Ultrasound strums familiar chords in RSNA exhibits

The onslaught of faster, smaller, more precise, and more portable ultrasound imaging technology continues. Nearly three dozen RSNA exhibitors will be showing ultrasound scanners whose portability has lately crowded onto center stage along with image quality and once optional capabilities, such as 3D/4D.

The growing demand for 3D/4D in obstetrics and cardiology has made such technologies commonplace for the way ultrasound is now done. The general public has become fascinated with these capabilities, as shown by the widespread popularity of 3D/4D fetal scans among maternity patients. It's no secret that the expectation of brilliant images for consultation with patients is nearly as great a need for physicians now as detail to make diagnoses.

Two other societal trends, seemingly at odds, can be credited with driving innovations in ultrasound technology: widespread promotion of early screening and diagnosis, and growing public concern over the risk of radiation exposure from radiographic screening examinations.

On the leading edge of these trends has been SonoSite, whose development of hand-carried ultrasound set the pace for miniaturization through much of the past decade. The company focuses on point-of-care ultrasound systems but still emphasizes sales into the radiology marketplace.

SonoSite introduced five new ultrasound systems in October, including one designed for general-purpose imaging, its M-Turbo, which supplants the MicroMaxx, previously the company's highest performance system. Other new releases, part of a new "S" class, are optimized for critical care, anesthesia, emergency medicine, and interventional procedures. Despite these offerings and obvious crossover from point-of-care specialties into radiology, the company will not have a booth this year at the RSNA meeting, a decision made for reasons not publicly disclosed.

Philips Medical Systems will be at the show, emphasizing productivity, as it has in past years, looking for advances in automation that improve image quality and presentation. Its iSlice multislice display, part of Vision 2007, provides quick review of volumetric data, allowing clinicians to select from a multi-image display to quickly find the best views. Another display method, called Invert imaging, provides a better look at the fetal heart.

This year Philips will continue to emphasize increased simplicity and productivity, showcasing its "one-transducer solution," the C5-1, which can be used to image any patient, according to the company, including the technically difficult ones. The device will trim exam time by 30% to 50% utilizing view guides and prompts. Philips' IT, called ViewForum, will borrow from the MR/CT model of image display, allowing ultrasound scans to be reviewed in the same environment as files from other modalities.

Zonare Medical introduced the first convertible ultrasound platform (Zone Sonography) at RSNA 2004. This year, it will show advanced upgrades to its convertible platform, including new transducers, image storage capabilities, and image quality improvements. Other enhancements include auto-optimization of 2D imaging, automatic spectral Doppler tracing, and wireless-ready connections. The z.one system offers high image quality in a compact package that can be converted back to a full-featured, cart-based system or docked into Zonare's new "miniCart."

GE Healthcare will feed the hunger for miniaturized ultrasound systems with its five laptop-sized systems. Designed for obstetrics and gynecology specialists interested in real-time 3D/4D ultrasound, the compact Voluson is GE's latest version featuring a high-resolution 4D transvaginal probe aimed at the early detection of fetal heart disorders.

The new system includes sonography-based computer-aided diagnosis (SonoVCAD) for obtaining volume images of the fetal heart. GE will promote the Volusion i for its improved clarity, which company execs say puts it on par with a CT or MR image.

Vivid i enhances the efficiency and reach of physicians by offering the functionality and high performance of full-featured, larger scale ultrasound systems for cardiovascular scans, but in a portable and wireless design. New features added to the Vivid i include stress echo, tissue velocity imaging, intima-media thickness measurements, and tissue tracking.

Logiq P5 is GE Healthcare's affordable compact ultrasound option for general imaging needs, spanning ob/gyn exams, urology procedures, breast imaging, cardiac assessments, and vascular studies. Its mobility also makes it practical for emergency medicine. The Logiq i model incorporates high resolution for general patient care in radiology, musculoskeletal, neonatal, breast, and vascular imaging.

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The Logiq e, another laptop-size model from GE, is geared for emergency and sports medicine evaluations, as well as interventional and surgical procedures, including regional anesthesia and repair of nerve injuries.

Its mobility makes ultrasound-guided procedures possible in remote areas with limited medical facilities.

Siemens Medical Solutions will present its new handheld system, the Acuson P10, as suited for initial diagnostic care and triage of cardiology and obstetrics patients in intensive care units, ambulances, and medical helicopters.

The hand-carried system, which weighs just 1.6 pounds, features a 3.7-inch diagonal flip-up monitor with a black-and-white LCD. The thumb is used to navigate user controls, much like the operation of a personal digital assistant. The device's lithium ion batteries allow about an hour of scanning before requiring a recharge.

The Acuson X300, Siemens' midrange portable, is an ultracompact, lightweight system applicable for daily clinical use in basic cardiology exams and in radiology, internal medicine, or ob/gyn departments. The system is portable enough not just for a patient's bedside, according to the company, but for an ambulance as well.

Ultrasonix Medical will show its Sonix CEP, a compact portable system designed specifically for emergency, critical care, and trauma settings. It is best suited for abdominal, adult cardiac, musculoskeletal, ob/gyn, superficial structures, and vascular care applications.

"But technicians do not have to struggle and push the bigger machine or handle the complexity of using the traditional systems," said Dr. Rob Reardon, director of emergency ultrasound at Hennepin County Medical Center in Minneapolis.

Sonix CEP features include 3D/4D imaging, 3D freehand imaging (which is advantageous for examining large organs), dual/quad color, wireless video streaming, and a 30-minute rechargeable battery.

For ob/gyn, Siemens will highlight the 5.0 version of its Acuson Antares platform for ob/gyn and breast imaging. The eSie Touch elasticity imaging feature, includes a speed-of-sound adaptation designed for fatty breast imaging.

Bundled with spatial compounding, the Acuson Antares provides 13 lines of sight-applied at greater steering angles-and enhanced tissue contrast, speckle reduction, and motion correction. When coupled with the company's syngo Auto OB measurements, introduced at RSNA 2006, the device can deliver automated biometry measurements for fetal growth assessment, including biparietal diameter, head circumference, abdominal circumference, and femur length. Amnioscopic rendering, a customized feature of the latest version, offers detailed 3D and 4D imaging views of the fetus. Another feature of the new model is multislice imaging, which displays 2D matrix images from any plane in a volume, similar to a CT scan.

Devoted to women's health and breast imaging, U-Systems will demonstrate its SomoVu 3D, an affordable option for radiologists focusing on breast cancer detection and diagnosis. The automated device scans the breast using a 15-cm probe. After a preview scan to determine the patient's breast tissue density, the device automatically sets the imaging parameters. The scan starts with a single push of a button and lasts about 60 seconds, rendering up to 350 ultrasound images that can be reviewed in 3D.

U-Systems' device is built on proprietary technology, called SomoSynthesis, that combines several ultrasound frames to reduce noise and increase signal-to-noise ratio, resulting in high image quality and contrast resolution.

Toshiba America Medical Systems will highlight its 4D volume-imaging applications for ultrasound. The 4D applications were designed to improve transvaginal/ob, small parts, and abdominal imaging procedures by reducing variation in the acquired images. The systems give physicians the option to analyze data after a patient is discharged. The company will feature a line of microconvex, endocavity, and linear 4D transducers.

Toshiba's featured product will be the upgraded Xario XG, which features a 19-inch monitor and comes standard with a bundled software package. The package consists of Advanced Dynamic Flow, which displays blood flow with directional information; ApliPure, which uses real-time spatial and frequency-compounding technology to deliver clearer image quality; QuickScan, a one-touch auto-optimization feature for 2D and Doppler imaging; and Trapezoid, for wide or expanded field-of-view imaging.

A premium high-performance system, the Aplio XG incorporates the intelligent component architecture platform for accelerated start-up, throughput, and image processing. Users can select slice thickness and the number of images to be displayed. An ergonomic control panel and 19-inch LCD increase user comfort.

Enhancements include new 4D technology and 3D multislice ultrasound. The Aplio upgrade may be shown as a work-in-progress, depending on whether FDA clearance comes in time for the meeting. If it does, shipments could begin in December.