Hewlett-Packard returns to its roots with introduction of new echo scanners

HP aims for even more market share with Sonos additions

Ultrasound vendor Hewlett-Packard is launching two new scanners this month in a bid to boost its already strong position in the echocardiography market. HP on June 3 announced the arrival of the premium Sonos 5500 and the mid-tier Sonos 1800, which will begin shipping by mid-June.

HP is the undisputed leader in cardiovascular ultrasound, with a market share that the company estimates at 61% in the U.S. and 42% worldwide. HP made a bid to expand its echo success into the radiology ultrasound market by introducing the ImagePoint scanner at last year's Radiological Society of North America conference (SCAN 1/8/97). HP reported this month that ImagePoint sales have surpassed 400 units.

The introduction of the new Sonos scanners indicates that HP's foray into radiology ultrasound will not distract it from its core echo market, where the company intends to build its already considerable market share, according to Paul Magnin, general manager of imaging systems at HP's Medical Products Group in Andover, MA.

"We will increase our market share significantly," Magnin said. "I think we can get 10 market-share points worldwide in a year."

Sonos 5500 replaces Sonos 2500 and has a price range of $190,000 to $350,000, depending on configuration. At lower price points, Sonos 2000 costs between $125,000 and $175,000.

HP will promote Sonos 1800 to customers seeking a value-oriented system. The mid-tier 1800, which replaces Sonos 1500, is specifically designed for smaller hospitals, clinics, mobile services, and physician offices. HP executives, however, hope to sell the product into the stress-echo labs of larger hospitals that also buy Sonos 5500 for more advanced studies. It lacks the bells and whistles of Sonos 5500, particularly quantitation functions, but the system can do virtually any other echocardiography exam.

In fact, Sonos 1800 rides the same frame as the general-purpose ImagePoint. The two products are physically identical, differing only in the software and the availability of an optical disk storage peripheral.

"The presets on Sonos 1800 are specialized for cardiology and for vascular work," said Gary Abrahams, marketing manager. "In addition, there are different color-flow maps within the system, so it has the HP color flow for cardiac, not the one that's used for general imaging."

New techniques. Sonos 5500 puts HP back in the technological spotlight with fusion imaging, a technique that creates optimized images from data obtained using a range of ultrasound frequencies emitted by a single probe.

"The fused image is a combination of penetration, resolution, and texture-a kind of sweet spot of what that image should be for the patient," Abrahams said.

Fusion imaging requires the use of a broadband beamformer and transducers that emit a range of frequencies. The S4 probe offers a band from 2 to 4 MHz; S8 from 3 to 8 MHz; and S12 from 5 to 12 MHz. The special-purpose transthoracic OmniPlane (TTO) probe, which operates between 3 and 6 MHz, is designed to image the heart with the same clarity as a transesophageal probe. The transducers capture more information than competing technologies, according to Abrahams, utilizing between 80% and 100% of the available bandwidth.

By combining fusion image processing, the broadband beamformer, and the new transducers, Sonos 5500 can create multiple images simultaneously, fusing the data into images optimized for contrast resolution and anatomical detail in relation to the patient.

HP's competitors have similar technologies. In fact, broadband beamformers and multifrequency transducers, such as those on ATL's HDI 3000 scanner, have been in service since the early 1990s. Last year, Acuson went further with its Sequoia system, generating the data with multiple beamformers and then conducting multiline processing, called coherent image formation, to create images that include both phase and amplitude data from ultrasound signals.

HP claims to have rolled these various concepts into one, and then gone to the next level by providing interactive control over the way these images are optimized. The keyboard of Sonos 5500 includes a dial with five settings, with each click calling up images optimized according to different parameters that weigh the image toward penetration, texture, or resolution. A triangular icon appearing in the corner of the display screen indicates how the image is optimized. The corners of the icon are marked by letters: P (penetration), T (texture), and R (resolution). Shading inside the triangle indicates which of the three are being emphasized.

Especially noteworthy on Sonos 5500 is the TTO, which can provide images comparable under at least some conditions to those delivered by TEE. This transthoracic probe, held against the chest rather than inserted down the throat, incorporates a tiny motor that sweeps a phased array across an arc covering the heart. Real-time 2-D images come up on the scanner display screen. Nine minutes later, the data are also reconstructed into high-quality 3-D images.

Another capability on Sonos 5500 is second-harmonic imaging without contrast agents. Researchers have noted that second-harmonic imaging has the potential to increase the contrast between tissue and blood in the myocardium. HP has incorporated that capability in its new system.

"Sonos 5500 offers a two-step process to improve image quality," said Dr. Roberto Lang, director of the Noninvasive Cardiac Imaging Laboratories at the University of Chicago. "Your first step would be fusion imaging, setting your penetration, resolution, or texture. Then you can go further, boosting your image by using second-harmonic imaging."

Fusion imaging and the ultraband transducers also improve the capability of quantitative functions on Sonos 5500, compared with its predecessor. Acoustic quantification, which defines global left-ventricular function and ejection fractions, as well as other parameters, can be successfully applied on up to 90% of patients compared with about 75% on the older Sonos 2500, according to clinical investigators at the University of Chicago. The reason is a combination of enhanced signal processing, less noise resulting from the improved beamformer, and the increased amount of data delivered by the ultraband transducers.

"These give us a fine edge definition that we didn't have to this degree before," Magnin said.