Philips echo product incorporates advanced 3D visualization, quantification

Philips' new echocardiography platform, iE33, promises to do for cardiology what its iU22 scanner began doing earlier this year for radiology: boost image quality while providing an integral connection to volumetric imaging that allows 3D visualization and quantification.

The echo system, released in mid-October, features 2D and 3D imaging in real-time, as well as 3D cardiac quantification that could have an enormous impact on cardiological practice. Especially intriguing is the potential for exactly measuring left ventricular volume and ejection fraction.

Barbara Franciose, CEO of the Philips ultrasound group, said these measures of cardiac health are often estimated rather than measured, leading physicians to guess about whether patients should get a pacemaker or defibrillator.

"Not every physician estimates these cardiac parameters, but many do for lack of a better option," she said. "The iE33 offers reproducible and quantifiable results about cardiac function. We believe eventually these parameters will be included on all echo exams. It is such an important metric."

Dr. Roberto Lang, a professor of medicine at the University of Chicago and director of the noninvasive cardiac imaging lab at University of Chicago Hospitals, said lifesaving interventions are based on the assessment of left ventricular function, noting that the iE33 streamlines and automates the process for making such assessments.

"This machine makes it easier for the physician to make all-around better diagnoses," he said.

The 3D visualization is nearly instantaneous, Franciose said, appearing onscreen after one or two heart beats, depending on the resolution desired.

The ultrasound beam is steered in several directions. Acquisition is accomplished using a fully sampled matrix array. Data are acquired as voxels, which are processed directly to the screen.

"That's a little different from what we think our competition is doing," she said. "They use a sparsely sampled array because they don't have the processing power."

Philips embeds its data processing in the data stream, she said, which utilizes an architecture and bandwidth that can support advanced processing on the fly.

"We can acquire a full volume in real-time and visualize it," Franciose said.

The quantification capability, like 3D visualization, supports clinical capabilities beyond those possible with other technologies. Cardiac volumes are assessed in their entirety, she said, using an automatic registration algorithm. Measurements are completed online in about a minute.

The iE33 is the second flagship ultrasound system released by Philips in the past nine months. The first, the iU22 (intelligent ultrasound) radiology system, was unveiled as part of a global marketing plan in February (SCAN 2/25/04) and shown at the European Congress of Radiology the next month (SCAN 3/24/04).

The iE33 is on its own odyssey. Marketing events are planned from now until at least early December in major U.S. cities. Along the way, the iE33 will stop in at the American Heart Association meeting Nov. 7 to 10 in New Orleans.

The two scanners are very different. The iE33, of course, has a user interface designed for echocardiography; the iU22 interface is uniquely radiological. The difference in clinical orientation is apparent in the displays. The iE33 provides two touch panels, which offer the operator the ability to view and control two images separately. The iU22 has just one.

The transducers are completely different, one set optimized for cardiac imaging, the other for radiological applications. But there is more of a difference in the probes. Only the iE33 offers PureWave crystal technology. This piezoelectric material, built into the transducer, is created from a single crystal. It confers greater transmit efficiency than conventional crystals, according to Franciose.

"It is optimized to handle diverse patient body types, from large to thin," she said. "It works on a wide range of patients, from the 300-pounder to the 120-pounder."

Eventually, the PureWave crystal may be migrated to the iU22 system, as Philips has put a lot into its development. Even before that happens, however, the two systems have a lot in common. They are, in fact, fraternal twins, sharing a common electronic DNA, consisting of circuitry and software that the company passed through FDA review more than a year ago (SCAN 5/28/03) as the "Boris Platform."

R&D engineers with a penchant for cartoon characters (e.g., Boris and Natasha, the nefarious archrivals of "Rocky and Bullwinkle") reportedly christened the platform. Philips initially described it as an "additional technology" with which to advance the state of the art, noting specifically that it would not replace either of the company's current major product platforms, the radiology-oriented HDI or cardiology-oriented Sonos.

While Boris itself did not replace those platforms, the two scanners built around Boris have. Much like HDI and Sonos bred two distinct families of scanners, so might the iU and iE platforms. The numbers 22 and 33 attached to the radiology and echocardiography systems leave plenty of room for sibling names.

"We might hypothesize that we could introduce products that extend upward in performance and baseline systems that extend below," Franciose said.