Ultrasound: Scanning Made Simple and Ergonomically Friendly

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Streamlining exams and boosting productivity is the focus of ultrasound users and vendors these days. With repetitive stress injuries already chronic among many sonographers and procedure volumes continuing to climb, a wide variety of ultrasound system vendors are offering more human-centric, ergonomically sound units with re-designed control panels, lighter probes and more software to make scanning less physical and user-dependent. Voice-controlled ultrasound systems are no longer something for the Jetsons. (Statistics show that 80 percent of sonographers have repetitive stress injuries, and 20 percent of them are debilitated by the injuries.)
   
New system enhancements debuting at RSNA came in a variety of applications, namely cardiovascular, abdominal, breast, small parts and surgery. And besides bringing ohs and ahs when viewing babies in utero, 3D and 4D imaging are adding new dimension to cardiovascular and vascular imaging. 4D has even been shown in one study to speed by 60 to 70 percent the time needed to scan patients, review images, and generate reports in a variety of applications. And 4D is no longer just attached to big-ticket prices, with vendors migrating this great technology down the ladder to portable systems, too. New features for hand-held ultrasound systems also brought a lot of interest as caregivers and facilities seek to practically and economically expand their clinical reach.

(Note: companies appear alphabetically.)



GE Healthcare showcased at RSNA two new cardiovascular ultrasound systems, new cardiovascular imaging capabilities on the LOGIQ 7, two new products for general imaging and new capabilities for the Voluson 730 Expert System for use in obstetrics and gynecology.

The Vivid 7 Dimension cardiovascular ultrasound system, with real-time 4D and multidimensional imaging capabilities, brings new echocardiography acquisition, reconstruction, and analysis techniques that allow physicians to view images in multiple planes simultaneously. New clinical tools include: multidimensional imaging, with acquisition technology that acquires bi-plane and tri-plane images with color and Doppler; 4D imaging, with real-time display of 3D imagines of the heart; 4D tissue synchronization imaging, a dynamic 4D parametric imaging model of dyssynchrony from a single heart beat; and bloodflow imaging, a vascular imaging mode.

The Vivid i, a miniaturized cardiovascular ultrasound system, features a portable, wireless design. The system's clinical utility and light weight make it ideal for urgent care, emergency room, critical care, and operating room use, according to the company. 

GE also profiled new cardiovascular imaging features and VoiceScan voice activation for the LOGIQ 7 shared services system. The features are designed to both serve the growing cardiovascular patient population and addressing sonographers' high rates of stress-related injuries. The new LOGIQ 7 system provides a full range of general imaging applications including abdominal, small parts, surgery and vascular, as well as a full suite of applications to support the growing number of cardiovascular procedures. The system's transesophageal (TEE) scanning and stress echo capabilities are complemented by a new set of quantitative tools to provide more precise methods for analyzing data. These new quantitative cardiovascular tools include: Tissue Velocity Imaging (TVI); Tissue Velocity Doppler (TVD); and Q-Analysis, which use numerical scores and mapping techniques to help increase diagnostic confidence, GE said. Applying the latest in wireless and speech recognition technologies, LOGIQ 7 now offers VoiceScan for hands-free voice command and track ball control of the system. With VoiceScan, clinicians can use intuitive words and phrases to activate more than 150 functions.

In general imaging, GE is featuring the new LOGIQ 9 and the new LOGIQworks Workstation. The LOGIQ 9 premium system offers volume and multi-planar imaging. With LOGIQ 9 and three new 4D transducers, clinicians can acquire and construct volumetric images instantaneously, up to 30 volumes per second. The system is built on GE's TruScan architecture that enables automatic image optimization and the flexibility of raw data manipulation and management. Image flexibility allows stored image optimization and measurement such as: Overall B-mode gain, dynamic range and gray scale maps; overall Doppler gain, baseline shift, sweep speed and inverted spectral wave form; Tru3D reconstruction from a stored cine loop; and anatomical M-mode.  

GE said the advantage of acquiring data in 4D brings is that the data volume can be interrogated from different angles, planes or volume reconstructions. Thus, the scan can be re-done several different ways without re-scanning the patient. GE calls it a "virtual re-scan." A study at Florida Hospital Celebration Health found that when using the a Volume Imaging Protocol along with the Logiq 9 and the LogiqWorks off-line workstation, sonographers documented time-savings of 60 to 70 percent in a 30-patient pilot study that estimated the time needed to scan patients, review images, and generate reports. The variety of studies included: breast, testicular, thyroid, pelvic, renal and abdominal exams.

The LOGIQworks workstation integrates GE's raw data processing and Centricity multi-modality workstation for high-performance processing and image review. A scaleable solution based on DICOM standards, LOGIQworks can support any clinical setting, from an imaging department to a fully networked  healthcare enterprise. The workstation features quick organ review, multi-planar measurement tools and volume analysis.

GE also debuted new Volume Ultrasound capabilities on the Voluson 730 Expert system. Building on 4D imaging, the Voluson 730 Expert allows clinicians to acquire, optimize, navigate and analyze volumetric data in real-time. New 4D transducers and Inversion Mode and Speckle Reduction Imaging further enhance visualization and diagnostic confidence with the system, according to GE.

GE Healthcare also introduced a new high-performance compact ultrasound system, the LOGIQ Book XP. The 10-pound unit can streamline clinical workflow by allowing clinicians to take the ultrasound exam to the patient, wherever that may be, GE said. It can be used nearly anywhere but the vendor sees most applications outside of the radiology department, such as in the OR and ER. LOGIQ Book XP is built on GE's software-based TruScan architecture and patented miniaturization technologies to provide the capacity to store more than 30,000 clinical images. The system's new 3S-RS phased array transducer delivers excellent image quality for cardiac screening and emergency applications, and the new i739-RS and t739-RS transducers offer dedicated capabilities for surgery, according to the company. GE said it expects to sell more than more than 2,000 LOGIQ Book XP systems by the end of 2005.



Medison America debuted a new mid-class ultrasound system and a new 3D package at RSNA.
   
The new SonoAce Special Edition (SonoAce 8000SE) builds on the SonoAce 8000 family by adding digital multi-beam processing. This greatly increases the frame rates during color and 2D imaging. The system also features an 80 GB hard drive and an optional CD/RW drive, color and power Dopplers with multi-beam receiving capabilities, pulsed wave spectral Dopplers with two active probe ports and an option for a third. It is equipped with Freehand 3D for software-based 3D image rendering, SonoView Lite image management software and built-in DICOM 3.0. It features harmonic imaging for better clarity and higher spatial resolution and an intuitive user interface. The system - which is being positioned as an entry-level color unit for small, private cardiology, general imaging and ob/gyn offices and clinics - will be available early next year, with a cardiology version of the system upgrade expected to roll out in the second half of 2005. Some 3,000 SonoAce 8000 systems (which debuted in mid-2002) have been installed worldwide to date.

Medison's new image processing package is called 3D-eXtended Imaging or 3D-XI.  Developed for the Accuvix XQ ultrasound system, the 3D-XI package includes: Multi-Slice View technology to enable, with a press of a button, 3D ultrasound anatomy to be displayed as precise serial slices similar to that of MR or CT imaging. As with CT and MR, the user can determine the exact distance between each displayed anatomical slice with slice increments 0.5mm to 3mm; Oblique View to enable the user to display oblique scan planes from acquired 3D volume anatomy; and VolumeCT, a tool to visually display the relationship of the coronal, sagittal, and axial views of the 3D data set. Each scan plane as well as the entire volume data set are interactive, providing a more precise orientation of the displayed intersecting anatomical data, Medison said.



Philips Medical Systems showcased the new Philips iU22 intelligent ultrasound system that combines advanced ergonomics with new levels of automation, the company said. It features high-definition imaging and diagnostic capability improving accuracy and user confidence. In addition, Philips xSTREAM architecture provides 3D and 4D imaging for the first time on a premium ultrasound system, the company said. An intelligent automation feature called QuickSCAN allows dynamic adjustment of as many as 40 different controls with one button. This is designed to improve workflow and create more consistent results across operators and skill levels. The iU22 also offers multiplanar reconstruction (MPR) resolution.

The system is optimized for 4D ob/gyn and breast examinations, as well as applications in abdominal, musculoskeletal, pediatrics, small parts, and vascular imaging. Focused on ergonomics and human-centric design to reduce technologist repetitive stress injuries and fatigue, the unit features a multidirectional control panel and monitor, light transducer cables, and angled, easy-access transducer connectors. And iCommand voice recognition feature allows hands-free control. New array configurations and ultra-high frequencies up to 17 MHz allow for imaging of previously challenging patients.



Siemens Medical Solutions debuted the new Encompass release for its ultra-premium ACUSON Sequoia ultrasound platform and showed enhancements that include its new fourSight 4D (real-time 3D ultrasound imaging technology) on the SONOLINE Antares.

The Encompass release for Sequoia includes Siemens' Native TEQ dynamic ultrasound technology, a works in progress, for improved diagnostic image quality, workflow and ergonomics. The advanced image optimization technology utilizes patient specific echo information to correct the most common technical scanning errors by instantaneously eliminating unbalanced, undergained and overgained images automatically, the company said. Hand motions on the keyboard are dramatically reduced as well with the goal of eliminating or significantly reducing repetitive stress injuries for sonographers. Native TEQ technology enables the ultrasound system's computer to read the signals that are returning from the individual patient, and then automatically adjust the parameters while the operator is scanning, so all images are optimized in real-time and the sonographer or physician can scan freely without having to touch the keyboard. There are no gain or depth-gain-compensation (DGC) control adjustments needed while scanning, and the computer is programmed to perform advanced real-time motion analysis in addition to accurately detecting and differentiating noise and artifacts from soft tissue. The image gain is automatically optimized in the axial and lateral dimensions in real-time, once the transducer touches the patient. As a result, the sonographer can now focus on the patient and exam versus the ultrasound system.

Siemens also showed fourSight 4D ultrasound imaging technology for the SONOLINE Antares, which debuted last summer (since then, Antares sales have jumped 40 percent, the company said). According to clinical evaluators, the advent of real-time 4D imaging enables interactive examination of internal structures from any viewpoint, and can assure better accuracy of measurements, detection of potential abnormalities and improved diagnostic assessments, all at the push of a button. The company also was showing a works in progress endovaginal probe (EV9F4) for ob/gyn and fertility work that is expected to be available early next year.

For the SONOLINE G60S and G50, Siemens showcased the inMotion software upgrade that was introduced earlier this year that adds imaging performance advancements and streamlines workflow, allowing users to increase clinical utility and ultimately improve patient care. A key new feature in the inMotion upgrade is the fourSight 4D imaging, including the C6F3 fourSight 4D transducer, and for the G50 system only, the EV8F5 fourSight 4D transducer. This new feature, which allows accurate size information to be acquired in 3D, includes a measurement tool for 3D imaging so that distance and area measurements can be obtained for quantification in multi-planar reformatting (MPR) and volume images.



SonoSite announced the fourth major upgrade to its hand-carried SonoSite Titan platform over the past 18 months since its launch. The installed base now numbers more than 2,500, the company said.
   
The version 2.3 upgrade, which is currently available, includes new transducer technology with the L25/10-5 MHz broadband linear array to guide interventional procedures such as catheter insertions; velocity color on the C60 transducer for increased color Doppler sensitivity in abdominal and ob/gyn applications; enhanced DICOM capabilities for faster transmission of images to a hospital networking or for archiving; and automated cardiac function quantification (Simpson's Rule).
   
The Titan weighs 7.7 pounds and boots up in less than 12 seconds.



TeraRecon and Fukuda-Denshi announced a new mid-range cart-based ultrasound system, the UF-850XTD. This fully digital scanner for multiple imaging applications includes an adjustable, 15-inch LCD monitor. The digital system architecture coupled with tissue harmonic imaging provides higher definition and higher frequency imaging to serve a wide range of diagnostic imaging needs such as cardiology, diagnostic radiology, OB-GYN, and other general imaging applications, TeraRecon said.
   
The companies also announced a strengthening of their partnership in the development and distribution of advanced ultrasound technology at the meeting. The first new R&D contract relates to 4D imaging, while the second relates to joint development of additional ultrasound systems that will include portable and cart-based B-Mode systems and a next-generation portable color Doppler system.



Terason showcased its Terason ultrasound system, a 128-channel scanner that uses ultrasound transducers running through a PC application on a commercial notebook computer. Features include voice activation, image storage for more than 40,000 images, image format versatility, and 3D integration. The scanner's target market niche is interventional radiology, as well as vascular, women's health, urology, and musculoskeletal applications.



Toshiba America Medical Systems (TAMS) launched Aplio xV, an all-digital, high performance ultrasound system and integrated 4D imaging onto its compact Nemio system.

TAMS said the new Aplio xV, which is currently shipping, delivers expanded visualization to aid diagnostic through a combination of key features, including imaging software packages for radiology and cardiology, Toshiba's iASSIST remote technology and a new flat CRT monitor. It also offers patent-pending Differential Tissue Harmonic technology that provides additional penetration at maximum depth. A one-touch, image optimization button called QuickScan also boosts overall image quality. The installed base of Aplio units can be upgraded with xV.
   
Toshiba also showcased a 4D works in progress feature that includes distance, area and volume measurements for its compact Nemio system. The unit includes: Quad Signal Processing (QSP) for four-times more data per transmission signal; Tissue Harmonic Imaging; a fully programmable console for one-touch operation to streamline workflow; Directional Color Angio that combines the sensitivity of color angiography with directional flow data to capture a more accurate representation of vascular anatomy; multi-frequency transducers including convex, linear and sector transducer capabilities with the ability to switch between harmonic and fundamental frequencies for optimal penetration; and communications the work with any DICOM or non-DICOM clinical environment via the simPACS image management system. Nemio delivers a range of clinical applications, including comprehensive OB/GYN, oncology and angiography studies. The new 4D imaging capabilities includes automated 3D volume acquisition and simultaneously displays real-time 2D images and continuously updates 3D volume for studies. The post-processing tools also will allow clinicians to more quickly and easily optimize the 3D volume dataset for the best possible 4D display, TAMS said. The new 4D feature can be added as an upgrade.



Zonare at RSNA launched the company's first Zone Sonography platform - a full-featured, cart-based scanner that converts to a 5-pound portable system with one button. The new system, which weighs 170 pounds when combined with the cart, combines advances in ultrasound technology with the flexibility of the z.one platform, which the company calls Convertible Ultrasound. When commercially available in early 2005, the system will serve a variety of imaging needs in general imaging, obstetrics, gynecology, vascular and other emerging ultrasound applications. Cardiac applications are slated to be added later.

The z.one platform features include a new approach to data acquisition and image formation. The system acquires data quickly in relatively few large zones rather than many narrow lines, allowing more rapid image storage, processing and display. The z.one system aggregates the original channel data and stores this information in Channel Domain Memory. All of the original raw echo information is then utilized in Channel Domain Processing to form the image and to provide greater options for image post-processing.

In addition, Zone Sonography makes it possible to produce, what the company calls, the first convertible ultrasound system. This allows the clinician to convert the z.one platform from a full-featured cart system into a compact, portable system with the push of one button. This also enables easy serviceability as Zonare offers a 24-hour scan engine swap program.

The company also announced at RSNA that it has added 11 new sales and applications members to its U.S. team and the signing of an agreement with Sea Ridge Software to sell its imorgan ultrasound mini-PACS.

The new personnel join the staff of more than 60 employees and an international distribution network representing distributors throughout Europe, Asia and the Middle East.

Zonare will sell the imorgan, a fourth generation, economically priced product that uses modular architecture, as an option with the z.one platform.