RSNA: Philips showcases multiple minimally-invasive solutions
Philips Healthcare demonstrated multiple new interventional solutions designed to facilitate image-guided navigation at the 2009 Radiological Society of North America (RSNA) conference in Chicago last week.

The company said its new image-guidance solutions focus on increasing the quality of minimally-invasive interventions and therapies; integrating images from different sources into a single, combined image and adding navigational information of instruments to these images. Booth highlights included Brilliance iCT interventional software, Allura Xper FD20 and PercuNav Image Fusion and Instrument Navigation. The company also shared an investigational device for non-invasive treatment of uterine fibroids.

The imaging and data backbone
“Across most surgical disciplines, minimally-invasive methods are becoming the standard since the procedures can help reduce overall healthcare costs and improve efficiencies,” said Bert van Meurs, senior vice president of interventional x-ray, for Philips. “However, this growth requires a significant amount of knowledge as techniques and technologies evolve.”

The Brilliance iCT 3.0 software release offers packages to facilitate interventional procedures in the CT gantry room—continuous CT and CT fluoroscopy. Continuous CT biopsy mode enables the clinician to perform gantry room scans using a foot pedal to keep their hands free to focus on the procedure and includes a remote monitor for viewing. Adhering to Philips’ DoseWise design philosophy, each exposure is a 240 degrees axial scan centered beneath the patient to shield the clinician’s hands from direct x-ray exposure. CT Fluoroscopy provides real-time guidance for interventional procedures (up to eight frames per second). Exposure time and dose displays keep the interventional radiologist aware of exposure levels throughout the procedure while viewing a single-fused image.  Philips said its CT interventional packages are available with cart or ceiling-mounted display monitors and can be configured on new or previously installed Brilliance iCT scanners.

Allura Xper system provides optional tools to support image-guided procedures, according to the company. The MR/CT Roadmap feature allows clinicians to synchronize live fluoroscopy with previously acquired MRA/CTA datasets to help reduce contrast media use and x-ray dose compared to standard 2D or 3D navigation. XperGuide can also overlay live fluoroscopy on MR/CT images for needle image guidance. Ultrasound access and use is also improved with the launch of the integrated CX50 system, combining superb image quality with full data, user interface and video integration. With the CX50’s portability, physicians in the cath lab can control the CX50 from the Allura Xper FD tableside module and view images on interventional exam room monitors.

Philips has used its acquisition of Traxtal and its portfolio of minimally-invasive instruments and software for image-guided intervention and therapy. Philips showcased PercuNav, which functions as a GPS for medical instruments, at RSNA 2009.

The company displayed PercuNav integrated into the Philips interventional suite of products, which provides 3D visualization and navigation tools to guide instruments to desired targets. Philips PercuNav tracks the tips of flexible and rigid instruments while inside the patient and displays the instrument position, orientation and trajectory on pre-procedure and intra-procedure images. The system also can generate and display fused multi-modality images. In addition to interventional procedures such as biopsy and ablation, PercuNav’s image fusion and visualization can be used to enhance diagnostic imaging studies by synchronizing stored images with real-time ultrasound.

Investigating new interventional devices
Philips also previewed Sonalleve MR-Guided HIFU Fibroid Therapy System, an investigational device for the non-invasive treatment of uterine fibroids. The procedure involves volumetric heating with real-time feedback for high procedural efficiency combined with a short procedure time. The Sonalleve MR-HIFU system is currently installed at 16 sites in the U.S., Europe and Asia for research purposes, with several sites conducting clinical trials for uterine fibroid therapy.