From the RSNA exhibit floor: Companies refine DR and CR to boost efficiency, complement existing products

For the better part of a decade, system manufacturers have eyed the DR market with growing anticipation, focusing blockbuster hopes on it, but realizing only modest returns. Their faith in the future of this segment fueled the development of early-stage systems.

This year, reality finally began to catch up with vendors' exuberance as a growing segment of the marketplace began to replace film systems with digital versions. In response, vendors at the RSNA meeting ratcheted up their product lines a notch, focusing on applications, image quality, and workflow.

Agfa HealthCare

Active in 40 countries and fielding representatives in another 100, Agfa develops, manufactures, and markets analog and digital systems for the graphics and healthcare markets.

Agfa this year revamped its computed radiography line "by the numbers," reintroducing established products with new names and often upgraded capabilities.

• The CR 75.0, a high-throughput system for centralized CR environments, and CR 25.0, a multiapplication digitizer for decentralized environments, were previously known as the Solo and Compact Plus, respectively. The CR 75.0 features a unique drop-and-go buffer that eliminates wait times and permits continuous workflow within the department. The 25.0 is a faster, highly versatile, small-footprint digitizer usable inside the x-ray room.

• The CR 50.0, which uses a patented needle phosphor plate, was designed for both efficiency and image quality. It was launched during the meeting.

• The company has upgraded its direct digital imaging technology by adding A#Sharp, a software enhancement that increases image quality.

Anexa

Analogic established this subsidiary to market its next-generation digital imaging solutions to end users in select markets, such as those addressing trauma and orthopedics.

• SyneRad Omni DR, a multipurpose DR system, passed FDA review a week before the RSNA meeting. It features the company's new GR17 amorphous selenium flat-panel detector, which was developed by Analogic's Anrad and will be sold by its other subsidiary, Anexa. The product provides multiframe acquisition capability in full 17 x 17-inch fields, providing customers with expanded clinical utility in joint stability and motion studies.

Canon Medical Systems

Canon provides fixed and portable flat-panel DR systems for general radiographic applications.

• CXDI-50G DR sensor panel was shown in multiple portable x-ray configurations. The design lets users take DR wherever a portable x-ray system goes. Additionally, the full-size DR sensor panel provides superior images at the bedside in about three seconds.

• The CXDI-40G integrates with a wide variety of general radiography systems, from ceiling-suspended multipositioning units to upright wall stands to RF tilting tables. It allows the capture of chest and abdominal digital x-rays without rotating the sensor panel.

• Mobile Access Station (MAS) manages patient and study information while streamlining workflow at every phase, including order issuance, patient work list acquisition, examination, image QA, and storage.

Eastman Kodak

The company's Health Imaging Group is focused on developing, manufacturing, and marketing advanced imaging products from analog to digital.

• The DirectView DR 9000 features a U-arm design with full range of motion for chest, extremity, abdominal, and trauma exams.

• The work-in-progress DirectView DR 7500 is being designed to support single- and dual-detector configurations. It can be customized to include a wall stand with retractable bucky. The detector can be controlled manually or synchronized with the overhead x-ray tube so that push-button control will automatically center the beam to ensure accurate source-to-detector alignment.

Edge Medical

Edge Medical Devices works with OEMs, integrators, and value-added resellers worldwide to bring DR to a range of diagnostic imaging settings, from private imaging facilities to community hospitals to major medical centers.

• The company's Plasma DR detector is based on proprietary technology that incorporates a microplasma line scanner, direct conversion amorphous selenium sensor, and low-noise readout electronics into a flat-panel detector.

Ferrania LifeImaging

CR solutions designed to complement DR offerings were highlights at the Ferrania booth.

• LifeInVision CR and CR Plus, two new tabletop CR units, offer advanced image management software built around erasable phosphor plates. Both systems are compatible with a mobile cart.

FujiFilm Medical Systems USA

The company has ported technology and engineering expertise from its photo film division to digital image analysis, evaluation, and processing. Its concept of image intelligence has evolved into image processing technologies that maximize the use of Fuji CR products.

• Fuji combined its customizable Flex UI digital x-ray software application with the convenience of PDAs to create the FCR Pocket ID. With the Pocket ID, patient data can be accessed quickly and verified at the bedside, increasing caregivers' efficiency while reducing the potential for medical errors.

• FCR Velocity-U DR system uses HD LineScan technology to push the advantages of storage phosphor technology. The system features near-immediate image preview and high throughput. Its companion Velocity-T should begin shipping by early 2005.

• ClearView-CS is a high-capacity, multiplate reader with dual-plate reading.

GE Healthcare

The company, one of the pioneers of flat-panel detectors, today relies on amorphous silicon-based technologies throughout its DR product line.

• The AMX 5D, a portable DR system, is built around the Revolution digital detector. The advanced applications-enabled product, to be commercially released in mid-2005, is GE's digital answer to its AMX 4 analog system.

• The company is also exhibiting a new CR scanner. Not yet named, the reader's scanning optics enable CR plates to be scanned and the images quickly previewed. A variety of device configurations, including centralized high-volume systems, distributed single-plate readers, and cassetteless flat panels, are possible with the scanner.

Hologic

The women's health specialist backed away from radiography over a year ago, closing down its DR line of end-user products in favor of OEM supply arrangements for its flat-panel detector. But the company returned to the radiography business this year, thanks to a technological extension of its Discovery series of bone densitometers.

• Radiologic vertebral assessment (RVA), an integral part of Hologic's upgraded Discovery systems, provides a high-resolution image of the spine in seconds as part of the bone densitometry exam. RVA was developed to promote earlier detection of spinal fractures, which are present in about one-third of women over 65. (The company emphasized that reimbursement for RVA is covered under a recently created CPT code for vertebral fracture assessment.)

InfiMed

The company offers digital image acquisition, processing, and review solutions for DR, as well as x-ray fluoroscopy, angiography, and cardiac cath. Systems can be used either as retrofits to update existing rooms or in new or refurbished rooms.

• StingRay Excel builds on the company's image processing core and flat-panel products. It also boasts a new set of image-processing features - ImageEnhance image processing, ImageStitch, and integrated generator interfaces - designed to optimize image quality and productivity.

Konica Minolta Medical Imaging

On the heels of a merger that combined Konica and Minolta, the company is seeking to expand its medical offerings through an emphasis on CR.

• IQue CR combines ease of use with the high performance of a dual-bay reader to boost productivity. The system includes pattern recognition software that allows IQue CR to learn how it is being applied and thus optimize its performance.

• CR QA, a quality assurance program, enables users to monitor the performance of their CR systems.

Lodox Systems

StatScan, a low-cost x-ray alternative to CT, is being marketed as an aid to emergency medicine. Recent upgrades promise to extend the system's utility.

• Rad-MP system upgrade of the company's Statscan Critical Imaging System combines a large field-of-view radiolucent table and patient chair for rapid, accurate imaging of seated and standing patients. The upgrade equips Statscan as a dual-purpose system capable of radiographic exams for trauma patients as well as ambulatory emergency room patients. It consists of a 20 x 28-inch (50 x 71-cm) radiolucent imaging table, hydraulic patient imaging chair, and platform. The imaging table can be used in both horizontal and vertical planes, and the adjustable hydraulic chair and platform can accommodate both seated and standing patients.

Orex

The company develops desktop distributed CR systems that provide image acquisition, processing, and display.

• Orex ZR, a newly designed mobile CR scanner, supports a range of specialized clinical applications. The highly mobile cordless, wireless system can seamlessly transmit CR images over a secure Wi-Fi connection within a hospital network.

• The lightweight and affordable ACL CR scanner line for multiple applications includes a versatile and cost-effective mammography configuration as a work-in-progress. Scanners can be configured to process imaging plates at 20, 41, 60, and 75 plates per hour on a single device.

• The dual-scanner ACLxy RAIS 2 combines two CR scanners on a single workstation to provide 150-plate-per-hour output and system redundancy in the event of a failure.

Philips Medical Systems

CR and DR systems offer a variety of price points and capabilities in Philips' radiography portfolio.

• Digital Diagnost VM, with CR/DR integration, efficiently covers a broad range of applications. Scheduling, verification, and postprocessing can be done at the data acquisition workstation. Features include cassette size flexibility, light weight, and wireless operation. Unveiled during the 2003 RSNA meeting as a work-in-progress, DigitalDiagnost VM is now widely available for about $350,000. The VM integrates CR and DR using a multipurpose single-detector configuration.

• Digital Diagnost TH, a radiography system with digital detectors in the table and wall stand, was shown with Philips Computed Radiography (PCR).

• PCR versions allow single-slot CR (Compano), or high throughput up to 165 plates per hour (Corado). CosimaX offers the same functionality as the Corado, but adds dual-side reading of small imaging plates, resulting in a 50% increase in DQE.

Quantum Medical Imaging

Q-Rad-Digital series was introduced as a new line of digital imaging systems offering three configurations, each designed to meet the various requirements and cost constraints of hospitals, imaging centers, and clinics.

• Q-Rad-D, a traditional two-receptor system with a direct digital imaging panel in both the elevating table and wall stand.

• Q-Rad-IQ, a dual digital receptor system with a direct digital imaging receptor in the elevating table and a second digital imaging receptor placed within a tilting and rotating wall stand.

• Q-Rad-SQ, a single digital receptor system with a direct digital imaging receptor located within a tilting and rotating wall stand and a mobile elevating float-top table.

Siemens Medical Solutions

The company is promoting postprocessing software to achieve gains in DR.

• The Mobilett XP Digital is a mobile digital x-ray system using flat-panel detector technology. The XP, featuring a 43 x 35-cm flat-panel detector for enhanced viewing, can store up to 3000 images. It also offers a touchscreen with intuitive user interface. The system's mobility allows its use in many clinical settings and specialties, including pediatrics, orthopedics, and emergency medicine.

• OrthoSpine and OrthoLeg, Siemens' scoliosis and long-leg imaging software packages, were shown. Images are acquired in a sequential acquisition mode, then automatically and seamlessly stitched.

• DiamondView, a contrast-enhancing software tool, provides sharper, clearer images.

Swissray

The company that helped pioneer DR with its CCD-based systems is seeking expanded clinical utility through the introduction of new end-user products, while enhancing image quality with works-in-progress software.

• ddRCombi Trauma enables trauma and other emergency patients to be imaged from head to toe, both AP and laterally, easily and without being moved. The system features a fixed table with elevating base, four-way floating top, and automatic detector positioning for cross-table imaging with the push of a button on a wireless handheld remote control device.

• Several works-in-progress were shown, including dual-energy imaging, for separation of bone and soft-tissue image elements; computer-aided diagnosis; and Osteocad, which provides bone mineral analysis and measurements derived from a Swissray ddR-acquired digital hand radiograph.

Toshiba America Medical Systems

A newcomer to DR, Toshiba is combining decades of engineering experience in film-based radiography with OEM-provided digital technology.

• T.Rad Plus DR system was shown in single- and dual-panel configurations. T.Rad is designed to improve productivity while enhancing patient care and eliminating the use of plain film. It features a 17 x 17-inch DR panel for large anatomical coverage and a flexible design that adapts to customers' departmental needs.

Varian Medical Systems

Varian develops x-ray tubes and is a premier supplier of the PaxScan line of flat-panel digital x-ray image detectors.

• The PaxScan 4030CB meets the needs of the emerging conebeam cross-sectional x-ray imaging market. This panel is a key component of Varian's radiation oncology imaging and treatment technologies, including the Acuity radiotherapy simulation and verification device and the On-Board Imager accessory for real-time image-guided radiation therapy.

• The PaxScan 2020 was designed for the cardiac and conventional C-arm market. A small panel that offers enhanced real-time imaging capabilities, the 2020 is suited to applications using 9-inch image intensifier tubes.