No matter how you slice it, CT vendors have continued to push the design and image quality of today's scanners, improving their overall clinical performance and increasing anatomical coverage. To no one's surprise, multi-detector CT, and particularly 64-slice, continued the buzz it started at this year's RSNA - however even the vendors were surprised the "other guy" didn't bring along a 128-slice scanner. "I think we're all waiting for healthcare facilities to figure out what to do with the image volume of 64-slice," several vendors voiced. Toshiba did offer a look into the future by demonstrating its 256-slice scanner. The works in progress scanner could image the entire heart in one rotation, but there's no word yet on when it will be commercially available.
GE Healthcare showcased its LightSpeed VCT 64 channel CT scanner, as well as using the show to springboard a new line of compact CT scanners.
GE also showcased what it tagged adaptive technologies for its VCT scanner, which now has 500 installs. In the future, GE said the scanner will be able to adapt to a patient's heart rate and anatomy, further personalizing their CT scan. Adaptive technologies also make dose reduction possible.
The new compact line of BrightSpeed scanners are available in 4-, 8- and 16-slice configurations. They include Volara digital data acquisition system (DAS) and the Xtrex FX workflow platform. The series also offers productivity tools to facilitate review and communication, such as direct volume visualization with direct multi planar reformat (MPR). Included in the BrightSpeed series is the wide open workflow with Xtream FX that provides imaging departments the ability to keep pace with the large volume of data generated by multi-detector CT systems. BrightSpeed will be commercially available in early 2006, GE said.
The company showed as a works in progress, the LightSpeed Xtra, a large-bore CT scanner for radiation oncology, bariatrics and interventional applications such as CT-guided biopsies.
GE also used RSNA to announce the next generation of application software for analyzing volume data sets called VCAR (volume computer assisted reading).
NeuroLogica Corp. introduced a mobile CT scanner called CereTom that has a 25-cm field of view. The system can be brought bedside and used in any hospital room or clinic bay.
According to NeuroLogica, the scanner is capable of performing normal CT, perfusion, xenon perfusion and angiography. It is designed for use in the ER, OR, ICU, MICU, SICU, NICU, interventional suite or any medical clinic. In the future, the company said CereTom may also be used by orthopedic surgeons and dental specialists.
Philips Medical Systems highlighted its Brilliance line of CT scanners, as well as debuted new innovations for enhanced CT clinical performance.
Philips' Brilliance CT 64-channel configuration provides expanded anatomical coverage for faster exams performed with shorter breath holds and less motion. It has 64 x 0.625 millimeter detector banks, giving total z-axis coverage of 40 millimeters, and has a maximum gantry rotation speed of 0.4 seconds.
Philips showcased what it calls CT Halo for improved, efficient workflow in the CT environment, including radiology, cardiology and oncology CT. The ambient experience designed for CT is coupled with remote post-processing capabilities that eliminate the need for a separate control room.
Looking into its crystal ball, Philips discussed a simultaneous multi-energy detector. The first, already in clinical trial at Hadassah Medical Organization in Jerusalem, Israel, is comprised of layers designed to simultaneously detect both low-energy and high-energy x-rays.
Another technology Philips showcased in the CT arena was new full coverage detector platform based on Nano-Tile technology that will image an entire organ such as the heart or head in a single rotation.
Philips also highlighted its new Philips Brilliance Workspace Portal that transforms conventional computers into a radiology workspace. Clinicians can view CT images and case information via Brilliance Workspace's software applications from various locations, and without having to load the CT dataset onto the PC.
In addition, Philips displayed its Philips Brilliance Workspace 2.0, which was developed for multi-slice CT and is adaptable across the entire Philips Brilliance family.
Showing a number of works in progress, Philips featured a virtual colonoscopy application and an analysis tool to evaluate the coronary arteries and advanced ventricular functional analysis.
Siemens Medical Solutions at RSNA introduced the Somatom Definition, a dual-source CT system that provides twice the temporal resolution, acquisition speed and scanning power, while minimizing radiation exposure. According to Siemens, the scanner can image full cardiac detail with as much as 50 percent less radiation exposure compared to traditional CT scans.
Siemens' Definition, which uses two x-ray sources and two detectors at the same time, features a 31-inch (78-cm) bore opening and a 79-inch (200-cm) scan range. In the area of cardiac diagnosis, the dual-source CT scanner can image patients with high or irregular heart rates, or even arrhythmia, without beta blocker medications, Siemens said. The system also enables physicians to better identify and characterize plaque, an early indicator of heart disease.
Siemens also revealed new CT clinical engines for acute care, cardiology, neurology and oncology. The clinical engines are available on Siemens' Somatom Definition, Sensation and Emotion CT scanners.
The syngo computer-assisted reading tools, combined with intelligent evaluation, automated follow-up, and image-guided intervention, present higher diagnostic confidence for preventive care, staging, follow-up exams, and real-time guided biopsies. Additionally, comprehensive tumor perfusion enables a fast and easy visualization of tumor enhancement and aids in differentiating tumors.
According to Siemens, the CT clinical engines are available in two workplace configurations - a dedicated CT Workplace and a MultiModality Workplace.
Toshiba America Medical Systems showcased a large bore CT scanner with a bore opening of 90 cm and a 70 cm acquired field-of-view, making it possible to scan patients of all sizes in various positions.
According to Toshiba, the system's QuantumPlus detector provides three different slice-width acquisitions, enabling the Aquilion LB CT to acquire isotropic images in all anatomical planes while achieving low-contrast resolution using the lowest dose. Clinical applications include oncology, bariatrics and interventional CT.
In the area of multi-detector CT scanning, Toshiba highlighted its Aquilion 64 CFX CT scanner that is dedicated to cardiac imaging. The scanner utilizes Toshiba's 64-row Quantum detector that acquires 64 simultaneous slices of 0.5 mm with each 400-millisecond gantry revolution.
The slices will continue to increase, according to Toshiba, as the company previewed for meeting goers a 256-slice CT scanner. The works in progress would be able to image the entire heart in one rotation.
Toshiba also announced at the show that new workflow, security and dose exposure enhancements have been added to its Sure line of automated scan applications for its full line of Aquilion CT systems.
New Sure enhancements include: SureWorkflow Image Accelerate, a works in progress that doubles reconstruction speed and allows reconstruction of up to 28 images per second; Enhanced DICOM Data Transfer allows data transfer from the Aquilion 32/64 CT systems to Vital Images workstations; SureSupport Enhancements Physician Education; SureExposure enhancements designed to reduce overall dose up to 40 percent and improve patient care; and SureCardio Enhancements that includes adaptable dose modulation software for cardiac CT available to the marketplace, ECG modulation is designed to reduce dose by up to 50 percent for improved patient care.
E-Z-EM Inc. debuted its works in progress EZ CHEM blood analyzer that was developed in conjunction with Nova Biomedical. EZ CHEM is a point-of-care device for conducting blood assays in patients, such as kidney function, prior to certain imaging procedures. The company expects to submit its application to the FDA for regulatory clearance in the third quarter of fiscal year 2006 with commercialization soon after.
Medrad at RSNA introduced Smartflow for its Stellant D CT injection system. Smartflow, built on a similar platform as Medrad's DualFlow, eliminates the need for manual calculations in tailoring CT injection protocols to specific patients.