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GE infuriates competitors at ISMRM with claims about new MR pipeline


Siemens and Philips debate significance of GE subsystemThe annual meeting of the International Society for Magnetic Resonance in Medicine is an unlikely location for either groundbreaking announcements or controversy. Vendors

Siemens and Philips debate significance of GE subsystem

The annual meeting of the International Society for Magnetic Resonance in Medicine is an unlikely location for either groundbreaking announcements or controversy. Vendors typically underscore technological developments, update timelines for the delivery of products announced at the RSNA meeting, and bask in the reflected glory of clinical data presented during this meeting dedicated to MR. Not this year.

On the eve of the Honolulu meeting, before a standing-room-only crowd of some 400 current and prospective customers at the Hilton Hawaiian Village, GE Medical Systems launched what executives billed as the "biggest breakthrough in MR in more than a decade." Excite, an optimized data pipeline for GE's high-field Signa systems, integrates the multiple components that transmit, receive, and process MR information. To describe the trappings of its introduction as fanfare would be an understatement.

The crowd broke into spontaneous applause as gymnasts clad in spandex did hand flips, swirled a crepe streamer, and balanced balls and hoops. They applauded even louder for an introductory video that hammered them with fireworks bursting on a projection screen, staccato claims of increased speed and high-power processing, and images of the brain, heart, and musculoskeletal system. It was cirque de Hawaii, GE-style, as company executives and a key luminary rose to the podium to extol the virtues of GE's latest "breakthrough."

"We optimized Excite from the front end all the way through, building a system that is parallel and scalable," said Mike Harsh, general manager of global MR engineering.

The next day, on the ISMRM exhibit floor, Siemens and Philips executives chastised GE for overstating the significance of Excite and wrongly inflating the product's strengths relative to their equipment. Nancy Gillen, vice president of Siemens magnetic resonance division, was blistering in her attack.

"What has been 'announced' by our competitor is technology that Siemens has been delivering and improving upon since 1998," she said. "As manufacturers of medical imaging equipment, we all have to act responsibly with regard to product launches and announcements. Otherwise we just reduce the science and technology to that of purchasing a household appliance, and we are concerned that this eventually will jeopardize the quality level of healthcare--as well as mislead shareholders."

Other Siemens responses were milder in tone but not in substance.

"We also do marketing, so therefore I can understand GE," said Robert Hebel, director of Siemens MR product management. "But I think this time they have crossed the thin line between marketing and not really telling the truth."

Philips' senior field director for MRI business development, Peter Luyten, Ph.D., was more puzzled than annoyed.

"What they are claiming--to have all those bits and pieces--that is exactly what we have been working out over the last decade, so I would say they are trying to catch up with us," he said. "To reverse it and say they are ahead doesn't make any sense to me."

Vendors seldom speak harshly about each other and even more rarely make those comments for the record. But GE fired the first shot when it cast aspersions on the capabilities of competing equipment. In slides presented Sunday night at the launch of Excite, GE compared specifications for its new pipeline to technologies built into the high-field systems of "Competitor A" and "Competitor B," a thinly veiled reference to Philips and Siemens. Each "competitor's" technology matched Excite on some specifications but overall neither compared well--in this venue--to the integrated capabilities of GE's new product.

"This is probably the first time since the original MR came to market that we looked at (the data pipeline) as a whole and changed it as a whole," David Weber, Ph.D., GE's manager of high-field MR, told DI SCAN.

During a sneak preview of Excite at GE Medical Systems headquarters several days prior to its launch at the ISMRM, SCAN quizzed Weber about the rationale for developing the product.

"We looked at our goals and what we needed to do and decided that we couldn't tackle just one component, that we had to look at the whole end-to-end architecture," he said.

Excite is more than repackaging, Weber told SCAN, more than branding what had not been branded before. GE spent three years and $31 million developing the technology, which is designed to enhance the acquisition of data as well as manage the resulting flood of data. The newly integrated data pipeline includes improved switches for turning gradients and radio-frequency signals on and off, which allows shorter TRs and TEs; eight channels in receiver coils to expand bandwidth; and faster reconstruction through the addition of more memory and better data buses. Advantages include faster scans, increased patient throughput, and better image quality; a 40% higher signal-to-noise ratio supporting enhanced functional imaging and spectroscopy; and increased resolution, achieved through image acquisition in a true 1024 matrix.

Competitors argue, however, that Excite is neither new nor better than their own equipment. On the ISMRM exhibit floor, Siemens and Philips executives picked apart GE's claims about Excite.

Siemens introduced eight high-speed RF channels in 1997, according to Gillen. Integrated panoramic array technology and parallel imaging techniques for higher speed imaging were cleared by the FDA for Siemens scanners in January 2002, she said. Syngo, which provides the foundation for these technologies, was introduced in 1998. These features, Gillen said, are available on the Siemens Symphony 1.5T, Harmony 1T, and Trio 3T systems to support advanced applications, including 4D angiography and cardiac imaging, as well as routine clinical imaging.

"The 'biggest breakthrough' in any technology should be just that and not one manufacturer catching up with another," she said. "In the digital imaging market where competition is fast and furious, we owe it to our customers and the patient population to honestly address breakthroughs that affect the delivery of healthcare."

Hebel countered another of GE's claims: that the 2 gigabytes of memory in Excite's processing component is "twice that of our closest competitor," a claim made in the marketing material accompanying the product launch.

"We have memory in that part (of our pipeline) that is 32 gigabytes," he said. "We do this with four very fast hard drives that perform as RAM and store all the data to do parallel reconstruction."

Philips' exec Luyten pointed to an instance in which Philips' equipment has gone well beyond the performance level attributed to Excite. The company's SENSE technology boosts the speed of data acquisition by a factor up to nine, he said. Excite, in unison with GE's parallel acquisition technology, called ASSET, achieves a factor of three or four, according to GE's Weber.

Philips' parallel acquisition technology, which it calls sensitivity encoding (SENSE), debuted more than two years ago. The company has steadily improved SENSE, Luyten said, while expanding its installed base to some 500 units.

"There is a lot of talk about technology. What we are trying to stress is really to get our products out in the field as quickly as we can and provide the technology to (end users) and learn what the clinical applications are and what drives the field to better utilization," he said.

Only three sites have installed Excite: Evanston Northwestern Healthcare in Illinois, and Edison Imaging and South Jersey Radiological Associates, both in New Jersey. Drawing from four months' experience and more than 1500 clinical exams with the new technology, Robert R. Edelman, M.D., chair of radiology at Northwestern University Medical School, described GE's new product as a first step toward a "can't miss" capability in MR functional brain, cardiac, and vascular studies.

"With this eventually we will be able to go to real-time examinations where we can overcome the technical limitations and artifacts that are now problems," he said.

GE expects to have 250 Excite installations by the end of this year and 1000 in two years. The product, which is scheduled to begin shipping in late summer, will be available simultaneously on newly manufactured units and as an upgrade for the installed base. Initially it will be configured for high-field units, but GE is planning versions for 3T and, eventually, other field strengths.

Its development is both a response to and a critical enabler of the boom in demand for MR procedures that GE analysts expect in the coming years, Cooke said. Last year's 31 million MR procedures worldwide will double in 2005, he said.

"More important, the mix of procedures will change," Cooke said.

Dynamic applications such as vascular imaging will become more popular, generating a majority of the expected 19,000 terabytes to be gathered in 2005--six times the volume of data currently being generated. Excite is designed to both create and handle the increasing load on GE scanners. Because it is scalable, end users will be able to purchase configurations optimized for four, eight, and eventually 16, 32, and 64-receiver channels. Each configuration will be packed with the processing capability needed to take advantage of the rest of the pipeline. MR cannot meet its potential for clinical expansion, Weber said, unless the data-handling technology is up to the task.

"We think this development will fuel the growth of MR as well as allow it," Weber said.

In the end, the clinical utility of the competing technologies may determine whose claims are correct. Siemens and Philips equipment is already in place. GE's Excite will soon be there.

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