Innovations drive ultrasound into expanding clinical roles

Miniaturization and portability have become the bulwarks of a new age of ultrasound that is pushing the modality beyond its traditional bounds. Vendors are focusing on making it compatible with demanding environments (e.g., emergency rooms, operating rooms, office settings), particularly by decreasing the footprint and increasing portability. New and enhanced offerings shown at the RSNA meeting focused on volumetric imaging, image-quality improvement, and improved workflow. Subsets of those themes include advanced technology in simpler, more compact formats.

Aloka

Aloka showcased its ProSound Alpha 10, a premium ultrasound system designed with significant enhancements to spatial and contrast resolution and near- and deep-field image uniformity. Alpha 10 features real-time volumetric imaging and eFlow, an enhanced spatial and temporal resolution technique designed to provide detailed visualization and reduced overlapping of blood flow and tissue information. The compound pulse-wave generator allows for design of transmission waveform as well as precision focus control of high-resolution ultrasound beams to reduce artifacts. The user-friendly and flexible system can be easily upgraded to accommodate future needs and enhancements.

Biosound Esaote

The company expanded its MyLab series with the introduction of MyLab 70, the first system on its new MyLab Gold platform. The new product boasts integration, full data sharing, and continuous workflow. A compact ultrasound system targeted toward the high end, MyLab 70 is designed for general purposes and features tissue enhancement imaging. It can handle phased, convex, and linear array, as well as Doppler probes. Easote has equipped it with its unique technological content, including eXtended Modular Architecture, eXtreme Beam Former, eXtreme Focusing Technology, eXtreme High-Frequencies imaging, and eXtreme View with real-time adaptive algorithm.

GE Healthcare

GE highlighted its Volume Imaging Protocol (VIP) platform, which enables physicians to improve productivity by acquisition, optimization, and analysis of volumetric data. With VIP imaging capability, sonographers can sweep across a target area of a patient's anatomy, collecting raw data using GE's LOGIQ7 or LOGIQ9 systems. These enable clinicians to acquire and construct volumetric images and scan an entire organ within seconds. Data can be moved to a LOGIQworks workstation for offline processing. LOGIQworks creates volumetric and multidimensional images in real-time, allowing clinicians to visualize and assess anatomy, masses, and lesions.

Hitachi Medical Systems

Hitachi spotlighted its HI Vision 8500 and HI Vision 6500 ultrasound systems. The 8500 includes the innovative SonoElastography option, which provides a new set of information by measuring the relative stiffness of tissue and overlaying that information onto the standard B-mode image as a traditional color map. The system also features multi-angle compound imaging, adaptive noise reduction, and four modes of tissue harmonics. It allows users to adjust the imaging parameters of a frozen image. Clinical applications include elastography; musculoskeletal, abdominal, interventional, ob/gyn, and vascular imaging; and biopsies. The HI Vision 6500 comes with a Version 6 upgrade. New features include SonoIQ one-touch image optimization and increased imaging depth. Version 6 also supports new options such as Hitachi's real-time 3D imaging technique.

Medison

Medison migrated its 3D Extended Imaging ultrasound image processing technology into its SonoAce 8000 Live, a 3D system specialized for ob/gyn. The enhancement makes the SonoAce 8000 Live a complete premium performance solution. This midrange system provides comprehensive clinical capabilities, including 2D, 3D, and 4D. The SonoAce 8000 Live was already distinguished by its synthetic aperture controls, volume 3D, PSAD beamformer, and sensitive power Doppler capabilities. It now provides convenient research functions, enhanced workflow efficiencies, and intuitive ergonomics. Medison touts the 3D XI technology as advancing ultrasound diagnosis to a CT- or MRI-like imaging quality. It includes multislice, oblique, and volume CT view. Multislice view transforms 3D volume data obtained from a regular ultrasound scan into a series of sequential images captured in intervals of 0.5-mm to 5-mm segments. Oblique view enables display of 3D volume data in various planes. Volume CT view enables multiple examinations of various regions and eliminates the need for multiple scanning.

Philips Medical Systems

Philips focused on its iU22, showcasing Vision 2005 enhancements to the system. These include improved cardiology capabilities, photo-quality 3D fetal imaging, and on-cart and off-cart upgrades to the QLAB Quantification Software. Advanced cardiology capabilities include live 3D echocardiography, more advanced transducer technology that produces high-quality echo images, and advanced echo quantification. Philips equipped the iU22 with new advances in transducer technology such as xMatrix array and PureWave crystal technology, as well as the new L9-3 transducer. In addition, Philips introduced:

• Updates for the HD11, the high-end ultrasound system that offers features once found only on premium systems, including SonoCT imaging and XRES image processing for high-definition performance. With the affordable HD11, Philips enables more clinicians to realize the benefits of evolving ultrasound technology. The product can be customized to the user's applications or specialty with options including stress echo, panoramic imaging, and contrast.

• HD11 XE, a cardiology version of the HD11, is equipped with QLAB quantification software. The system offers strain quantification using Tissue Doppler Imaging, automated media thickness measurements of carotid and other superficial arteries, and region-of-interest quantification to analyze pixel intensities from 2D or color Doppler.

• HD3 system, an office-based, highly mobile, compact product with high-definition performance is Philips' smallest and most mobile HD system. It extends higher performance ultrasound to more users. It provides basic ultrasound users with features such as gray-scale and color Doppler imaging with one-button image optimization, Cineloop review, tissue harmonic imaging, an adjustable flat-panel monitor, and analysis packages and measurements for various exams.

Siemens Medical Solutions

Siemens displayed advancements for its flagship Acuson Antares and Acuson Sequoia ultrasound scanners, as well as new products and technology. The new Antares premium edition is a complete ultrasound system that provides upgradable and comprehensive clinical capabilities, research functions, enhanced workflow, and improved ergonomics. The premium edition is capable of 2D, color Doppler, 3D, 4D, and contrast agent imaging. It features Siemens' fourSight 4D imaging technology, new rendering modes, and the new EV9F4 endovaginal 4D transducer. For technically challenging patients, the highly upgradable system provides Cadence contrast pulse sequencing for advanced contrast agent imaging applications and Extend performance technology. Other highlights at Siemens' RSNA booth included:

• The Encompass II package added to the Sequoia platform, which includes a high-resolution flat-panel display monitor and CD/DVD-R. It also provides High Resolution Color Flow (HRCF), an innovation that applies Chirp-coded excitation to color Doppler to address spatial resolution, color bleeding, slow flow sensitivity, color penetration, vascular hemodynamics, and deep flow identification. The technology will be most useful for imaging in the abdomen and obstetrics, renal studies, peripheral vascular studies, and imaging of small parts such as breast, thyroid, testicle, and tumor studies.

• The Encompass III release, designed for Sequoia, provides Axius Velocity Vector Imaging (VVI), a quantitative motion analysis tool that extracts and displays myocardial mechanics from ultrasound information. VVI can be used with any transducer for all cardiovascular imaging.

• The Sonoline G60, a scalable multispecialty system featuring enhanced fourSight 4D ultrasound imaging technology that provides easy 4D volume acquisition and workflow that reduces exam acquisition and postprocessing time.

• The Sonoline G40, an ultraportable color Doppler system that offers superior diagnostic capabilities for a wide range of patients and applications. Features include Hanafy Lens transducer technology, high sensitivity color Doppler, and Virtual Format imaging.

SonoSite

SonoSite presented the third generation of its hand-carried MicroMaxx ultrasound technology. The eight-pound notebook-sized system includes high-performance features such as high-frequency linear and multiplanar transesophageal imaging. The scanner's 128-channel beamformer, integrated into four ASIC (application-specific integrated circuit) chips, enhances performance in a configuration smaller than conventional ultrasound systems. Image resolution and performance is comparable to larger systems. MicroMaxx offers the option of the SonoCalc IMT (intima media thickness) software for early detection and management of cardiovascular disease. SonoSite also showed two new broadband transducers for use with MicroMaxx: P10, a high-frequency phased-array probe for pediatric and neonatal radiology and cardiology assessment, and the HST 13-6, a high-frequency linear-array probe for imaging the vascular system and superficial structures.

TeraRecon

TeraRecon introduced two new multifunctional digital, portable, color Doppler ultrasound systems: UF-780XTD and 785XTD. With these new systems, TeraRecon takes portable ultrasound systems closer to full-sized machines in terms of functionality. The UF-785XTD, for cardiovascular applications, offers three probe connections (unique among portable scanners) plus dual-beam processing. The UF-780XTD, for general applications, comes with two simultaneous probe connections plus single-beam processing. Both systems feature a modern, high-tech, portable scanner design and are equipped with 15-inch LCD monitors with XGA image quality. Imaging modes for both include 2D, tissue harmonics, M mode, color Doppler, spectral Doppler (CW/PW), and power Doppler. The new systems possess ECG capability, built-in hard drives, and DVD-R capability, as well as a J2K board for efficient video clip recordings. Transducers and software upgrades are compatible across TeraRecon's entire XTD product line. Both units are pending FDA clearance.

Terason

Terason introduced its new T3000 ultrasound system, which offers 256 beamforming channels as well as 12-MHz transducer support and multiple focal zones. The system is targeted to general, vascular, and breast imaging, interventional radiology, image-guided intervention, endocrinology, and nephrology. Clinical uses include abdominal, intraoperative, neonatal and pediatric, musculoskeletal, cardiac, peripheral vessel, laparoscopic, transrectal, and transvaginal applications.

Toshiba America Medical Systems

Toshiba showcased updates to its Aplio and Xario systems. Aplio was enhanced with the company's expanded Differential Tissue Harmonic Imaging (DTHI), while Xario features 4D imaging. Expanded DTHI enables scanning of larger patients who previously couldn't be imaged with ultrasound technology. Toshiba also reported that clinical evaluations have demonstrated that the technology can improve efficiency. The advanced 4D technology in Xario, which the company describes as "affordable," helps improve departmental efficiency as it enhances both user and patient comfort. The 4D upgrade is appropriate for multispecialty practices that need 3D images viewed in real-time. Xario provides users with button-touch volume acquisition as well as simultaneous 2D and 4D display. Other new Xario features include postprocessing tools, real-time MPR display, and a 4D measurement package. Technology migrations from Aplio have introduced new capabilities such as Toshiba's Advanced Dynamic Flow wide-band color Doppler technique, as well as Panoramic View and Advanced Contour Tracking for cardiology applications.

Zonare Medical Systems

Zonare upgraded its z.one ultrasound system with two new transducers, calculation packages, and a program that automatically recognizes and adjusts for differences in body sound propagation. The two new transducers expand the system's imaging capabilities and applications. The P10-4 transducer is designed for neonatal, infant, and pediatric imaging. Its design provides a comfortable grip for scanning through isolettes and very small acoustic windows, and it offers up to seven different frequencies, including harmonic imaging at 8 MHz, two color Doppler frequencies, and three B-mode frequencies. The small footprint of the new P4-1 transducer addresses clinicians' need for easy access in abdominal and ob/gyn sonography, providing flexibility with nine frequencies. The transducer can penetrate up to 30 cm. The new calculation packages address abdominal and venous imaging. They enable sonographers to use a protocol checklist with reports that include organ sizes, Doppler results, and a section for medical notes or comments. The sound speed compensation program automatically adjusts the sound speed based on differences in patient body habitus, thereby optimizing clinical images.