ACC 2005 Wrap-up

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In between a clinical study indicating that a quarter of Americans are resistant to aspirin's anti-platelet effects and a press release clarifying that only chocolate bars made by Mars (that preserve naturally occurring cocoa flavanols in cocoa beans) are heart-healthy - cardiac CT stole the limelight at March's annual meeting of the American College of Cardiology in Orlando. Advances in 64-slice CT systems were showcased by GE, Philips, Siemens and Toshiba, while all touted new cardiac-focused installations in leading-edge medical centers across the country. Cardiac image and information management systems and echocardiography units also gained mindshare. (By the way, chocolate bars show promise in maintaining healthy blood flow and improved elasticity in blood vessels, so grab a Dove bar and enjoy!)

Biosound Esaote showcased new software available for its MyLab30CV high-performance, portable ultrasound system. The 19-pound ultrasound system is capable of meeting all diagnostic requirements in cardiovascular applications, including adult and pediatric scanning in the hospital setting, NICU and outreach programs. Image quality is suitable at the critical-care bedside, MPTE in the operating room, stress echo in the office or whole body imaging for the mobile service. Adding to its line of diagnostic, portable ultrasound systems, Biosound Esaote also unveiled MyLab25 targeted for vascular laboratories.

Digirad Corp. displayed a prototype of its all-in-one, mobile triple head cardiac gamma camera. The Cardius-3M AIO is the mobile prototype of Digirad's Cardius-3 imager. The prototype's all-in-one chassis supports the camera, chair and acquisition processing station on a single frame, Digirad said. The system is designed for exclusive use by Digirad Imaging Solutions (DIS), Digirad's imaging leasing services division.

GE Healthcare touted enhancements to its cath lab, IT and MRI platforms, and announced its first cardiac CT installation.

The first cardiology-specific installation of GE's next-generation volume computed tomography scanner, the LightSpeed VCT has been installed at Round Rock Cardiology, an independent cardiology practice near Austin, Texas. The LightSpeed VCT 64-slice CT scanner enables cardiologists to capture images of the heart and coronary arteries in five heartbeats. It also allows the imaging of any body organ in one second and can perform a whole body trauma scan in less than 10 seconds. In one rotation, the system creates 64 submillimeter images, totally 40 mm of anatomical coverage. It has the capability to attain 43 millisecond temporal resolution. GE said it had installed four LightSpeed VCT's to date and is installing one per week around the world in 2005.

Enhancements to the Innova 4100 and Innova 3100 cardiovascular and interventional imaging systems incorporate a new automated imaging technique called InnovaBreeze that GE says allows physicians to more clearly see the vessels and anatomy from the stomach down through the legs. During imaging, the table moves to follow an injection of contrast media.

On the IT front, GE showcased the Centricity Cardiology CA 1000 that can act as a dedicated modality workstation, a departmental solution when combined with an archive system or an enterprise-wide solution with Centricity PACS. Using CA 1000, caregivers can now access a single, comprehensive patient jacket for both radiology and cardiology images without compromising depth of clinical tools and workflow needed in the cardiac department.

GE also announced a new version of its CardioSoft multi-function cardiac testing software, which can capture ECG data and enables physicians to update the EMR patient record with critical cardiac data. CardioSoft software, which will be available this spring, provides seamless integration with GE's Centricity Physician Office - Electronic Medial Record (CPO-EMR) system.
New cardiac imaging techniques developed with the high-definition magnetic resonance (HDMR) system also were showcased at ACC. HDMR, available on GE Signa 1.5T and 3.0T MR systems, is helpful with difficult-to-image patients due to movement, including Parkinson's patients and children who do not respond to sedation.

Heartlab, Inc. previewed its new Ascentia cardiovascular information system that provides multimodality image analysis tools, digital reporting, and secure portal access to patient records delivered via a web-based technology. Ascentia Portal delivers diagnostic-quality DICOM images to PCs on the inter/intranet, the company said. Heartlab's compression on demand technology delivers different levels of lossless and lossy compression from the original images in the DICOM archive.

Ascentia WorkStation enables access to diagnostic-quality images and review tools for multiple cardiology and vascular imaging exams. Ascentia Results Management offers integrated, structured reporting which allows physicians to create reports digitally while reviewing cases on-line.

Also, as a works-in-progress, Heartlab showed the Ascentia HeartStation to handle digital ECG management for electrocardiograms from any vendor's ECG equipment.

IDX Systems Corp. officially entered the cardiac image and information management space, launching Imagecast for Cardiology.

Using a web-based, single database CVIS/PACS, clinical staff throughout a hospital enterprise has continual access to complete patient cardiac images and information, including cardiac cath, echo, CT, MRI and nuclear medicine. In addition, the system provides physicians with access to all related images from the patient's electronic medical record.

Imagecast for Cardiology allows organizations to integrate third-party components through an open API framework while supporting industry standard protocols and open connectivity through Integrating the Healthcare Enterprise (IHE) cardiology initiatives, IDX said.

Medrad Inc. introduced as works-in-progress the Avanta Fluid Management Injection System and the Vanguard Dx Angiographic Catheters. Avanta improves patient and operator safety by controlling the delivery of contrast at low flow rates and low pressures in variable mode, the company said. The fey feature of Medrad's new Vanguard Dx Angiographic Catheter is its patented RadiantFlow tip technology that produces a "cloud" of contrast intended to enhance mixing and distribution.

Mennen Medical showcased its FDA-approved Horizon Angio patient monitoring and documentation system designed for interventional cardiologists and radiologists. Horizon Angio is a computerized medical device that analyzes a full range of patient physiological parameters during interventional peripheral arterial analysis procedures, while performing a range of monitoring functions. For electronic documentation, the Horizon Angio offers reporting, custom physician reports, ADT interfacing, HL7 and XML data exports.

Philips Medical Systems introduced the new Philips' HD11 high definition echocardiography system and iE33 echocardiography system - both designed for the cost-conscious healthcare provider.

In CT, Philips demonstrated enhanced and new cardiovascular technologies, including a fusion technology that allows 3D CT images to be transferred to the Philips Allura Xper FD cardiovascular x-ray system. Philips said the technology can improve visualization and treatment planning for patients who need to undergo more invasive procedures such as stent placement.

Philips showed for the first time a Comprehensive Cardiac Analysis (CCA) package targeted for cardiologists, cardiac radiologists and CT technologists. The software allows users to perform detailed evaluation of the coronary arteries and advanced ventricular functional analysis. The technology aims to reduce the time and complexity of a cardiac evaluation and is based on one-click total heart segmentation.

For the cath lab, Philips introduced the newest member to the Allura Xper family of flat detector (FD) systems-the Allura Xper FD10/10. The biplane cardiovascular x-ray system is suited for a full range of applications, from interventional cardiology, electrophysiology to pediatric cardiology, including customized settings for each application, Philips said.

In the informatics realm, Philips showed its portfolio of cardiology information technologies that is comprised of advanced modules, such as Xcelera Echo Lab Management, Cath Lab Management, Qlab for 3D echo and advanced quantification and Webforum - all of which allow clinicians to integrate medical images and patient records, as well as share information across departments.

Philips IntelliVue Telemetry system - also on board at ACC - is a wireless device designed for uninterrupted cardiac monitoring that operates in the 1.4GHz wireless medical telemetry service band.

RealTimeImage (RTI) used ACC to preview its web-based cardiology image management system, iPACS Cardio. The digital cardiovascular imaging system supports concurrent viewing, management and archiving of cine cardiac imaging modalities, including cath, echo, MR and CT. Optional functionalities include quantitative coronary analysis, left ventricular analysis and quantitative analysis of vascular morphology in peripheral arteries, RTI said.

Siemens Medical Solutions closed the gap between old and new ACC, showing the tried-and-true anchors of cardiovascular imaging - echo and cardiac cath - as well as shed some light on the promises of cardiac CT and MR. Cardiac IT offerings also were in the mix.

Siemens highlighted technologies developed specifically for the cath lab, including the AXIOM Artis dFC magnetic navigation system, which combines a digital fluoroscopic imaging system - the AXIOM Artis dFC - with Stereotaxis Inc.'s Niobe magnetic navigation system.

In cardiac CT, Siemens exhibited the new SOMATOM Sensation 64 that allows 64 slices per rotation and 0.37 second rotation time to offer speed and sub-millimeter volume coverage. Siemens said that 200 64-slice CT systems have been installed, 80 of which include the Somatom Sensation Cardiac64 in hospitals' cardiovascular departments or institutions specializing in cardiovascular disease.

In cardiac MR, Siemens demonstrated the Magnetom Avanto, a 1.5T MR system that incorporates total imaging matrix (Tim) technology. Tim is a whole body surface coil design with 76 integrated coil elements and up to 32 channels [76x32], and its integrated coil weighs less than two pounds.

Siemens announced new capabilities for the Acuson Sequoia C512 and C256 echocardiography systems. The Paragon release for both echo systems offers patient-specific imaging through TEE ultrasound technology for Doppler and the automatic optimization of scale, baseline, gain and dynamic range for Doppler spectral images.

Siemens introduced to the cardiology market its Soarian Disease Management that supports the entire disease management process. Remote patient monitoring is facilitated via biometric, interactive voice recognition (IVR), or hand-held devices. Beta installations are in place at the Nebraska Heart Institute (NHI) and South Carolina Heart Center (SCHC), with availability slated for mid-2005.

Siemens previewed as a works-in-progress KinetDx Solutions Network Version 4.0. A key highlight of the new software is a feature that allows physicians and sonographers to create patient reports utilizing an evidence-based method of diagnosis, in addition to new report upload file formats, and cardiac measurement transfer capabilities for the Acuson Cypress cardiovascular system.

SonoSite Inc. highlighted the advanced cardiac capabilities of its portable Titan ultrasound system, including the SonoCalc IMT (Intima Media Thickness) software for assessment of cardiovascular risk. SonoCalc provides physicians with the ability to analyze the IMT of a patient's carotid artery and compare it with published population data to generate an individualized cardiovascular health profile report.

SonoSite also featured the Titan 2.2 cardiology upgrade that offers full cardiac and vascular calculation packages, pulsed wave and continuous wave Doppler imaging, tissue harmonic imaging, velocity-based color Doppler and M-Mode. SonoSite said it has also enhanced the system's DICOM capabilities with the addition of DICOM Modality Worklist.

Toshiba America Medical Systems demonstrated a new cardiovascular imaging application for its Aplio CV ultrasound system, showed further enhancements in cardiac MR and announced the 100th installation of its 64-slice CT scanner.

The Aplio CV's new dyssynchrony imaging (DI) technique previewed at ACC aids cardiologists in the quantification of left ventricular mechanical dyssynchrony by providing a color-coded display that demonstrates the timing of events within the myocardium of the heart.

Aplio CV's comprehensive packages include Doppler measurements and advanced clinical data analysis, and tissue doppler imaging quantification (TDI-Q) software and advanced automated contour tracking (A-ACT). The Aplio CV also features Toshiba's IASSIST remote controller that uses Bluetooth wireless networking technology.

In the cardiac MR domain, Toshiba introduced a new cardiac configuration for the Excelart Vantage 1.5T MRI system. The Vantage CGV configuration features gradient strength of 30 mT/m (milliTesla per meter) and a slew rate of 130 mT/m/ms (milliTesla per meter per millisecond) to meet clinical requirements for advanced cardiac MR examinations.

Toshiba also demonstrated the advanced cardiovascular applications of its Aquilion 64 CFX multislice CT scanner. Images of a patient's heart can be captured in five to 10 seconds. The 64-row quantum detector enables the Aquilion scanner to acquire simultaneous slices of 0.5mm with each 400-millisecond gantry revolution.

Toshiba said it installed its 100th Aquilion 64-slice CT system at the Manhattan Diagnostic Radiology - Cardiovascular Center (MDR0CC) in New York City.

A newly formed partnership between cardiology image and information management systems vendor Witt Biomedical Corp. and InSiteOne provides Calysto users the option to purchase and utilize InSiteOne's on- and off-site DICOM storage technology.