quality at low dose levels.
Philips Healthcare (Andover, MA) introduced the Juno DRF, a remote-controlled flat detector system that combines digital radiography and fluoroscopy applications. The system's dual imaging mode is designed to accelerate workflow and increase patient throughput as well as to provide flexible room utilization.
The DigitalDiagnost--ER wireless system from Philips Healthcare is a wireless X-ray system designed for the emergency room, trauma units, and recovery bays. Its rugged, portable detector, built-in handle, and cable-free design provide the flexibility to maneuver around patients and capture difficult anatomical views.
Siemens Healthcare (Malvern, PA) highlighted the Ysio, a DR solution with a color touchscreen control. Ysio is available as a wall stand with an integrated detector; a wall and table system with a wireless detector (wi-D); or as a mixed detector solution for high throughput and flexibility. Its table supports up to 660 lbs and lowers to 21 in.
Toshiba America Medical Systems (Tustin, CA) showcased its Infinix VF-i bi-plane vascular x-ray system with dual 12-in X 12-in mid-sized flat panel detectors. The wide FOV offers expansive coverage during bi-plane neuro and vascular imaging procedures on a broad range of patients, including pediatric. The system's new processor provides Volume Navigation, a new 3D road mapping technique, in which an interventional fluoroscopic application fuses a 3D angiogram acquired on the VFi/BP configuration with live fluoroscopy.
For more RSNA 2010 coverage including: Ultrasound, Breast Imaging, and MyAR TV interviews, visit www.appliedradiology.com
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