3D radiography and filmless future offer exhibit highlights

Vendors prepare new technologies that blow the dust off old but updated ideas at RSNA conference

Radiography vendors this year will aim to provide more than just a digital image or an easy way to store and enhance images. The devices they plan to bring to the RSNA meeting have been designed to make dreams of a filmless future come true.

At their booths on the exhibit floor of the world's largest radiology meeting, industry leaders will promote 3D as the future of radiography. GE Healthcare began its argument for volumetric radiography last year with the release of the Definium 8000. The device relies on its Volume Rad feature to acquire low-dose projection images in a sweep of the x-ray tube to produce high-resolution slices that can be viewed on a workstation.

Other companies, notably Philips Medical Systems, approached the same point last year, using digital radiography and fluoroscopy technology as part of its MultiDiagnost Eleva system. This year, Philips hopes to bring it all together with a digital x-ray platform that allows static and dynamic 2D and 3D images in a single room.

"With this technology, we can take a general 3D radiograph, compare it with a 3D CT and 3D MR, and register all of them in space to provide a more complete view of the human body," said Scott Burkhart, vice president of Philips general x-ray.

Similar developments at GE are driven by the recognition that customers want more than just a digital radiograph.

"Digital x-ray provides the ability to have an image anywhere at any time-with speed," said Dave Widmann, GE general manager of global radiography and R/F.

With some 70% of all images acquired in a hospital and up to three million images taken per day on x-ray machines, radiography is the ultimate screening modality, he said.

"It is the place where your very first path to diagnosis is established," Widmann said.

This year at the RSNA meeting, GE will extend its Definium 8000 into advanced applications made possible by its 3D imaging approach and also beyond the tertiary hospitals that have been the strongholds of advanced imaging technologies.

"We must satisfy the needs of smaller hospitals and physician imaging clinics, as well as address the need for flexibility in some of our traditional room applications that may not have been digital, such as fluoro imaging, and use those rooms for basic digital imaging," he said.

Siemens will join GE on the fringes of this venture, targeting smaller hospitals with versions of its most advanced x-ray systems. For the last several years at the RSNA meeting, the company has shown its Axiom Aristos FX, a robotically controlled universal x-ray system that supports thoracic and extremity scans, as well as emergency, trauma, and pediatric applications. This year, Siemens has optimized the mechanical components, shrinking the overall system by 25% to create a new version, the Axiom Aristos FX Plus, which will fit into rooms just 16 meters square.

"We want to bring it to all hospitals, not just the high-end universities and outpatient centers that have more space," said Gerhard Schmiedel, senior director of product marketing for Siemens fluoroscopy and radiography systems.

The German company will expand the flexibility of its Axiom Aristos VX with an extended arm for the digital detector. The Plus version of this system will accommodate patients in stretchers and wheelchairs.

FUNCTIONALITY RULES

Advanced functionality will underlie many offerings on the RSNA exhibit floor, some using nascent leading- edge technologies, and others based on more mature features. Two years ago, Anexa entered the fray of selenium-based detector systems with a single-detector system, called Synerad Omni, and followed with three others, all digital. Building robotics into its product, Ferrania Technologies has crafted the LifeInVision DR 982, which automatically positions the digital detector in any projection needed for a general radiography exam. It is one of several DR products offered by the Italian company, which uses amorphous silicon plates from Trixell, the joint venture formed by Philips and Siemens.

Imaging Dynamics has exploited CCD-based technology to create the Xplorer family of products, including the 1500 upright DR system, 1600 U-arm motorized unit, and 1800 multipurpose machine, which can be configured as a dual-detector inpatient system or a dedicated orthopedic scanner.

Last year, Swissray broadened its approach to digital x-ray, offering a choice between its mainstay CCD technologies and silicon flat-panel detectors.

"We are the only company offering a full line of DR products based on both technologies," said Ueli Laupper, senior vice president for global sales and marketing at Swissray. "We are able to fulfill any application in DR and meet any budget."

The company today offers eight DR products. Those configured with CCDs are priced at $375,000, and those with flat panels begin at $475,000. At the RSNA meeting, Swissray will add a ninth offering to its line, a CCD-based system designed for general radiography systems.

"It will be at the lowest price point of all our systems," Laupper said.

Shimadzu has been putting the meat and potatoes on imaging's table for a century. This year, it will bolster its offerings with a new radiography system, featuring an upgraded overhead tube mount, onboard touch panel controls, and a new wall stand. The new system can be configured for film or either of two flat-panel plates from Canon: the 14 x 17-inch CXDI-50G for table studies or the 17 x 17-inch CXDI-40EG for wall stand exams.

FILMLESS OPTIONS

Philips will try to revive the onetime popular, but largely failed, theme of filmless radiology at the RSNA meeting. Although about 60% of the imaging market today is at least partly digital, about 95% of institutions still use some film, according to Burkhart.

"At Philips, we believe the technology is at the point where you can let go of film," he said. "It doesn't really serve a viable function."

Ultimately, the Dutch company wants to create a radiography and R/F room, offering customers the option of either flat-panel detectors or computed radiography plates and their readers. Other companies are working toward a similar end. This year, Siemens and Toshiba will integrate flat-panel detectors into their R/F rooms.

Toshiba will complement its Kalare R/F system with a portable digital radiography panel. This detector can be used in a wall stand, in the table of the R/F system, or propped up next to the patient to perform cross-table laterals. It can be placed under or beside a patient in a stretcher or wheelchair.

"This will drive up the utility of the (R/F) room, while making all exams done in this room 100% filmless," said Allan Berthe, radiology product manager for x-ray at Toshiba America Medical Systems.

Philips is taking the concept further, seeking to find the nexus of all things digital from x-ray to MR. The company plans to use its iSite PACS as common ground.

"Interfacing and networking will kill you as you move into digital technologies," Burkhart said. "We are taking that out of the equation and making sure all of our solutions are seamless."