The Radiological Society of North America held its 92nd
Scientific Assembly and Annual Meeting (RSNA 2006) from November 26
through December 1, 2006 at McCormick Place in Chicago, IL. More
than 61,000 people attended this year's meeting, and >730
companies filled 514,800 square feet of exhibit space. The
following is a brief review of some of the new technology that was
featured at RSNA 2006.
At RSNA 2006, Barco (Kortrijk, Belgium) introduced its latest
line of gray-scale diagnostic display systems, showcased a new
online service for high-grade Quality Assurance (QA) of picture
archiving and communication system (PACS) display systems, and
previewed 2 advanced visualization applications.
Barco's new Nio line of gray-scale display systems, available in
2MP, 3MP, and 5MP resolutions, are driven by a high-speed BarcoMed
Nio display controller, featuring the company's proprietary AURA
technology. With 64-bit peripheral component interconnect (PCI)
performance, the systems are capable of a download speed of up to
230 Mb per second. When combined with the optional BarcoMed Nio PCI
Express display controller, the system can download up to 320 Mb
per second with 1024 simultaneous levels of gray.
The systems also feature the company's Backlight Output
Stabilization (BLOS), which is designed to provide fast power-up
and continuous Digital Imaging and Communications in Medicine
(DICOM) compliance. It also comes equipped with a protective front
cover to shield the LCD from damage.
The Nio display systems also feature the company's new MediCal
QAWeb service, a secure online service providing automated DICOM
calibration, QA, display asset management, problem solving, and
According to the company, this new service was developed "to
optimize the availability and DICOM-precision of all the PACS
display systems within a facility." To install, the MediCal QAWeb
Relay is added to the facility's PACS. Once installed, the system
permanently monitors all display systems throughout the facility to
ensure maximum availability and compliance with DIN-6868-57, AAPM
TG18, or other regional quality guidelines. DICOM calibration and
QA tasks are performed automatically in the background and, should
a problem arise, the system immediately notifies the proper
The system architecture also incorporates a central MediCal
QAWeb Server that provides a variety of remote capabilities,
allowing users to log in from anywhere inside or outside the
hospital and check the status of every display or add additional
displays. When required, corrective action can also be performed
re-motely via the MediCal QAWeb Server, which, as an added safety
measure, resides in a secured environment hosted by Barco.
MediCal QAWeb is offered at 3 service levels: Essential,
Advanced, and Premium. The Essential service level provides a basic
feature set for QA and remote support and includes a 2-year
warranty. The Advanced level features additional capabilities for
QA and asset management, as well as extended remote support
functions and a 3-year warranty. The Premium level includes a full
array of advanced services for asset management, remote support,
extensive reporting, and a 3-year warranty. This highest level of
service also includes added hardware services, including a
single-swap, color-matched display replacement on the next business
day in the event of a hardware failure.
In addition to the currently available products shown, Barco
previewed 2 works-in-progress at RSNA 2006: ColonMetrix for
computed tomography (CT) colonography and a new positron-emission
tomography (PET)-CT fusion application to its Voxar 3-dimensional
Voxar 3D ColonMetrix, which the company plans to fully integrate
into the Voxar 3D platform, was designed to allow radiologists to
interpret a CT colonography study and generate a report within
approximately 10 minutes. It incorporates a variety of advanced
tools designed to supplement traditional 2-dimensional image
review, including the ability to perform real-time manipulation of
colon image data with accelerated 3D fly-through, and has
integrated computer-assisted reader and DICOM reporting
Voxar 3D PET-CT Fusion was designed to support the
interpretation of whole-body fluorodeoxyglucose (FDG) oncology
studies and allow real-time interaction with PET, CT, and fused
volumes (Figure 1). According to the company, powerful automation
and visualization tools have been added to make the detection and
interpretation of lesions in PET-CT imaging faster and more
The company expects both Voxar 3D ColonMetrix and Voxar 3D
PET-CT Fusion to become commercially available in the United States
FUJIFILM Medical Systems
FUJIFILM Medical Systems USA, Inc. (Stamford, CT) unveiled a new
line of direct radiography (DR) products at RSNA 2006. At the
center of this product line is a new DR detector that the company
notes was designed to provide "the highest spatial resolution and
superb detective quantum efficiency." This detector is being
introduced in the company's Velocity-Ufp and the Velocity-Tfp
digital X-ray systems, which are both part of the company's fully
integrated digital room replacement, SpeedSuite. The Velocity-Ufp,
which will begin commercial shipment in the first quarter of 2007,
is a compact reader for chest and other upright exams, with a
throughput of up to 240 images per hour.
The Velocity-Tfp is a new table system designed to accommodate
patients weighing up to 506 pounds, with the same productivity as
the upright system. The company expects to begin shipment of this
system during the second quarter of 2007.
The third component of the new DR product line was shown as a
work-in-progress. The SpeedSuite Unity is a flexible U-arm system
designed to be used by both hospitals and outpatient imaging
centers for a full range of imaging studies (Figure 2). Pending
regulatory approval, Fuji expects the SpeedSuite Unity to be
available in mid-2007.
Following the launch of the company's Computed Radiography for
) full-field digital mammography system in 2006, Fuji also focused
on digital mammography at RSNA. In particular, the company
announced that, with the upcoming release of Synapse PACS version
3.2, the system will include additional digital mammography
According to the company, version 3.2 will extend Fuji's
proprietary Reading Protocol technology that will offer
reader-specific preferences to be set, which will provide
consistent screening workflows and the flexibility to accommodate
the challenges presented by diagnostic mammography. These
reader-set preferences will be able to be used across multimodality
women's imaging, including ultrasound and magnetic resonance (MR)
In addition, Synapse 3.2 will include support Mammography
Quality Standards Act (MQSA) compliant overlays, the integration of
computer-aided detection (CAD), and the company's Access Over
Networks compression algorithm. The company expects to release
Synapse 3.2 in the second quarter of 2007.
In other mammography news, the company announced a U.S.
distribution agreement with Siemens Medical Solutions (Malvern, PA)
through which Siemens will add Fuji's FCR
system to its product portfolio for both new and existing Siemens'
customers, complementing their own MAMMOMAT NovationDR system.
"Siemens has had a successful presence in the mammography
market, and this agreement is an example of how we can leverage
their breadth of experience so that our products get maximum
exposure to decision makers," said Andrew Vandergrift, Fuji's
National Marketing Manager, Women's Healthcare Imaging. "We're
looking forward to a successful, collaborative relationship, and to
helping spread the adoption of Fuji's clinically proven FCR
technology so that digital mammography is accessible to more women
in the United States."
Siemens Medical Solutions
Siemens Medical Solutions (Malvern, PA) previewed, as a
work-in-progress, the ACUSON Antares system, premium edition, which
will feature new elasticity imaging technology (Figure 3).
According to the company, this new ultrasound imaging technique is
expected to allow physicians "to accurately distinguish
characteristics of breast lesions, more clearly demonstrating
relative tissue stiffness or hardness, infiltration, and cystic
regions." Based on initial research conducted by Richard G. Barr,
MD, PhD (Professor of Radiology at Northeastern Ohio University's
College of Medicine and Radiologist at Southwoods X-ray and MRI in
Youngstown, OH) and presented at RSNA 2006, it is hoped that this
new capability may reduce reliance on breast biopsy procedures.
"In our work, elasticity imaging has been found to have high
specificity," said Barr, who studied 166 breast lesions using this
technique. "If our results can be reproduced in a large,
multicenter trial, this technique could significantly reduce the
number of breast biopsies required."
The Antares system, premium edition, will also be equipped with
the company's tissue stabilization technology, Advanced SieClear
Spatial Compounding, and its Dynamic TCE Tissue Contrast
Enhancement for speckle reduction and improved contrast resolution
and image presentation. In addition, this system will feature new
volumetric imaging and automation capabilities with available
options, including the new Fetal Assessment Application and
Advanced fourSight technology.
Siemens also showcased its new High Performance Imaging release
for the ACUSON Sequoia ultrasound system. Like the Antares system,
the new Sequoia release includes the Advanced SieClear Spatial
Compounding technology and Dynamic TCE capabilities. In addition, 2
new transducers are expected to be available soon for this system:
the 17L5 HD transducer, a high-density ergonomic probe for imaging
of small body parts, breast, and subtle pathologies; and the 9L4
transducer for cerebrovascular, peripheral arterial, and deep
venous imaging. New advanced clinical applications are also
expected to be available for the Sequoia system, including syngo
Mitral Valve Assessment for 3D evaluation of mitral valve
morphology and pathology and the new syngo Arterial Health Package
for intima-media thickness measurements.
Siemens also featured the company's new X Class products, the
ACUSON X300 and X500 ultrasound systems, at RSNA 2006. Both of
these lightweight, fully featured systems are equipped with the
company's ErgoDynamic imaging system design and a variety of
The X500 system was designed for a range of radiology and
cardiology applications, and it includes optional transesophageal
and stress echocardiography capabilities. Available features
include fourSight 3D/4D imaging and the syngo Arterial Health
Package technologies. The system's TGO (tissue gain optimization)
PLUS feature optimizes tissue gain and brightness in both the axial
and lateral planes with the push of a button. The system also
features a 17-inch flat panel display, an articulating arm, and a
height-adjustable and customizable control panel.
The X300 is an ultracompact system designed for use in such
settings as the emergency department. It also features TGO
technology for consistent image quality and advanced Hanafy lens
transducer technology designed to provide improved image uniformity
when scanning patients who are technically difficult-to-image.
Siemens also showcased a variety of products in other clinical
areas, including its recently approved syngo Lung CAD, which is
designed to assist in the detection of solid lung nodules in CT
examinations of the chest, and the MAGNETOM Trio MR system,
Siemens'first MR system capable of 3T whole-body imaging with Tim
technology. The company also highlighted its new MammoTest prone
table, which is designed to offer clinicians the choice of upright
or prone stereotactic breast biopsy systems. This system features
360˚ lesion access, polar coordinate targeting, and a
high-resolution fiber optic camera.
Planar Systems, Inc. (Beaverton, OR) featured the Dome EX series
of gray-scale display solutions at RSNA 2006.
Designed to provide a value-added display solution to specialty
markets, the EX line is built on the company's Dome DA(4)
architecture, allowing for up to 1024 calibrated shades of
"Diagnostic images viewed on Dome EX displays can exhibit the
finest details, and the fourfold increase in calibrated gray shades
provides a truer representation of the original digital data
captured by the device," said Patrick Herguth, Vice President and
General Manager of the Medical Business Unit for Planar Systems.
"The technology to display 1024 calibrated gray shades exists in
every EX panel via the DA(4) architecture. We have just been
waiting for the graphics controller and software operating systems
to evolve enough to take advantage of our technology."
The new display systems are available in 2MP (Dome E2), 3MP
(Dome E3), and 5MP (Dome E5) resolution. The company also offers a
solution that combines 2 high-fidelity Dome gray-scale displays
with one Dome E4c color display, designed to allow the user to use
the Dome E4c for 3D reconstructions, cross-sectional data sets, and
worklists while still having a high-fidelity gray-scale
representation on a dedicated Dome E3 or Dome E5 display.
E-Z-EM, Inc. (Lake Success, NY) previewed, as a
work-in-progress, its first MR-compatible contrast injector system,
EmpowerMR, at RSNA 2006 (Figure 4). Based on the company's
EmpowerCT injector systems, the EmpowerMR features the same user
interface and safety features as the CT systems in a format
designed to not interfere with the MR scanner.
The new injector uses a hydraulic control system instead of
shielded electrical control components. It has no shielded iron
motors, piezoelectric motors, or electrically active motor-control
circuitry adjacent to the scanner, which, the company notes, is
expected to minimize the possibility of electrical interference
with the scanner's magnetic field. The system, which is not battery
operated, links to its electrical supply by a single pass-through
cable that does not require special shielding.
The company also announced at the meeting that it received
marketing clearance from the U.S. Food and Drug Ad-ministration
(FDA) for its EmpowerSync system, a product based on the CAN-CiA
(controller area network-[CAN] in automation) DSP 425 protocol.
This system enables the synchronized operation of EmpowerCT and
EmpowerCTA injector systems and CT scanners from all manufacturers
who adopt the DSP 425 standard.
The CAN-CiA DSP 425 protocol, an internationally recognized
standard for data transmission between scanners and contrast
injector systems, permits automated and coordinated operation of
both the scanner and the injector system from the scanner's control
"The DSP 425 protocol is the coming standard for data
transmission between injector systems and CT scanners," said Senior
Vice President- Global Sales, Marketing, and Engineering, Brad S.
Schreck. "With receipt of FDA clearance for EmpowerSync, our
EmpowerCT and EmpowerCTA injector systems will now be compatible
with this standard."
Vital Images, Inc. (Minnetonka, MN) featured a theme of "The
ViTALCommunity" at RSNA 2006, highlighting the company's focus on
"relationships empowered by comprehensive solutions," including
Vitrea software, the Web-based ViTALConnect solution, the
VitreaACCESS system, ViTAL U educational programs, and its
ViTALPerformance maintenance and services program.
Highlighting its flagship software, Vitrea and Web-based
ViTALConnect, the company demonstrated how by working together with
VitreaACCESS these systems "provide the power and speed of
workstation applications bolstered by the communication and
distribution flexibility provided by the Internet." They showed how
physicians using Vitrea 3.9 can manipulate studies to create key
images, then push them to the ViTALConnect 4.0 solution, where
users anywhere within the enterprise can restore the Vitrea
workflow and continue further analysis and manipulation utilizing a
Web interface. VitreaACCESS-Remote extends this capability by
allowing radiologists to access their advanced visualization
desktop from a remote location through a virtual private
"We've worked very closely with customers to understand the
complexities in their workflow and to simplify those workflows
through elegant software solutions," said Susan A. Wood, PhD,
Executive Vice President of Marketing and Product Development for
Vital Images. "The result is that ViTAL is able to provide our
customers with anywhere, anytime access to clinically relevant ad
vanced visualization and analysis solutions customizable to fit the
needs of their enterprise."
The company also showcased their ViTALPerformance program, which
offers automatic software upgrades for the life of a solution, as
well as remote diagnosis, and the interactive clinical protocol
assistance program, ViTALAssist.
The company's education center, ViTAL U, offers courses designed
to provide hands-on training in such areas as vascular, thoracic,
and cardiac applications. These courses are offered throughout the
year at the company's Minnesota headquarters as well as online, at
regional road shows, and, by request, at facility sites.
Coming in February
RSNA 2006 review: Part 2