Did Milwaukee vendor try to steal Acuson's Sequoia thunder?GE Medical Systems has served notice that it is ready to keeppace with the leaders in the innovation-intensive ultrasound industry.The Milwaukee vendor on April 27 debuted a new
GE Medical Systems has served notice that it is ready to keeppace with the leaders in the innovation-intensive ultrasound industry.The Milwaukee vendor on April 27 debuted a new technology calledMaximum Resolution for its high-end Logiq 700 scanner. GE claimsthat the technology has spatial resolution up to four times betterthan conventional systems.
GE's timing for the release appeared uncannily prescient, comingjust 48 hours before Acuson's debut of its long-awaited Sequoiasuper-premium platform. GE officials were unavailable to commenton the timing of the MR release, although some of the more than100 radiologists who attended GE's Chicago debut said that theywere called to the clinical forum on "short notice."
Maximum Resolution consists of hardware and software upgradesto Logiq 700 that unlock much of the potential inherent in theplatform. At the Chicago forum, GE's top engineers highlightedthe technical virtuosity of Logiq 700 MR: its ability to deliverunusually narrow beam width; multiple transmit zones across ascan area; a higher dynamic range; and center frequencies up to12 MHz.
The result is spatial resolution close to that of CT and MRI,according to Sharbel Noujaim, global business leader for GE. Anearly uniform dot size produces texture that is the same virtuallythroughout the gray-scale image display in both the near- andfar-fields. Logiq 700 MR is capable of visualizing objects 300microns or less; its color flow is capable of visualizing downto 1 mm, and its real-time, pulsatile power Doppler is unlikeanything ever previously demonstrated at a scientific meeting,according to the vendor.
Logiq 700 MR can display more than 10 times the ultrasoundinformation possible on existing conventional systems, accordingto Omar Ishrak, GE general manager of global ultrasound.
"And 10 times more signal information is only a conservativeestimate," said Ishrak, who led the development of MaximumResolution.
Each of the radiologists at the Chicago forum who presentedresults from their clinical experience with Logiq 700 MR alludedto resolution, color flow, and power Doppler capabilities beyondany they had seen before. Dr. Barry Goldberg, a professor of radiologyat Thomas Jefferson University in Philadelphia, described Logiq700 MR as a significant leap forward in GE's technology.
Goldberg presented cases demonstrating ultra-high resolutionin gray-scale and color Doppler on human and animal subjects.In one case the new technology showed the sutures that tied asurgically repaired carotid artery together; in a kidney and ina gallbladder, small structures were revealed with great easeand at great depths, Goldberg said. He noted the ability of Logiq700 MR to store and recall an image taken earlier for comparisonwith a current image, a feature that proved useful in comparingthe response of a pancreatic duct before and after chemical dilation.
"It was not a matter of remembering where things were,"he said. "We had it on screen and could measure the differencein the size of the duct."
Goldberg showed images from Logiq 700 MR compared with thoseof other high-end ultrasound equipment to demonstrate the comparativeclarity delivered by the GE scanner and the ability of the machineto find and delineate structures not otherwise seen. In one case,the system found lesions that were missed on an MRI study of apatient.
In applying color flow and power Doppler to renal, liver, andperitoneal animal studies, Logiq 700 MR delivered increased resolutionwhen contrast media were used.
"I don't see anything but a positive (result) when youget more resolution," Goldberg said. "We saw lesionsof high contrast down to 1 to 2 mm on animals that we could clearlydefine, whereas we had been talking about 5 mm before."
Imaging specialties. Some of the most striking results wereobtained in musculoskeletal, breast, and small-parts imaging.Dr. Ronald Adler, an associate professor of radiology at the Universityof Michigan in Ann Arbor, showed gray-scale images of tendons,resolving structures between 200 and 300 microns in size and demonstratingsigns of carpal tunnel syndrome and rotator cuff abnormalities.Power Doppler images showed blood flow in vessels around nervesand fluid indicating synovial inflammation due to arthritis.
Dr. Thomas Stavros, director of ultrasound at Swedish MedicalCenter in Englewood, CO, explained how the wider dynamic rangeof Logiq 700 MR increased the echogenicity of blood flow.
"I suspect we might be seeing individual red cells,"he said in regard to one case.
Stavros focused mainly on the technology's ability to enhancebreast imaging, specifically to visualize what previously hadbeen possible only in histological studies done under a 10-powermicroscope -- a capability requiring resolution in the range of150 microns, he said. A series of images demonstrated individualducts in the breast, some showing the infiltration of cancer.
"These are pathways of low resistance to invasive cancer,"Stavros said. "Virtually all breast cancer arises in theseducts."
Logiq 700 MR also proved extraordinarily sensitive in visualizingsuspicious breast lesions, an area ATL has staked out as its ownon the basis of a premarket approval application for its Ultramark9 HDI scanner to characterize suspicious breast lesions. The higherdynamic range and narrow beam width of Logiq 700 MR produced clearer,more defined margins around malignant tissues and better definitionof capsules around benign lesions.
"I found better margins, capsule, and internal structureon the GE," Stavros said. "It is relatively apparentthat there is a major difference with this machine."
That difference can be traced to the open digital architectureof the system, said GE executive Noujaim. The current versionuses 128 transmit and receive channels, but that can be expandedto 512 or beyond. The radiology version of Acuson's new Sequoiasystem employs 512 channels.
"Whenever we need those extra channels, we can use themand when we show clinical relevance, we will use them," Noujaimsaid.
The scanner's digital architecture can support center frequenciesof up to 20 MHz. Advanced algorithms running onLogiq 700 MR inconcert with new transducer technology support center frequenciesup to 12 MHz.
Further, the system's parallel processing capability allowsthe utilization of more than one beam at a time -- so-called multipletransmit zones -- across the image, which can increase resolution,Noujaim said. The highly programmable system further providesthe opportunity to adjust signals, depending on the applicationand situation.
Jump-starting Logiq 700. Maximum Resolution should be a neededshot in the arm for the Logiq 700 program. GE debuted the scannerwith much fanfare at the 1993 Radiological Society of North Americameeting (SCAN 12/15/93), but the system was slow to get to marketand did not spark the strong sales that GE had hoped. Sales ofthe scanner were eclipsed by Logiq 500, its lower priced cousin,and GE repositioned Logiq 700 last year as a super-premium scannertargeted at developing advanced clinical applications.
Maximum Resolution demonstrates GE's ongoing commitment toultrasound and shows that a major vendor can move as quickly asthe dedicated vendors in developing new technology, accordingto Ishrak.
"GE is committed to acquiring technological leadershipin ultrasound and we have demonstrated a credible process by whichwe can get that, if we don't have that already," said Ishrak,who promised attendees at the Chicago symposium a new breakthroughin high-end ultrasound every year.
Ishrak hopes to migrate the expanding capabilities of Logiq700 to other products in the family, namely the mid-range Logiq500 and 400 models.
"Over the years, Maximum Resolution ultrasound will beavailable on all our machines," he said. "We will takeearlier breakthroughs (made on Logiq 700) and migrate them downso that when we get into a rhythm, it will be a new product inevery segment every year."
GE's ambitious plans for the future reflect the rapidly evolvingstate of technology in the ultrasound industry, a fact that investigatorsalso recognize.
"No one company provides a stationary (technological)target," Stavros said. "Omar's plan to do somethingon an annual basis indicates that he realizes he is shooting ata moving target and he has to keep things moving very rapidly."
New scanners with Maximum Resolution and MR upgrades for theinstalled base of Logiq 700 owners will begin shipping this month.The list price of a field upgrade is about $30,000. For a newscanner configured with MR, list prices range from $250,000 to$300,000, depending on options.
Like competitor Acuson with its new Sequoia scanner, GE faceschallenges in acclimating potential scanner buyers to prices inthe $300,000 range. GE appears to be taking the same positionAcuson has adopted to accomplish this difficult task: The increasein image quality is worth the higher price.
"It goes back to a matter of clinical value. If you canshow (radiologists) that there is clinical value, people willpay the money for it," Ishrak said. "People pay thiskind of money to buy other modalities because there is value forit."