Products allow departments to quickly obtain consistent results from user to user and patient to patient

Manufacturers are succeeding in their efforts to fine-tune ultrasound technology in an industry that has enjoyed steady market growth in the past four years. A flourishing replacement market has helped fuel that growth.

A Technology Marketing Group report published early this year found that, in the one-third of U.S. sites and installed units surveyed, 1998 ultrasound procedures totaled nearly 15 million in hospital radiology sites of more than 200 beds. At least 42% of those 1900 sites planned to buy new equipment in the next three years.

Buoyed by this growth, ultrasound developers continue to emphasize refinements to existing technology, such as hardware and software upgrades that further strengthen ultrasound’s position as a key medical imaging modality. Visitors to the RSNA meeting will see developments in three-dimensional imaging, but other key themes at the show will be improvements in image quality and productivity, as well as connectivity, with many firms showing upgrades to their products’ DICOM capacity.

Companies are working on ultrasound technology that integrally links image quality with productivity. On the floor will be offerings that standardize ultrasound images and streamline the imaging process, allowing a hospital department to quickly obtain consistent results from user to user and patient to patient. Acuson will highlight Imagegate, a software and hardware upgrade for its Aspen and Sequoia platforms that expands the units’ Native Tissue Harmonic Imaging (NTHI) capability, and boasts an image optimization feature that allows users to collect images without having to fine-tune the system parameters, which the company believes will help clinicians reduce the need for repeat exams.

ATL Ultrasound will also highlight improvements to image quality and productivity with its new tomographic technology, SonoCT Real-Time Compound Imaging. Introduced in September, SonoCT is part of ATL’s Performance 2000 upgrade package for the HDI 5000, available on the company’s HDI 5000, and is an attempt to not only make ultrasound more efficient, with easily reproducible results, but to improve its image quality by reducing noise. Performance 2000 also consists of ATL’s third-generation tissue harmonic imaging and improvements in DICOM connectivity.

As more clinical research on the use of contrast imaging emerges, vendors have continued their work in contrast-enhanced imaging. Big news at ATL’s booth will be the RSNA meeting debut of a new contrast technique called real-time perfusion imaging. This cardiology feature is based on ATL’s pulse inversion technology and allows clinicians to image small cardiac blood vessels using contrast in real-time without destroying the agent’s microbubbles.

Siemens will present a software package for Sonoline Elegra called Photopic Ultrasound. This product is said to enhance the contrast capability of the unit by increasing the contrast and spatial resolution of images for better views of parenchymal organs and other low-contrast areas.

WHAT TO LOOK FOR

Attendees can expect to see various new units and unit upgrades on the floor, including a system with harmonic imaging improvements and new probes from Aloka; a unit for abdominal, ob/gyn, vascular, small parts, breast, and urology imaging and a portable device with phased array and linear capabilities from Biosound Esaote; two lightweight, mobile units from Siemens; and a next-generation PowerVision System from Toshiba.

Here are a few of the highlights to watch for:

Acuson. Acuson will feature its Imagegate hardware and software upgrade for Sequoia and Aspen that the company launched in September. Designed for both general ultrasound and echocardiography platforms, Imagegate includes improved user interface features such as a keyboard with logically grouped function keys and down lighting that reduces double strokes, according to the company.

Another feature is Image Control, a capability that allows users to obtain an image without having to fine-tune the system parameters. Imagegate also adds to Aspen and Sequoia’s DICOM compatibility, not only improving the communication between the platforms and KinetDx, Acuson’s PACS offering that will be on display at the show, but allowing users to transmit images and access a patient’s demographic information from the hospital’s HIS/RIS network while the exam is in progress.

Acuson will also introduce two new transducers with Imagegate: 4C1 and 6C2, both of which carry two-dimensional and Doppler sensitivity.

Aloka. Aloka will showcase SSD-5500 PureHD, an upgrade to its premium unit, SSD-5500, that includes harmonic imaging improvements and new probes that provide Hemispheric Sound Technologies. These advances are meant to optimize the beam to collect what the company believes are artifact-free images.

SSD-5500 PureHD carries harmonic detection capabilities intended to improve contrast and spatial resolution, and its high-speed digital multiprocessor produces images with high temporal resolution with more than 400 frames per second. The unit also has a cardiology option that allows users to diagnose cardiac wall motion such as Automatic Segmental Motion Analysis, Tissue Doppler Image Measurements, and Real-Time Free Angular M-Mode.

ATL. The biggest news in ATL’s booth will be a tomographic ultrasound technology, SonoCT Real-Time Compound Imaging, a feature that ATL believes will improve the quality of ultrasound images by making them more consistent regardless of user or patient, and will dramatically reduce artifacts. SonoCT collects tomographic data by imaging tissue from multiple viewing angles, using computer beam steering techniques to fire ultrasound beams through the transducer along different lines of sight. The information is grouped into a single compound image and updated in real-time.

SonoCT is available as an option and an upgrade on ATL’s HDI 5000, and is part of Performance 2000, a larger upgrade package ATL is highlighting at the show. Performance 2000 includes the company’s third-generation tissue harmonic imaging, improvements in broadband flow imaging, color power angio imaging, and DICOM connectivity on the HDI 5000.

ATL plans to highlight real-time perfusion imaging, a cardiology feature for Performance 2000 that allows clinicians to image small cardiac blood vessels using contrast in real-time without destroying the agent’s microbubbles. Real-time perfusion imaging is based on ATL’s pulse inversion technology, Power Pulse Inversion, a postprocessing capability that cancels out the fundamental transmit and receive signal, leaving just the harmonic waveform returned by the contrast agent.

Biosound Esaote. Biosound will introduce Technos, a new system for abdominal, ob/gyn, vascular, small parts, breast, and urology imaging that rounds out the company’s radiology and shared service markets offerings. The FDA-cleared unit features a full digital beamformer, supports curved and linear phased-array transducers that operate from 2.5 to 13 MHz, and operates in 2-D imaging, M-mode, Doppler, CFM, and power Doppler.

Biosound will also highlight its two portable cardiovascular systems, Caris and Megas, launched early this year. Caris is a 35-pound, 9-inch-high unit for mobile, ICU, and CCU applications, while Megas is a 48-pound unit with phased array and linear capabilities.

Hewlett-Packard. HP plans to feature its HP ImagePoint Hx system at the show, a multispeciality digital unit with harmonic imaging capability for cardiac, abdominal, and ob studies, as well as two new transducers, HP Ultraband S4 sector transducer and HP Ultraband c3540 curved linear transducer. ImagePoint Hx also carries HP’s stress echo option and features triplex imaging, which allows users to track tissue movement and blood flow simultaneously in 2-D, color flow, and Doppler.

Siemens. Highlights in the Siemens’ booth will include two new mobile ultrasound systems for its Sonoline product line. Sonoline Adara weighs 165 pounds and is a mobile black and white unit with 10 transducers with frequencies up to 8.5 MHz. The second unit, as yet unnamed, will be a high-end digital mobile color-flow system that will incorporate the company’s Ensemble Tissue Harmonic Imaging and SieScape panoramic imaging capabilities, and will include a 13.5-MHz high-frequency probe.

Also featured will be software upgrades to Siemens’ 3-Scape Imaging technology, such as algorithms that add surface rendering capability to the feature and allow users to measure what’s being imaged. Siemens will highlight a new software package for Elegra, Photopic Ultrasound, which will further enhance the contrast capability of the unit by increasing the contrast and spatial resolution of the image for better views of parenchymal organs. It will also improve contrast in other low-contrast areas, according to the company. Siemens also will present CX-5, a new Multi-D Array transducer for abdominal scanning.

Toshiba. In its booth, Toshiba plans to highlight PowerVision 8000, its new high-end system for radiology and cardiology applications. The unit has a wider dynamic range than Toshiba’s other offerings, and allows users to image patients who have traditionally been difficult to image. PowerVision 8000’s PowerView feature will provide integrated DICOM capability and 3-D imaging for both radiology and cardiology applications.

PET leads the charge in nuclear medicine

Interest remains high in imaging with fluorodeoxyglucose

Imaging with fluorodeoxyglucose continues to bolster nuclear medicine, with interest in PET technology fueling purchases of both gamma cameras with coincidence options and dedicated PET systems. Industry watchers predict sales of dedicated PET units will increase by 300% this year.

Evidence of this burgeoning interest will abound at the show, with vendors such as ADAC and SMV moving more forcefully toward dedicated PET. ADAC will feature CPET, its dedicated unit, as well as CPET-MX, a mobile unit. SMV plans to unveil Positrace, a work-in-progress, mid-range system that also incorporates a CT scanner.

A key concept at this year’s meeting will be integration: of nuclear medicine departments into the hospital, of equipment within the nuclear medicine department itself, and of data from different modalities. Many vendors plan to highlight work that fuses anatomical data derived from CT scans and functional data from PET imaging.

ADAC. ADAC plans to unveil a gamma imaging device that it believes will have unprecedented flexibility in applications, as well as unique performance levels and architecture. ADAC will display Cardio 60, a new version of its Cardio dual-head 90° gamma camera launched at this year’s meeting of the Society of Nuclear Medicine, as well as two works-in-progress protocols, Vantage ExSPECT II, a nonuniform attenuation correction technique, and InStill, an automated motion correction algorithm for cardiac imaging. In September, ADAC agreed to acquire UGM Medical Systems, its long-time MCD and CPET technology R&D partner, and introduced CPET-MX, a mobile PET unit based on CPET’s Curved Crystal Technology (CCT).

Digirad. Digirad will highlight upgrades to its single-head, solid-state digital gamma camera, Digirad 2020 TC Imager, and will display its next-generation SPECT rotating chair, called SPECTour. The company has changed its detector system, switching from cadmium zinc telluride (CZT)-based units to sesium iodide/silicon photo diode-based detectors.

Picker. Showcased in Picker’s booth will be Irix, its three-head gamma camera, with a work-in-progress gPET 3 option that allows all three heads to be used in PET mode. Picker plans to have Irix with gPET 3 installed at two beta sites by the RSNA show. The company will emphasize Beacon, its work-in-progress, barium-133-based nonuniform attenuation correction product that performs in both PET and SPECT modes. The FDA has cleared Beacon S, the SPECT version, and Picker expects clearance for Beacon P, for PET imaging, before the RSNA meeting.

Picker will also stress its Integrated Oncology concept. The company has been working to integrate product lines in its CT and oncology divisions, developing CT/PET image registration, as well as two new software packages, Acqsim and Acqplan. Acqsim allows users to identify the location of disease in the body using fused data from PET/CT studies, while Acqplan helps clinicians create a treatment plan for the patient. Cancer therapy is being added to the program through a collaboration with radiation therapy firm Varian Medical Systems.

Siemens. Siemens plans to emphasize integration at this year’s RSNA show with a software architecture platform that will link all its modalities’ computers, information systems, and equipment. The nuclear medicine group will present a new acquisition computer based on this common platform. Siemens also will highlight its disease management focus, displaying works-in-progress such as the next generation of its prototype PET/CT unit installed at the University of Pittsburgh, as well as additional applications for the LSO-based detectors it has been developing in its PET/SPECT device.

SMV. The buzz in SMV America’s booth will be around work-in-progress Positrace, a PET scanner with large axial coverage for full-body scanning. Positrace has six detectors arranged in a hexagonal configuration, an 80-cm opening, and an integrated CT scanner. SMV expects to submit a 510(k) for Positrace early next year.

The company will also display DSTi, a dual-detector, variable-angle dedicated cardiology unit with 400 x 300-mm detectors, and will highlight its VCR/TAC attenuation correction device for coincidence imaging used on its DST-XLi gamma camera.

Toshiba. Toshiba plans to emphasize its work on integration between modalities, as well as its products’ connectivity and productivity. The company will highlight a next-generation UltraSPARC 10, 333-MHz GMS-5500A/PI workstation for its 7100, 7200, and E.Cam cameras. The company continues to develop a work-in-progress image fusion program that combines CT, MRI, and nuclear medicine images.