3D and 4D systems attack weaknesses in ultrasound

Three- and four-dimensional ultrasound systems have generated stunning pictures, especially of the fetal face, and they offer the tantalizing prospect of offline image reconstruction. Early systems garnered a lukewarm reception, largely because they lacked wide clinical application, flexibility in image processing, and productivity-conscious tools. But volumetric ultrasound displayed at the RSNA meeting demonstrated the maturation of the technology, with new systems for routine general radiology and for imaging complex anatomy and pathology, as well as postprocessing enhancements for presenting and evaluating data in multiple planes and user-friendly, push-button data interrogation.

Esaote

A major supplier of medical diagnostic imaging systems, particularly in Europe, Esaote exhibited a fusion software product that correlates and overlaps CT/MR images with ultrasound. A division of the Bracco Group, the Genoa, Italy-based company also displayed a multipurpose portable ultrasound system for standard radiologic imaging. Both products are commercially available in Europe and will be submitted to the FDA for approval in 2005.

• Virtual Navigator, which is connected to Technos MPX premium ultrasound, synchronizes real-time ultrasound and volume data previously acquired with CT or MR imaging. Designed to assist interventional radiology and ultrasound-guided biopsy, the system precisely locates target anatomy through 3D reconstructions of CT/MR information, superimposes it on ultrasound scans, and tracks needle or catheter advancement and delivery to the target in real-time.

• MyLab 25, a sequel to the recently released MyLab 30 cardiovascular unit, is a compact ultrasound system that offers linear array for vascular and small parts imaging, convex array technology, and a wide variety of general-purpose probes. MyLab uses a Windows XP operating system, has an integrated CD writer and USB pen drive facility for storing and transferring clinical studies, and offers online thumbnail image display.

GE Healthcare

GE Healthcare has implemented 4D technology on a radiology platform, focusing as much on productivity as on image quality. The company has also incorporated CrossXBeam spatial compounding in all its ultrasound probes and added a new probe for 4D abdominal imaging.

• The new Logiq 9 allows clinicians to capture volumes of data in several dimensions in real-time to improve the visualization and evaluation of normal anatomy, lesions, and masses. Among its features are CrossXBeam spatial compounding, speckle reduction imaging, coded ultrasound acquisition, and automatic optimization.

• LogiqWorks, a workstation that accepts raw data obtained by GE's TruScan architecture early in the imaging chain, provides a range of advanced postprocessing reconstruction and image optimization opportunities.

Hitachi Medical Systems America

In addition to its Hi Vision 5500, 6500, and 8500 product lines, Hitachi Medical Systems showed Sono Elastography. A work-in-progress at the 2003 RSNA meeting, Sono Elastography is now available on the premium 8500 Hi Vision unit. It detects differences in elasticity among tissues in real-time on both color and gray-scale images across a variable dynamic range.

Medison

A leading supplier of 3D and digital ultrasound systems, Medison released a comprehensive diagnostic ultrasound image processing package on its top-of-the-line ultrasound system. The company also showed its new midlevel, full-featured, color sonographic system.

3D-eXtended Imaging (3D-XI), developed for Medison's flagship Accuvix XQ system, has three major features:

• Multi-SliceView transforms 3D volumetric information from standard ultrasound scans into a series of sequential images captured at 0.5 to 3-mm segments with the twist of a dial.

• Oblique View presents the anatomy of interest in any desired oblique perspective.

• Volume CT depicts sonographic information as a volume cube to generate multiplanar views with depth or cross-sectional views and to produce intersecting scan planes that can be rotated in space.

• Dynamic MR, which automatically reduces the speckle pattern and increases the contrast resolution of ultrasound scans.

SonoAce 8000 Special Edition offers digital multibeam processing to increase frame rates during color and 2D imaging. It also has an 80-GB hard drive with an optional CD/RW drive, multibeam-receiving color and power Doppler capability, pulsed wave spectral Doppler, and two active probe ports. SonoAce 8000SE includes Freehand 3D for 3D image rendering, DICOM 3.0 compatibility, harmonic imaging, and intuitive controls.

Philips Medical Systems

Not keen on holding new product releases for major radiology shows, Philips Medical Systems earlier this year unveiled the iU22 high-end ultrasound system. Unveiled in February and first seen in Europe at the European Congress of Radiology in March, the iU22 was introduced to the U.S. at the RSNA meeting. Philips also displayed the scalable midlevel EnVisor unit and its Explora series of high-performance, high-frequency (up to 17 MHz), ergonomically designed transducers.

• The iU22 offers instantaneous 4D imaging as well as improved visualization for 3D, 4D, and multiplanar imaging. The system capitalizes on Philips' SonoCT and XRES technology and xStream architecture to quickly acquire, manipulate, and quantify full-volume imaging data sets. The iU22 is sensitive to ergonomics: It has lightweight transducer cables, angled transducer connectors, iCommand voice recognition, and one-button optimization.

• Incorporating some of the premium features from the Philips HDI and Sonos platforms, the EnVisor is capable of 2D, color flow, and pulsed Doppler imaging. It includes Philips' color power angiographic and M-mode imaging, directional CPA, dual and triplex imaging, and it provides trapezoidal and panoramic display. A 3D surface rendering option is available in an ob/gyn package.

Siemens Medical Solutions

Concentrating on tailoring ultrasound image acquisition to individual patients as part of an overall patient-specific imaging concept, Siemens Medical Solutions has rolled out the Encompass release for its top-of-the-line Acuson Sequoia system. On the value side, Siemens has incorporated 4D imaging into affordable Sonoline G60 and G50 systems and added urologic, emergency medicine, and pediatric enhancements to the compact gray-scale Sonoline G20.

• The Encompass release takes advantage of Native TEQ dynamic ultrasound technology, which uses patient-specific echo information to eliminate poorly gained or unbalanced images. Native TEQ was first introduced as a manual operation last year; it is now automatic on the Sequoia.

• The inMotion upgrade for the G60 and G50 systems includes fourSight 4D imaging and 4D transducers, the 135SP intraoperative transducer for both systems, and the EV8F5 endovaginal transducer for the G50 system. The upgrade provides a 3D measurement tool for making distance and area calculations in MPR and volume data sets.

• Clarify, a vascular enhancement for power Doppler and 2D gray-scale imaging that was available on only two transducers last year is now available on all Antares and Sequoia transducers.

• The G20 system, introduced earlier in the year, has a new urologic release with a biplane endorectal transducer for prostate imaging and a brachytherapy package for ultrasound-guided radioactive seed implantation. Also available on the G20 are a curved transducer, an expanded measurement and reporting package for emergency medicine, and a pediatric transducer.

SonoSite

A pioneer in the development of compact ultrasound systems, SonoSite enhanced its flagship 7.7-pound Titan system with the version 2.3 upgrade, which includes new transducer technology designed for facilitating interventional procedures, as well as enhanced general-imaging options.

• The L25/10-5, a 25-mm, 5 to 10-MHz broadband linear array transducer for performing venous access procedures, supports pulsed wave and color power Doppler imaging. The C60 transducer includes velocity color to increase color Doppler sensitivity during abdominal and ob/gyn imaging.

• DICOM capabilities have been expanded to accelerate the transmission of image data, and cardiac function quantification has been automated.

TeraRecon

The partnership of Fukuda-Denshi and TeraRecon has brought high-definition digital ultrasound scanning to market. In addition to the portable color Doppler UF-750XT, TeraRecon is offering the new digital cart-based color Doppler UF-850XTD.

• UF-850XTD makes use of XTrillion multibeam digital signal processing chip technology to achieve high frame rates, increase axial resolution, and reduce noise. Suitable for cardiac as well as general imaging, the system features continuous wave Doppler, a wide range of high-frequency, convex, linear, or phased array transducers, a 15-inch LCD or CRT monitor, and a 3D imaging option.

Toshiba America Medical Systems

The company has enhanced its all-digital high-performance Aplio and compact Nemio lines.

• In addition to tissue Doppler and contrast imaging technology based on Toshiba's Intelligent Component Architecture, the Aplio xV offers an optional software package, including an extended field-of-view mode that produces a trapezoid image from a linear or sector transducer, differential tissue harmonic imaging, Quick Scan one-touch image optimization, and ApliPure real-time spatial and frequency compounding.

• Nemio has added 4D imaging that incorporates automatic 3D volume acquisition, simultaneous display of 2D data in real-time, and continuous updates of 3D volume studies.

Zonare Medical Systems

Formed five years ago, Zonare formally launched its Convertible Ultrasound system at the RSNA meeting. The product is based on Zone Sonography technology, which captures echo data from large zones with a broad transit beam. This contrasts with the standard ultrasound method of gathering and processing echo data in narrow lines and forming a small number of beams from each transmission.

• Convertible Ultrasound can be transformed from a 150-pound cart-based system to a compact 5-pound bedside unit. The user interface is equipped with a full-sized, back-lit keyboard, full DGC pods, and large freeze buttons, as well as an array of lightweight transducers.