The theme for the 88
Scientific Assembly and Annual Meeting of the Radiological Society
of North America (RSNA 2002)--"Leading Medicine's Digital
Transformation"--was echoed throughout the proceedings; from the
infrared beaming stations located throughout the McCormick Place
Convention Center to the Scientific Program and the Technical
RSNA President Nick Bryan, MD, PhD, expounded upon this theme in
his Presidential Address, saying that the ongoing digital evolution
will bring revolutionary changes to radiology. He predicted that
"the practice of radiology will fundamentally change from
relatively inefficient, small, local operations that still keep the
radiologist relatively remote from the patients, to very
competitively managed, large, automated medical enterprises that
will better incorporate the patient into the process."
He called on radiologists to embrace the digital nature of their
profession. "Essentially, all contemporary imaging studies consist
of data which is intrinsically digital," he said, "allowing a much
more efficient and flexible use of this data and making it more
readily available to patients, referring physicians, and other
partners in healthcare."
The full scope of the digital environment, however, is more than
just images, workstations, and software, he noted. "The wealth of
information in these front-end components of the digital
environment must be integrated into the rest of the enterprise. The
radiologist, after adjusting to the changes," he proposed, "will be
very happy having immediate access to all images and ancillary
data, taking advantage of computer-assisted diagnosis (CAD), and
generating rapid reports that can be distributed anywhere, at
anytime." As a result, he concluded, "our referring physicians will
be ecstatic to have prompt access to our images and reports and the
health system will be happy because its patients are happy, its
physicians are happy, and it costs less."
16-Slice PET/CT Systems
Among the highlights of this year's nearly 600 Technical
Exhibits was the introduction of the first positron emission
tomography/computed tomography (PET/CT) imaging systems to feature
a 16-slice CT component.
CTI Molecular Imaging
(Knoxville, TN) unveiled its new REVEAL XVI PET/CT, and
Siemens Medical Systems
(Malvern, PA) introduced the biograph 16.
The REVEAL XVI by CTI (Figure 1) combines lutetium
oxyorthosilicate (LSO) "fast PET" crystal technology with 16-slice
CT, and, according to the company, can perform high-speed cardiac
procedures as well as tests for cancer detection and monitoring in
13 minutes for most patients.
"Our expectations are that the LSO PET scan, merged with a
16-slice CT image, will foster more accurate tumor detection and
precise localization, improved biopsy sampling, and better
assessment of patient response to therapy," said David Townsend,
PhD, professor of radiology, University of Pittsburgh Medical
Center and co-inventor of the PET/CT concept. "Further, the
addition of the 16-slice CT capability is a major breakthrough
because it allows the PET/CT scanner to perform high-speed cardiac
tests, such as CT angiographies and real-time interventional
"Combining faster scan times with better resolution allows
visualization of coronary activity within one cardiac cycle for
evaluation of coronary artery problems, wall-motion abnormalities,
and heart tissue viability," agreed Todd Blodgett, MD, of the
University of Pittsburgh Medical Center.
For cancer monitoring, Townsend said this system "gives the
physician an improved assessment of recurrence or remission, and of
the impact of chemotherapy or radiation at the tumor site."
"The ability to complete a PET/CT scan in 13 minutes is very
convenient for patients and a major advantage for clinicians in
high-throughput clinics or very large radiology practices," said
Thomas Hook, senior vice president at CTI. "REVEAL offers
radiologists the ability to conduct PET/CT studies for numerous
oncology and cardiology applications on one system."
The company expects to begin full production on the $2.5 million
system in the second quarter of 2003.
The other system introduced at RSNA 2002, the biograph 16 from
Siemens, combines the company's SOMATOM Sensation 16 CT with its
ECAT ACCEL PET system and includes the company's ultrafast ceramic
(UFC) CT detectors and LSO PET crystals.
The company reports that the biograph 16 can perform whole-body
oncology scans with submillimeter isotropic CT resolution in 7 to
15 minutes. The system also provides a larger field of view and
co-scanning range than those of the company's previous hybrid
According to the manufacturer, this new technology is opening
the possibilities for unprecedented PET/CT applications across the
imaging spectrum. In oncology, protocols have been established for
the whole body, lung, and colon scanning procedures. In cardiology,
advanced applications include cardiac viability and imaging
perfusion, calcium scoring, and CT angiography; with a single
cardiac image acquired in <20 seconds. In neurology, the system
can be used for brain perfusion studies designed to assess chronic
conditions such as epilepsy and Alzheimer's disease.
Siemen's proprietary syngo and Soarian software solutions allow
the biograph images and patient data to be distributed, accessed,
and viewed across the enterprise.
The company expects to begin customer installations in spring
2003, with a price set at approximately 20% higher than the
previous most expensive biograph units.
R2 Technologies previews CAD for CT
In other CT news,
(Sunnyvale, CA) showcased its CAD software with OmniCAD technology
as a work in progress. The OmniCAD is designed for the detection of
lung nodules in multislice CT images.
The ImageChecker CT CAD software uses proprietary algorithms to
detect and highlight potential areas of interest. In addition, it
provides measurement and characterization information about the
detected nodules. The company points out that the technology allows
the detection of nodules in CT images of the chest obtained for any
clinical indication, not just for lung cancer screening
"We are extremely excited about the use of CAD in CT and the
potential to significantly improve chest imaging," said Gordon
Gamsu, MD, professor and vice chairman, Department of Radiology,
Weil Cornell Medical Center, New York, NY, who is also a member of
the company's Chest CT advisory board. "Early-stage lung cancer is
very difficult to detect, but with the opportunity to use R2's CAD
software for the detection of lung nodules in multislice CT exams,
we may be able to identify lung cancer early and potentially save
In addition, the company announced that it has received 510(k)
clearance for its ImageChecker CT display workstation. The
workstation is a combination of dedicated software and hardware
designed to allow the radiologist to review CT exams with the
addition of CAD. The workstation receives CT exams and DICOM
structured reports of CAD-identified areas using DICOM protocols.
After reviewing each study, the user can view screens that
summarize his or her findings and save the information to a local
Clinical studies for the ImageChecker CT CAD software are
currently under way in the United States and Europe.
Toshiba unveils new open MRI and previews flat-panel
Toshiba America Medical Systems
(Tustin, CA) introduced its Ultra open magnetic resonance imaging
(MRI) system (Figure 2) and demonstrated its Dynamic Direct
Conversion Flat Panel Detector as a work in progress.
The Ultra features a unique MRI gradient field technology with
an amplitude of 25 mT/m (milli-Tesla per meter) and a slew rate of
100 T/m/sec (Tesla per meter per second). According to the company,
this allows the system's gradient speed to be almost five times
faster than the current open systems and 250% greater than
The company notes that the Ultra was designed to handle a full
range of diagnostic procedures including routine neurology, body
and musculoskeletal imaging, as well as more advanced
neurofunctional and cardiovascular imaging. "The Ultra utilizes a
very powerful gradient system to accomplish advanced clinical
applications, high-resolution imaging, and faster scanning," said
Dane Peshe, director, MRI and Nuclear Medicine Business Units at
Toshiba. "This approach to increasing MR performance levels allows
the Ultra to retain the spacious environment that patients have
come to expect in an open system."
The company notes that the Ultra can perform many of the most
sophisticated high-field imaging techniques including single-shot
echoplanar imaging diffusion, TrueSSFP, SuperFASE, and Black-Blood
In addition, Toshiba previewed its Dynamic Direct Conversion
Flat Panel Detector (FPD), the DynaDirect, as a work in progress on
its Ultimax multi-purpose X-ray system. With the DynaDirect, the
X-rays are converted directly to digital signals without first
being converted to light. The detector delivers a 150-micron pixel
size with a 14 * 14 inch coverage area.
"With DynaDirect, clinicians have already begun seeing more
anatomical detail with greater clarity than ever before," said Don
Volz, director, Vascular X-ray Business Unit. "In addition to the
clinical benefits, eliminating film with a fully digital system
holds numerous productivity and efficiency benefits."
Once approved, the technology will be made available in a
Hologic showcases new bone densitometer
(Bedford, MA) unveiled its new line of bone densitometers, the
Discovery series (Figure 3), at RSNA 2002. The new line combines
10-second bone density measurements with 10-second vertebral
The system utilizes the company's proprietary OnePass
Technology, which permits low-dose single-sweep scanning of the
spine (L4T4) with a 10-second acquisition time. The rapid
acquisition time is paired with Hologic's Express BMD, which
provides spine and hip bone mineral density (BMD) results in 10
seconds, and with the company's Instant Vertebral Assessment (IVA)
for rapid assessment of spinal fractures.
The Discovery Series also includes a suite of productivity
tools: The Express Exam feature groups routine scan protocols with
automated patient positioning, scanning, and analysis workflow.
Tech Tips aids the user in setting the proper patient alignment,
scan start position, and correct scan position.
Once the images are acquired, the CADfx feature quantifies the
degree of vertebral compression and simplifies IVA interpretation.
The electronic reporting package integrates high-speed paperless
data transfer, remote soft-copy image review, and automated report
generation and distribution. The IRIS Connectivity Suite is IHE
Year-3 compliant and can incorporate DICOM Modality Worklist, HL7
format output, and Microsoft Word-based electronic reporting
"Discovery is the result of more than 15 years of innovation in
osteoporosis assessment," said Eric von Stetten, PhD, vice
president and general manager of the Osteoporosis Assessment
Division at Hologic. "By pairing 10-second bone density
measurements with 10-second high resolution vertebral imaging, we
believe Discovery provides physicians with the highest quality
diagnostic information in the shortest amount of time. Discovery's
unique combination of workflow enhancements, electronic reporting
capabilities, and cutting edge technology sets the new standard for
patient care and productivity."
All-digital handheld ultrasound units from
(Bothell, WA) showcased its new handheld, all-digital ultrasound
series, the iLook (Figure 4) at RSNA 2002. Weighing just 3 pounds,
the iLook was designed to be used throughout the hospital to
deliver a "quick look" in clinical diagnostics and vascular access
Initially, the company is offering two versions: The iLook 15 is
intended for initial diagnosis of gallstones, abdominal aortic
aneurysms, and pericardial or pleural perfusion across a wide
variety of departments throughout the hospital.
The second version, the iLook 25--named for its 25-mm probe--was
designed to be used during routine vascular access procedures, such
as catheter insertions or placement of central or peripheral
Both systems measure 6.4 * 10.85 * 1.5 inches with an integrated
5-inch thin-film transistor color Liquid Crystal Display with
brightness and contrast control. Both offer 2-dimensional and color
power Doppler. Harmonics are available on the iLook 15. Video can
be output to a videocassette recorder, video printer, or external
monitor. The iLook stand or a mobile docking station can be used to
download bitmap images, and direct connectivity to a PC can be
achieved using the SiteLink image manager.
"Our technology is driving a movement toward visual medicine
that directly supports the top priorities in healthcare today--to
reduce costs, increase access, increase safety, and improve quality
of care," noted Kevin M. Goodwin, president and CEO of SonoSite.
"iLook represents the newest member of the SonoSite family of
systems and represents our unique ability to place the power to see
inside the body directly in the hands of trained physicians,
enabling them to make more informed decisions in any healthcare
The handheld device "frees up our larger machines for more
complex studies and procedures, while giving physicians who depend
on clear ultrasound imagery the information they need," reported
Peter L. Cooperberg, MD, FRCP(C), professor of radiology,
University of British Columbia and chief of radiology, St. Paul's
Hospital, Vancouver, BC. "I have used SonoSite's hand-carried
ultrasound devices for several years as an effective and
cost-efficient way to improve how we care for our patients. Using
visual technology in a clinical setting improves our ability to
find and treat medical conditions early. We can make the diagnostic
and treatment processes more convenient and more comfortable for
Both versions feature a single, fixed transducer and can be
powered by battery or AC with battery back-up. They are controlled
with a touch screen similar to that found on PDAs and cost from
$12,500 to $15,500.
Kodak highlights latest dry laser Printer
Eastman Kodak Company
(Rochester, NY) featured its new Kodak DryView 8900 laser imaging
system (Figure 5) at RSNA this year.
This newest member of the DryView family contains three film
drawers that are all capable of handling any of five film sizes: 14
* 17, 14 * 14, 11 * 14, 10 * 12, and 8 * 10 inches. The imager is
capable of producing >180 films per hour at a laser resolution
of 650 dpi for all film sizes. The manufacturer notes that the
ability to hold such a variety of film sizes makes this unit
suitable for producing output from modalities that generate mixed
film sizes, such as computed radiography.
"The DryView 8900 system doubles the image resolution offered by
most existing dry laser systems for general radiography and offers
much greater speed," said Gregory Cefalo, worldwide marketing
manager for laser imaging systems at Kodak.
This fifth-generation printer has a top-mounted, multi-bin film
sorter that helps to decrease the unit's footprint and allow for
greater flexibility in placement. The DryView 8900 also features a
touch screen, multilingual color control panel, bagless DryView
film cartridges, and Kodak's proprietary Automatic Image Quality
Control (AIQC) process that verifies that all images have passed
pre-set quality assurance parameters.
The DryView 8900 laser imaging system is expected to be
available in the second half of 2003.
Amersham presents new corporate identity program
(Princeton, NJ) unveiled its new corporate identity campaign at
RSNA 2002. Called "Every Single Second..." The campaign is based on
the idea that every second, a patient somewhere in the world
undergoes a procedure using an Amersham Health product.
"At Amersham Health, we are proud that every single second one
of our products is used around the world to make a difference in a
person's life," said Daniel L. Peters, president of Amersham
Health's Medical Diagnostics business worldwide. "Physicians and
technologists rely on our products to assist them in early,
accurate diagnosis and to provide the information they need to
determine the most effective treatment."
RSNA meeting attendance
The RSNA reports that the total attendance at the 2002 meeting
was up 11% over last year, with 59,200 attendees, compared with
53,569 in 2001 and 60,443 in 2000. There were 24,471 radiology
professionals at RSNA 2002 compared with 21,406 last year, and
24,600 in 2000.