Acuson Aegis system clears hard-copy bottleneck

Acuson lobbed a surprise weapon into the high-end ultrasound battlethis month. The vendor launched an ultrasound image managementsystem dubbed Aegis. Over three years in development, Aegis willhelp streamline ultrasound lab procedures and clear an image-qualitybottleneck that might otherwise have diluted future improvementsin scanner performance, according to Samuel H. Maslak, Acusonpresident and CEO.

"We have a number of things under development that aregoing to substantially improve image quality," Maslak toldSCAN. "But as we improve the ultrasound image on screen,we are blocked in our ability to bring (the improved image) intothe reading room. In many cases, it is in the reading room thatthe diagnosis is made and not on the screen of the ultrasoundsystem."

Acuson has been frustrated for years by the limitations imposedon ultrasound image quality by the hard-copy output devices thatare an essential element in ultrasound lab procedures. Most scanningis performed by sonographers. Radiologists either watch as scansare redone or wait until films of previous shots are developedto make their diagnoses.

Apart from image problems inherent in this process, patientsoften have to wait until the film is developed, which causes inconvenienceto them and slows throughput for the department. Acuson claimsthat Aegis can improve throughput by 20%.

Multi-image camera manufacturers responded to the concernsof scanner vendors in the days before color-flow Doppler imagingby making a number of improvements to the image quality and reliabilityof their cameras, Maslak said.

"But with all that, the multi-image camera is still byfar the least reliable performer in the ultrasound system. Itis the weakest link in the imaging chain, and color just makesit more difficult," he said. "We are at the point ofdiminishing returns. If we improve image quality on the screenand it doesn't go anywhere, we haven't done it."

Aegis allows for the replay of images on the scanner itselfor on an independent viewing station. Acuson and other scannerscan be networked together and images fed to higher quality laserprinters.

Acuson has signed agreements with both 3M and Kodak to connectAegis with their laser imagers and other cameras.

Although Kodak offers an ultrasound management system of itsown in cooperation with PACS partner Vortech, Acuson is viewedmore as a potential ally for sales of high-end printers and archivedevices than as a competitor in image management. Scanner vendorswill always have an advantage in linking with their own systems,noted Daniel M. Trott, Kodak vice president of marketing for EktascanImagelink Systems.

"They know their own equipment better than anyone else.They can take advantage of specific proprietary protocols withintheir own devices that provide access to particular informationwe will never have. However, what we do have is the opportunityto take that island of network capability and connect it to therest of the world on their behalf," Trott said.

One limitation of the first release of Aegis is that it doesnot have a cine capability, although that is under development.Nor does Aegis provide an interactive optical disk archive ofits own. But the system can hook up to third-party archives andport information to PACS and hospital information systems.

Images are stored for a short time on the system itself andthen backed up to optical tape. Aegis does retain a database ofthe information surrounding the images and can indicate whereparticular images have been stored on tape.

The Apple Macintosh-based Aegis will be offered as an optionfor use on nearly 7000 Acuson ultrasound scanners installed worldwideand on all new scanners sold by Mountain View, CA-based Acuson,said Clay Larsen, director of marketing for general imaging.

System pricing will range from a low of $15,000 for basic imageacquisition and review capabilities on a single scanner to over$200,000 for two file servers linking a network of eight scannersand two physician review stations. Acuson expects to sell mostAegis configurations in the $70,000 to $125,000 price range, Larsensaid.

Aegis marks a significant product departure for a company thathas dominated the premium radiology ultrasound scanner marketfor nearly a decade with its dedication to a single imaging system.Acuson is careful, however, to position this new product as anextension of the diagnostic and departmental management capabilitiesof its 128 XP scanner, rather than an independent picture archivingand communications system.

"Aegis is not a PAC system, and we are not a PACS vendor,"Maslak said.

While video images from other ultrasound systems can be grabbedand integrated with Acuson images on Aegis, the system's mostsignificant selling point is its ability to automatically collectand store both patient data and color-flow Doppler images fromthe XP. Internally, Aegis will use the Macintosh QuickTime datastandard, although it will port ACR-NEMA standard images.