It wasn't long after radiologists began viewing digital images on cathode-ray tube monitors that they realized they could also manipulate the data. In the 1980s Diagnostic Imaging carried crude images of 3D CT colon scans. Today the 3D colon quest is solved and advanced visualization vendors are on to lots of other things.
This year you'll see them introduce enhancements for existing functions. But they are also looking at ways to better extend advanced visualization throughout the enterprise and over wi-fi networks to appear on mobile computing devices like the iPhone. Some are looking at advanced visualization applications for specialties outside radiology facilitated by centralized database storage. And tapping into the growth in digital mammography, vendors are promoting advanced workstations for this modality.
Five vendors—Carestream, TeraRecon, Visage, Vital Images, and Ziosoft—stand out as providing advanced visualization systems. Three of the four major modality vendors—GE, Philips, and Siemens—also participate in the advanced visualization market via their PACS offerings. All eight of these companies compete in “workstation shootouts” where their advanced visualization systems are tested against one another. Other companies occupy niche segments of the market such as MedImage (nuclear medicine) and MIMVista (PET and radiation oncology).
Vital Images sees opportunities in trying to reach other specialties within the enterprise, said Nichole Gerszewski, the firm's senior marketing communications and brand manager.
Carestream Health is highlighting its PowerViewer, which goes far beyond the functionality offered by integrated or native 3D capabilities by automatically registering and matching, directly within the standard viewer, volumetric data created at different times and by different modalities.
Radiologists can dynamically view image data in different planes without switching to other applications or workstations, according to the company. Automatic registration also enables radiologists to manipulate one data set in any spatial plane knowing the other data sets will automatically follow. This advanced comparison includes different rendition types such as multiplanar reformatting (MPR), minimum intensity projection (MinIP), and others.
The PowerViewer represents a new departure, said Hadas Padan, director for product management and strategic development, healthcare information solutions, at Carestream Health.
“Until now, we were bringing dedicated applications such as vessel analysis, cardiac analysis, and PET/CT into the workstation so that all these applications could be accessed from one desktop,” she said. “Now, in addition to dedicated applications, the PowerViewer incorporates advanced visualization for most volumetric procedures as part of the radiologist's standard viewing tool, greatly improving radiologists' productivity and enabling faster reporting.”
Japan-based Ziosoft, a relative newcomer to the U.S. advanced visualization market, is emphasizing the origins of its product, which was designed from the ground up to be a thin-client system, said Terry Chang, director of marketing. Many of the others in the market have thick-client origins, whereby much of the processing is done where the image is displayed. In the thin-client model, it is done on a server and the images are sent out to the user in processed form.
At this year's RSNA exhibit, Ziosoft will be highlighting MR applications, which Chang said could be of greater interest because of growing concerns about CT dose. These include cardiac function analysis, MR cardiac perfusion, cardiac delayed-enhancement analysis, and MR perfusion. Ziosoft will also emphasize CT applications such as 4D brain perfusion (compatible with Toshiba's Aquilion One 320-slice scanner), and SPECT/CT cardiac perfusion applications along with improvements in its colon, vessel analysis, and reporting modules.
Finally, Ziosoft will promote ZioTerm, a free basic viewer for 2D/3D applications in academic research. Unlike its other applications, ZioTerm is not FDA-approved and thus is not cleared for clinical use, but the company hopes it will find a following among student researchers and help build support for the main product, Chang said.
