CT developments transcend multislice

The advent of multislice technology nearly a decade ago led to a sea change in discussions about CT. Hardly a sentence could be spoken without mentioning numbers, whether they were slices, rotations, or reconstruction speeds. Radiology's number obsession was overshadowed at the 2005 RSNA meeting, however, by the development of new technologies, efficient platforms, and even an architectural adaptation designed to put a friendlier face on the patient experience.

GE Healthcare

The dominant vendor in the North American CT market showcased its flagship LightSpeed VCT, which scored its 500th installation worldwide prior to the RSNA meeting. Postprocessing enhancements for the VCT and the addition of a lower tier CT platform were other highlights.

• BrightSpeed, offered in quad-, eight-, and 16-slice versions, delivers the same image quality and productivity as its big brother LightSpeed but in a package small enough to fit into the space allotted to single-slice scanners. Many of the electronics and productivity tools developed for the premier 64-slice LightSpeed VCT have been incorporated into the BrightSpeed. The new scanners feature the Xtream FX workflow platform and the Volara digital data acquisition system.

• Lung VCAR (volume computer-assisted reading) finds, isolates, and analyzes lung nodules identified with CT, comparing the measurements with previous results to determine whether the nodules are growing.

• A wide-bore, 16-slice CT, multipurpose system work-in-progress featuring CT fluoroscopy can handle bariatric, radiation oncology, and interventional applications.

Hitachi Medical Systems America

A provider of CT systems to Philips before the introduction of multislice technology, Hitachi returned to the CT arena in spring with the introduction of a quadslice scanner. As the year drew to a close and the imaging community congregated in Chicago, the company added a 16-slice version. Both systems, members of the CXR platform, are built around components developed and supplied by Analogic.

Medrad

Long-timer vendor of CT injectors Medrad showcased its Stellant D dual-syringe injector with a software work-in-progress upgrade for cardiac CT imaging. The experimental system is designed to advise users on injection protocols as determined by patient characteristics.

NeuroLogica

The Danvers, MA, start-up presented its first product to RSNA visitors, the multislice CereTom. The compact, ultraportable, and cordless CereTom, which cleared the FDA in July, is designed to improve access to high-quality CT imaging for head and neck imaging, particularly involving traumatic brain injury. It features a 25-cm field-of-view.

Philips Medical Systems

Philips extended its Brilliance platform with postprocessing advances aimed at extending the clinical base of CT outside typical applications to include virtual colonoscopy and cardiology, while replying technologically to recent developments in dual-energy CT by Siemens. Expressing its penchants for patient comfort and productivity, the company unveiled an architectural adaptation of the CT suite designed to bring patients closer to family and staff.

• CT Halo, an offshoot of the Philips "Ambient Experience," eliminates the traditional control room in a CT suite, placing the CT console a few steps from the gantry but behind a movable lead-shielded window.

• Brilliance Workspace portal allows users at any PC to access the proprietary software applications so it functions like a Brilliance Workspace, without loading the CT data set onto the computer.

• Brilliance Workspace 2.0 features direct integration into the HIS and RIS.

• A computer-assisted reader (CAR) is in development for use on the company's virtual colonoscopy package. The CAR feature automatically segments and finds intracolonic polyps. It also automatically segments data and provides predetermined measurements.

• Comprehensive Cardiac Analysis helps in the evaluation of coronary arteries and ventricular function. It visualizes the entire coronary tree, provides morphologic analysis of the vessel lumen, and depicts cross-sectional views of specific arteries.

• Respiratory Correlated Imaging improves treatment planning by preserving the spatial relationships and respiratory motion information that may allow better targeting of tumors that move as a patient breathes.

• A work-in-progress multi-energy detector records different x-ray energies. The detector might simultaneously record different tissues.

• The extra coverage afforded by a work-in-progress wide area detector built from Nano-Panel technology would allow an entire organ, such as the brain or heart, to be scanned in a single rotation.

Siemens Medical Solutions

Siemens dropped the other shoe in the days leading up to the RSNA meeting with the release of its Somatom Definition dual-source CT scanner. Siemens earlier had been accused by competitors of developing a "band-aid" - z-Sharp technology, which doubles the slice production of the scanner's 32-row detector - to cover its inability to fabricate a 64-slice detector. But with the release of the dual-source Definition, it became apparent that z-Sharp was only the first step in a radically different approach to CT.

• Somatom Definition uses two detectors mounted at a 90° angle to each other. Each detector contains 32 elements and is aligned with its own Straton x-ray tube. The CT generates a slice in 83 msec, half the time of a conventional 64-slice scanner and fast enough to freeze a beating heart. Customers will pay between $2.3 million and $2.5 million for the new scanner, about a half-million dollars more than for any of the current-generation 64-slice scanners.

• Somatom Emotion 16, an air-cooled CT designed for routine radiological applications and priced below the Sensation 16, appeared at the RSNA meeting as a commercial product. (It began shipping in summer.) Eliminating the water chiller, otherwise needed to cool the x-ray tube, makes the system more compact and easier to site.

• CT Clinical Engines boost data acquisition and improve image quality in acute care, cardiology, neurology, and oncology. CT Acute Care Engine provides an extended field-of-view while expanding the scan range up to 200 cm. CT Cardiac Engine is designed to ensure motion-free imaging. CT Neuro Engine helps in the evaluation of complex vascular structures by subtracting bones, differentiating brain tumors, and diagnosing strokes (postprocessing is done in less than 10 minutes). CT Oncology Engine assists in detecting, localizing, visualizing, and differentiating tumors

Toshiba America Medical Systems

The past year has established the 64-slice Aquilion as among the best of the superpremium scanners. The CFX configuration is optimized for cardiac applications. This year marked the commercial introduction of a large-bore Aquilion for bariatric and oncological applications.

• Aquilion LB (large bore) appeared as a commercial product. The system, shown last year as a work-in-progress, was developed for oncology applications. It offers a 90-cm bore, 85-cm display FOV, and 70-cm acquired FOV. A board positioned on the patient table puts the patients at a 25° upward tilt for radiotherapy simulation.

• Enhancements to the Sure line of technologies - software packages designed for specific CT functions - included SureCardio enhanced ECG Modulation, adaptable dose modulation software for cardiac CT, which promises to reduce dose by up to 50%. Works-in-progress in the Sure line featured at the Toshiba booth included SureWorkflow's Image Accelerate, designed to double reconstruction speed by reconstructing up to 28 images per second; and enhanced DICOM Data Transfer that supports rapid data transfer from the Aquilion 32/64 CT systems to Vital Images workstations.