Ultrasound vendors address major customer concerns

Ultrasound is undergoing a renaissance of sorts, as progress along familiar lines creates a critical mass of clinical capability.

"Advancements in key areas have raised the level and value of examinations," said Terri Bresenham, vice president and general manager of the global diagnostic ultrasound business for GE Healthcare.

At the RSNA meeting, vendors will address four major areas of interest in ultrasound: volumetric imaging, increased portability, image quality, and improved workflow. Subsets of these topics include applying advanced technology in simpler formats, extending the use of ultrasound, and promoting state-of-the-art ergonomics.

The most prevalent trend involves 3D/4D volumetric imaging, which suggests the future of ultrasound as it finds it way into more meaningful clinical applications.

"Volumetric imaging is no longer a novelty," Bresenham said.

At last year's RSNA meeting, Medison's Accuvix XQ 3D/4D systems generated significant buzz because of a multislice capability that enables more rapid and precise viewing and diagnosis. Sequential imaging, procedure standardization, and improved productivity made it a major attraction. Gordon Parhar, director of the ultrasound business unit at Toshiba America Medical Systems, said he wouldn't be surprised to see works-in-progress involving multislice capability at this year's meeting. This capability, which displays anatomy with a precision more typically found in CT and MR, is delivered by Medison's 3D XI sonography system.

"Currently, Medison has the only multislice ultrasound available, but I wouldn't be surprised if others show it in some form," Parhar said.

Philips will focus on its iU22 platform, launched in 2004. Enhancements to this product will take center stage again this year, said Jim Hutchins, marketing communications manager for the company's ultrasound division.

"It's the major driver in our premium line, and we will be introducing the first major upgrades," he said.

These will include live 3D echocardiography, more advanced transducer technology that produces high-quality echo images, and advanced echo quantification.

Earlier this year, Philips introduced the HD11 system as a new class of high-end ultrasound systems that deliver features once found only on premium systems, said Jim Brown, senior director of clinical/technical marketing in Philips' ultrasound division. These features include SonoCT imaging and XRES image processing, which provides high-definition performance.

HD11 provides improved image quality, 3D/4D imaging, ergonomics, and quantification at a more accessible price point. The product can be customized to the user's applications or specialty, with options including stress echo, panoramic imaging, and contrast. In addition to the HD11, Philips plans to feature its new HD3, an office-based, highly mobile, compact product.

Toshiba has enhanced its Xario system with improved workflow, better image quality, and advanced ergonomics. Transducers have been added to improve bandwidth and sensitivity, increase penetration, and achieve high spatial resolution. These enhancements should make the product attractive to more markets, Parhar said.

The company is also focusing on its Aplio system, with its differential tissue harmonics capability that provides high spatial resolution, improved contrast resolution, and increased penetration. This year, more transducers will be added.

"When first introduced, it was only applicable to abdominal and linear-array transducers," Parhar said. "Its broader set of probes will enhance the ability to treat the technically difficult or hard-to-scan patients."

Biosound Esaote will show an expanded version of its MyLab product line. MyLab, a compact ultrasound system, delivers premium performance and offers portability and applicability for a range of clinical specialties, according to the company. New features include 4D and V-Pan, a seamless linear acquisition for an unlimited field-of-view, as well as expanded applications support such as obstetric calculations and improved online and offline digital functionality, according to Andrew Horning, Biosound's clinical product manager.

Portable systems no longer serve a niche market, Horning said. Increasingly, companies are packing more functionality into more compact systems.

"Miniaturization is big," Bresenham said. "Vendors are placing the power of large machines into laptop-style products so that ultrasound can go anywhere."

Lars Shaw, vice president of worldwide marketing for Zonare, calls this the "radiology without walls" model. At last year's RSNA meeting, Zonare debuted not only its product line but the company itself. This year, the focus is on advancements in the technology and utilization of its z.one product, a platform that converts from a full-featured cart-based system with a full user interface into a compact portable system that weighs only 5.5 pounds.

"It has made a huge impact on customers' departments," said Mark Miller, Zonare's vice president of sales and marketing.

In a radiology lab, z.one becomes a complement or supplement to existing high-end systems, as it goes right to the patient's bedside. To increase value, Zonare is introducing two new transducers: the P4-1, a multifrequency phased-array transducer, and the 10-4 phased-array transducer for neonatal imaging and pediatrics.

SonoSite, the company that started it all, will showcase its ultraportable third-generation MicroMaxx, which began shipping this summer. The system weighs less than 8 pounds and is the size of a laptop computer, yet delivers image resolution and performance comparable to conventional cart-based ultrasound systems weighing over 200 pounds, according to the company.

"We have focused on image quality and presentation, combining as much functionality as possible onto fewer chips," said Jeremy Wiggins, director of product management at SonoSite. "This has allowed us to build the MicroMaxx-and it will let us build derivative products that could be smaller and more focused on specific applications."

In the realm of compact, portable systems, Fukuda Denshi offers a color Doppler system, its UF750 XT, and earlier this year received clearance from the FDA to begin marketing a larger cart-based but still portable general-purpose system, dubbed the 850 XTD.

Aloka last year unveiled its flagship Alpha 10, a general-purpose system that can be optimized for women's healthcare and perinatology. The system, which has since been cleared by the FDA, includes 4D software that allows vertical and horizontal rotation of volumetric images. Alpha 10 features a split screen capable of simultaneously displaying a 4D image and up to three additional images.

Siemens Medical Solutions has increased product offerings to help customers find the right application and clinical setting for the technology. Its Sonoline G40 system combines high image quality, workflow advancement, and color Doppler capabilities for a variety of settings and applications, according to the company. The intuitive user interface enables imaging of more patients in less time, and it is easily transportable.

To achieve workflow improvement, Siemens has incorporated Native TEQ technology into its Sequoia ultrasound system. It employs patient-specific echo information to correct common technical scanning errors automatically. The technology is particularly helpful during portable exams. It improves image quality and ergonomics as well as workflow.

"It minimizes the interaction of the sonographer with the system by making the system more intelligent and optimizing the controls by itself," said Arnd Kaldowski, vice president of worldwide sales and marketing for Siemens' ultrasound division.

Siemens will feature improvements on the Sequoia system that address high-resolution color flow. The company has enhanced volumetric imaging on its Antaris systems with the addition of transducers, imaging modes, and increased system speed.

Siemens has also enhanced its Cypress product, a miniaturized, digital, phased-array echocardiography system, with added capabilities and a transducer that allows it to be used for more applications.

Hitachi Medical Systems America will highlight its unique sonoelastography option. The visual presentation data resemble a traditional color map overlaid on the gray-scale image, said Matthew Ernst, Hitachi ultrasound product manager. Together they indicate the relative stiffness of tissue.

Sonoelastography, like volumetric imaging, represents a new way to interpret data. And like volumetric imaging, it has taken a while to get to market, as the first experiments with this technology were performed more than two decades ago. Hitachi believes its time has come.