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Vendors showcase innovations at the RSNA conference in Chicago

CHICAGO – At the RSNA conference last November, which attracted some 50,000 attendees, Toshiba introduced new products in four different modalities – angiography, CT, MR and ultrasound. The angiography announcement attracted a good deal of attention – the Infinix I Sky+, a ceiling-mounted system that features a double sliding C-arm. It’s the first of its kind in the market, and enables clinicians to increase their coverage, speed and patient access. The new C-arm has 210 degrees of anatomical coverage on both sides of the patient and a high-speed 3D rotation of 80 degrees per second. (When you see the C-arm move, you realize it’s very fast!)

John Morra, a senior clinical consultant at Toshiba Canada Medical Systems, noted the Infinix I Sky+ provides near CT resolution, in 3D, while clinicians are working in the operating room or radiology suite – meaning the patient doesn’t have to be moved for a CT exam, or given a CT study later to check on the quality of the procedure. It can all be done while the patient is having the procedure performed.

In keeping with the move towards dose reduction and ‘imaging wisely’, the Infinix I Sky+ has automated and user-selectable dose management tools designed to minimize X-ray exposure to patients and clinicians.

With its new Vantage Galan 3T MR, Toshiba is offering an immersive in-bore MR Theater option. As the images displayed appear to be much farther away than the actual bore, the MR Theater provides a more comfortable experience, encouraging patients to relax and stay still during the MR exam. (This writer, placed inside the machine, found the experience to be interesting and relaxing – and a real change from being inside a typical MRI bore.)

The 71-cm bore is wider than most MRIs, and Toshiba’s Pianissimo technology reduces noise levels significantly – according to the company, noise levels are just above ambient rooms levels. Traditionally, MRI noise has been a complaint of patients and staff working with the technology. Toshiba says image quality has also been improved in the Vantage Galan 3T, and the system offers non-contrast blood vessel imaging from head to toe.

In CT, the company announced the Aquilion ONE GENESIS Edition, its premium offering. The new system is aimed at research centres and acquires 640 slices with every gantry rotation – the rotation speed is .275 seconds. The bore is very wide, at 78 cm, and the bed is able to accommodate patients weighing up to 694 lbs.

Software available with the system utilizes forward projection iterations to deliver high-quality images with up to 85.3 percent dose reduction, compared with previous CT exams. A full volumetric reconstruction (320 images) for routine clinical use can be obtained as fast as three minutes.

Toshiba also launched new ultrasound machines at RSNA, the Aplio i-series 700 and 800. The systems offer new technological advances and ergonomic improvements.

For its part, GE Healthcare announced the industry’s first self-compression solution for mammography. The Senographe Pristina system has been designed in France with the help of clinicians, technologists and patients; it helps reduce the pain, discomfort and anxiety that women experience when undergoing mammograms by enabling them to control the compression of the machine against their breasts. The patient uses a remote control to adjust the amount of pressure, with the help of a technologist, so she can set what feels right for her.

Claire Goodliffe, global marketing director for women’s health at GE Healthcare noted that better images have been obtained when women control the compression – they are actually compressing more than technologists, resulting in higher resolution pictures.

It’s believed that compliance with mammography exams will go up, too, as there is less anxiety about the exams when women feel they have more control over the procedure.

Other ergonomic features have been added to the system, too. The gentle, rounded corners of the bucky, where the breasts are positioned, were designed to help reduce discomfort. Instead of women tensing pectoral muscles while grabbing the conventional handgrips, which can make it hard to acquire good images, they can lean comfortably on armrests, relaxing the muscles to simplify positioning, compression and image acquisition. GE Healthcare noted the system is undergoing FDA review in the U.S. and is not yet for sale; Canadian sales are also awaiting regulatory approvals.

At the RSNA meeting, GE Healthcare unveiled Freelium, a magnet technology designed to use one percent of the liquid helium typically used by conventional MRI magnets. Instead of the average 2,000 liters of precious liquid helium, Freelium is designed to use only about 20 liters.

MRI uses superconducting magnets cooled to -452 degrees F in order to take high-definition pictures of a patient’s brain, vital organs, or soft tissue. The only way to keep MRI magnets currently in clinical use that cold is by using thousands of liters of liquid helium mined from below the earth’s crust.

Helium has gone through two shortage crises, impacting hospitals and patients around the globe. The helium supply appears to be finite and demand has been rising over the past decades.

Magnets with Freelium technology are designed to be less dependent on helium, much easier to site, and eco-friendly. Thanks to Freelium technology, hospitals would no longer need extensive venting that often necessitates siting a magnet in a separate building or newly constructed room.

“Venting pipes for helium can sometimes be more expensive than the magnet,” commented Ioannis Panagiotelis, chief marketing officer, global MR business, at GE Healthcare.

Additionally, a Freelium magnet would not need any refilling during transportation nor throughout its lifetime. Therefore, when the Freelium technology is integrated into a commercialized product in the future, it could make MRI more accessible and less expensive to site and operate. This is particularly important in developing regions that lack necessary infrastructure, and in major metropolitan cities where siting a magnet can cost more than the magnet itself.

GE Healthcare notes that Freelium is not yet a commercialized product, but rather a technology that is still under development.

“It’s a revolutionary advance for the industry and we look forward to integrating Freelium technology into MRI systems so clinicians and their patients can benefit from it in the near future,” said Stuart Feltham, magnet engineering leader of GE Healthcare MR. “There is still more than 70 percent of world’s population with no access to MRI. Our vision is to leverage this low-helium technology to increase world-wide accessibility of MRI so that more people can benefit from its diagnostic capabilities.”

GE Healthcare has been building it cloud and Deep Learning capabilities, and has launched partnerships with the University of California at San Francisco and at Boston Children’s Hospital. The systems being tested are designed to lend expert advice to radiologists – for lung screening at UCSF and pediatric brain imaging in Boston.

These systems may prove to be of enormous help in future, with growing demand for diagnoses but a severe shortage of radiologists, especially sub-specialists, commented David Hale, president and CEO of enterprise imaging care and healthcare IT at GE Healthcare.

Deep Learning systems can screen the exams for radiologists, enabling them to concentrate on the most urgent cases first. They can also help radiologists spot problems in the exams, thereby boosting the quality of their readings.

Overall, GE Healthcare will be accenting the role of smart systems and analytics as a way of enhancing patient care around the world. In Canada, new projects are on the go, including leading-edge work at Toronto’s new, high-tech Humber River Hospital, called North America’s first “digital hospital”.

And as Heather Chalmers, general manager of GE Healthcare Canada notes, “so much healthcare is happening outside the walls of hospitals, in long-term care and home care, that it is important to be connected to it.” For that reason, Chalmers likes to use the term “intelligent healthcare” as the mission going forward.

At RSNA 2016, Siemens Healthineers announced its robot-supported ARTIS pheno angiography system, which was developed for use in interventional radiology, minimally invasive surgery, and interventional cardiology. Because it can scan up to 15 percent faster in the body area than prior Siemens Healthineers systems, the system’s syngo DynaCT clinical software application can produce 3D images that use less contrast media, thus decreasing the load on the patient’s kidneys.

The ARTIS pheno’s C-arm is 5 inches wider than its predecessor system, the Artis zeego, and has a free inner diameter of 37.6 inches, which offers more space for handling adipose patients and enables use of longer instruments. The system’s multi-tilt table is designed to accommodate patients up to 617 pounds.

The end of the table can tilt up and down to stabilize patient blood pressure or facilitate breathing, for example. And like the Artis zeego, the ARTIS pheno’s robotic construction provides a flexible isocenter, so it can follow all table positions while representing the patient’s target area from virtually any angle.

Surgeons must be able to work easily while standing so they can perform lengthy operations without fatigue. They also must maintain optimum access within the operating area. Recognizing these needs, Siemens Healthineers designed the easy-float tabletop of the ARTIS pheno multi-tilt table to be easily moveable, regardless of the tabletop’s tilt or the patient‘s weight.

The ARTIS pheno recognizes the tabletop’s position at all times and automatically aligns to the tabletop. The memory positions allow the system to move the C-arm out of the operating area quickly and move it back to the same position for further imaging, so surgeons can check results directly during the operation.

Optional application packages can be used with the ARTIS pheno to accommodate requirements in complex cases, including spinal fusion procedures. Up to 10 vertebrae can be visualized in 3D imaging using syngo DynaCT Large Volume.

Syngo Needle Guidance then allows the user to plan extensive procedures using screws or needles.

Clinicians can precisely plan screw paths, and the Automatic Path Alignment function automatically aligns the C-arm to follow those paths. The laser integrated with the system’s image detector displays the planned surgical path, helping to improve accuracy and speed in the OR.

At Chicago’s McCormick Place, the separately managed healthcare business of Siemens presented itself for the first time under its new brand name, Siemens Healthineers. According to the company, the new name underlines the company’s pioneering spirit and its engineering expertise in the healthcare industry.

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