X-ray

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Around the exhibit floor, workhorse x-ray units of all kinds debuted - with the focus on digital and computed radiography. Special procedure units for interventional work now have the added benefit of flat panel detectors - completing the link of x-ray to the digital radiology department.



Toshiba America Medical Systems used RSNA as the launching pad for the T.RAD Plus Series of traditional radiographic systems featuring digital radiography capabilities. The series includes both floor and ceiling-mounted configurations and systems with one or two DR panels. Toshiba claims the industry's fastest image preview time, according to Don Volz, director, X-ray Business Unit. The T.RAD Plus Series features a 17x17 field of view.

For vascular imaging, Toshiba also demonstrated the single-plane Infinix VC-i. A new 3D digital angiography (3D-DA) protocol displays intricate bone and neurovascular structures in three dimensions to assist in interventional procedures.

Toshiba's 3D-DA combines digital subtraction angiography (DSA) with 3D visualization to provide detailed bone and vascular structures for better evaluation of neurovascular lesions such as intercranial aneurysms as well as volume measurements. This capability was developed in conjunction with physicians at Johns Hopkins University Hospital.



Siemens Medical Solutions expanded its Axiom Artis digital angiography line with the introduction of three new flat-panel digital systems. The new units include the Axiom Artis dTA, Axiom Artis dMP, and Axiom Artis dFA. They are differentiated by price and application, ranging from high-end rotational angiography studies to gastrointestinal exams. All are based on the flat-panel detector technology found on other systems in the Axiom Artis line.

The Axiom Artis dTA is a fast (60-degree/second in rotation and orbital direction) ceiling-mounted C-arm system for rotational angiography and 3D imaging. It is targeted at dedicated interventional radiology departments and university hospitals. The dTA is similar to Axiom Artis systems for cardiac applications, which have smaller flat-panel detectors, Siemens said. The dTA's detector dimensions are 30 x 40 cm, compared to 20 x 20 cm for the cardiac dTC. Price will be in the range of $1.85 million, depending upon configuration. The system will begin shipping in May 2004.

Siemens will introduced the Artis dFA and the dMP systems. The dFA is an all-round interventional radiology and vascular surgery system with a rotational speed of 40-degree/second and a list price of about $1.55 million. Its target market is mid-sized hospitals.

The dMP is a multipurpose unit with a list price in the range of $1.35 million, and covers applications from gastrointestinal imaging to angiography. Its target market is community hospitals. Both the dMP and the dFA are expected to be available in August 2004.

Siemens also debuted the FDi enhancement for the entire AXIOM product line, allowing radiology departments to utilize time, space and costs more efficiently.  FDi augments radiography systems with digital imaging.

Siemens showcased its AXIOM Aristos FX and AXIOM Multix M. The AXIOM Aristos FX is a fully automated digital radiography system that allows for thoracic and extremity scans, as well as emergency, trauma and pediatric applications. The flat panel X-ray and ceiling-mounted design of the Aristos FX means virtually all radiographic exams can be done in one room.

The AXIOM Multix M portable flat-panel detector performs general-purpose radiographic applications, both on and off the table, as well as in the standing position. The cost-effective Multix M features a flat-panel detector that is quickly and easily inserted into the Bucky table or wall stand tray.  Upon insertion, the detector is automatically centered, allowing for both landscape and portrait format positioning.



At the x-ray section of GE Medical Systems' booth, the company debuted its Precision MPi multipurpose R&F and interventional digital x-ray system as well as two new capabilities for the Revolution XR/d digital x-ray platform. The system uses a CCD-based digital detector and can fit into a 12 x 12-foot room. The system, which received FDA clearance in late November, provides angulated imaging to separate overlying anatomic structures for easier viewing for the clinician. It replaces the now discontinued TiltC+. The Precision MPi is expected to be available in the first quarter of 2004, and will be priced in the $600,000 to $900,000 range.

In addition, GE has added new software applications to its Revolution XR/d digital x-ray platform. RapidScreen Digital, offered via a partnership with Deus Technologies, is a computer-aided detection system designed to improve detection of lung cancer. Tomosynthesis for the Revolution XR/d was also shown as a works-in-progress.

GE also announced that the Innova 4100 gained a new tilting table, and GE is discussing a works in progress 3D capability on the Innova 4100 that could debut late in 2004.



In cardiovascular x-ray, Philips Medical Systems showed as a works-in-progress its latest interventional system, the Allura Xper FD20, a large-field-of-view flat detector system with Philips' new Xper user interface. Philips also showcased its Integris 3D-RA interventional tool for high-speed, high-resolution 3D imaging throughout the body.

In general x-ray, demonstrated its Philips DigitalDiagnost multipurpose single-detector system. A new single-detector geometry includes angulated over table exposures. It allows clinicians to conduct RAD examinations, limiting the need to buy multiple systems for different examinations. Key success factors of the system are the flexible detector carrier mounted on a moveable column combined with a single sided suspended table.



Eastman Kodak Co.'s Health Imaging President Dan Kerpelman is promising a "much stronger statement" in the digital radiography from the company in 2004.

At RSNA 2003, Health Imaging exhibited its DirectView DR 7100, DR 5100 and DR 9000 systems. The DR 7100 is designed for table, upright and extremity radiology exams and features independent movement of the tube and bucky assembly for flexible patient positioning. The DR 5100 is designed for chest and other upright examinations for both ambulatory and non-ambulatory patients. The DR 9000 comes in a U-arm design with a range of motion for chest, extremity, abdominal and trauma exams.

Kodak has begun shipments of its new tabletop DirectView CR 500 system. The single-cassette DirectView CR 500 outputs 14-by-17 inch cassettes at a rate of more than 60 plates per hour and provides an image for preview in 56 seconds or less. The CR 500 device is designed for remote imaging areas, rural facilities, ICUs and other specialty healthcare environments.

Kodak also showcased its DirectView CR 850 and CR 950 systems. The CR 850 can produce as many as 91 cassettes per hour for 14-by-17 inch cassettes and has footprint of 25-by-29 inches. The CR 950 manages 16 cassettes at a time for high-volume radiology departments. An image is available for preview in approximately 30 seconds.



Konica Minolta Medical Imaging at RSNA touted its Konica Minolta Xpress dual-bay CR system as the fastest selling dual-bay CR unit (earning 12 percent of the CR market in 12 months), as well as fastest unit in the marketplace. The Xpress CR features a compact footprint, 24-second preview and 40-second cycle times and simultaneous multiple-plate configurability. The plate technology has also been enhanced, offering 40 percent higher DQE than last year. It is also designed to meet the budgetary requirements of most radiology facilities. A works in progress Patient Identification Assistant allows a remote PDA to sync up with the worklist.  To enhance workflow, this enables a plate to be barcoded with an exam and patient and dropped in any reader.



In computed radiography, Fujifilm Medical Systems introduced as works in progress two new members of its SpeedSuite CR series - the FCR Velocity-U and the Velocity-T. The Velocity-U offers low-cost of ownership for a chest system, and yields average throughput of 140 images per hour (maximum throughput is 240 images per hour). Fully processed images are displayed in seven seconds, according to John Strauss, director of marketing, imaging systems. The FCR Velocity-T offers the same functionality for general radiographic exams. Both systems also offer the advantage of a glass panel replacement of $1,500, if necessary, rather than the $75,000 to $150,000 replacement cost for a flat-panel DR device, Strauss says. These are the latest products to feature Fujifilm's HD LineScan technology.

Fujifilm also unveiled a new works in progress CR reader, the XG5000. Processing up to 165 imaging plates per hour, this reader offers the highest throughput available today in a high-capacity, multi-plate cassette-based x-ray device, the company said.

With a four-cassette stacker design, the XG5000 resembles its predecessor, the FCR 5000. The XG5000 can read and erase storage phosphor imaging plates efficiently, including multiple imaging plates, allowing an image to be available at the Flash IIP console in 15 seconds. The Flash IIP also integrates the functions of patient identification and image review, as well as image optimization and transmission, into its compact workstation.

The XG5000 was expected to be released by the end of 2003.



Canon Medical Systems showcased its Canon CXDI-40C premium DR system and the CXDI-50G portable DR unit. The Canon CXDI-40C features 17x17-inch imaging area, and an amorphous silicon flat panel sensor with a cesium iodide scintillator, very high detective quantum efficiency (DQE) and high film speed. The portable CXDI-50G is designed for trauma and bedside exams, combining a 14-x17-inch imaging area with a lightweight design (10.6 pounds and less than an inch thick).  The system is large enough for chest and abdominal imaging, yet easy to position as a conventional film cassette or CR imaging plate when performing lateral or axial imaging of limbs or other areas. When capturing images in the x-ray room or bedside, preview images can be viewed in 3 seconds, with total imaging processing taking 20 seconds to complete. The system's sensor contains about six million pixels, with each only 160 microns. This is Canon's second portable unit, joining the CXDI-31 that utilizes a 9x11-inch sensor and is used in neonatal, pediatric and orthopedic imaging.



Shimadzu Medical Systems on the RSNA floor showcased a host of new technologies, including its new Digitex Premier vascular digital subtraction system, with 1024x1024 matrix real-time digital subtraction angiography (DSA) capable of up to 30 frames per second - both acquisition and display - in the single-plane mode. The Digitex Premier includes a high-speed, real-time disk array that can store as many as 40,000 images in the matrix and as many as 120,000 images in the 512x512 matrix.

Digitex Premier also has a patented Vessel Power technique designed to improve visualization by changing the contrast medium density in the acquisition area without changing the background density.

Shimadzu also promoted its new Sonialvision high-end, all-digital, remote R/F system, available as a 90/90 elevating table with a 12- or 16-inch image intensifier. The image intensifier is retractable, allowing the table to lower to assist in patient loading. Digital tomography and planar tomography with computed radiography (CR) are available, even with the table in the upright position.

Shimadzu also previewed its works-in-progress RadSpeed radiographic system, which features a 600-pound patent capacity elevating table, overhead tube support, generator and wall bucky. The newly designed generator offers flexible configurations that can accommodate all imaging requirements from the lowest Kw settings to the largest patients.

Shimadzu Medical Systems highlighted its ceiling mounted C-Arm system, AngioSpeed VC/HC, featuring the new MH200S positioner. Benefits of the MH-200S tri-axis positioner include a 225-degree isocentric movement that allows easy left or right patient approach, 108 programmable positions, improved rotational DSA function and it supports Shimadzu's "SAFIRE" flat panel detector technology.

"SAFIRE" - Shimadzu advanced flat imaging receptor - is a collaboration with Sharp Corp., Osaka, and Shindengen Electric Manufacturing, Tokyo, that will be available in the United States second quarter, 2003. The direct-conversion flat panel detector is geared toward today's interventional cardiac imaging industry, says Shimadzu.

Shimadzu's new multipurpose vascular/cardiac C-Arm system, the AngioSpeed VF/HF features the MH-300Tri-Axial Positioner. Imaging can be performed from cerebal studies to peripheral DSA as a result of MH-300's flexible positioning capability.



InfiMed announced at RSNA the availability of the PlatinumOne Cardiac and PlatinumOne Combo systems for the digital cardiac cath lab marketplace. Designed as vendor-neutral upgrade solutions, the systems offer full digital functionality for use in cardiac cath and interventional procedures. InfiMed says that adding a PlatinumOne allows cath labs seamless digital acquisition and DICOM sharing for a fraction of the cost of a new lab. The system offers instant digital cardiac imaging plus built-in DSA and RF capabilities.

Both systems include PC advancements for expanded image storage, faster image processing, automated DICOM connectivity for remote viewing and archiving and InfiMed's high-speed CCD camera design.



Swissray introduced as a works-in-progress the ddRRealtime, high-resolution digital radiographs acquired at fast frame rates. This dynamic imaging method will extend the clinical utility of Swissray direct digital Radiography ddR-systems by enabling joint motion and other kinematic studies as well as rapid skeletal survey in the trauma environment. ddRRealtime will be made available as a retrofit for currently installed Swissray ddR-systems.



With the cost-conscious customer in mind, Edge Medical Devices launched as a works in progress a new series of flat-panel digital x-ray systems. The new line will be available for sale in Europe in early 2004, and in the U.S. following FDA clearance.

For direct distributors, Edge debuted the Primo, with a thin-profile Quix-DB Digital Bucky, Quix-FP flat panel detector, GridSafe grid handling system and detector-integrated five-field AEC and operator console. The Primo-1 includes one digital bucky, while the Primo-II features a dual bucky design for integration into new and existing wall stands and tables. Primo's Operator Console provides a simple user-interface and exam-specific image processing. It is service and print-class compliant, with a DICOM Worklist option. A modular design also allows both shelf-mounted and free-standing configurations.

Edge also offers the Legato, and previewed a works-in-progress Presto system. Legato includes a Quix Digital Bucky mounted on an automated Tilting Radiographic Stand and Edge's Easy-Lock stretcher and operator console. The works-in-progress Presto combines an elevating and float-top articulated table with the Legato system. It is compatible with ceiling or wall-mounted tubes.



Orex Computed Radiography highlighted increased processing speed of up to 150 plates per hour and up to a 50 percent smaller footprint for the ACLxy CR scanner. The new scanner offers increased speed and throughput of up to 75 cassettes an hour on a single scanner; increased speed of up to 150 cassettes per hour on the dual RAIS II scanner; normal and high-resolution modes ranging from 5 to 20 pixels/mm; regular and lose-dose applications with speed equivalent to film ASA 100, 200 and 400. Optional features include a mobile cart, special configurations for bone densitometry, radiation therapy and mammography applications and a range of cassette types and sizes. The mammography configuration scans images at 50 micron resolution.



Alara Inc. announced at RSNA the FDA clearance of its CRystalView desk-top computed radiography (CR) system. The Alara CRystalView system is provided in a true desk-top configuration. It automatically unloads, scans, erases and re-loads the storage phosphor imaging plate. Scanner throughput is in excess of 50 plates/hour for 14x17-inch cassettes in standard (6 pixels/mm) resolution. Smaller cassettes are scanned at a higher resolution of 9 pixels/mm. The CR reader itself is a desktop, network scanner that can accommodate up to four quality control workstations operating simultaneously.



CMT Medical Technologies launched its SmartRAD digital radiography system. The flat panel system features a single or double detector configuration, is offered as a retrofit to an existing unit or as a digital subsystem OEMs can incorporate into their own equipment. The systems feature a Pixium 4600 flat panel (17x17-inch active area), an intuitive touch- screen interface, integrated setting of the x-ray generator exposure parameters, retrieval of patient demographics from DICOM worklist providers and Anatomically Programmed Radiography (APR).