The January 2007 issue of
included Part 1 of the review of products displayed at the 92nd
Scientific Assembly and Annual Meeting of the Radiological Society
of North America (RSNA 2006), held November 26 through December 1,
2006 at McCormick Place in Chicago, IL. In Part 2 of the coverage,
we present more of the innovative technology showcased at this
GE Healthcare (Waukesha, WI) displayed the company's full line
of radiology products at RSNA 2006, with particular highlights in
the areas of computed tomography (CT) and magnetic resonance
In its CT line, the company featured the new LightSpeed VCT XT
scanner, which is capable of capturing images of the heart and
coronary arteries in as few as 5 heartbeats. The scanner was also
designed to reduce radiation dose by up to 70% during diagnostic
cardiac examinations using the new SnapShot Pulse feature. This
feature drives a process known as prospective triggered gating in
which an automated response to a patient's heart rate ensures that
the X-ray is only on for portions of the scan, thereby reducing the
patient's radiation exposure time.
"Based on more than 100 patients scanned with our new system, we
were able to obtain high image quality for a wide range of patient
sizes while the average radiation dose was approximately 5 mSv with
a range of 1 to 9 mSv," said Jean-Louis Sablayrolles, MD, head of
CT Cardiac Imaging Radiology at the Centre Cardiologique de Nord,
The system also includes the company's new VolumeShuttle
technology. This feature doubles the coverage of the width of the
anatomy without increasing the radiation dose (as compared with a
single axial acquisition) and uses a single contrast injection.
This capability was developed to address the need for wide coverage
for both dynamic angiography and perfusion in a single scan for
whole-organ anatomic and physiologic assessment.
In addition, GE introduced the latest addition to their
BrightSpeed line of smaller, multidetector CT scanners, the
BrightSpeed Select (Figure 1). Available in 4-, 8-, and 16-slice
configurations, the company notes that the BrightSpeed Select was
designed to provide quality images in a smaller scanner system.
"By bringing the innovations of our LightSpeed VCT to the new
BrightSpeed Select, we are giving more clinicians access to
excellent image quality and, in turn, helping them provide better
patient care," said Brian Duchinsky, General Manager of CT Product
Development and Marketing.
According to Duchinsky, the BrightSpeed series with the Volara
digital data acquisition system offers a high standard of image
quality, resolution, and optimal-dose imaging. It also offers
productivity tools (such as direct volume visualization with direct
multiplanar reformatting) directly on the operator console.
GE also introduced CT analysis software, Perfusion 4 Neuro, for
use in the assessment of perfusion, blood volume, and capillary
permeability changes that may relate to stroke or tumor
angiogenesis. According to the company, this software program
"provides quick and reliable assessment of the type and extent of
cerebral perfusion disturbances by providing qualitative and
quantitative information on various perfusion-related parameters
such as regional blood flow, regional blood volume, mean transit
time, capillary permeability, and Tissue Classification Index."
The new Tissue Classification Index was developed to assist in
determining the status of the tissue based on various
perfusion-related parameters during the critical first 6 hours
following the onset of symptoms.
"When it comes to the triage of acute stroke patients, 'time is
brain,'" said Michael H. Lev, MD, Director of Emergency
Neuroradiology and the Neurovascular Lab at Massachusetts General
Hospital, and Associated Professor of Radiology, Harvard Medical
School, Boston, MA. "The ability to create accurate 'turnkey'
perfusion maps with a single mouse click is a welcome and powerful
new tool in our stroke diagnostic armamentarium."
In the field of MR, GE featured its Signa High-Density (HD)
Head-Neck-Spine MR imaging array. This system allows the user to
scan multiple neurology patients or perform a series of
examinations on a single patient without changing coils.
The phased-array system features 29 elements and 16 channel
outputs to cover a patient's entire upper body with a single coil,
providing high-density signals designed to produce uniform high
quality images in brain, neck, and spine studies. The modular
design allows the user to scan with individual head, neck, or spine
sections or to use them together as an integrated unit, while the
thoracic and lumbar portion can be left on the table during most
GE also introduced CartiGram, an MR application designed to
assist in the evaluation of articular cartilage integrity. When
collagen breaks down, there is increased mobility of water in the
cartilage and, consequently, a prolongation in T2 relaxation times.
This application, available as an option on the Signa HDx platform,
uses T2 values to automatically generate color maps, helping
clinicians visualize changes in the composition of articular
Royal Philips Electronics (Amsterdam, The Netherlands) used RSNA
2006 as the backdrop to showcase its full range of imaging
technology and to unveil the company's latest single-photon
emission computed tomography (SPECT) system, the Philips BrightView
SPECT (Figure 2).
This system, the company notes, "is a fully featured, variable
angle camera differentiated by Philips' CloseUp technologies, which
enable higher resolution through smarter software, new electronics,
and minimal distance between detector and patient."
Designed to accommodate nearly all patients from infants to
larger adults, the system features an open gantry and a 450-lb
table capacity. It also features the company's BodyGuard technology
to move the detectors closer to the patient through automated
contouring. The thin imaging pallet and small cardiac dead space
were designed to improve image quality in bone and cardiac studies.
The compact system also features customizable automated acquisition
capabilities to help streamline workflow and allow for future
Philips also exhibited the GEMINI TF (time-of-flight)
positron-emission tomography (PET)/CT system, which is now
available with a 64channel CT component. According to the
manufacturer, this system provides enhanced small lesion
detectability, shorter scan times, and reduced patient radiation
dose. Acquisition of an adult whole-body PET scan with this
open-gantry system can be completed in <10 minutes.
The company also announced the availability of a new PET/CT
Pulmonary Toolkit that provides respiratory-correlated imaging and
intuitive patient feedback on select GEMINI configurations.
In the field of MR imaging, Philips showcased the new Philips
Achieva 3.0T X-series, which features enhancements to the magnet,
gradient, and radiofrequency (RF) technology and a larger field of
view. This system, which will be available in a mobile
configuration, features several of the company's imaging and MR
application technologies, including spectroscopy,
diffusion-weighted whole-body imaging with background body signal
suppression (DWIBS), and SmartExam, which was de-signed to provide
one-click planning, scanning, and processing.
Philips also previewed its next generation of computer-aided
detection (CAD) software for pulmonary lesions and nodules in
digital radiographic chest images. The xLNA Enterprise 2.0,
scheduled to be available in the United States in the first quarter
of 2007, was designed to assist in the visualization,
identification, and evaluation of lung nodules as small as 5
Summarizing the Philips products displayed at RSNA 2006, CEO
Steve Rusckowski said, "Any imaging company can provide clinicians
with a lot of data. But at Philips, we strive to intuitively,
instantly, and accurately pinpoint the right information to help
physicians, nurses, and technologists provide the best possible
patient care. Evident from our complete portfolio of healthcare
products and technologies introduced this year, Philips
consistently develops patient-focused solutions for every stage of
care while improving access to systems that enhance the overall
quality of care."
IBM (Armonk, NY) announced at RSNA 2006 that Iowa Health Systems
(IHS) plans to use the IBM Grid Medical Archive Solution (GMAS) for
its enterprise-wide storage system.
IBM, in conjunction with Bycast Inc. (Vancouver, BC), will help
IHS establish a storage system based on the IBM GMAS to manage the
healthcare organization's imaging and other fixed content data,
such as audio, video, and medical documents. With this system, IBM
notes, "IHS will be able to easily deploy a disaster recovery plan
over a wide area network, maintain business continuance by allowing
clinical applications to operate in the presence of faults, and
verify authenticity of retrieved data and auto-rebuild corrupted
The GMAS, which is available in single-and multiple-rack
configurations, utilizes Bycast StorageGRID software and integrates
IBM System Storage DS4000, IBM System Storage EXP100 Expansion
Unit, and xSeries servers.
"Customers, such as Iowa Health System, are utilizing innovative
technology to help deliver improved patient-centric care," said
Bruce Gardner, Director of IBM Healthcare and Life Sciences. "A
solution such as IBM GMAS can help reduce the complexity and cost
of managing medical images and data so clinicians can effectively
and efficiently access patient information."
Ziehm Imaging GmbH (Nuremberg, Germany) featured the most recent
version of the Ziehm Vario 3D C-arm at RSNA 2006 (Figure 3). This
new digital X-ray system features variably isocentric C-arm
movement and an interface for intraoperative 3-dimensional (3D)
imaging. The user can choose the image intensifier/object distance
and, if necessary, may change the settings between the individual
exposures without affecting the position of the isocenter in
relation to the patient. An on-screen display on the Vario Center
interface guides the user through all settings. Following each
scan, the 3D image is recomputed and displayed on high-resolution
18-inch flat-screen monitors. A 3D imaging user interface provides
optimum orientation within the volume and setting of the diagnostic
slices in the coronal, axial, and sagittal planes.
Available options include Active Cooling for unlimited operation
time, a generator-mounted laser localizer, a dose area product
meter with digital display, and a connector for an external
radiation warning light.
The company also introduced its new Object Detected Dose Control
(ODDC) tool for the Ziehm Vision series of C-arms. The new tool,
which covers the entire field of view, provides real-time motion
detection designed to adjust the noise reduction level whenever
there are moving objects. The system also reduces the pulse
frequency in nonmoving objects. It also features Automatic Metal
Correction to reduce the blooming effect when a metal object is in
Eastman Kodak Company (Rochester, NY) introduced a new digital
radiography (DR) system and a new workstation at RSNA 2006.
The new DR system, known as the KODAK DIRECTVIEW DR 9500,
features a ceiling-mounted U-arm, which contains both a tube and
detector, that was designed to move around the patient. It provides
2 operator interfaces at the U-arm that allow the technologist to
change the X-ray generator parameters and technique settings
without leaving the patient. Patient data from a DICOM worklist can
also be viewed at the operator interface and at the operator
console. The system also features autopositioning capabilities to
move the equipment into preprogrammed positions. The KODAK DR 9500
system is scheduled to be available worldwide in the second quarter
Kodak also highlighted a new workstation designed specifically
for digital image management. According to the company, the Virtual
Access Desktop for KODAK CARESTREAM Radiology Solutions is "an
entry-level workstation that helps facilitate the transition to a
digital environment by equipping technologists, medical staff, and
clinical users with basic image review, advanced printing
capabilities, and short-term storage." This desktop system features
edge enhancement to improve visualization of bone and lung
structure, a scrolling feature for long-length CR images, and
true-size printing. An optional CD distribution program allows the
images to be output to a CD.
"Our digital radiography portfolio illustrates our dedication to
innovation and our willingness to develop solutions that meet the
divergent requirements and budgets of healthcare providers of all
sizes," said Michael L. Marsh, General Manager of Digital Capture
Solutions and Vice President, Eastman Kodak Company. "We can
deliver a customized solution based on the patient examination
applications, room size, volume, and other considerations of each
Toshiba America Medical Systems, Inc. (Tustin, CA) showcased its
new suite of workflow and storage enhancements for its CT systems
and previewed, as works-in-progress, the company's new 1.5T and 3T
MR systems at RSNA 2006.
Enhancements to its Aquilion CT system include version 3
software on the CT console, which is designed to provide faster
scanning and data analysis. The company also demonstrated the new
Automated PhaseXact software component of the
Cardio package, which automatically locates the optimal phase of
the heartbeat during the image acquisition pro-cess (Figure 4).
Version 3 also provides enhanced DICOM data transfers with speeds
of up to 60 images per second.
"Toshiba continually strives to raise the standard of care, and
we are pleased that clinicians and patients alike will benefit from
the industry's highest-performing line of CT systems," said Doug
Ryan, Senior Director of CT Business Unit. "These enhancements to
our Aquilion systems provide clinicians with the level of
confidence they need to optimize diagnosis and enhance overall
departmental workflow and efficiency."
Toshiba also announced plans to install the company's first U.S.
256-slice CT scanner, on a beta-test basis, at the Johns Hopkins
University School of Medicine and its Heart Institute in February
2007. The system, which will remain at Hopkins for a limited time,
will be tested for its usefulness in the early assessment of
critical radiology and cardiac CT protocols. This work-in-progress
scanner was designed to acquire a volume of data large enough to
cover the brain or heart in a single rotation.
In the field of MR imaging, Toshiba previewed its new EXCELART
Vantage Atlas 1.5T MR system as a work-in-progress. According to
the company, this new 128-element system was designed to "deliver
high-resolution images across the entire body with faster imaging
times, rendering quick and accurate diagnoses and increasing
patient comfort." Its integrated coil was developed to allow
clinicians to perform multiple examinations without repositioning
the patient. In addition, an optional 205-cm acquisition range
allows for feet-first imaging for the entire body, except the neck
and head, allowing the patient's head to remain outside the scanner
for most studies. Other optional packages include advanced
echoplanar imaging, diffusion and perfusion imaging, peripheral
angiography and fresh blood imaging, SuperFASE (fast advanced
spin-echo) imaging, and Body Vision. The system will also feature
the company's SPEEDER parallel imaging technology and its
Pianissimo technology for reduced acoustic noise.
Toshiba also previewed a 3T version of the EXCELART Vantage MR
system, which features a new magnet design and short-bore
combination. This 3T system will include whole-body imaging and
spectroscopy designed to capture information not obtainable with
1.5T MR systems.
Compressus Inc. (Washington, DC) highlighted its suite of
enterprise systems integration software solutions, the MEDxConnect
System, at RSNA 2006. Designed to provide connectivity and
interoperability between acquisition devices, picture archiving and
communication systems (PACS), hospital information systems,
radiology information systems, and other related information
systems, MEDxConnect components include the Medical Message
Mediator (M3), the Virtual Worklist, and the Systems Management
The M3 component uses communications protocols to control the
HIPPA-compliant flow of images, reports, messages, and other data
between independent systems. The MEDxConnect Virtual Worklist
software runs on the M3 server and enables users to manage
diagnostic and reporting workflow by retrieving, routing, and
storing all DICOM images and generating worklists from multiple
PACS or network systems throughout the enterprise.
The SMD enables the monitoring of enterprise activities and
assists in identifying inefficiencies or bottlenecks in workflow,
providing a variety of numeric and graphic tools.
"As healthcare enterprises grow in size and complexity,
enterprise systems integration will become increasingly vital to
the successful management of patient care and the bottom line,"
said Janine Broda, Vice President and General Manager for
Compressus' Medical Solutions Division. "Compressus' MEDxConnect is
an innovative technology that supports healthcare's need for a
fast, effective, accurate, and affordable solution that provides
seamless connectivity and interoperability."