Toshiba line guides neurointervention

Toshiba America Medical Systems will install the first two unitsof a sophisticated product line of neurointerventional imagingsuites this year. The first installations will be at the Universityof California at San Francisco and Massachusetts General Hospitalin Boston, said Philip A. Smith, vice president of x-ray and nuclearmedicine operations.

The suites have two major imaging components:

• a ceiling-suspended biplane fluoroscopy and stereodigital subtraction angiography positioner to guide the catheterization;and

• a surgical planning workstation capable of overlayingstereo DSA, magnetic resonance imaging, computed tomography andsingle-photon emission computed tomography images of the brain.

The primary application of this interventional neurology systemis in planning and guiding the treatment of aneurysms in the brain,using detachable balloon catheters. Dr. Grant B. Hieshima, a professorof radiology and neurosurgery, leads the team developing thisprocedure at UCSF, Smith said.

Toshiba surveyed roughly 1300 U.S. hospitals with catheterizationlabs to determine how many have a dedicated intracranial angiographysuite. About 100 hospitals answered affirmatively. These hospitalstend to have a strong neurosurgical program and constitute thepotential market for dedicated neurointerventional suites. TheToshiba suite costs about $2.7 million, including both workstationand positioner, he said.

A Sun Microsystems-based workstation integrates stereo DSA,MRI, CT and three-headed SPECT brain images into a composite image,providing an anatomical, morphological and physiological representationof the brain. Nonmetallic markers are inserted in the skull priorto imaging in order to ensure that the images line up, and a correctionis made for geometric distortion on the workstation. Image dataare ported to the workstation via an ethernet network, Smith said.

Interventional physicians use this composite image of the brainand vessels to practice the catheterization and aneurysm therapybefore the actual procedure. The objective is to leave a balloonthat is filled with a hardening agent in the aneurysm to blockthe blood flow. The catheter is inserted at the groin.

"The catheter is moved into the aneurysm on the workstationwith variable balloon sizes. The physicians can then calculatewhat percent occupancy is taken inside the aneurysm. They strivefor 90% occupancy, which cannot always be done with just one balloon,"Smith said. "It helps if you can plan ahead of time, sinceit takes an hour to two hours to move the catheter all the wayup to the aneurysm (during an actual procedure) under fluro."

BRIEFLY NOTED:

• Balloon angioplasty catheter company Schneider of Minneapolishas filed a patent infringement suit against competitor SciMedLife Systems, also of Minneapolis. The technology involved inthe suit was licensed by Schneider from German inventor Dr. TassiloBronzel and used in the firm's Monorail coronary balloon angioplastyproduct.

SciMed's Express catheter allegedly violates this patent,according to Schneider. SciMed is seeking advice of counsel andwill not comment further on the allegations at this time, thecompany said in a written statement.

• ADAC Laboratories of Milpitas, CA, introduced Pegasys2, an upgraded version of its Pegasys nuclear medicine workstation,last month. The new workstation has a processing speed of over28 million instructions per second. The system can reduce thetime required for cardiac SPECT imaging processing from 20 minutesto under two minutes, ADAC claimed.

About 200 Pegasys systems have been installed worldwide sincethe workstation's introduction a year ago. The nuclear medicinevendor also completed clinical trials on its dual-head GenesysSPECT camera and initiated regular production shipments in April.