CAD streamlines to speed workflow

As more emphasis continues to be placed on the early detection of cancer, vendors are touting computer aided detection (CAD) software as the "second pair of eyes" to assist physicians to identify, segment, measure and analyze suspicious pathology. At RSNA, it was apparent that vendors are working hard at developing the CAD technology needed for a variety of imaging modalities, including mammography, breast ultrasound and MRI, CT colonography and lung CT.  

Enhancements to systems at the show focused on making CAD more user-friendly and easy to integrate into day-to-day workflow. CAD is not only for the identification and evaluation of lesions of interest, but available with comprehensive editing and evaluation tools that bridge diagnostic decisions with treatment planning.

3TP Imaging Sciences announced it changed its name to CAD Sciences. CAD Sciences' CAD products use a proprietary Full-Time-Point analysis algorithm (fTP) that offers robust reporting and streamlined workflow capability.

Cedara, a Merge Healthcare company, announced the market release of Cedara B-CAD 1.0 to assist radiologists in the analysis of solid breast nodules via ultrasound by automatically analyzing, segmenting and classifying shape and orientation characteristics of user-selected regions of interest. B-CAD automatically generates a report using the ACR BI-RADS ultrasound lexicon classification form, Cedara says.

Kodak's Health Group is distributing the system as part of an integration with the Kodak Carestream mammography workstation.

Confirma at RSNA highlighted new features, products and options to CADstream CAD software for breast MRI studies. The company announced an expanded version of SureLoc, CADstream's interventional guidance tool, that is now compatible with all interventional guidance equipment.

CADalog, a new feature on CADstream, provides storage and timely access to CADstream studies saved with a CADalyst user interface, as well as studies available for on-demand retrieval, Confirma says. It also views and compares previous and current studies.

As a new option for CADstream, Confirma introduced z3D contrast acuity, which enhances the visualization of time-intensity changes. The tool is under clinical investigation.

EDDA Technology showcased version 1.0 of its IQQA-Chest software that is tailored for softcopy review of digital radiographic chest images, as well as demonstrated works in progress software for dynamic liver imaging.

IQQA-Chest now features advanced DICOM connectivity (including DICOM storage, query/retrieval, structured report and send) and a refined worklist to enhance workflow efficiency. It detects lesions as small as 5mm.

IQQA-Liver, which is pending FDA approval, is designed to assist in the review of serial multi-phase CT acquisitions of the liver using dynamic imaging techniques. Clinical testing of the system has been conducted in two hospitals in China.

iMED introduced its CAD Colon 1.0 which identified 85 percent of polyps of 5mm to 10mm and 95 percent of polyps above 10mm in an internal clinical study on 52 symptomatic patients. It is now being tested within IMPACT, a multicenter clinical study which targets to analyze more than 350 patients.

Invivo Corp. showcased DynaCAD version 1.1 breast MRI CAD system with additional features for improved workflow and increased diagnostic confidence. Enhancements include standardized structured reporting, improved image viewing and image analysis and new options for interventional planning.  It also has expanded and configurable archiving options for automatic creation of post-processing image series and storage to PACS archives and export options available in multiple file formats for incorporating DynaCAD data into other PC applications and to create CDs and DVDs.

Kodak's Health Group announced enhancements to its film-based mammography CAD system that include a viewing application for CAD results in portrait or landscape mode and the ability to save scanned mammograms as DICOM files. As films are digitized for CAD, they also can be sent to an archive or any vendor's PACS. Also new is a feature that allows users to save log files from the system and report the number of markers per film and per case.  Kodak also showed a works-in-progress that will enable its mammography CAD hardware to also run bone mineral density tests.

Median Technologies showcased its web-based software CAD-Lung and CAD-Colon. The works-in-progress software provides tools and accurate segmentation to aid clinicians in the process of detecting and characterizing lesions of interest.

Medicsight used RSNA to highlight its CAD software for lung CT - LungCAD - and CT colonography studies - ColonCAD - that are soon-to-be-available as an option within various advanced visualization software packages.

Medicsight's LungCAD software will be integrated with Viatronix's V3D-Explorer and available in Q1 2006, as well as integrated with TeraRecon's AquariusCAD server and Aquarius workstation and be available in Q2 2006.

Medicsight's ColonCAD will be integrated with Vital Images' Vitrea CT colonography imaging software and will be commercially available in Q1 2006; Viatronix's V3D-Colon will be integrated with ColonCAD in Q1 2006; and TeraRecon's stand-alone AquariusCAD server and Aquarius workstation will incorporate ColonCAD in Q2 2006.

Neurognostics, Inc. showcased its functional magnetic resonance imaging (fMRI) products and services, namely the MindState fDAD that in October was issued a special 510(k) approval for market clearance by the FDA. Originally, MindState fDAD received 510(k) clearance in February 2005 as an fMRI data acquisition device. The Special 510(k) allows Neurognostics to enhance fDAD by providing a library of stimulation paradigms, data collection protocols and image processing services, collectively known as MindState fDPD, and marketing it for clinical use, according to the company. With this clearance, the company is able to provide off-site fMRI data processing services to its customers.

R2 Technology at RSNA launched a new system designed for digital mammography CAD display and introduced a new software upgrade for the company's mammography CAD software. The company also highlighted lung CAD applications.

R2 unveiled its new Citra mammography applications suite, for use with Sectra's multi-modality, vendor-neutral, universal breast imaging workstation. Citra "CAD-enables" digital mammography reading workflow - providing radiologists with decision-support tools during review of mammography cases. Key features include: RightSize Optimized Temporal Comparison that equalizes the size of all displayed images to facilitate the comparison of prior and current images; EmphaSize Variable Size CAD Marks that provides variable size CAD marks that correlate to lesion significance; PeerView Digital CAD Display that enhances the suspicious region to help the radiologist understand the specific features detected by R2's algorithm; and LesionMetrics CAD-Enabled Decision Support.

Citra works in conjunction with the Sectra IDS5/ breast imaging workstation and R2's ImageChecker D Mammography CAD system, and is compatible with all FDA-approved full-field digital mammography (FFDM) systems.

R2 also introduced its new ImageChecker Version 8.1 Mammography CAD system that is available as an upgrade for existing systems. It offers the R2 Malc mark, EmphaSize variable size CAD marks and the GreenLight user interface.

Riverain Medical showcased its FDA-approved RapidScreen RS-2000D - a CAD device that digitizes and analyzes chest x-rays to identify regions of interest that may have features associated with early-stage lung cancer.  

Using existing PA/AP chest x-ray films, the system provides second opinion for Stage 1 lung cancer ranging from 9 to 30 mm size. Since RapidScreen is intended as a review tool, no additional dose is required. The system is compatible with all modalities that generate DICOM 3.0 conformant direct radiography, computed radiography and digitized images.

Siemens Medical Solutions used RSNA to preview its new suite of CAD products that are currently awaiting FDA approval, as well as highlighted a cardiac CAD product intended for use with echocardiography examinations.

Siemens demonstrated syngo LungCARE CT with NEV (nodule enhanced viewing) and the next-generation version of syngo LungCARE CAD that provides improved detection performance and workflow enhancements. syngo LungCARE CAD is available on the syngo MultiModality Workplace 2006A for sale in Europe. U.S. availability is pending FDA approval.

Siemens' syngo Colonography CT with PEV (polyp enhanced viewing) supports the detection of colon polyps in CT colonography exams. PEV is available on the syngo MultiModality Workplace 2006A as well as syngo Suite.

Siemens announced its Mammography CAD product for use with full-field digital mammography systems will be available in Europe in early 2006. Availability in the U.S. is pending FDA approval.

In addition, Siemens showed its Axius Auto EF, a cardiac CAD product for use in echocardiography exams.