Toshiba focuses on streamlining interventions

When it comes to interventional work, Toshiba wants to streamline procedures and capitalize on acquired data. One approach to realizing those goals is physical, the other is philosophical.

The physical solution is a new five-axis interventional positioner that the company plans to begin marketing soon. The first such system is installed in a cath lab at Columbus Children's Hospital in Columbus, OH. It features floor mountings and an innovative C-arm design that allows operators to move the equipment completely out of the way.

"You can get all the way around the patient without having to walk around the machine," said John Zimmer, vice president of marketing for Toshiba America Medical Systems.

When ready to launch the system commercially, the company will refer to it as multi-axis instead of five-axis. The idea is to get away from the numbers game and focus on the benefits the product brings to the medical team.

But the new interventional positioner is just the most obvious example of a philosophy that Zimmer hopes will take root in the way imaging data are handled.

In the U.S., healthcare is delivered beginning with the least expensive and least invasive procedures. When heart problems are suspected, echocardiography is typically the first exam chosen. If 64-slice scanners live up to their promise, coronary CT angiography may be the next and possibly the last exam before a patient undergoes cardiac catheterization.

Toshiba is hatching plans to use data obtained during echo and CTA exams to speed up interventional procedures performed under x-ray guidance.

"We are looking at ways to use data acquired in diagnostic exams to drive the interventional equipment," Zimmer said. "This equipment would still be under operator control, but the diagnostic data would provide the optimum path for doing the procedure."

This would involve inputting imaging data into a model that could be transferred into the interventional system, guiding the C-arm into the optimal position to perform the procedure. In so doing, the company would make use of data that had already served its primary purpose, patient diagnosis, thereby providing more bang for the imaging buck.

Data optimization would be transparent to the operator, as the machines would be programmed to automatically repurpose the diagnostic data. The challenge will be to establish the interfaces for such data exchanges.

These links often are already in place between cardiac cath and echocardiography, Zimmer noted.

"In many cases, you see the ultrasound equipment right in the cath lab," he said. "That connection (between the interventional and ultrasound systems) will be easier than, for example, establishing an interface with CT."

Toshiba is moving in that direction through a partnership with McKesson, which so far has resulted in a mini-PACS for handling data from Aquilion 64-slice scanners. The mini-PACS will be marketed to hospitals and imaging clinics without PACS (DI SCAN 8/21/06, Toshiba allies with McKesson on CT mini-PACS). Eventually the architecture will grow to support other needs, one of which may be a link between CT and cardiac cath.