Exhibitors highlight revved-up MR performance, new applications

The International Society for Magnetic Resonance in Medicine is geared toward the eggheads of MR: the knob twisters who squeeze as much from their clinical scanners as they can, the experimentalists who push the limits of ultrahigh-field imaging.

Vendors reach out to these folks on the ISMRM exhibit floor, pressing their wares by appealing to the technical aspects that draw booth visitors to the annual meeting. At the May meeting, however, vendors made their usual pitches while acknowledging the real world. The big five that dominate MR-GE, Siemens, Philips, Toshiba, and Hitachi-each gave its take on how the industry is developing, putting products into the context of their own R&D.GE Healthcare and Siemens Medical Solutions portrayed their latest 3T scanners as the means for unlocking the potential of this new standard for high-field imaging and broadening its appeal. Hitachi Medical Systems sought to breathe new life into the moribund open MR marketplace with its 1.2T Oasis, which the company has since begun installing at luminary sites in the U.S. Siemens cast its total imaging matrix, or Tim, as the thread that weaves together advanced applications. Toshiba America Medical Systems played off the coil theme with a cardiac coil for its 1.5T scanners but focused attention at its booth on its imaging protocols that eliminate the need for gadolinium-based imaging agents. Philips Medical Systems showcased its leading-edge efforts to develop quantitative MR.

Each vendor was seeking to increase its space in a market that shrank about 7% last year in terms of unit sales to U.S customers. Equipment sales revenue declined 4%. Early signs from the first half of 2008 suggested a modest upturn, as industry executives expressed optimism that this year will be better than last, even if only fractionally so. Lingering reimbursement shortfalls, particularly in the outpatient sector, and macroeconomic fears of a recession have dampened interest in new systems.

The silver lining is the continued growth of 3T, as this segment accounted for a revenue rise in 2007 of about 4% over the previous year. At the ISMRM meeting, GE framed its new 3T MR750 as the first in a new generation of Signa scanners designed to handle the toughest imaging cases with minimal effort. Compared with other 3T systems developed by GE, the MR750 offers more powerful gradients, increased anatomical coverage, enhanced parallel imaging, and a user interface that simplifies routine as well as academically challenging protocols, according to Jim Davis, GE vice president and general manager of global MR business.

Preliminary tests showed that GE's latest 3T scanner can cut the time needed for peripheral vascular exams to six minutes and breast exams to four. Real-time cardiac scan times will be performed in one-third less time, according to the vendor.

WIDE OPEN SCANNERS

Siemens showcased its 3T Verio. Debuted at the 2007 RSNA meeting, the scanner features a 70-cm-wide bore yet is compact enough to fit in the same footprint as a 1.5T system. Siemens cast the system as being in a new class of premium MR, offering the high throughput and clinical reach conferred by 3T, patient comfort with its short length and 70-cm bore, minimal operating costs, and siting advantages due to a short, ultralight magnet. Its wide bore, which shares the same diameter as Siemens' open-bore 1.5T Espree, allows for the diagnosis of obese patients by using a table with 550-pound capacity.

Wide-bore magnets and expanding clinical applications for such high-performance systems have cut deeply in recent years into demand for open MR systems, causing this segment to all but collapse. Sales of open systems last year dropped by almost half compared with the earlier year, as revenues plummeted to just $65 million from $120 million in 2006.

Hitachi hopes to turn this situation around with the 1.2T system shown at the ISMRM meeting. Oasis offers the kind of productivity and range of applications typically achieved with a cylindrical high-field scanner, said Sheldon I. Shaffer, vice president and general manager for Hitachi MR and CT. Yet it does so through a novel design that creates an unusually open venue by offsetting the two poles that support the dual discs of the superconducting magnet.

In developing the new product, company engineers applied technologies developed for the Hitachi 1.5T Echelon, a closed cylindrical high-field scanner. Commonalties between the two allow Hitachi to migrate features on the Echelon, such as a pulse sequence for dynamic abdominal and bilateral breast studies and a noncontrast MR angiography protocol for visualizing the peripheral vasculature.

MR's workhorse 1.5T systems last year accounted for more than 70% of the $1.3 billion in revenue from new unit sales in the U.S. The 630 such units shipped to U.S. sites, however, was virtually the same number as were sold in 2006. Efficiency and advanced applications are critical to keeping 1.5T systems relevant.

Above and around its booth at the ISMRM meeting, Siemens broadcast this message: "pushing the boundaries of MR." Displays and presentations throughout the booth struck a common chord, showcasing Tim-the company's total imaging matrix coil and radiofrequency technology introduced some five years ago-as the unifying thread that ties Siemens' many MR scanners together.

"The strategy has always been there," said Don Fowler, who in January became vice president of marketing for Siemens MR. "I just wanted to bang the drum louder."

Over several years, Siemens has expanded its portfolio to eight scanners, most recently adding a second 3T scanner, the premium-performance Verio, and a fourth 1.5T system, the budget-priced Essenza. Tim serves as the focal point that brings the portfolio into crystal clarity, Fowler said.

Philips appealed to the futuristic bent of meeting-goers with its approach to quantitative MR. The company is moving toward the day when the precise measurement of the data points that underlie MR images may provide an exact and definable basis to recognize the early signs of disease and response to therapy.

In presentations at the ISMRM meeting, Philips described MR techniques that quantify the presence of cancerous tumors and heart disease. Stefanie Winkelmann, Ph.D., a Philips research scientist, explained how quantitative MR might be used to characterize tumor parameters such as vascular growth, hemodynamic changes in the response to treatments, and the permeability of vasculature.

Toshiba was on the leading edge of practicality years ago with pulse sequences that produced MR angiograms without using gadolinium-based contrast. Their significance became apparent when gadolinium was associated recently with the occurrence of nephrogenic systemic fibrosis.

Toshiba's techniques, highlighted at the ISMRM meeting, rely on differences in the MR signal that distinguish blood and surrounding soft tissue.

Meanwhile, in a presentation at the meeting, a team from Quality Electrodynamics, Toshiba, and Case Western Reserve University described a 32-channel cardiac array for use on the Toshiba 1.5T Vantage Atlas that they said will provide acceleration factors in any direction, including oblique phase-encoding.

These are examples of clinical need catching up with advanced research, a process engrained in the crossroads of practicality and advanced applications visited often at ISMRM 2008.

Mr. Freiherr is business editor of Diagnostic Imaging.