Ultrasound

Three- and four-dimensional ultrasound systems have generated stunning pictures, especially of the fetal face, and proffered the tantalizing prospect of offline image reconstruction. Early systems got a lukewarm reception, largely because they lacked wide clinical application, flexibility in image processing, and productivity-conscious tools. But volumetric ultrasound displayed at the RSNA meeting demonstrated the maturation of the technology with new systems for routine general radiology and for imaging complex anatomy and pathology, as well as postprocessing enhancements for presenting and evaluating data in multiple planes and user-friendly, push-button data interrogation.

Preliminary findings from a national trial of ultrasound as a screening tool in patients at high risk for breast cancer shed light on key variables that influence radiologist interpretive performance.

Although still in research stages, freehand 3D ultrasound shows promise in guiding surgery and radiotherapy in the clinical setting, according to researchers at the University of Cambridge in the U.K.

Patients with uterine fibroids have a new treatment option, which uses MR to guide a high-power ultrasound beam that heats and destroys fibroid tumors. The ExAblate 2000 technology was approved by the FDA in October and showcased at the 2004 RSNA meeting.

As radiation therapy develops more sophisticated targeting, researchers are turning to new imaging methods to direct it. Fused scintigraphy and CT images and daily ultrasound scanning both show promise as tools to concentrate intensity-modulated radiation therapy (IMRT) and spare surrounding healthy tissue.

Focused ultrasound can cook a lot more than uterine fibroids. The ablation technique is also safe and effective treating large hepatocellular carcinomas, according to papers presented Wednesday.

Ultrasound-guided therapy using adult stem cells could expand the modality’s role in the diagnosis and management of urethral and bladder conditions. New applications include endoluminal probes, Doppler technology, and 3D imaging capabilities, according to papers presented at the RSNA meeting Sunday.

Cedara Software is developing a computer-assisted detection system for breast ultrasound. The software, announced as a work-in-progress at the RSNA meeting, is intended to identify the sonographic characteristics of benign as well as malignant breast masses and to classify the extent of malignancy for specific nodules.

Medison has added digital multibeam processing to its SonoAce 8000 SE mid-level ultrasound system. The new capability, shown at the RSNA meeting, increases frame rates during both color and 2D imaging and supports harmonic imaging to enhance clarity and spatial resolution. Features include multibeam color and Doppler imaging and pulsed-wave spectral Doppler.

Toshiba’s high-performance Aplio scanner just got an upgrade. The Aplio xV debuting at the RSNA meeting features standard and optional software designed for radiology and cardiology.

Sonographic examination with microbubble contrast agents can reliably characterize focal liver lesions, confirm or exclude hepatocellular carcinomas, and remove the need for more invasive, costly imaging, according to studies presented Monday.

GE Healthcare is framing 4D ultrasound as the way to accelerate workflow, using protocols developed for the company’s new version of the Logiq 9. The scanner, outfitted with 4D algorithms and three volumetric probes, debuted this week at the company’s booth on the RSNA exhibit floor.

Radiologists are taking advantage of new data that support imaging techniques to rule out acute appendicitis. They may help lead to consensus on the best protocols to diagnose this condition accurately, according to studies presented Monday.

As radiation therapy develops more sophisticated targeting, researchers are turning to new imaging methods to direct it. Fused scintigraphy and CT images and daily ultrasound scanning both show promise as tools to concentrate intensity-modulated radiation therapy (IMRT) and spare surrounding healthy tissue.

Preliminary findings from a national trial of ultrasound as a screening tool in patients at high risk for breast cancer shed light on key variables that influence radiologist interpretive performance.

As I type this article in the newsroom at McCormick Place, subtle but clinically significant changes may be occurring in my fingers. If ever I undergo an imaging examination of my hands and wrists, the radiologist will need to know that increased fluid in my 2nd and 5th flexor sheaths is probably quite normal because I am a regular typist.

Ultrasound-guided therapy using adult stem cells could expand the modality’s role in the diagnosis and management of urethral and bladder conditions. New applications include endoluminal probes, Doppler technology, and 3D imaging capabilities, according to papers presented at the RSNA meeting Sunday.

A new shared services system built around an advanced processing chip was released jointly at the RSNA meeting by TeraRecon and Fukuda-Denshi.

The industry jumped back on track in October, clearing 36 new devices compared with 25 the month before. October’s pace was slower than the same month a year earlier, when 42 radiological devices passed review. But for 2004, vendors stayed slightly ahead of the previous -- record --year: 283 to 277.

PET pioneer acquires micro-CT firm CTI Molecular Imaging plans to acquire ImTek, a provider of micro-CT systems for imaging laboratory animals used in medical research. The $3.75 million cash deal is expected to close by the end of November. Financial performance and milestone achievements hold the potential for future incentive payments. The acquisition of ImTek, which designs and manufactures the MicroCAT scanners, would complement CTI Concorde, a business unit of CTI Molecular Imaging dedicated to the manufacture of micro-PET scanners.

Healthcare grows more complex and unwieldy with each innovation. Faster CTs, hybrid imaging, 4D ultrasound, and digital radiography threaten to overwhelm practitioners with data. Better communications offer some hope.

Philips’ new echocardiography platform, iE33, promises to do for cardiology what its iU22 scanner began doing earlier this year for radiology: boost image quality while providing an integral connection to volumetric imaging that allows 3D visualization and quantification.

A lull enveloped September, as FDA reviewers cleared just 25 new radiological devices -- a slight dip from August and well below the earlier summer months, which rode into the high 30s. The industry was still well ahead of last year, however, in the total number of devices cleared for marketing in the U.S.

GE Healthcare will focus on volumetric ultrasound at the RSNA meeting this year - not the postprocessing, time-consuming kind that has come to characterize 4D ultrasound for much of the past decade, but one that acquires volumes of data that remain intact and can be interrogated later on. It's an important distinction that GE executives hope will change the practice of ultrasound and provide the company with an edge over its competitors.

Sales of gamma cameras have been flat for so long they have become one of the few certainties in the otherwise unpredictable marketplace of medical imaging. True to form, the two factors in a major predictor of future change, equipment orders versus sales, were virtually equal for gamma cameras in the first half of 2004 at about $185 million for North American customers. But there is reason to believe that will change and that the progenitor of this change will be SPECT/CT.