CAD widens its reach
Computer-assisted detection has now expanded its focus to helping physicians more effectively view mammography, MRI, ultrasound, CT and x-ray images with an eye toward breast, lung and colon cancer detection. Look for a nice boost to CAD this year in providing connectivity to PACS to smooth department workflow.

Cedara (Booth #1918) is showcasing its Cedara B-CAD application, the world's first CAD for assisting radiologists in analyzing breast ultrasound images. It automatically analyzes, segments, and classifies shape and orientation characteristics of user-selected regions of interest (ROI). It allows quick additions of annotations to DICOM images and automatically generates a report using the ACR BI-RADS Ultrasound Lexicon Classification Form.

B-CAD also can be integrated with I-ReadMammo, Cedara's multimodality breast imaging workstation. As a united offering, Cedara I-ReadMammo with Cedara B-CAD represents a solution for breast imaging workflow through support for multiple FFDM vendors and modalities, specialized tools for mammography reading, CAD marker display and more.

Confirma, Inc. (Booth #8750) is highlighting its CADstream CAD system for magnetic resonance imaging that automates the processing of MRI studies. CADstream's core automated features include image registration, multiplanar reformatting, subtractions, angiogenesis maps, curves, maximum intensity projections (MIPs), volume summaries and SureLoc for real-time interventional guidance. CADstream also incorporates advanced features, including a streamlined portfolio for more comprehensive treatment planning - incorporating the BI-RADS Atlas for lesion classification - and a multimodality-ready configuration, offering users the ability to display and compare mammography, ultrasound and breast MRI studies.

The latest version of CADstream includes an expanded version of SureLoc that calculates coordinates for interventional guidance. SureLoc now reports needle position for both grid and pillar methods in real time (insertion location, depth and needle angle) and displays images and needle position in the patient's orientation. This feature is compatible with interventional breast coils and with vacuum-assisted biopsy systems, and is available on any networked PC for access at any location.

In its initial application, CADstream is being used to assist in the analysis, interventional guidance and reporting of breast MRI studies. CADstream is DICOM 3.0 compliant, allowing integration with any MRI scanner and PACS.

EDDA Technology (Booth #1505) is highlighting its flagship IQQA-Chest v1.0 that debuted at RSNA 2004, as well as showing as a works in progress IQQA-Liver system - both from the  Intelligent/Interactive Qualitative and Quantitative Analysis (IQQA) series of products.

IQQA-Chest is a software system designed for soft-copy reading of digital radiographic chest images that assists physicians in the identification, quantitative evaluation, diagnosis and reporting of pulmonary nodules. EDDA points out that the latest clinical study involving five hospitals in China on CT-confirmed nodules suggested improved performance in detecting lung nodules from screening populations using both DR and CR technology. (The results have been accepted for oral presentation at RSNA 2005.)

EDDA recently released IQQA-Chest v1.1 featuring advanced DICOM connectivity (including DICOM storage, Query/Retrieval, Structured Report and Send) and a refined worklist design to further enhance workflow efficiency.  

IQQA-Liver, which is pending FDA approval (which could come prior to showtime), is geared toward enhancing workflow for the application of dynamic liver imaging that is challenged by data overflow from multislice CT. Namely with 32- and 64-detector CT, the number of slices in a dynamic CT series can easily reach a few thousand, with at least four phases acquired in a typical dynamic CT study with contrast. IQQA-Liver is designed to assist the review of serial multi-phase CT acquisitions of the liver using dynamic imaging techniques. It offers advanced visualization and quantitative evaluation tools empowered by image registration and segmentation techniques and can be used in the diagnosis and staging of primary liver disease and liver metastases as well as in pre-operative assessment. Clinical testing of the system has been conducted in two hospitals in China.

iCAD, Inc. (Booth #8550) is announcing the availability of its TotalLook next-generation imaging solution, a comprehensive film-to-digital offering that converts prior film mammograms into digital format for comparison with more recent images from digital mammography systems - and adjusts the digitized images for correct display on the same workstation and in the same context as the current year digital mammogram. By providing radiologists with a "total look" at a patient's multi-year breast examinations, the solution reduces light box glare and eliminates the need to shift back and forth from light box to workstation to speed workflow, improves productivity and reduces discomfort, iCAD says. Working in conjunction with iCAD's SecondLook CAD systems, TotalLook presents a comprehensive film-to-digital solution that makes it easier for women's health centers to transition to digital mammography.

TotalLook, which includes an iCAD digitizer-based workstation and software, automatically retrieves and receives patient information from HL-7 or DICOM worklists; digitizes standard mammography films in 23 seconds; captures the full fidelity of original film mammograms in each digitized image; tracks and labels records in industry-standard DICOM format; sends complete records to multiple DICOM destinations simultaneously; and displays high-resolution digitized images on many DICOM workstations in any hanging protocol.

Invivo (Booth #5102) is highlighting its DynaCAD system for MRI designed to standardize and improve the efficiency and workflow of breast MRI exams. DynaCAD Version 1.1 further expands many core DynaCAD features to provide the most advanced, comprehensive set of tools for MR image analysis, interventional planning and reporting. Since the end of 2004, more than 100 hospitals and diagnostic imaging centers have adopted DynaCAD.

Kodak's Health Group (Booth #4312) is showing for the first time at RSNA new software enhancements to its Mammography CAD system that recently received FDA approval. The new software for the Kodak Mammography CAD System increases the system's sensitivity to microcalcification clusters while reducing the number of false positive markers, the company says.  Existing customers are receiving software upgrades as part of Kodak's standard one-year warranty.

Kodak also is debuting a bone mineral density (BMD) test with its Mammography CAD system as a works in progress. With this solution, a mammography exam and BMD exam of the patient's hand can be captured using the same mammography x-ray equipment and film.

MEDIAN Technologies (Booth #3986) is presenting as works in progress CAD-Lung and CAD-Colon. CAD-Lung for chest CT offers exceptional sensitivity and follow-up capabilities for the detection and characterization of pulmonary abnormalities, the company says. It is intuitive, easy to use from any PC and PACS-enabled. It can detect regions of interest that contain nodular structures, which are presented to the user as marks on the original images. The user can also add his/her own findings by double-clicking on any point of the image. The system computes the segmentation of the nodules and their properties (size and volume). CAD-Lung can compare nodules present in two different datasets of the same patient acquired at different dates and compute their difference of volume and volume growth.  

The works in progress CAD-Colon detects polyps and masses and extracolonic abnormalities in CT colonography. It offers powerful identification tools and unique 3D segmentation for accurate detection and visualization of colonic lesions. Based on the MEDIAN CAD-Platform, MEDIAN's intuitive user-interface, CAD-Colon provides automatic processing and real-time interpretation for improved productivity. CAD-Color automatically detects regions of interest present in the lumen of the colon on both prone and supine datasets whose shape and density are similar to the shape and density of polyps. Presented as regions of interest on the original images, the user can scroll the images with the results of the detection. The user can add his/her own findings by double-click on any part of the images. The system will automatically extract the abnormalities and computes its characteristics such as length, width, volume and density. The system also automatically pairs the abnormalities found in the prone and supine datasets.  

Medicsight (Booth #2974) is showcasing its Medicsight ColonCAD API 2.0 that includes what the vendor calls "the only user-adjustable CAD," meaning the sphericity filter setting can be altered to suit the users' preference, clinical situation, and experience. The system also displays findings on both multiplanar reconstruction (MPR) mode and 3D flythrough views so they can be utilized for primary 3D or primary 2D reading methods. It also features a Polyp Enhanced Filter (PEF) that identifies defects protruding into the colonic lumen, automatically highlighting any area of the colon wall that contains raised spherical regions and marking them for further investigation.

Medicsight's CAD products have been revised this year to allow the technology to be seamlessly integrated into PACS and advanced 3D workstations. This is a massive step forward for CAD, the company says, because it allows for a more rapid take up of the technology allowing different companies to take advantage of the technology in many different workflows.

Riverain Medical (Booth #3945) is showing improvements in sensitivity and specificity in its RapidScreen system, the first and only FDA-approved chest x-ray CAD system. The company is demonstrating lateral CAD chest images - further improving the ability to detect early-stage lung cancer especially in the difficult area that is partially hidden by the heart.  It seeks to identify solitary pulmonary nodules between 9 and 30 mm and other suspicious nodules on the original standard AP/PA chest x-ray. Dual-energy CAD images are being shown as a works in progress as more hospitals look to digital chest devices for taking routine chest procedures.

The company also is showing advanced CAD development for other diseases in the chest and lung such as cardiac diseases. And it is demonstrating the ability for RapidScreen to have universal connectivity to many PACS.

R2 Technology, Inc. (Booth #8532) is featuring its portfolio of CAD products, including the ImageChecker DMax, ImageChecker LS, ImageChecker D and ImageChecker CT Lung Nodule V2.0 systems.

The ImageChecker DMax offers high throughput and superior laser scanning image quality to serve the growing CAD needs of high-volume mammography centers. The system accepts film and digital images from all major FFDM vendors, and integrates with reporting systems from Mammography Reporting System Inc., Magview Systems and PenRad Technologies, Inc. As with all ImageChecker products, it is powered by R2's Gold Standard CAD Algorithm.

The ImageChecker LS offers a tabletop package designed for low volume, film-based mammography sites, while the ImageChecker D is designed for digital-based mammography centers. The system accepts images from a broad range of FFDM vendors and delivers CAD results to DICOM workstations or PACS, allowing for maximum flexibility - even in multi-vendor work environments.

The ImageChecker CT Lung Nodule V2.0 System, with its AutoPoint automatic temporal comparison feature, assists in the review of multislice CT chest exams to help maximize physician accuracy and efficiency in finding actionable lung nodules early and tracking the changes over time. Independent clinical studies show that in 23 percent of multislice CT chest exams originally read as having no actionable nodules, the ImageChecker CT CAD system detected nodules of clinical significance. A new tool for this system, Pulmonary Artery Patency Exam (PE) for Chest MSCT, uses CAD to help physicians more accurately and efficiently detect potential pulmonary artery obstructions, such as emboli or tumors, during review of multislice exams.

Lastly, R2 is featuring Sectra's multi-modality, multi-vendor breast imaging workstation that now provides R2's ImageChecker D digital mammography CAD results on full-field digital mammography (FFDM) images from Fischer Imaging, GE Healthcare, Hologic and Siemens Medical Solutions.