Ultrasound

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Many cutting-edge ultrasound systems highlighted at RSNA are getting smaller but also more powerful, packing a seemingly endless amount of functionalities/capabilities into an ever-shrinking profile. Though most portable ultrasound system vendors won't usually say as much (and in truth the systems haven't yet quite reached the imaging quality of larger, cart-based systems - but they are getting very close!), one has to wonder if portable machines will be the asteroid that killed the dinosaurs, metaphorically speaking. Talk about bringing a powerful tool to the point-of-care!
   
Be that as it may, the premium and mid-range ultrasound systems on display are packed full of imaging punch for an ever-broadening range of clinical applications. 3D/4D capability was an oft-mentioned capability and grants sonographers with powerful tool for guiding through volume data. A number of systems allow for virtual rescans of raw image data, which lets clinicians essentially re-do a scan without having a patient come back to the office. Also, ergonomic features being released should be effective in reducing stress and strain on sonographers.
   
Of note, too, were several systems that provide tools that allow ultrasound images to be fused with static CT/MR, for example.


Aloka introduced its new ProSound Alpha 10 ultrasound system - the company's new flagship products with a number of advanced features in addition to enhancements in spatial and contrast resolution, as well as near and deep uniformity of images, the company says.    
   
Of the advanced features, the company's Real-Time 4D package includes 3D measurements, 360 degrees of vertical and horizontal rotation, and a 1/2/4 way split screen for simultaneous display of a 4D image with as many as three additional sections.

Another highlighted feature was eFlow, a blood flow analysis tool that provides for sensitive detection of blood perfusion. The tool is designed for the evaluation of superficial blood flow, renal and deep renal blood flow, fetal blood flow, umbilical cord flow, and blood flow to tumors, among other applications, the company says.

The ProSound Alpha 10's Compound Pulse-Wave Generator is capable of producing a transmission signal through on/off signal timing to reduce signal noise.

The scanner began shipping in November.


Ardent Sound Inc. (aka Guided Therapy Systems, Inc.) brought its Voyager compact ultrasound system for its RSNA debut. The system gained FDA marketing clearance earlier this year.

Voyager is designed to function as a peripheral with a standard laptop or desktop personal computer. The system features a flexible design, and with its PC platform enables end-users to regularly upgrade the system with new software and firmware, for instance, 3D and other options. The Voyager is DICOM compatible and is capable of data transmission and archiving across networks.

Ardent Sound has priced the system under $5,000, so as to make it affordable for medical offices, clinics, medical residents, students, rural communities and developing countries, the company says.

Also on display were the Spark ultra high-frequency array system and Seeker general-purpose array system. Each of these peripheral systems include a number of probes, and can interface with most computers or laptops. Spark and Seeker are both pending FDA-approval.


Biosound Esaote Inc., a division of Esaote SpA, displayed new additions and upgrades to its MyLab series of ultrasound systems.
   
The MyLab 70 system is geared for general imaging that includes a full set of ultrasound features for use in radiology, vascular applications as well as by OB/GYN practitioners. Key components of the MyLab 70 include:
  • Tp-View - for use in breast and vascular applications with linear transducers and scanning extended structures, the systems trapezoidal imaging is able to enlarge view without resolution reduction;
  • VPan lets the user see the entire anatomical structure displayed on a screen during musculoskeletal and vascular applications;
  • Pure Brilliance Imaging enhances the grayscale commonly obtained in conventional ultrasound;
  • Contrast Tuned Imaging (CnTl) - a technology used in combination with ultrasound contrast agents for better results due to micro-bubble detection capabilities;
  • 3D/4D Capability; and
  • RF signal output which makes tissue characterization easier and closer.
Other features include real-time archiving, Wi-Fi and Bluetooth connectivity and DICOM compliance.

Two other lower-end systems were on display: MyLab 15 and MyLab 20. Both systems are easily upgradeable and suited for OB/GYN and musculoskeletal applications. The systems are fully digital, include DICOM output, as well as an internal archive. MyLab 20 offers a color version.

Esaote also showcased a work-in-progress system called Virtual Navigator which combines two different imaging modalities such as real-time ultrasound and static imaging (ie. CT/MR) and fuse the data together for an "easier and faster diagnosis," the company says. Virtual Navigator is especially designed to provide increased precision during image-guided diagnosis and interventional procedures.

Also on displays was the MyLab 50 ultrasound system for cardiovascular exams.


GE Healthcare showcased at RSNA its new Volume Imaging Protocol for ultrasound. In capturing volume ultrasound, the new technology gathers raw data and by using GE's LOGIQ 7 or 9 systems, the information can be shifted to a LOGIQworks workstation to be processed offline. The LOGIQ system includes a number of specialized tools and is based on a combination of the company's Centricity workstation capabilities, with a special plug-in for ultrasound.

The VIP technology allows for virtual re-scans of patients well after the original scan through manipulation of the raw data. Volumetric and multi-dimensional images can be created in real-time which broaden the tool set available to clinicians as they evaluate anatomy, masses and lesions. Through the acquisition and construction of volumetric images, whole organs can be scanned in a matter of seconds, according to the company.

GE estimates that VIP could boost scan time productivity by 30 to 50 percent, free up hospital bed space, and overall, reduce stress on sonographers.


Hitachi Medical Systems highlighted new features of its HI VISION line of high-resolution digital ultrasound systems. The company has upgraded the system in hopes of offering clinicians the ability to capture details not ordinarily available with conventional systems.
   
The HI VISION 6500 system now includes Real-time 3D Imaging which enables users a number of 3D features and additional scanning parameters, Hitachi says. This system also can be used for breast imaging in combination with its L53L long linear probe which is designed specifically for ductal echography.
   
The HI VISION 8500 system also has a new feature called SonoElastography which is able to acquire tissue elasticity data through the use of freehand compression while a scan is going on. Sonographers are able to integrate this information with images via overlay techniques or split-screen functions, the company says.


Medison introduced new additions to its mid-range ultrasound Sonoace 8000 live. One big addition to the system is the migration onto the system of the company's 3D Extended Imaging (3D XI) technology, which offers diagnostic ultrasound image processing. The tool was originally included in Medison's flagship system, the Accuvix XQ Prestige. This toolset adds to what is already the foundation of the SonoAce: synthetic aperture controls, Volume 3D, PSAD beam former capability and high power Doppler imaging.
   
3D XI is designed to bring CT and MRI-like imaging to ultrasound diagnosis, the company says. It is comprised of the following technologies:
  • Multi-Slice View which transforms 3D volume data captured through regular ultrasound scanning into a sequence of images captured in .5mm to 5mm segments;
  • Oblique View technology allows clinicians to view 3D volume data in an assortment of views, and can provide an improved look at the correlation between organs and the rest of the region of interest; and
  • VolumeCT View that provides cross view and cube sectional view functions for multiple examinations on various regions by visually displaying relation with one 3D volume scan data.
Medison also showcased a new cardio-vascular edition of the SonoAce Special Edition (SE). The mid-class ultrasound system has been outfitted with new processing technology, as well as CW (Continuous Wave) Doppler imaging and pulse inversion harmonic imaging so that the system can support phased array transducers.


Mindray showcased its DP-9900Plus Digital Ultrasonic Diagnostic Imaging System which puts to use the company's all-digital ultrasound technology. The system joins ultra broad-band, multi-frequency technology with an ergonomic engineering design. Other features include high-quality images, numerous peripheral ports (ie. dual USB, CD-R/W and optional DICOM 3.0). The DP-9900Plus is suitable for multiple clinical purposes such as abdominal imaging, urology, gynecology, obstetrics, cardiology, small parts, HIP, and peripheral vessels.


Philips Medical Systems showcased several of its ultrasound systems each with considerable upgrades.

The company emphasized its iU22 Intelligent Ultrasound System which includes what Philips calls "Vision 2005" enhancements. These include new cardiology capabilities such as Live 3D Echo and 3D/4D abdominal image quality, on- and off-cart upgrades to QLAB Quantification Software, and a new L9-3 transducer.

The iU22 has the latest in the company's transducer technology with X3-1 xMATRIX array transducer for real-time, volumetric imaging for general and cardiac applications. It also is capable of liver imaging to see lesions in two planes simultaneously. PureWave crystal technology enables users to accomplish work that used to require two transducers. Additionally, a new S5-1 transducer has been added for increased image clarity.

SonoCT with XRES technology is part of the iU22 system for 3D, 4D and MRP imaging which allows for such new applications as real-time 4D imaging of the fetal heart, Philips says. Also, the iUP22 is capable of quantifying 3D datasets through a feature known as QLAB.

Philips' HD11 XE is a multi-specialty ultrasound system and includes many high-end features at a more affordable cost level. Like the company's premium system, the HD11 XE includes SonoCT and QLAB quantification software, but also STIC (spatial-temporal image correlation) which can be used to define fetal cardiac structures. The system also includes iSCAN Intelligent Optimization technology; Region of Interest (ROI) quantification - to analyze pixel intensities from 2D or color Doppler data sets; Strain Quantification - for velocity, strain rate and strain image data; interchangeable transducers, a flat-panel monitor, and improved ergonomic features.

Also highlighted was the HD3 which is a more basic model geared for general office visits and can be used for smaller areas of the body such as the thyroid. It is the most mobile of Philips' ultrasound system offerings, but offers some powerful tools such as a broadband digital beamformer capable of capturing more information than narrowband technologies, Tissue Harmonic Imaging (THI), pulsed Doppler, Color Doppler and Color Power Angio and Freehand 3D surface rendering.


Siemens Medical Solutions at RSNA highlighted upgrades to its Sequoia ultrasound system and its new Encompass II release which is part of the ACUSON Sequoia ultrasound platform.

Enhancements for the company's flagship Sequoia system include a new high-resolution, flat-panel monitor, ergonomic features which make the system more easily transportable, a memory stick device for patient data transport, and a DVD burner for image storage.
   
The Encompass II release features high-resolution color flow (HRCF), a technology that applies Chirp-coded excitation to color Doppler to dramatically address spatial resolution and sensitivity. HRCF technology addresses spatial resolution, color bleeding, slow flow sensitivity, color penetration, vascular hemodynamics and deep flow identification. Also featured in the release is a high-resolution flat-panel display and integrated CD/DVD-R capability, the company says.    
   
Additional ultrasound products and technology highlighted at RSNA include:
  • The Encompass III release which includes the ability to extract and display myocardial mechanics from ultrasound information called Axius Velocity Vector Imaging (VVI) for the shared-service Sequoia ultrasound platform. The quantitative motion analysis tool is intended for use with any transducer for all cardiovascular imaging including adult, pediatrics, transesophageal (TEE), intracardiac echocardiography, fetal and vascular applications;
  • The ACUSON Antares ultrasound system, premium edition, a complete ultrasound system with 2D, 4D, color Doppler and contrast agent imaging, provides integrated tools for diverse clinical practices and research institutions;
  • The SONOLINE G60 S ultrasound system, a scalable, multi-specialty system with fourSight 4D ultrasound imaging technology which has been enhanced to offer easy 4D volume acquisition and workflow support to speed up processing time; and
  • The SONOLINE G40 ultrasound system, an ultra-portable color Doppler system with Hanafy Lens transducer technology, high sensitivity color Doppler and Virtual Format imaging.
Siemens also showcased advances such as its Cadence contrast pulse sequencing (CPS) technology for improved contrast detection and specificity for molecular imaging with ultrasound.

The company also presented its ongoing advances in ultrasound imaging that have resulted from the company's acquisition of Sensant Corp. and its investment in silicon ultrasound transducer technology. The technology is expected to offer efficient volumetric 4D imaging for a wide range of applications, and is expected to be commercially available within two years, Siemens says.


SonoSite Inc. emphasized the new capabilities of its MicroMaxx hand-carried ultrasound at RSNA. The system weighs less than 8 pounds, boots up within 12 seconds and can be used pretty much anywhere, such as an imaging lab or a patient's bedside. In addition, the system provides image resolution and system capabilities that are comparable to larger, more expensive cart-based systems, according to the company.
   
New features of the MicroMaxx include:
  • Two new broadband transducers: the P10/8-4, a high-frequency, phased-array probe for pediatric and neonatal radiology, and the SLA/13-6, a high-frequency linear array for imaging the vascular system, musculoskeletal, and superficial structures;
  • SonoRES, a smart algorithm that capitalizes on the processing capability of the system's Chip Fusion technology for real time adaptation of speckle reduction in obstetrical, neonatal neurology and abdominal imaging on the P17, C60e and P10 transducers;
  • Transcranial Doppler which is designed to provide imaging within the required power levels for trans-temporal, trans-occipital and trans-orbital windows on the P17 transducer for neurologists and neuroradiologists; and
  • Wireless capability the allows immediate transfer of still frames and clips of dynamic images wirelessly from the patient beside or imaging lab to the interpreting physician via DICOM networks or SonoSite's PC viewing software, SiteLink.


TeraRecon Inc. at RSNA highlighted its partnership with Fukuda Denshi Co. Ltd. through which the companies introduced a cart-based cardiovascular ultrasound scanner - the Imagic Sigma 5000 series. The system offers high-definition imaging features, streamlined workflow, and ergonomics features designed to boost efficiency, operability, and usability for ultrasound examinations. The cardiac-focused scanner features include tissue Doppler imaging, anatomical M-mode, non-imaging CW capability, and tissue harmonic imaging. The workflow features include comprehensive patient data management and archiving capabilities. The ergonomic design includes a unique motorized height adjustment of the operator console and a high-resolution flat screen that swivels and tilts, the company says.

TeraRecon will act as exclusive distributor in the United States and Canada for the Imagic Sigma 5000 series. Other systems that are part of the company's line-up of advanced multifunctional scanners including the UF-750XT portable color Doppler system, and the UF-850XTD mid-range system.


Terason showcased its newly launched t3000 and t2000 ultrasound systems, as well as the recently released Terason Echo.

The Terason t3000 system is based upon proprietary Teratech Architecture, which combines the front-end Fusion Processor with PC-based back-end data processing. The t3000 system runs as a Windows application and can be quickly converted from a portable unit to a cart-based system.
   
Another launch at RSNA was Terason's 2000 system which includes SmartProbe that allows standard laptop computers to provide high-quality diagnostic images usually associated with larger systems. SmartProbe includes a transducer and miniaturized, 128-channel beamforming electronics. The actual acquisition of the images, as well as management and processing, are all performed using a Terason Software, the company says.
   
The recently launched Terason Echo Ultrasound System was also on display. It is based upon the Teratech Architecture that combines the front-end Fusion processor with powerful PC-based back-end data processing. The Echo system also runs as a Windows application on a standard laptop computer, and can be converted from a portable to cart-based.

Terason will begin shipping the Echo system in January, and is creating a direct sales force to represent the new product line, the company says.


Toshiba America Medical Systems Inc. at RSNA demonstrated the newest features for its ultrasound line which includes the Aplio and Xario. The company has expanded the Differential Tissue Harmonic Imaging (DTHI) capabilities for the Aplio ultrasound system, and introduced 4D imaging for the Xario.  
   
Toshiba has seen "steady adoption" of its premium and high-end ultrasound systems. In fact, the company says it has shipped more than 1,500 Xario systems globally since its introduction to the market in October 2004, and the Aplio system has 4,000 units installed globally (since 2001).
   
The Aplio XV premium edition now includes the company's second-generation DTHI technology for use with larger patients who could not previously be sufficiently scanned with ultrasound, and who sometimes require follow-up MR exams. In addition, the expanded DTHI capability is designed to improve efficiency within a clinical practice, the company says.
   
Each of Toshiba's systems also include the ability to save native data captured during an ultrasound exam so that "virtual rescans" can be done without requiring a patient to come in again. Essentially, if the image data were not properly evaluated the first time around it can be completely redone.
   
The lower priced Xario system, which is geared for facilities in the range of 300 beds, now includes 4D technology which is ideal for multi-specialty practices that require high-quality, three-dimensional images of the internal anatomy viewed in real-time. Xario includes a full set of transducers, post-processing tools, real-time MPR display, a 4D measurement package, and a high-resolution monitor held by an articulated arm designed to reduce stress on sonographers. In addition, 4D technology allows clinicians to increase success rates using automated 4D volume acquisition and enables simultaneous display of 2D and continuously updated 4D volume images, the company says.
   
Other features which have been migrated to Aplio are also now available on the Xario, such as Advanced Dynamic Flow, a wide-band color Doppler technique, along with Panoramic View and Advanced Contour Tracking for cardiology applications.


Ultrasonix Medical Corporation of Canada previewed its Sonix Live ultrasound video streaming technology in conjunction with the company's Sonix SP ultrasound system. The technology will become available on Ultrasonix diagnostic systems in early 2006.
   
Sonix Live is designed so that physicians, clinicians, and researchers can utilize it in areas such as education, image observation, and research collaboration. Using the technology, doctors in remote areas of the world will be able to utilize the live video streaming to potentially review images from the other side of the globe. In a critical situation such as a trauma setting as well as rural areas with limited access to specialists, such technology can not only save patient's lives, but also increase diagnosis efficiency and help physicians to ease patient's concerns, according to the company.

With an open PC-based operating architecture, the Sonix product series provides a wireless LAN capability, and also features 80 GB hard drive, high image quality, front-load CD/DVD drive, and two front-load USB 2.0 drives for maximum data transfer convenience, the company says.


U-Systems showcased its innovative Automated Breast Ultrasound System (ABUS) which is designed to assist radiologists in the detection and diagnosis of breast cancer. The automated system is able to scan the breast and correlates a region of interest on the mammogram with its corresponding ultrasound image, the company says.
           
The ABUS contains two main components, an Automated Breast Scan Station (ABS) and a BreastView Station (BVS). Through these features, the system acquires 3D volumetric breast image data for display. The ABUS also includes a wide-field-of-view transducer which helps guide a clinician through the accumulated volumetric breast ultrasound information.

The ABUS has been cleared by the FDA for commercial use. The first U-Systems ABUS product being commercially released is called SomoVu, the company says.


Zonare Medical Systems at RSNA introduced several new upgrades to its new z.one ultrasound system. The new upgrades include two new transducers, calculation packages and a program for automatically recognizing and adjusting for the differences in body sound propagation, through the company's Zone Sonography technology.

The new upgrades boost the capabilities of the z.one system, the world's first Convertible Ultrasound system, the company says.

The new z.one system technology retains all the raw data obtained in the ultrasound signal. Clinicians are able to instantly convert the system from a full-featured, cart-based unit into a premium compact, ultrasound system with all the performance of larger, more expensive ultrasound units. And interestingly, software upgrades to the system can now be downloaded via the internet.

Zonare demonstrated how, through new software, body wall thickness, fat layer and tissue attenuation affect the way ultrasound sound waves travel through a body during an ultrasound exam. The company is now offering a way to automatically adjust the sound speed based on differences in a patient's body habitus and instantly optimize the clinical image.
   
This software works by "adjusting for the speed of sound in the tissue itself," according to the company. The software thereby improves contrast and sharpness of the image.
   
Zonare also introduced three new transducers at the show:<>
  • The P10-4 transducer which was developed to be used for imaging neonatal, infant, and pediatric patients. It features a comfortable grip for scanning, and offers up to seven different frequencies including Harmonic Imaging at 8.0 MHz received, two Color Doppler frequencies, and three B-Mode;
  • The new P4-1 was developed for easy access in abdominal and OB/Gyn sonography, and includes nine frequencies. This should eliminate the need to change transducers during an exam. The transducer's small footprint is essential for easy access between patients' ribs, dressings, or whenever acoustic access is a challenge. For larger patients, the P4-1 offers penetration up to 30 cm; and
  • L8-3 is a new linear transducer offering.
Zonare also highlighted its new calculation packages for abdominal and venous imaging. The packages allow ultrasound professionals to use a protocol checklist with reports that include organ sizes, Doppler results, and a section for medical notes or comments.


ULTRASOUND PERIPHERALS


Biodex Medical Systems showcased the latest in its ultrasound and echocardiography tables, highlighting the new Sound Pro which combines imaging features from its Ultra Pro and Echo Pro tables. The Sound Pro is fully capable for both ultrasound and echocardiography and is designed for imaging centers with limited physical space as well as a limited budget. The table is 30 inches wide, has a 500-pound patient weight capacity, as well as a height range of 23 to 39 inches. Sound Pro also is suited for bariatric use.
   
Additionally, a controller which can be operated with the hand or foot adjusts the table position so that scans can be done from a seated or standing position. Sonographers can have easy access to a patient's for thoracic exams via a cushioned swing-out section of the tabletop. The table also includes cushioned arm supports as well as a 2-inch-thick mattress.


Civco Medical Instruments introduced its new CIVCO Assist Positioning Arm System for interventional procedures at RSNA. The system allows physicians to place and hold instruments to aid treatment when performing ablations, biopsies and other minimally invasive procedures in ultrasound, but also CT. The system holds medical instruments in a set location for extended periods of time, to reduce risk and the likelihood of repetitive stress injuries, the company says.
   
Key features of the CIVCO system include three stabilizing options, curvilinear positioning arms, arm attachments and accessories.