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Hybrid scanning will take on new meaning at the RSNA meeting, where powerful SPECT/CT systems and enhanced PET/CTs will be on display.
Philips and Siemens plan to showcase two new SPECT/CT scanners that should begin full production next year. GE Healthcare, which first combined SPECT and CT four years ago, will exhibit an advanced version of its Infinia Hawkeye hybrid system, but whether this version will offer the same power as its new competitors is not yet known.
Philips' and Siemens' hybrids are designed around multislice CTs. The Infinia Hawkeye relies instead on a single-slice CT that is powerful enough to provide data for attenuation correction and anatomical localization but too weak to generate diagnostic images.
Improvements to the nuclear medicine side of the Infinia Hawkeye will boost the credibility of the hybrid system, said Pascale Witz, general manager of functional and molecular imaging for GE Healthcare International. Witz noted, however, that as of September GE had yet to finalize the details of its Chicago exhibit, and she declined to comment on whether a future GE SPECT hybrid would include multislice CT.
PET/CT will get a boost from an upgrade developed by Philips that will address its prospects in cardiology and Alzheimer's disease.
As completely new products, however, Philips' Precedence and Siemens' TruePoint Symbia will overshadow the iterative advances in PET/CT. The Siemens product will provide the option of combining a dual- or six-slice CT with the company's e.cam dual-detector gamma camera.
Precedence combines Philips' Skylight gamma camera technology, which uses vertically hung dual detectors, with its Brilliance multislice CT platform. The company will promote two configurations: one with six slices, intended for oncology; the other with 16, designed for cardiology. Both will feature a software package called Astonish that improves hybrid images through advanced data correction algorithms, according to the company. Molecular imaging software to quantify and track patient data will also be included.
"We will be displaying a lot of technologies and demonstrating how much easier it is to use them versus any of our competitors' products," said Ian Farmer, vice president and general manager of Philips Nuclear.
In hopes of creating more demand for PET/CT, Philips will upgrade its 16-slice Gemini PET/CT to support cardiovascular assessments as well as Alzheimer's disease. The company, which currently offers a dual-slice PET/CT, will expand its portfolio with a product featuring two to 16 slices, Farmer said.
"This will have new technology that will provide for significant improvements in image quality and throughput," he said. "But we will not be talking about the specifications until we are on the RSNA show floor."
The developers of Symbia and Precedence expect their systems to do for gamma cameras what hybrid imaging did for PET. Results from the two studies performed during a single visit will not only boost workflow but may uncover disease that would otherwise elude detection. Siemans plans to emphasize that point with early results from a luminary site that is using its TruePoint Symbia, according to Markus B. Lusser, vice president of worldwide sales and marketing for Siemens nuclear medicine division.
"We have a study in which the CT and SPECT interpreted separately showed normal results, but by fusing them together and using attenuation correction, you could see something was wrong," Lusser said. "This supports our message that the fully integrated high-performance gamma camera and CT improves image quality and clinical outcome."
Achieving such results will not come cheaply. The Precedence and Symbia are each expected to list for about $1.5 million.
GE's Infinia Hawkeye costs only about half as much, due largely to its reliance on a simpler and less costly CT scanner. Prospective buyers of the Infinia Hawkeye may be tempted not only by the lower price but by enhancements being made to the system. New features include fanbeam collimation for enhanced brain SPECT and a camera-based PET option for extended clinical utility. The company unveiled these upgrades at the European Association of Nuclear Medicine's annual congress in September.
Such iterative changes are often shown at the RSNA meeting, as vendors use this venue to showcase improvements in their line that have occurred since the Society of Nuclear Medicine meeting six months earlier. Toshiba America Medical Systems, for example, will highlight upgraded software for its T.CAM gamma cameras, and Philips will roll out a PC-based workstation called JetStream.
GE's nuclear medicine advances, however, will be transferable to the Infinia Hawkeye, as the company plans to equip the product with SmartStep technology designed to improve CT axial resolution.