RSNA

Toshiba America Medical Systems has been talking for years about the development of a 256-slice CT. This morning, the company outdid itself, introducing a 320-element detector onboard its FDA-cleared Aquilion One. The announcement came as the exhibit floor opened, just hours before Philips Medical Systems unveiled a 256-slice CT, its Brilliance iCT.

A study from the Midwest that tracked the effects of converting from traditional transcription to voice recognition software indicates the automated approach is more accurate. The new approach also contributed to an impressive improvement in report turnaround time compared with manual report preparation.

RSNA newcomer Parascript is demonstrating at the RSNA meeting this week algorithms its executives claim could dramatically reduce false positives in mammography computer-aided detection. AccuDetect software could cut false positives by 60% to 80% below those typically encountered in mammography CAD, according to Yuri Prizemin, Parascript director of product marketing.

A radically redesigned CT platform unveiled by GE Healthcare at the RSNA meeting produces images of soft tissue that rival those taken using MR, according to GE executives, who are framing the platform as a wholly new breed of CT scanner.

A newcomer to the RSNA exhibit floor has introduced an all-in-one PACS solution with a beginning list price of just $15,000. But while QStar Technologies may be new to the annual Chicago meeting, it is a 20-year veteran of the IT business and a mainstream supplier of storage equipment to PACS vendors.

In keeping with family tradition, my niece has entered the radiology business. She is getting ready for her first RSNA meeting and asked me, “As a potential customer, what would you want to see or hear at our booth this year?”

Slice wars erupted nearly a decade ago with the introduction of quadslice CT scanners. Since then, it's been one battle after another, as the industry jumped to eight slices per rotation, then 16, up to 32 and 40, back to 16 (with generators of varying power), then 64. Along the way, semantic skirmishes have broken out over what was a slice and whether multislice CT should be called MD (multidetector) CT.

Every modality other than ultrasound has siting requirements, sometimes big ones; cardiac cath labs and angio suites, are examples. But even the largest sonography systems can be wheeled from one room to another. Some can fit in the palm of your hand. There are trade-offs, to be sure. These nano scanners don't have much display space, and the computing engine can't compare to those on cart-based systems. But the market wants portability, the more the better, in some cases.

This year has been a miserable one for the makers of PET/CT units, so miserable that one vendor-Hitachi Medical Systems of America-has stopped marketing its hybrid scanners. Others are struggling under the weight of a plunge in sales of some 30% compared with the same periods last year.

Breast MR is approaching celebrity status. A raft of expert opinions, notably from the American Cancer Society, has established MR in public and professional minds as a leading means to diagnose cancer among patients at high risk and possibly even among patients in the general population.

Three-D reconstructions are routinely used in the imaging of many organ systems. Not only do referring physicians and patients like the volume-rendered images, but radiologists are finding the inclusion of coronal and sagittal reformats imperative to making the most confident diagnoses. The use of advanced imaging over the last year has become important in several organs, mainly the heart/chest (Figure 1) and the abdomen/pelvis.

The onslaught of faster, smaller, more precise, and more portable ultrasound imaging technology continues. Nearly three dozen RSNA exhibitors will be showing ultrasound scanners whose portability has lately crowded onto center stage along with image quality and once optional capabilities, such as 3D/4D.

Demand for digital x-ray is soaring, about 10 years later than most industry insiders predicted. Better late than never, for sure, but the reasons behind the rise of this class of products are as much economic as technological. Volume sales are bringing down the price of digital x-ray systems, just as the adoption of PACS is making digital radiography more a need than a want. Vendors are responding with more powerful equipment bearing attractive prices.

Integration of medical informatics systems continues to penetrate deeper into the hospital enterprise, driven by a search for increased efficiencies and better patient care-all on a tight budget. While the integration of radiology information systems and PACS occurs at the radiology department level, the convergence of healthcare informatics reaching across departments and entire enterprises has begun. Orthopedic and women's clinics, cancer and cardiac imaging centers are all adopting digital modalities and attendant support systems.

Barely three years after the introduction of 64-slice CT, Toshiba America Medical Systems will ask the market at this year's RSNA meeting to embrace scanners capable of 256 slices. Siemens Medical Solutions will introduce a 128-slice scanner just one year after releasing its dual-beam CT. Philips will tout newly upgradable CT scanners, and GE Healthcare will demonstrate image quality enhancements that company executives say will deliver soft-tissue contrast similar to that found with MR.

It's always been about applications in MR: expanding the reach of the modality, capturing higher resolution images, doing faster scans to cut down on artifact. Developers of this modality have had little choice. While its rival CT had been progressing with logarithmic precision from base 2, MR was rooted to decimal-based field strengths classified as low-, mid-, and high.

What topics of research occupy the minds of radiologists? Dr. Peggy Fritzsche, chair of the RSNA Research and Education Foundation, revealed the top 25 questions in biomedical imaging and radiation oncology that the radiology community wants answered during the RSNA meeting in November.

PET imaging to diagnose brain tumor and monitor recurrence after treatment is an evolving field of research. Investigators at the RSNA meeting presented studies revolving around five tracers, as well as various permutations of imaging combinations such as FDG-PET with MR spectroscopy. While results are promising, challenges remain before any of these research avenues becomes clinically routine.

The total attendance tally for the 2006 RSNA meeting falls short of prior years despite a slight increase in local and international professionals. A drop-off in exhibitor attendance accounts for the decrease.

A consumer-grade monitor made by Dell Computers may be sufficient for interpreting radiography images, one of radiology's most demanding applications, according to a presentation at the RSNA meeting on Thursday.

Radiologists could optimize their diagnoses of lung abnormalities using computer-aided detection systems, provided they develop a better understanding of the strengths and shortcomings of every factor involved in the process. Learning this could save a day or two in court, according to studies presented at the RSNA meeting.

A prototype search engine uses advanced content-specific algorithms to efficiently search databases of image files contained in public Medical Imaging Resource Center storage servers. The search engine was developed as a joint project between the Baltimore VA Medical Center and the University of Maryland. The prototype is the alpha version of a vertical search engine designed to match users with radiology-specific content.

Two new detector systems entered the marketplace at the Canon Medical Systems booth this week on the RSNA exhibit floor. The Canon CXDI-50C Portable features a 14 by 17-inch detector plate. The Canon CXDI-40EC features a 17-inch square area.

CR vendor Radlink debuted at the 2006 RSNA meeting a value-priced system designed to help physician offices convert from film to digital radiography. The Pro Imaging will leverage the company’s existing lines, which include the CR Pro computed radiography system, hardware to digitize existing x-ray films, and software for managing practice workflow and data.

Houston-based Absolute Medical Software Systems introduced its RIS product at the 2006 RSNA meeting. The company has enhanced the practice management functionality of the RIS for claim submissions, insurance, and self-pay collection. The new features are designed to boost efficiency by eliminating duplication of data input and maximizing returns on claims processing, according to the company.