Philips moves first in direct-sensor CR

Philips Medical Systems took a pioneering step last week withthe introduction of a direct-sensor computed radiography system.The selenium-based ThoraVision digital chest system is the firstnon-phosphor CR system offered by a major multimodality imagingsystems vendor.

While ThoraVision stakes out technological ground for futuredevelopments in digital medical imaging, Philips does not expectthe technology to translate into significant revenue right away,according to Michael P. Moakley, PMS president and CEO. Philipsunveiled the CR unit at the European Congress of Radiology meetingin Vienna last week.

"We don't look for a mass market for ThoraVision,"Moakley said. "Our expectations are rather mild. But it isa breakthrough that had to come. We have digital images in CT,MR, angiography, and R/F. The last link was to digitize routineradiography."

ThoraVision also provides Philips with a technical platformto build its sub-PACS--or "cluster"--concept in picturearchiving and communications systems, under development for severalyears.

"This is one step in several that we will be taking usingthe same base technology," Moakley said. "ThoraVisionrepresents the future relative to PACS clustering, in terms of(digital image) transmission between ICU, surgery and emergencyrooms. It represents an acid test in performing chest imagingin a digital format with greater throughput and image qualityacceptable to the radiologist."

Philips has been working on the selenium detector technologybehind ThoraVision for a decade, according to Jos Bakker, programmanager for digital systems and PACS. Selenium was chosen becauseof its broad dynamic range and wide tolerance to over- or underexposure.

"It is a product we feel will turn radiology upside down,"Bakker said.

The system produces extremely low noise, he said. A high signal-to-noiseratio allows for better image quality, lower dose or a combinationof the two.

"It allows people, if they are happy with the noise, toreduce dose," Bakker said.

Imaging parameters are optimized automatically, allowing techniciansto spend more time with the patient rather than tuning their x-raymachines, he said.

ThoraVision offers three image formats on screen:

• portrait (43 x 35 cm);

• landscape; and

• extra large (49 x 43 cm).

The large format is 30% higher than any existing fluoroscopydisplays, Bakker said.

Philips has installed four ThoraVision systems worldwide. Theone U.S. site is at Duke University in Durham, NC. There are twoinstallations in Europe--in the Netherlands and Germany.

The vendor hopes to ship "significant numbers" nextyear, although it realizes that most prospective customers arestill evaluating the new technology, he said.

ThoraVision's largest application will likely be the lungs,although other thoracic objects, such as the heart, pericardium,trachea and blood vessels, can also be imaged. Pulmonary radiographyis the second most frequent x-ray examination (at 20% of all applications)after skeletal radiography, Philips said.

Because of film limitations, it has not been possible beforeto obtain simultaneous images of equal quality in both areas ofthe mediastinum and lungs, the company said.

BRIEFLY NOTED:

• Acuson this month released a new ultrasound system designedfor intraoperative echocardiography procedures. The 128XP/10spis configured for use by anesthesiologists and cardiologists performingintraoperative and transesophageal procedures, according to thecompany.

Intraoperative echocardiography is a growing market that hasnot been completely penetrated by ultrasound, according to DaveBruce, product manager. There are some 900 cardiac surgery facilitiesin the U.S. and 450,000 open heart surgeries are performed eachyear.

The 128 XP/10sp is designed to help surgeons reduce the riskof stroke that can occur during cardiac surgery by providing real-time,high-resolution assessment of cardiac structures and hemodynamics.Intraoperative ultrasound helps surgeons avoid areas where plaquecan break free and embolize to the brain, causing stroke.

The scanner is built on the 128 XP platform and can be equippedwith Acuson's recently released Acoustic Response Technology (SCAN5/19/93), according to Bruce.

The scanner uses miniature transducers for epiaortic, epicardialand epivascular imaging, with high resolution and maneuverabilityin tight surgical fields.

• Philips Medical Systems has released two new upgrade packagesfor its Gyroscan ACS-II 1.5-tesla and Gyroscan T5-II 0.5-teslascanners. The upgrades add expanded capabilities to the scanners,such as magnetization transfer contrast and keyhole imaging.

The Release 3.0 upgrade package includes a quadrature bodycoil for studies of large anatomy; high-performance gradient coilsfor thin-slice, small field-of-view imaging; and extended flowcompensation to reduce artifacts induced by blood or cerebralspinal fluid flow.

Expander Package includes several advanced MRI techniques,such as magnetization transfer contrast; keyhole imaging for fastdynamic studies with high temporal and spatial resolution (SCAN12/30/92); extended regional saturation (REST) to optimize motionsuppression within targeted anatomical regions; multi-chunk 3-D,which reduces exam time for single-volume 3-D studies by dividingthe volume into subvolumes, or "chunks"; and spectralpresaturation with inversion recovery (SPIR), a technique forfat suppression on the Gyroscan ACS system that is being madeavailable for the Gyroscan T5.

Release 3.0 and Expander Package can be acquired sequentiallyor bundled together. Release 3.0 will be made available on receiptof Food and Drug Administration 510(k) clearance, according tothe company.

• Advanced NMR announced last month that it received ordersfor six InstaScan echo-planar imaging systems. Five of the orderswere made under the arrangement the Wilmington, MA-based companyentered into with GE Medical, in which GE gains two-year exclusiverights to InstaScan in exchange for a guarantee to buy 100 EPIsystems by the end of 1994 (SCAN 3/10/93). The remaining orderwas a direct purchase and has already been installed, accordingto the company.

The company values the orders at about $2 million. The ordersbring sales of InstaScan to a total of 12 systems.

• Lorad has been awarded a patent for its charge-coupleddevice (CCD) camera, used in the company's DSM Digital ImagingSystem for digital spot mammography. DSM works in conjunctionwith the company's M-III mammography unit as well as its StereoGuideprone needle biopsy system. Lorad is also developing a full-breastdigital imaging system using the CCD camera (SCAN 9/8/93).

• Philips Medical Systems unveiled a new ultrasound scannerat the European Congress of Radiology meeting in Vienna this month.The scanner, dubbed P600, is designed for the mid-range marketand is targeted at hospitals requiring a mobile back-up to a premiumsystem or for institutions needing a multipurpose alternativeto high-end scanners. The P600 is capable of general abdominal,ob/gyn, urological, vascular, small parts, cardiac and intraoperativeimaging.

P600 offers gray-scale imaging and spectral Doppler, with optionalcolor Doppler. Other features include digital cine memory, ECGgating and real-time biplane display.

• Toshiba Medical Systems Europe took advantage of the ECRto launch Xtension, a multimodality image processing workstation.In addition to standard CT and MRI processing functions, Xtensionfeatures 3-D surface and volume rendering, maximum intensity projectionand MR angiography. The workstation operates on a Sun SPARC 10platform and can be linked to Agfa, Kodak or 3M peripheral devices.