Digital x-ray vendors build portfolios as firms debut new CR, DR systems

The digital x-ray market continues to face challenges in persuading end-users to convert their radiographic equipment to the digital realm. With price tags as much as three times more expensive than analog equipment, most healthcare institutions appear to be taking a wait-and-see approach to the technology.

The slow-developing DR market failed to dissuade vendors from introducing new products, however, and longtime computed radiography vendor Kodak even chose to enter the sector, introducing a family of three systems. Siemens, Swissray, GE, and Hologic also filled out their product lines with new units.

CR vendors aren’t letting DR firms run away with the digital x-ray market, however. Advancements abounded in digital x-ray’s oldest technology. Fuji rolled out its dual-side reading capability, while Agfa discussed its new CR scanhead technology, currently under development.

Other notable developments in the CR marketplace included increased market activity in lower-end applications, as vendors seek to bring digital radiographic technology to lower-volume and remote scanning environments. Kodak, Lumisys, and RSNA newcomers PhorMax and Digident all highlighted sub-$100,000 systems.

Agfa Medical

• Agfa continues to stress its commitment to CR. The firm discussed its new scanhead technology under development (SCAN 9/15/99), which it believes would cost less and improve speed and image quality. The technology uses an integrated circuit design to allow the CR reader to function as an array of scanners rather than as one single detector. Agfa declined to comment on a commercialization timeline for the technology.
• Agfa also announced two OEM deals at the meeting. The vendor will replace Fuji as GE’s CR supplier (SCAN 12/15/99). In addition, Agfa announced that it has agreed to provide low-end CR developer PhorMax with its Musica image processing software. PhorMax will also offer Agfa imaging plates directly to resellers and end-users of PhorMax products.

Canon Medical Systems

• Canon expanded its DR efforts with the introduction of CXDI-22, a bucky system that operates both as an upright and table system, using a universal stand (SCAN 12/15/99). CXDI-22 utilizes the same amorphous silicon-based flat panel detector employed in CXDI-11, Canon’s upright DR system introduced at the 1998 RSNA meeting. CXDI-22 features a 17 x 17-inch imaging area, and a 2.9-inch-thick sensor plate that does not require replacement of existing bucky table systems. Upright and tabletop radiographic positions can be recorded with CXDI-22, according to the company. A bucky sensor unit with removable grid, operation/preview unit, and control station will cost approximately $250,000.

Cares Built

• Cares Built again highlighted its Clarity 7000 amorphous silicon flat-panel detector. The firm expects to receive FDA 510(k) clearance for Clarity 7000 by the first quarter.
• The Keyport, NJ-based vendor also introduced a remote controlled R/F room, which could be equipped with Clarity 7000.

Digident

• This Israeli dental CR developer made its RSNA meeting debut with the introduction of a low-cost CR reader. The product, called Paxi-r, will have an end-user price of under $30,000. Paxi-r, which can scan a single plate or a four-cassette magazine and includes PACS and teleradiology software, will be sold in the U.S. pending FDA 510(k) clearance.

Eastman Kodak

• Kodak entered the DR marketplace with the introduction of a family of three systems employing amorphous selenium detector technology (SCAN 12/15/99), developed in partnership with Analogic. DR 5000 is a dedicated chest system, while DR 7000 is a retrofit product designed to allow hospitals to take advantage of their existing x-ray equipment as they transition to digital capture. DR 9000 is a full-room system for general purpose radiology, targeted for customers installing new x-ray rooms or converting to fully digital environments. Final pricing has not yet been determined, but DR 7000 will likely cost under $300,000. DR 5000 will probably range between $300,000 and $400,000, while DR 9000 is expected to cost between $400,000 and $500,000. Rochester, NY-based Kodak expects to begin installations of reference sites in the first quarter of 2000, with general availability targeted for late in the second quarter.
• In CR developments, Kodak presented two new systems, CR 800 and CR 900. CR 800, a single cassette-distributed CR unit, will be positioned at the low end of the product line. Targeted for intensive care units, emergency rooms, and remote clinics, CR 800 will have a list price of under $100,000 and is expected to be available in April.
• CR 900 supports all the functions available on CR 800, but incorporates an autoloader capable of handling up to eight cassettes. Kodak believes CR 900 is ideal for centralized CR processing installations where automatic cassette loading can greatly streamline workflow. CR 900 will have a list price of $175,000.

Fischer Imaging

• The Denver-based company highlighted the versatility of its Traumex system, which can be used for head, chest, skeletal, extremity, or trauma imaging, and can be upgraded to DR1000 or DR1000C, digital systems developed in collaboration with Hologic’s Direct Radiography Corp.
• Fischer also displayed a work-in-progress DirectRay digital detector integrated into an x-ray table.

Fuji Medical Systems USA

• Fuji debuted FCR 5501D, a high-end CR reader that it hopes will broaden the utility of CR (SCAN 11/25/99). It features Fuji’s new dual-side reading capability, which combines clear base imaging plates and dual optical readers. The technique allows readers to read x-ray information from both sides at the same time. It also improves the device’s detective quantum efficiency (DQE), and carries a 17 x 17-inch imaging area that can perform two exposures in seven seconds and can process 120 imaging plates per hour. Fuji expects the reader will be available early this year.
• The Stamford, CT-based vendor also unveiled its Speed Suite concept, which allows customers to purchase a complete turnkey digital x-ray room, according to the vendor. Speed Suite includes Fuji’s cassetteless CR systems and x-ray generating equipment. Single room or two-room arrangements are available. In the two-room setup, one room is equipped with a CR table unit (FCR-9502) and a conventional bucky on the wall, while the other room is fitted with an upright unit (FCR-5501) and a conventional table.
• Fuji also announced two group purchasing organization contracts. The vendor has received a three-year contract to supply its full line of CR products to Health Services Corporation of America’s member organizations. Fuji values the deal at more than $23 million. Premier has also signed a three-year, dual-source deal with Fuji. The agreement covers Fuji’s full CR line and has an estimated value of more than $80 million, according to Fuji.

GE Medical Systems

• GE debuted Revolution XR/d, a general purpose digital x-ray table. Revolution XR/d is expected to be available in the third quarter. When ready, Revolution XR/d will join the Revolution XQ/i digital chest system in the Waukesha, WI-based vendor’s DR portfolio. Revolution XR/d will range in price from $350,000 to $600,000.
• The vendor also announced that since the 1998 RSNA show, more than 13,000 patients have been imaged using Revolution XQ/i. Eighteen systems have been shipped, with 25 more expected to be delivered soon.
• GE introduced Advantx LCA/LP+, a dual-purpose angio room and biplane neuro suite. The biplane general and neuro angiographic system’s 16-inch image intensifier frontal plane and 12-inch image intensifier lateral plane provides optimum imaging for peripheral angiographic studies and neuro interventional procedures, according to GE. The system also includes SmartFluoro2, a method for improving image quality and reducing dose in fluoroscopy.
• GE closed its acquisition of OEC Medical Systems during the meeting.

Hitachi Medical Systems America

• Hitachi debuted VA 200, a new digital rotational angiography system featuring a 3-D reconstruction processor. With VA 200, the gantry can be tilted plus or minus 20 degrees, and includes a 12-inch image intensifier.
• The Twinsburg, OH-based vendor also showed Swissray’s digital x-ray products in its booth.

Hologic/DRC

• Hologic introduced two new direct digital general radiography systems (SCAN 12/15/99). Epex and Radex are based on DirectRay solid-state electronic and semiconductor technologies to capture x-rays. Epex is a high-end unit, while Radex is a simpler system designed for the outpatient market. Both units will be installed in clinical facilities during the second quarter of 2000.
• The firm has also established a new organizational structure for bringing its systems to market: Hologic will design, market, and service its radiographic products, while its subsidiary, Direct Radiography Corp. (DRC), will be responsible for designing, manufacturing, and servicing DirectRay detectors. DRC will market the detectors as fully integrated Hologic radiographic systems, as a digital image capture upgrade for existing x-ray equipment sold through distributors, and as a component for OEMs.

InfiMed

• InfiMed received FDA 510(k) clearance just prior to the show for its StingRay digital detector retrofit product. StingRay, which uses amorphous silicon flat-panel detector technology from Trixell, will cost approximately $200,000. InfiMed will distribute StingRay through dealers and also hopes to secure OEM channels for the retrofit.
• A new feature set has been added to the vendor’s GoldOne R/F digital retrofit, including image auto-optimization and DICOM modality worklist and print compliance.

Konica Medical Imaging

• Konica added Regius 150, a cassette-based CR reader (SCAN 12/15/99). Regius 150 joins the Regius 330 cassetteless chest and abdominal imaging system in the Wayne, NJ-based vendor’s portfolio. It can be used in emergency rooms, critical care and trauma centers, and radiology departments, according to Konica. Regius 150 can scan 75 plates per hour and has five plate scanning slots. A QA workstation is included. Available now, Regius 150 has a list price of $186,000.

Lumisys

• Lumisys rolled out ACR-2000i, an upgraded version of the Sunnyvale, CA-based firm’s ACR-2000 Desktop CR product. The new release incorporates an integrated eraser, which allows users to automatically erase several phosphor plates without physically removing them from the system. ACR-2000i has a list price of $60,000, the same as ACR-2000, which can be upgraded to include an integrated eraser.
• The firm also announced a servicing and financing agreement with GE Medical Systems and GE Healthcare Financial Management.

Marconi Medical Systems

• Marconi’s Venue interventional products, which features the firm’s FACTS amorphous silicon flat-panel fluoroscopy unit and the PinPoint frameless stereotactic guide, was featured as part of the vendor’s LifeFlight CT trauma suite concept.

Nucletron/Oldelft

• Nucletron, which absorbed Oldelft’s x-ray diagnostics group in March 1999, showed its Digidelca-C digital chest imaging system and Digidelca-M digital x-ray screening system.

Philips Medical Systems

• In digital spot imaging developments, Philips introduced its EasyVascular capability for its Multi Diagnost 4 R/F system. EasyVascular features several post-processing features, including CO₂ Imaging, which stacks images of the peripheral vasculature below the chest. A landmarking feature provides users with background anatomy and the ability to mark the position of pathology in relation to the patient’s anatomy.
• The Best, Netherlands-based vendor also highlighted its integration capabilities for its digital x-ray products. Its Digital Diagnost digital bucky system can now be fully integrated with Philips’ CR systems, and images from Digital Diagnost and the CR system can be viewed at the firm’s multimodality EasyVision workstation or printed together on one film.

PhorMax

• PhorMax showcased its CRView low-cost CR system, which will have a price point of approximately $50,000 (SCAN 10/13/99). The San Francisco-based firm is preparing its 510(k) application for submission to the FDA, and expects CRView to be available at midyear.
• Just prior to the show, PhorMax announced a multi-year contract for Agfa’s phosphor imaging plates, which will be configured for CRView.

Shimadzu Medical Systems

• Shimadzu has added an R/F option for its Cvision c-arm product. Cvision, initially designed for remote control use, can also now be equipped with a control handle on the image intensifier, which allows physicians to have direct control of the intensifier at the tableside. This capability will be ready for shipping in May. Another new feature for Cvision, Real-time Smooth Mask DSA, allows both mask and live images to be acquired during a single exposure for true real-time digital subtracted angio images, according to the company.
• YSF-120D R/F, introduced last year as a work-in-progress, is now available. The 90/15 configuration R/F system, available with up to a 16-inch image intensifier, has an integrated digital imaging platform that improves imaging with reduced operator scatter radiation and a larger, more effective imaging field due to geometric magnification, according to Torrance, CA-based Shimadzu.

Siemens Medical Systems

• Siemens showcased Vertix FD, a DR system that joins the Thorax FD upright and Multix FD table flat-panel DR systems introduced at the 1998 RSNA meeting. Vertix FD has an overhead tube stand and a wall stand that moves out, enabling both upright chest imaging and tilting bucky work. If desired, the overhead x-ray tube can be combined with both a bucky table and wall stand detector in a single room, decreasing overall costs. Delivery for all three systems will begin in May, with mass production expected in October. The systems will range in price of $350,000 to $500,000.
• Siemens introduced Iconos R200, a remote-controlled fluoroscopic system designed for applications such as routine fluoroscopic procedures and x-ray exams, and for myelography, venography, and angiography. It includes integrated image optimizing components that employ Siemens’ CARE low-dosage program, and specialized accessories that simplify pediatric examinations, which may be conducted at lower doses, according to Siemens. Iconos R200 offers parallax correction for angulated projections, keeping the object of interest centered in the field of view. Siemens’ QuattroVision workstation, available as an option, provides a 2K, 10-bit image matrix for acquisition, display, and storage. Iconos R200 will begin shipping in April.
• In other R/F developments, Siemens showcased Leonardo, a work-in-progress Windows NT-based workstation that includes modules to optimize radiological reports and improve throughput. With Leonardo, users can view exposures directly at the workstation, perform post-processing, or combine the exposures into reconstructed images.

Swissray

• Swissray expanded its DR product line with the introduction of ddRChest-System and ddRCombi, a unit aimed at emergency room/trauma centers (SCAN 12/15/99). Both systems employ Swissray’s ddR-Bucky CCD-based digital detector. ddRChest-System will begin shipping in the second quarter of 2000, and will have a price range of $360,000 to $375,000. ddRCombi will ship in either the second or third quarter and will have a price range of $350,000 to $650,000.

Thomson Tubes Electroniques

• Thomson introduced TH 9416 HP2, a new 7-inch/4-inch dual-field x-ray image intensifier for mobile C-arms. The intensifier offers several improvements over prior versions, including higher contrast ratio (16:1 at 10 mm), a higher resolution (54 lp/cm) in zoom mode, and a lower x-ray exposure.
• The French firm also showcased its new line of high-definition radiological imaging units, targeted for high-resolution fluoroscopy, cardiology, angiography, and digital radiography systems. Available in 9-inch, 12-inch, and 16-inch formats, the unit includes latest-generation power supply and x-ray image intensifier, dedicated optics, 12-bit CCD camera, and remote control functions.

Toshiba America Medical Systems

• Toshiba changed the name of last year’s Symphony 1000 radiographic and R/F digital equipment package using Agfa’s CR technology to the Alliance 1000.
• The Tustin, CA-based vendor also discussed work under development with an amorphous selenium flat-panel detector, touting the direct conversion benefits of the technology. Toshiba’s detector converts x-rays directly to an electrical charge, which is then digitized; some other DR systems convert first to light and then to a charge. Dynamic vascular studies were demonstrated. The detector will be capable of both dynamic and static imaging, according to the firm. Toshiba estimates the detector is three years away from commercialization.
• Toshiba has expanded the clinical utility of its CCD-based Efficiency 450D multi-purpose x-ray system for R/F, non-vascular interventional, and general angiographic procedures. A 12-inch image intensifier is now available, and users can also take advantage of EPS-Plus, a Windows NT-based digital photo spot technology.
• Toshiba showed 3-D angiography capability as a work-in-progress.

Trex Medical

• Trex put the spotlight on its new Heritage series of x-ray and R/F systems, introduced in October (SCAN 10/27/99).

Trixell

• Trixell announced that it has begun production of its Pixium 4600 digital x-ray detector, the first digital x-ray detector produced by the digital x-ray conglomerate. Volume production will begin early in 2000. Trixell’s production site in Moirans, France, was designed for capacity of up to 5000 units per year.

Varian Medical Systems

• Varian expanded its amorphous silicon flat-panel detector offerings with PaxScan 4030, a 40 x 30-cm panel targeted for digital radiographic applications. Another introduction, PaxScan 2520, is available in several configurations for interfacing with many x-ray imaging systems, according to Varian.