SmartLight challenges conventionswith computer-controlled light box

Digital Film Viewer carries hefty price tag

An Israeli start-up called SmartLight wants to change the wayradiologists read films, with a high-tech, glare-free replacementfor the traditional light box. The Haifa company is led by severalElscint veterans, including vice president of R&D Daniel Inbar,and made its debut at last year's Radiological Society of NorthAmerica meeting.

Inbar had the tall order of introducing a pricey new productat a time when radiology departments are under intense pressureto cut costs. In addition, the long-term future of film is indoubt as digital image management gains popularity. SmartLight,however, believes that the productivity and image quality gainsbrought by its technology will offset its high price. The picturearchiving and communications systems (PACS) market, meanwhile,is still in its infancy and has not yet begun to challenge filmin most hospital environments.

SmartLight's Digital Film Viewer uses a computer to adjustglare and ambient light that can have an impact on how radiologistsread films. The technology can enhance productivity, improve workingconditions and reduce the incidence of missed pathology, Inbarsaid.

"We have built into the computer our knowledge of humanpsychophysics," said Inbar, who also chairs the company'sboard. "The computer sets the light parameters to removeglare and sets the light intensity and ambient room light so youcan best see the image written in silver on the film."

SmartLight's technology senses when film is snapped onto thelight box and illuminates a matrix of tiny squares correspondingto the area covered by the film. Simultaneously, the computerdims the ambient light in the room. The result is a starkly illuminatedimage outlined in black that seems sharper than images viewedon regular light boxes.

One drawback of the high-tech light box is its high-tech cost-- about $30,000 for SmartLight 2000, which has enough surfacearea to display two 14 x 17-inch films and is targeted at emergencyrooms, orthopedics and ICU applications. SmartLight 4000 costs$50,000 and has double the viewing area for radiological applications.These units can be linked vertically or horizontally in any configurationdesired. The question is whether an imaging department could affordto do so.

Inbar helped found Elscint and served in various roles at thatcompany, including vice president of marketing and chief scientist.Contrary to conventional wisdom, he believes that the cost constraintsof managed care and capitation have made this system a bargain.

"This relatively low-cost product, which costs you a fractionof (the cost of) a new imaging system, enhances the image qualityof five or 10 x-ray rooms or other imaging rooms," he said.

Low-tech alternatives, such as light boxes that use metal orplastic blinders, or cardboard cutouts that are manually placedaround the edges of film, reduce glare and cost much less thanthe SmartLight film viewers. But these solutions are not as easyto use nor do they provide the reading quality possible with SmartLight,Inbar said.

Published reports indicate that up to 30% of pathologies presentin film images are missed. One reason may be glare; another maybe dense film caused by x-ray overexposure. SmartLight's filmviewer overcomes both problems automatically by masking the areanot covered by film and by adjusting the intensity of light tomeet the density of the film, Inbar said.

SmartLight also offers a feature called TouchSpot, wherebythe radiologist can illuminate a specific area of a film for addedclarity and detail by simply touching that area with a finger.Taken together, these measures promise to improve productivitywhile reducing visual fatigue, irritation and discomfort thatradiologists may experience after hours of straining to see smalldetails against a brightly lit background, Inbar said.

The first SmartLight product has already been installed inthe U.S. at the New Jersey University of Medicine and Dentistry.Other beta sites are scheduled for installation in the first quarterof 1996. Commercial deliveries are expected to begin by mid-year,according to Inbar. SmartLight, which has corporate headquartersand R&D labs located in Haifa and U.S. headquarters in Plano,TX, will initially focus on sites in Texas, then branch out intoother parts of the U.S. and finally the rest of the world usinga combined force of direct sales and distributor representatives.Thomas Boon has been named president of the U.S. office.

"There are large and small companies that want to representus in this country and the rest of the world,"Inbar said.