Philips debuts software upgrades for flat-panel cardiac cath system

Enhancements star at TCT show in Washington, DC

Philips Medical Systems unveiled three technologies at the Transcatheter Cardiovascular Therapeutics (TCT) trade show that promise to improve workflow, image quality, and safety when using the company's cardiac cath system. Xper allows settings on Philips' Integris Allura Flat Detector (FD) system to be customized to suit physician preferences. Xres automatically reduces image noise and patient dose. And FRESCO enhances the visualization of stents. All three technologies exhibited at the TCT show Sept. 15 to 19 in Washington, DC, are now shipping.

Xper (x-ray personalized) offers programmable system settings, a new user interface, and smart integration features designed to boost workflow efficiency. Once Xper has been programmed, physicians need only sign in at the console, input the patient's name and such characteristics as size or type, and indicate the procedure. Xper does the rest, pulling details about the patient from the hospital information system, setting the dose and frames per second for the procedure, and guiding the cath lab stand through each required movement. Xper also processes the images to look the way the clinician wants.

"Customers have been asking for a system that adapts to the way they work," said John Steidley, vice president of x-ray at Philips. "This is really what our new cath lab does."

Xper speeds the process further by providing a multipatient, multiuser menu that allows two patients to be followed simultaneously from scheduling to data archiving.

The upgraded FD system features a second enhancement, a real-time imaging algorithm that improves the visualization of coronary arteries. Xres (extreme resolution), developed initially for use on other imaging modalities and adapted to the Allura, performs 350 million calculations per frame. This leads to crisper, sharper images, according to Steidley.

FRESCO (freezing and enhancing stents in coronary arteries) debuted as an option on the Integris Allura. The algorithm stacks successive images of stents implanted in the coronaries, then processes them into an ultrahigh-resolution image that can be examined to determine the status of the implant. Calcium deposits in the arterial wall can interfere with stent deployment, Steidley said. FRESCO helps physicians spot those problems, allowing the interventional team to try again and reassess their efforts until they achieve the success they want. This is especially important when working with drug-eluting stents.

"The whole ballgame with these is to embed the wires into the wall of the vessel so the drug can be delivered," he said.

The improved resolution possible with FRESCO makes such evaluations possible, he said.

Philips began shipping the Allura FD in March 2002 as an alternative to its traditional configuration, which is built around an image intensifier. About 80% of orders now are for the flat detector, according to Steidley.

The digital technology is continuing to evolve. Philips showed a rotational angiography subsystem as a work-in-progress at the TCT meeting. The system, which is being tested at the University of Colorado Health Sciences Center, makes a 180 degrees to 220 degrees sweep of the chest in about four seconds, recording some 120 images along the way. The data are then compiled into a 3D model of the coronaries.

Philips executives expect that the technology will be commercially available to visualize the coronaries by the end of 2004.