Now that computer-aided detection systems are increasingly accepted in radiology, software developers are creating new algorithms to focus on pathological processes while fine-tuning existing ones to better define disease targets. Companies that operate in the breast MR market are tailoring products to look for physiological parameters, including permeability and cellular density, angiogenesis, and contrast enhancement patterns. Mammography CAD developers are easing the transition from analog to digital scanning by overcoming glitches that complicate the comparison of prior and current images, such as size and resolution. Colon and lung CAD providers are offering automatic volumetric and size calculations.
Originally named after its 3TP (three time point) software program, which compares MR signal intensities at three different points in time, the company changed its name to CAD Sciences to reflect its broadening technological base. Two products shown at the RSNA meeting rely on proprietary fTP+ (full time point) analysis, which calculates physiological parameters associated with breast and prostate cancer.
A subsidiary of Merge Healthcare since mid-2005, Cedara concentrates on custom engineering applications and tools for medical imaging OEMs and international markets. In the CAD arena, Cedara announced the market release of B-CAD, a CAD system for breast ultrasound that was shown as a work-in-progress last year.
A pacesetter in developing CAD systems for the analysis and interpretation of breast MRI, Confirma showed an expanded version of SureLoc, its tool for MRI-guided breast interventions, as well as a new storage and retrieval option and a visualization method for evaluating contrast enhancement patterns. The company also displayed its flagship CADstream product, which optimizes registration by eliminating cardiac artifact, produces angiogenesis maps and curves, and creates volume characterizations, including 3D volume renderings, diameter measurements, location specifics, and the BI-RADS Atlas lexicon for classification of each lesion in an MRI study.
A development stage company, DOBI is focused on improving the diagnosis of high-risk and malignant breast disease by identifying abnormal vascularization associated with tumors. Its DOBI (dynamic optical breast imaging) system is highly sensitive to the differential light-transmission properties of abnormal vascularization after application of an external pressure stimulus. The company is selling the ComfortScan System outside the U.S. and has begun clinical trials in anticipation of submitting the product to the FDA for approval.
Based on technology it acquired a year ago from MiraMedica, Eastman Kodak introduced a film-based mammography CAD product using a digitizer that takes 2.5 minutes to scan four films and allows imaging facilities to input about 25 cases per hour. Eastman Kodak also showed at the RSNA meeting a work-in-progress CAD solution for bone mineral density testing. The software issues a report on a patient's bone density based on an x-ray of the hand using the same film and x-ray unit as a mammogram.
The company offers a range of products addressing light to heavy volumes in mammography. Standard-bearers include the SecondLook 700 for high-volume centers, a CAD system that scans films and analyzes and stores images in a single console. Conversely, the ClickCAD program allows mammography centers with a relatively light volume to use iCAD equipment without purchasing it, so long as they share the reimbursement.
A Torino, Italy-based developer of advanced CAD products, iMED Medical Imaging Lab showcased its first product, CADColon at the RSNA meeting. The system includes a high-end computer designed to process data quickly and efficiently, a high-resolution 24-inch monitor to display 2D and 3D reconstructions, measurements, and data, and a user-friendly graphical interface.
A subsidiary of Intermagnetics General, Invivo has entered into a strategic partnership with Siemens Medical Solutions that will incorporate its DynaCAD system for breast MRI into Siemens' Magnetom MR product line. DynaCAD has five functional modules. DynaMatch suppresses image motion artifacts and automatically performs subtraction on 2D and 3D images. DynaMap provides color parameter maps that visualize changes in MRI signal intensity. DynaMIP produces dynamic MIP for interactive functional 3D visualization. DynaFlow gives interactive access to time-intensity curve data. DynaLoc automatically calculates target coordinates for MRI interventions. New features include an automatic search option that seeks out the most suspicious regions of interest, has improved configurations for archiving, and exports options in multiple formats.
A developer of CAD products that allow radiologists to review images and CAD findings at the same time, Medicsight displayed its application versions of the ColonCAD and LungCAD products. Both incorporate a "sphericity" threshold that can be set manually to discriminate between actual pathology and morphologic features that may interfere with interpretation, such as blood vessels in the lung and retained stool or haustral folds in the colon.
R2 Technology has teamed with Swedish workstation leader Sectra to produce a "CAD-intelligent" system that optimizes the presentation of CAD information on mammographic images. The companies jointly launched the Citra Mammography Applications Suite at the RSNA meeting.
To its RapidScreen CAD system for chest radiography, Riverain Medical has added new functionalities to reduce the false-positive rates of detection of solitary lung nodules in regions of interest located in the hilar area and near the ribs. The company also is testing a dual-energy subtraction CAD system to find suspicious lesions in difficult-to-see areas on chest scans.
Although Siemens has partnered with a number of vendors to include CAD in its imaging equipment, the company also is developing its own CAD products.