Four-D technology highlights new ultrasound offerings

A flurry of ultrasound systems, from high end to handheld miniatures, arrived on the RSNA exhibit floor, allaying fears that the massive consolidations since the late 1990s would affect the diversity and quality of products. There was the usual fare of upgrades and enhancements, along with a few mid- and low-tier offerings. Standouts, however, were products exhibiting volumetric reconstructions.

Some reflected past years' machinations, bearing labels such as "real-time 3D" or "4D" because volumetric data, once acquired and reformatted, could be postprocessed interactively. But, remarkably, others promised instantaneous acquisition and display. The clinical benefit of these systems may be hard to predict, as relatively few diagnostic applications for 3D reconstructions have been documented. But the arrival of systems that provide true real-time 3D imaging will almost certainly have an impact on the way ultrasound is practiced.

Advanced Imaging Technologies

Aiming to advance further into niche markets, AIT showed its Avera breast imaging technology, which relies on the diffractive rather than reflective properties of sound to gather boundary and tissue information. The dedicated breast imaging system, introduced at the 2001 RSNA meeting, permits rapid assessment of breast tissue without compression or ionizing radiation.

• The company said that FDA clearance to market the system provides a means to perform immediate biopsies on suspicious breast masses during a diagnostic imaging session. Avera offers dynamic, real-time imaging, automated multiplanar scanning, and high spatial and contrast resolution.

Aloka

A longtime provider of value-oriented ob/gyn equipment, Aloka has been expanding its product offerings in recent years to reach new clinical applications.

• ProSound SSD-3500 was shown as a work-in-progress. Pending FDA clearance, the midtier system could enter the U.S. market in early 2003. The system features a 12-bit analog to digital conversion and the use of second harmonic imaging. Software commands allow the system to be optimized for penetration or resolution without replacing the probe.

GE Medical Systems

Once a provider of only specialty ob/gyn systems, GE has evolved over the past decade into a leading vendor of ultrasound equipment at all performance levels. Volumetric imaging continues to play a central role in its marketing efforts, as the company showcased its Voluson product line, whose core technology was obtained as part of the 2001 acquisition of Kretztechnik. GE also extended its Logiq line of products with two lower tier offerings. (Premium and high-performance offerings, the Logiq 9 and 7, were introduced in 2001.)

• Voluson 730 Expert features a second-generation technology, dubbed RealTime 4D Ultrasound for its ability to simultaneously display images in three planes and in real-time motion. The Expert version acquires data 50% faster than its predecessor, the Voluson 730 Pro. Although intended primarily for fetal imaging, the Expert may also be used for other applications such as breast and prostate evaluations.
  
• Logiq 5 features the company's TruScan architecture, which creates advanced technology for both routine and complicated applications. The new system has a small footprint and user-friendly design.
  
• Logiq Book is a portable system. Although the product is about the size of a laptop computer, LogiqBook is built on TruScan architecture and has many of the same features as its more powerful brethren.

Hitachi Medical Systems America

The full line of EUB ultrasound systems was displayed by Hitachi, including its high-performance EUB-6500. The system combines premium image quality, a wide array of probes, improved operator ergonomics, and portability to offer a broad and diverse range of clinical applicability.

• For the first time, the company's EUB products were shown as a complete line, with sales, marketing, and service responsibilities now under control of HMSA. The change, announced in October, consolidated all of Hitachi's U.S. distribution of diagnostic imaging products under the HMSA banner.

Medison

Despite financial woes caused largely by dot-com investments that went bad, Korea-based Medison continued its tradition as an innovator in 3D ultrasound with the launch of a new flagship volumetric product. This system was buoyed by a high-performance portable product.

• Accuvix XQ was announced prior to the RSNA meeting but was officially introduced in Chicago. The product is undergoing final testing. A new image-rendering algorithm developed specifically for the system is expected to provide better 2D and 3D images than any previous Medison product, according to the company. Other features include harmonic imaging and autoimaging optimization.
  
• SonoAce Pico combines color imaging and portability in a digital package. Pico is a general-purpose system capable of performing most procedures related to ob/gyn, internal medicine, and radiology. The lightweight scanner is about the size of a briefcase yet offers digital beamforming and harmonic imaging. It also provides spectral and color Doppler and freehand 3D. Pico runs on the Linux operating system and can be networked.

Philips Medical Systems

R&D initiatives by one-time independent vendors ATL and Agilent (a.k.a. Hewlett-Packard) have been united under the Philips ultrasound banner. The company continues to upgrade HDI and Sonos product lines with internally derived technologies, as well as some drawn from outside R&D.

• HDI 4000 integrates 3D transducer technology developed by Kretztechnik and built by Medison, which is a major supplier of technology to Philips Ultrasound. The system, formally unveiled at the European Congress of Radiology in March, will be used primarily for ob/gyn applications, although other applications may come later. In addition to 3D imaging, users may perform 2D, tissue-specific, tissue harmonic, pulse inversion harmonic, and contrast-specific imaging.
  
• An enhanced HDI 5000, Philips' flagship, features an articulating monitor, palm rests, foot rests, and a lighter, more maneuverable cart. The improvements reflect an industry-wide trend toward user-friendliness and ergonomics.
  
• Sonos 7500 with Live 3D echo exemplified the premium technological end of ultrasound. Although shown at other medical trade shows, notably the American Heart Association meeting in mid-November, the new product was making its first RSNA appearance. Sonos 7500 is designed specifically for echocardiography, visualizing 3D volumes in real-time, as the heart beats.
  
• EnVisor, a general-purpose midrange ultrasound system, combines technology developed independently by Agilent and ATL and merged by a joint engineering team of Philips Ultrasound. Unveiled in October and selling for $40,000 to $60,000, the system will be offered in both general imaging and dedicated cardiology configurations.

Shimadzu

Following a tradition of providing value-oriented imaging technologies, Shimadzu showed enhancements to both of its digital color Doppler products: SDU-2200 for general-purpose imaging and SDU 1200 for abdominal, pelvic, fetal, urological, and vascular imaging.

• Enhancements include the company's new Version 5.1 software, which will be available to customers in January.

Siemens Medical Solutions

By combining its R&D talents with those of Acuson, Siemens has become one of the world's largest and most innovative developers of ultrasound equipment. Its claim to the development of leading-edge technology was exemplified by this year's introduction of a true real-time volumetric scanner.

• fourSight generates volumetric reconstructions instantly as the probe is placed on the patient. Multiplanar reformatted slices can be shown alongside the 3D images. Specially designed solid-state transducers use a curved array to acquire data across a series of planes. Built into the Sonoline Antares platform, fourSight includes real-time volume editing tools and supports flexible image display formats, which allow one-to-one, two-to-one, or four-to-one display.
  
• The StellarPlus Performance package further upgrades the Antares with options including tissue equalization, migrated from the Sequoia, Color SieScape Panoramic Imaging, SieClear MultiView Spatial Compounding, Cadence Contrast Agent Imaging, and 3-Scape 3D imaging.
  
• Sonoline G50, a midrange digital ultrasound system, supports vascular, cardiac, breast, abdominal, small parts, and ob/gyn imaging. G50 features Tissue Harmonic Imaging, AutoColor technology, MultiHertz multiple frequency imaging, and directional power Doppler imaging for use in ob/gyn, abdominal, vascular, shared service cardiac, and urology applications. Depending on configuration, G50 sells for $50,000 to $80,000.
  
• The Signature II option for its premium-end workhorse Sequoia system is a software enhancement designed to improve imaging as well as workflow. A key improvement is the extension of CHIRP-coded excitation to seven additional transducers, enabling high-resolution imaging at greater depth.

SonoSite

Underscoring its commitment to portability, SonoSite showed its iLook system, which weighs less than 3 pounds. Two models were displayed.

• The iLook 15 was designed for quick-look diagnostics, including basic abdominal and cardiac imaging, in emergency, radiology, intensive care, surgical recovery, and other departments. The iLook 25 was designed for use in vascular imaging procedures. The handheld duo supplements SonoSite's 180Plus, which weighs 5.7 pounds--about twice the weight of the iLook.
  
• The company highlighted the ability of the iLook products to stand up to harsh working conditions. It weathered being dropped to the floor without sustaining damage. The iLook 15 sells for about $12,900 and the iLook 25 for around $15,500.

Toshiba America Medical Systems

As part of a renewed effort to increase market share in the U.S., Toshiba has added both sales and marketing staff to its ultrasound division. The company has continued to develop its technology, particularly on its premium Aplio.

• Advanced dynamic flow, a Doppler technology, improves the visualization of microvessels in tumors and organs. The Doppler Digital Image Optimizer detects low-velocity blood flow, while Adaptive Image Processing combines gray-scale tissue and blood flow characteristics.
  
• Dynamic Micro-Slice electronically focuses the elevation plane of the ultrasound beam to deliver ultrathin, high-resolution images.
  
• ApliPure, a work-in-progress, is intended to improve contrast resolution by using spatial compounding to sequentially combine ultrasound images acquired from different scanning directions in real-time. The technology uses frequency compounding to acquire multiple ultrasound images at different frequency bands simultaneously in order to improve detail resolution.