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Companies introduce impressive technologies for digital imaging at RSNA

CHICAGO – Over 28,000 medical professionals from the United States, Canada and around the world flocked to the Radiological Society of North America’s 100th annual meeting at the end of 2014, seeking updates on the latest imaging techniques and technologies. Many innovations were found on the show floor, where vendors showcased their work in CT, MR, PET, dose reduction, vendor neutral archives, zero footprint viewers, and more. Here are just some of the latest developments:

TOSHIBA demonstrated the tight integration of its Infinix C-arm, typically used in Interventional Radiology, with a CT scanner to produce the Infinix 4D CT – a system that enables clinicians to achieve faster, safer and more accurate interventions. With this innovative combination, healthcare providers can plan, treat and verify in a single clinical setting for better patient care – rather than transferring patients between departments, risking infection and dragging out procedure times.

The system improves workflow with its Sure Guidance technology (pending Health Canada clearance) that allows for seamless and automatic transition between modalities – the CT slides back and forth over the table, so the patient doesn’t have to be moved. And, it is capable of saving hours by allowing clinicians to perform CT and interventional procedures within the same room and verify treatment success immediately after procedures.

Toshiba says the Infinix 4D CT improves workflow of IR, oncology and cardiac procedures, providing interventionalists with CT images of targeted organs and producing more precise views of areas to be treated and device placements. Clinicians can also adjust the procedure with real-time studies instead of relying on CT images taken at an earlier time.

Currently the solution is FDA cleared with the Infinix Elite and Aquilion ONE ViSION Edition configuration, and is pending Health Canada clearance.

Toshiba displayed a new CT detector technology that will be incorporated into all of its CT machines going forward. Called the PureVision detector, the new technology converts X-ray energy much more effectively, producing sharper images than ever before. The company also showed the industry’s largest bore CT, with an opening of 90 cm, designed to accommodate large patients.

PHILIPS had many innovations to showcase at its booth, including its new DoseWise Portal – said to be the industry’s first integrated radiation dose management solution for patients and clinicians. According to Philips, DoseWise Portal is a cloud-based, vendor agnostic, turnkey software radiation management solution that allows clinicians and administrators to gain an understanding of radiation use in the form of tailored reports, alerts and advanced analytics.

Computer tomography (CT) scans are of most concern, with a higher average diagnostic radiation dose per scan and nearly 68 million performed annually in the U.S. “Dose management is a critical issue, and the reality is that sometimes the higher radiation dose of a CT is necessary for a particular patient in order to reach a definitive diagnosis, in the shortest time, and at the lowest cost,” said Gene Saragnese, executive vice president and CEO of Philips Imaging Systems. Philips is also targeting radiation dose from general X-ray, fluoroscopy, mammography, and nuclear medicine.

Not only does DoseWise Portal track the dose of patients, but it also offers real-time information about the radiation being absorbed by clinicians and staff. It’s done through the use of badge-like sensors, which are integrated into the system and report exposure levels after each procedure.

Philips also launched its IntelliSpace Portal 7.0 at RSNA 2014. The system is said to offer radiologists a more integrated view of each patient moving along the health continuum and the ability to create faster pathways to definitive diagnosis for referring physicians.

“Diagnosing a patient can often take multiple scans – from MRI to X-ray to CT – and requires a collaborative review of imaging results and surrounding data including clinical notes, EMR data and more,” said Jeroen Tas, CEO, Healthcare Informatics Solutions and Services, Philips. “IntelliSpace Portal 7.0 is a critical solution connected to the Philips HealthSuite Digital Platform, integrating data from multiple imaging systems, enabling radiologists to put their patients on a faster and better path to treatment.”

IntelliSpace Portal 7.0 also connects radiologists and referring physicians across clinical domains, integrating with multiple modalities and hospital information systems (HIS), picture archiving and communication system (PACS) and radiology information systems (RIS). Clinicians can review and complete cases from virtually any location.

IntelliSpace Portal Enterprise, the multi-site companion to the IntelliSpace Portal, connects multiple hospitals to ensure every clinician always has access to the same applications – and grows the solution as the hospital network grows.

IntelliSpace Portal 7.0 also offers a broad set of clinical applications covering cardiology, vascular, oncology, neurology and other clinical domains.
Highlights include:

• New cardiovascular applications like Advanced Vessel Analysis, which have been shown to reduce time to results by up to 77 percent relative to PACS analysis.

• Integrating with the Philips Allura Interventional Suite, bringing advanced analysis directly to the point of care and enabling physicians to review interventional and diagnostic x-ray datasets.

• New applications to help measure and track COPD (Chronic Obstructive Pulmonary Disease) and workflows designed to speed the detection of pulmonary emboli address recent growing interest in pulmonary disease management.

At RSNA 2014, Philips also announced the launch of Ingenia 1.5T S, a new MR system designed for “First Time Right” imaging and for faster workflow, while enhancing the patient’s experience during magnetic resonance imaging (MRI) examinations.

Inconclusive image quality due to patient motion is a constant issue, making it difficult for clinicians to get accurate results in the first attempt. One repeat exam can throw off an entire day’s schedule by two to three hours, affecting throughput and patient satisfaction.

Ingenia 1.5T S is designed for “First Time Right” imaging, addressing the issue in a holistic way. Ingenia 1.5T S combines superb fat-free and motion-free imaging techniques, patient-centric workflow and a unique patient experience during the exam. The system is complemented with the patient in-bore solution, which offers a comforting, engaging visual distraction. It provides patients with the option to personalize their experience by selecting a visual theme to fill the room with colorful video images, which they can view during the examination.

This is combined with soothing audio to create an immersive experience, allowing the patient to relax through the exam.

The system also includes AutoVoice, to provide clear instructions and coach the patients, while scanner noise is reduced through ComforTone scan techniques. Its Premium IQ imaging, powered by dStream, allows for faster and more robust imaging, while the automated and intelligent iPatient platform provides quick patient setup, allowing clinicians to focus time on ensuring patient comfort.

Philips also showed off its new Vereos PET/CT, which it calls the world’s first and only true digital PET/CT. According to the company, it offers approximately twice the volumetric resolution, sensitivity gain and quantitative accuracy compared to analog systems.

And it announced the IQon Spectral CT, an industry-first CT that adds spectral resolution to the image quality, delivering anatomical information and the ability to characterize structures based on material content.

GE HEALTHCARE unveiled its own MRI innovation at RSNA 2014 in the form of the SIGNA Pioneer, a new, 510(k) pending, 3.0T magnetic resonance imaging (MRI) system that enables clinicians to generate multiple image contrasts in a single MRI scan – including T1, T2, STIR, T1 FLAIR, T2 FLAIR and PD weighted images of the brain in a single acquisition.

The contrast of images can be changed even after completing the scan by simply moving the cursor on the MAGiC interface to change acquisition parameters such as TR, TE and TI. MAGiC enables one scan that can do the work of many and can be processed in many ways – which GE Healthcare calls an industry first.

MAGiC, the result of a collaboration with SyntheticMR AB, is one-and-done imaging that could provide significant productivity benefits. With MAGiC, a single scan that delivers six contrasts can be completed in as little as one-third the total time taken to acquire each contrast separately using conventional techniques. This time saved could potentially allow clinicians to scan one more patient per hour, every hour of every day, GE Healthcare said.

GE Healthcare announced DoseWatch Explore, which uses data + analytics to make the invisible, visible, the company said. DoseWatch Explore will be an entry-level, cloud-based web application offering detailed dose and protocol information, analytics and reporting at the touch of a hand.

Slated for release in 2015, it will be the latest addition to GE Healthcare’s expanding portfolio of dose management and optimization offerings. This solution will help GE computed tomography (CT) customers gain greater visibility for their practice-level dose performance, requiring no onsite IT integration and minimal resource commitment.

Tracking of exam information, including dose and protocol parameter details, provides visibility to system settings that impact the amount of dose delivered. New levels of visibility around dose can help providers deliver better patient outcomes based on data and analytics, “making the invisible, visible.”

SIEMENS: On the CT front, the U.S. Food and Drug Administration (FDA) recently cleared Siemens’ syngo.CT Liver Analysis software. The software can reduce time-consuming steps and improve decision-making in oncological surgery by delivering preprocessed segmentation results and intuitive workflow guidance for in-depth analysis of vascular supply areas.

The software provides information regarding tumor size and location and can help physicians assess the amount of the resected liver tissue and better understand the vascularization of the affected liver segments.

Siemens also showed its MRI technology for assessing prostate cancer. It can rule out the presence of life-threatening cancer with more than 89 percent certainty, the company said. SEEit – Siemens’ new solution for prostate MRI – is designed to enable users of the MAGNETOM Aera 1.5T and MAGNETOM Skyra 3T systems to perform a noninvasive prostate MRI without an endorectal coil.

Powerful coil technology and unique applications help to streamline processes and maximize system utilization. Siemens’ direct RF and high-density coil technology Tim 4G and the unique readout segmented diffusion technology, RESOLVE, deliver the essential signal to noise (SNR) and resolution to perform examinations purely with surface coils.

Powered by Siemens’ new software architecture syngo MR E11, SEEit can enable users perform a routine multiparametric prostate exam (T2-weighted and RESOLVE) in just 10 minutes of scan time when used with the new Body 60 channel coil. Reading and reporting of the acquired data can be performed efficiently with the syngo.via Prostate engine, which provides standardized communication according to PI-RADS, a structured reporting system for prostate MRI.

In molecular imaging, the Biograph mCT Flow 5 PET/CT system overcomes the limitations of conventional bed-based, stop-and-go PET/CT imaging with FlowMotion, a new technology that moves the patient smoothly through the system’s gantry while continuously acquiring PET data.

The Biograph mCT Flow with FlowMotion enables imaging protocols based on the individual organ of interest, leveraging the finest volumetric resolution, the company said. FlowMotion expands accurate, reproducible quantification in all dimensions for precise disease characterization in therapy monitoring while enabling physicians to offer as low as reasonably achievable (ALARA) dose to every patient.

Additionally, the combination of a 78 cm bore with five-minute ultrafast scanning and a continuous sense of progress throughout the scan offers a potentially more comfortable exam experience for the patient.

The latest version of Siemens’ syngo.via 3D and advanced visualization software supports physicians in treatment decision-making, planning, and assessment based on meaningful information – specifically for the field of oncology.

Supporting the entire cancer care continuum across various modalities and departments, syngo.via is well-positioned to facilitate prompt, sound decisions and cost-effective therapy.

In women’s health, Siemens’ MAMMOMAT Inspiration Prime Edition digital mammography system lowers patient radiation dose by up to 30 percent, compared to its predecessor model, depending on the patient’s breast tissue thickness.

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