Ultrasound manufacturers address patient care with product innovations

One of the world's smallest portable scanners, a new approach to 3D imaging, an award-winning convertible platform, and a novel method for detecting deep body tumors are among the many ultrasound highlights in the Technical Exhibition at ECR 2008.

Hitachi Medical Systems is unveiling its real-time tissue elastography technology on the company's range of Hi Vision ultrasound scanners. Although the technology is relatively new, the idea behind it is centuries old. Palpating tissue to investigate its stiffness is one of the oldest diagnostic procedures, first described by Hippocrates. Knowing that a tumor becomes palpable when its hardness is greater than the surrounding tissue, physicians in Ancient Greece used palpation to determine the size, shape, and even malignancy of a lesion.

Elastography uses ultrasound to measure the response of tissue to stress. As a result of the large contrast in stiffness that often exists between cancer and normal tissue, even small lesions can be identified on elastography.

The strain image is calculated and displayed as a color overlay of the conventional B-mode image. The stiffer structures are displayed as blue areas, while the more easily deformed tissues are displayed in red. Clinical evaluation has shown that lesions can be characterized more rapidly and with a higher degree of confidence when elastography is incorporated into the conventional ultrasound examination, according to Hitachi.

The technology, available with more than 20 transducers, is of diagnostic value in a variety of clinical areas, including breast and urology and, via an endoscopic approach, the pancreas and lymph glands.

California-based Zonare Medical Systems is heading east with its z.one ultra system, which was recently awarded the title of best handheld ultrasound unit by KLAS, the U.S. medical technology analysts. The device is a cart-based system that users can convert into a compact device.

The company says its software-based architecture allows the unit's performance to continue improving as greater processing power becomes available. System upgrades can be downloaded via the Internet, permitting advances in clinical capabilities and cost-effective maintenance.

In one newly launched example, Zonare has introduced an obstetric calculations package. This upgrade includes nuchal translucency, nasal bone length, cerebellar diameter, and humeral, radius and ulna, and fetal fibula measurements. The latest machines will include a new DVD burner archive capability.

GE Healthcare is showcasing its Logiq Care Area Series ultrasound systems, which are customized to particular types of 3D imaging such as pediatric, vascular, and breast. These applications provide results in newborns needing ventricular volume measurements of hydrocephalus, elderly patients requiring real-time ultrasound of the hemodynamics of a pseudoaneurysm, and women undergoing ultrasound scans for breast lesions.

Logiq is based on GE's raw data approach to ultrasound imaging. Instead of storing images as video pixels, data are kept as digitized ultrasound waveforms. The company says that this approach gives extremely high ultrasound fidelity and allows data to be captured in 3D in near real-time.

This makes ultrasound more like CT and MR in that clinicians, regardless of care area, can view, reprocess, reslice, and review images even after the patient has left the hospital or clinic, according to GE. The "tomographic-type" ultrasound technique gives users access to parallel slices through the captured data. In addition to providing new access to ultrasound views, this approach could be a better match to the MR and CT department workflow, which may drive departmental efficiencies.

Handheld ultrasound devices may lack the stunning image quality and data processing capability of the cart-mounted scanners, but they are making steady progress.

Siemens will demonstrate a unit that weighs only 700 g, is about the size of a mobile telephone, and fits neatly into the physician's pocket. The Acuson P10 device is intended for use in those situations far away from the relative calm of a hospital radiology department, where instant decisions are crucial. The device is designed for the sort of emergencies dealt with in outpatient departments, rescue helicopters, and intensive care units.

It is easy to operate, according to the company and, when set to high definition acquisition, can be used to evaluate heart action, display artery damage, examine the pelvis, and detect accumulations of liquids. In obstetrics, it can be used during childbirth to determine the location of the fetus, the chances of survival and position, and to visualize the amount of amniotic fluid or bleeding.

Another cutting-edge technology on show in the exhibition is Vision 2008, the latest upgrade by Philips to its iU22 ultrasound system. This offers expanded volumetric capabilities, new imaging solutions for technically difficult patients, new interventional tools, and new approaches to improve workflow efficiencies.

The C5-1 curved-array transducer raises the quality of imaging available in patients undergoing abdominal, obstetrical, gynecological, and interventional procedures, according to Philips. It combines the performance of the company's PureWave crystal technology with enhancements in tissue aberration correction and coded beamforming.

On the Esaote stand, ECR participants can find out more about the MyLab ultrasound product line. This includes the MyLab70XVG unit, which can be fully integrated with the Virtual Navigator technology. This is described by Esaote as a revolutionary modality that provides real-time fusion of ultrasound and CT/MR imaging.