The world of women’s imaging is one area of imaging showing real growth in 2007. Vendors continue to add to or upgrade their mammography, ultrasound, MRI, mammography CAD and breast biopsy product lines—focused on meeting the medical needs of women. The most significant growth is the move to full-field digital mammography—with a whopping 85 percent increase since last year according to the FDA’s Mammography Quality Standards Act statistics. Frost & Sullivan predicts that total revenues in the North American x-ray mammography market will likely skyrocket to $563.5 million in 2013 from $380.9 million last year. In response to market needs and growth, vendors are fine tuning mammo CAD, dedicated breast MRI and 3D and 4D ultrasound systems—as well as PACS to manage all those images, and imagers when hardcopy is needed. On the horizon, too, is digital breast tomosynthesis (DBT)—with the first FDA approvals expected sometime next year.
Advanced Imaging Technologies (Booth 2179) is introducing image-guided biopsy capabilities as a key component of its real-time, through-wave breast ultrasound device, ARIA BIS. Also being featured is a new workstation designed to deliver multiple image displays, including whole breast bilateral and inter-modality and over-time comparison views, as well as superior contrast and spatial resolution of dense tissue. Both new product features make it possible to provide breast imaging, diagnosis and image-guided biopsy in one PACS/DICOM compliant system. ARIA BIS is a real-time, through-wave ultrasound imaging device that has demonstrated superiority over the combined use of mammography and conventional ultrasound at detecting solid masses and an ability image dense breast tissue effectively, according to the company.
Agfa HealthCare (Booth 4106) is launching its latest flexible, table-top imager, delivering mammography quality images. The Drystar AXYS is a dual-film size, direct digital imager with excellent image quality, offering a multi-application hardcopy solution, mammo-quality images with 508 dpi image resolution, very short access time, and convenient imaging with two film sizes on-line.
The Impax Mammography Suite has been specifically designed to facilitate diagnostic breast imaging reading in digital environments, as well as digital screening workflows in local and multi-site organizations. It supports the display of mammography CAD through the integration with iCAD's Second Look Digital and R2 ImageChecker CAD image markers and is highly configurable with regards to workflow and integrations needs, Agfa says.
American Mammographics (Booth 1711) is exhibiting its MammoSpot platforms and spot compression paddles for diagnostic mammography and the new S.O.F.T. Paddle for Screening Mammography. S.O.F.T. Paddle is the "Special Optimized Full Tilt" compression paddle and is used as an alternative to the standard or conventional flat-compression paddle in screening mammography for superior compression of the mid- and anterior breast and less discomfort for the patient, according to the company. The uniform compression achieved with S.O.F.T. Paddle also provides for reduced exposure time and less chance of motion blur. MammoSpot platforms and paddles for diagnostic mammography are the only spot compression/magnification devices available that offer the unique "double-spot" compression capability for supplemental mammographic imaging. S.O.F.T. Paddle and MammoSpot are available for all major brands of mammography equipment.
Aurora Imaging Technology (Booth 6754) is introducing AuroraBiopsy, the completely automated and fully integrated MR-guided biopsy technology. Biopsy is possible with a simple click on the lesion displayed on the monitor, followed by a click on the marker for the integrated stereotactic guidance system to direct the needle precisely where it needs to be, Aurora says.
AuroraBiopsy provides the ability to target multiple lesions in the same breast or both breasts in a single procedure. The system features breast stabilization paddles for wide access to sample all breasts sizes—small or large—and are inclusive to the Aurora System’s integrated package. The AuroraBiopsy also includes a needle guidance procedure which easily accommodates all current core biopsy or vacuum-assisted biopsy devices on the market today.
Beekley Corporation (Booth 8433) is introducing its new line of N-Spots for marking nipples in mammography. “Perfect for Digital” N-Spots feature distinct 2.3mm non-metallic pellets that immediately, unmistakably and consistently document the nipple’s location on the screen without causing artifact. N-SPOTS are available in three nipple marker styles: round disc, extended tab with adhesive free center; and Soft ‘n Stretchy pinch-free material with adhesive free center; all in a patient-friendly floral design, according to Beekley.
BRIT Systems (Booth 3503) is showcasing new enhancements to the BRIT Vision multi-modality breast imaging workstation. The company is demonstrating a bundled mammography solution that integrates MRS’ mammography reporting software into the company’s flagship workstation. This advancement is the direct result of customer feedback and is expected to help streamline clinical workflow.
Carestream Health (Booth 2513) is exhibiting CAD for Chest and Digital Mammography at RSNA 2007. In addition to CAD for film-based mammography, Carestream Health is demonstrating CAD software for its CR-based mammography platforms, as well as CAD software for other vendors’ full-field digital mammography (FFDM) systems. The CAD for CR and FFDM solutions are available outside of the United States. The company also is displaying Chest CAD and bone mineral density testing on its Kodak Directview DR 3000 platform that is only currently available in China.
Fujifilm Medical Systems USA (Booth 1129) is showcasing its full-field digital mammography (FFDM) system, Fuji Computed Radiography for Mammography (FCRm). The FCRm multiple-reader presents mammography providers with various equipment configuration combinations; the centrally located Clearview-CS, multi-plate reader serves several rooms, while the Clearview-1m, single-plate reader, can be installed right in the exam room.
Gamma Medica-Ideas (Booth 5439) is introducing its dual-head LumaGEM system for applications such as molecular breast imaging (MBI). Gamma Medica-Ideas’ LumaGEM dedicated gamma camera has been marketed up to this point as a single-head system. A prototype dual-head LumaGEM for molecular breast imaging has been in use at the Mayo Clinic for the last two years.
The LumaGEM system features fully solid-state digital detection utilizing eV Products cadmium zinc telluride (CZT) to provide superior resolution compared with the conventional scintillation camera technology traditionally used in gamma cameras. It also allows minimal dead space at the edges of the image, permitting the closest access to the chest wall.
The camera features a gantry that is versatile in positioning the patient, with a full range of motion, according to Gamma Medica-Ideas. The mounting mechanism allows the use of light breast compression to ensure that the radiologist can obtain images using any standard mammography view.
GE Healthcare (Booth 1729) is exhibiting the Senographe Mobile Essential, its newest digital mammography product to receive FDA approval. It features the largest digital detector in the mammography market, advanced ergonomic design for the technologist, optimized patient comfort and seamless workflow connectivity, according to GE.
The Senographe DS integrates screening, diagnosis and interventional capabilities all-in-one system. It features a narrow tube head and slow compression; exclusive dual track anode with molybdenum/rhodium filter; automatic optimization of parameters; and Sharp IQ grid.
GE's Senographe Essential digital mammography platform features an enlarged detector that easily accommodates large breast images without degradation of small breast images, the company says. Digital capabilities optimize workflow and connectivity, while providing 3D images and capacity for interventional mammography procedures. It offers a large detector designed specifically for mammography is 24-by-31 cm; seamless integration and optimized image matrix; and ergonomic design.
The newest version of GE’s Seno Advantage Review Workstation, Version 2.1, is designed to maximize the power and performance of the Senographe Essential and the Senographe DS digital mammography systems. Flexible features allow images to be displayed with tissue equalization or premium view processing, either automatically or manually with a simple push of a button. It also offers user-customizable protocols, toolbars and preferences; dedicated keypads that put functionality at the fingertips; and communication and storage via DICOM and other formats.
The Signa HDx 3.0 tesla MRI system’s XVRE volume-reconstruction engine provides virtually real-time image generation. The XVRE is the enabler for new XV (expanded volume) clinical applications that utilize acceleration techniques such as Asset and Gem. Gem is a hybrid acceleration technique that uses variable sampling.
GE also is featuring a range of technology for breast imaging, including breast MRI solutions: Vibrant for bilateral imaging; Brease for breast spectroscopy; and 8-channel Breast Array, with excellent signal-to-noise and better access for intervention and CADstream integration, the company says.
The Voluson E8 advanced ultrasound technology platform delivers new imaging tools and technology such as SonoVCAD (sonography-based volume computer-aided diagnosis), an automated imaging tool that improves workflow by making it easier to acquire volume images of the fetal heart, according to GE. For sonographer comfort, the system incorporates various ergonomic solutions that follow all the Society of Diagnostic Medical Sonography’s (SDMS) study recommendations.
GE’s Volume Imaging Protocol (VIP), a method of acquiring volume sweeps using GE’s exclusive True Raw Data, releasing the patient and then reviewing the study using tools such as Raw Data Virtual Rescan and Volume Ultrasound reconstruction, has proven to offer more than a 30 percent decrease in scan time and rescans, the company says.
GE’s ViewPoint offers a comprehensive data management solution for diagnostic ultrasound users, including structured reporting for vascular and OB/GYN studies. ViewPoint combines reporting and image archiving with database technology that speeds report creation while capturing image, patient and measurement data for subsequent analysis, helping to make ultrasound workflow quicker and easier.
Also in the ultrasound arena, GE is exhibiting the LOGIQ i laptop-size ultrasound imaging system suitable for bedside radiology. The 10-pound system empowers clinicians with volume imaging and wireless capability for comprehensive point-of-care radiology, vascular, neonatal, breast and musculoskeletal imaging, including areas with constricted space such as the intensive care unit or between incubators in the neonatal intensive care unit. The LOGIQ i features the capacity to store raw ultrasound data and transmit it wirelessly to a workstation.
For bone densitometry, the Lunar iDXA is designed to help doctors detect, diagnose and monitor treatment of osteoporosis. The system also enables clinicians to simultaneously assess body composition and ascertain fat distribution.
Hologic (Booth 7113), whose merger with Cytyc was approved by Cytyc stockholders in October and who also recently acquired BioLucent, is introducing a number of new products at RSNA, including MammoSite.
MammoSite targeted radiation therapy provides a higher daily dose that can be used for a shorter period of time—five days versus five to seven weeks. MammoSite places the radiation source inside the lumpectomy cavity.
Also on display is the Selenia S digital mammography system that is specifically designed for the screening mammography facility or mobile environment. The Selenia S, which uses the Hologic direct conversion detector, can be upgraded to include all diagnostic tools available, the company says. Also new is the tungsten x-ray tube option for Selenia. The tungsten tube in combination with a special silver filter allows images to be acquired at a lower dose without compromising the image quality of Selenia, according to Hologic. The silver filter’s intended use is for imaging thicker breasts with both lower dose and shorter exposure times to eliminate problems with patient motion. Systems shipped with the tungsten tube option will be calibrated to have a minimum of 30 percent reduction in dose, for a 4.5 cm breast, compared to Selenia/Molybdenum systems.
SecurViewDX, Hologic’s diagnostic workstation, has the intelligence to look at the image details and content for every procedure type and automatically hang the images in the order that users prefer. And since SecurViewDX allows users to change their workflow with drag-and-drop ease, it can create and store an unlimited number of hanging protocols for multiple radiologists without affecting a colleague’s settings. It also offers analysis and manipulation tools and customizable image layout and orientation. Intelligent roaming moves from one quadrant of the breast to the next, displaying every section at full resolution and skipping areas of the image where no breast tissue is present.
In the CAD arena, the company is showing the Hologic R2 CAD and the DigitalNow upgrade that digitizes films for soft-copy display so that prior screen-film images are displayed on the workstation along with the current digital images and can be sent to an archival system for use in years to come.
The MammoPad breast cushion is a 2007 addition to the Hologic portfolio. Designed for comfort, the radiolucent cushion's grip-like surface holds breast tissue in place to ensure optimal breast positioning for digital and analog mammography.
The company also is showcasing its Hologic breast biopsy tables and upright solutions that include the MultiCare Platinum, and the Digital StereoLoc II optimized to work with the Selenia system. New this year to the Suros ATEC (Automated Tissue Excision and Collection) breast biopsy system portfolio is the Suros Celero vacuum-assisted spring loaded core biopsy device for the breast ultrasound market. With the option of firing inside or outside the breast, the device is designed to access hard-to-reach lesions in the axilla, near the chest wall, near implants, or behind the nipple, the company says. It securely holds the tissue sample in place while acquiring large cores.
Hologic also is demonstrating how the low dose Discovery bone densitometer is improved with new functionality, including Hip Structure Analysis (HAS), and the use of abdominal aortic calcifications (AACs), as seen in Discovery IVA scans. HAS uses specialized software to examine the structural geometry of 2D DXA scans.
Hologic is showcasing its investigational breast tomosynthesis system with a selenium-based detector. A specially designed booth will allow visitors to see a demonstration of how 2D and 3D imaging (breast tomosynthesis) can be accomplished. Also being investigated is Hologic’s full-automated breast density assessment tool, Quantra. The new tool uses a complex model of the x-ray imaging chain to calculate the amount of dense tissue penetrated at each pixel in the image, which is independent of how the image was acquired. Using images from Selenia, Quantra gives the total volume of fibro-glandular tissue in cubic centimeters, as well as the total volume of the breast, removing the vagaries due to human estimation.
Lastly, the company is previewing its Hologic’s 3-D Discovery Bone Densitometer that is pending FDA clearance. It uses a rotating C-arm on the Discovery system, allowing images of the femur to be acquired at different angles and 3D reconstruction.
MagView (Booth 7610) is premiering its latest technology, a paperless patient history module designed to run on tablet PCs. The MagView’s Patient History module allows breast imaging facilities to electronically collect breast history information. Once a patient has completed entering her pertinent breast history, the information is automatically entered in the patient’s electronic chart in MagView. Questions are displayed with large fonts that reduce eye strain and phrased in layman terms. With large “back” and “next” buttons, even patients with little computer knowledge can immediately use MagView’s Patient History module without trouble. When a patient completes her questionnaire, the information is securely uploaded to her record in MagView, thus eliminating the need for a staff member to manually enter the data. MagView’s Patient History module supports a paperless workflow by providing technologists and radiologists with immediate access to the patient’s history. MagView’s. Although designed for ease of use on any tablet PC, MagView’s Patient History module can also run at a kiosk or any other Windows OS workstation.
MammoBase (Booth 1604) is introducing the MammoProfile at this year’s RSNA. The kiosk-based product allows mammography patients to enter their own history data into MammoBase, radiology information systems or hospital information systems. After entering data via a touch screen, patients can then view informational custom or internet videos about mammography and women’s healthcare.
The MammoProfile workstation is linked across the network to the regular MammoBase database or RIS/HIS. The individual's responses feed into the MammoBase patient-history area, and are instantly accessible there. Technologists can then print out optional history sheets with patient demographics and history, as well as breast diagrams and other tools.
After the patient has finished responding to the "medical history wizard," she can put on headphones and view multi-media resources about breast cancer until she is called in for her exam. Among topics she can access: breast self-exam; diagnosis and treatment of breast cancer; and risk factors and warning signs.
Mammography Reporting System (Booth 2403) is showcasing their new version 6.6 with one-touch negative reporting features on the MRS Mammography Reporting System. Designed to save time with the one-touch negative concept, the newest version synchronizes with digital workstations to keep the radiologists on the same patient on all monitors, synching 5K digital workstations and the network running the MRS application.
Medipattern (Booth 5515) is announcing seven new B-CAD products at RSNA, including six versions of B-CAD for breast ultrasound imaging and one version for breast MRI (magnetic resonance imaging). Medipattern crosses the modality boundary by creating CAD products for breast ultrasound imaging and breast MRI from the same algorithm platform technology.
The new B-CAD and works-in-progress for CAD on whole-breast ultrasound, are being displayed. B-CAD reads the images in cine loops, automatically detecting and characterizing lesions. CAD results are reviewed by the radiologist, who can edit them, and then B-CAD automatically enters all of the evidence and findings into a natural language report.
The B-CAD 1.2.1 turn-key solution includes a DICOM network-ready PC with a B-CAD viewer and CAD reporting system. It reads the images in cine loops, automatically detecting and characterizing lesions. CAD results are reviewed by the radiologist, who can edit them. B-CAD then automatically enters all of the evidence and findings into a natural language report. B-CAD 1.2.1 also is available in a software format for loading onto existing equipment. The modules can plug into new or existing PACS viewers to support the new C4 revision level for Cedara and the multimodality women’s health IDS5 workstation from Sectra. It is available through Medipattern’s U.S. reseller channel and partners.
Available outside the United States is B-CAD 2.2 in two formats: as a software product intended for Medipattern’s resellers to load onto workstations; and as a plug-in module for the Sectra IDS5 workstation. B-CAD 2.2 electronically analyzes breast masses using all of the American College of Radiology’s BI-RADS (breast imaging reporting and data system) feature categories: size, shape, orientation, margin, lesion boundary, echo pattern, post-acoustic features, and calcification in masses. Version 2.2 gathers all of the information required to track multiple lesions and completes the imaging procedure by automatically documenting the results in a pre-formatted report.
Medipattern’s morphology CAD for breast MRI is being shown as part of Confirma’s Version 5 CADstream product. It performs detection and characterization of features based on physical shapes or morphology within a breast MRI. Medipattern’s morphology CAD, joined with Confirma’s kinetic CAD, form a complete approach to reviewing MRI images, detecting lesions via both physical characteristics and dynamic flow characteristics.
Medison America (Booth 2903) is showcasing a new ultrasound system, the Accuvix V10.
The Accuvix V10 enables enhanced diagnostic accuracy and shortened diagnostic time, providing high-quality images through its 17-inch, 1280 x1024 high-resolution flat-panel display set on an articulating arm. The Accuvix V10 provides Doppler image quality using speckle reduction filter, full spectrum imaging, DynamicMR and features 2D, 3D and 4D image technologies.
Merge Healthcare (Booth 1122) is exhibiting the latest versions of its standalone clinical applications, which provide tools for specific areas of a clinical practice. Merge Mammo is a multi-modality, vendor-neutral mammography workstation application. As a works-in-progress, the company is showing Merge Mammo 7.1, which includes leading-edge support for 10-bit video cards. In addition, this application contains features such as support for 64-bit and Vista OS, more customization options for viewing and measurement tools, improved viewing protocols and support for 12-bit printing.
NDS Surgical Imaging (Booth 6554) is introducing its AXIS V display for mammography. Designed specifically for use in digital mammography and PACS workstations, the AXIS V product features excellent ambient light adaptability and high-quality diagnostic images, the company says.
PenRad (Booth 3200) is releasing its latest mammography information system software, Version 8.0. DICOM productivity items include the option to provide worklists, structured reports, and PenFetch to pre-fetch and route prior images from your PACS.
PenRad also is expanding its soft copy connectivity and connects to nearly all PACS workstations with single or bi-directional synchronization, or through CCOW.
New features include Confirma MRI CAD Integration, Quick Read report paraphrasing, PenRead to capture key tracking items from HL7 results, email of results to patients and/or referring physicians and the ability to scan documents. New procedure types including scintimammography, cryoablation, brachytherapy and sentinel node have been added along with additional administrative reports.
Philips Medical Systems (Booth 4048, 4129, 4165) is providing a look at their works-in-progress MammoDiagnost DR, a digital solution for mammography designed for high-volume screening. The solution, with an expected 2008 FDA clearance, features Philips Eleva workflow at the console and integrates seamlessly into existing PACS via DICOM. It features an amorphous selenium detector with 85µm pixel size; a large field of view: 24x30 cm; and automatic exposure control and compression optimization.
Planmed (Booth 8324) is introducing a new, full-field digital mammography (FFDM) unit—the Planmed Nuance Excel—with a unique combination of high performance, 24x30 cm amorphous selenium–based direct digital detector and special x-ray filtration. The new technology offers optimal digital mammography image quality with significantly reduced radiation dose. The Nuance Excel comes with Planmed’s acclaimed MaxView and Side Access breast and patient positioning systems for improved mammography imaging workflow.
The company also is presenting its Nuance DigiGuide, a digital stereotactic biopsy system, and a motorized, height-adjustable Nuance Acquire Station (NAS) for FFDM. Planmed CAD images are shown at the Nuance Softview workstation featuring DigiPad short-cut key panel for efficient soft-copy reading. The Planmed Nuance Excel is complemented by the Planmed Mammography Information System (MIS).
Sectra (Booth 6513) is exhibiting their photon-counting, full-field digital mammography system, the Sectra MicroDose Mammography. The system has not yet received FDA approval and is being marketing outside the U.S. In addition to maximizing image quality, increasing throughput at the lowest radiation dose on the market, Sectra MicroDose Mammography features the latest developments within photon-counting technology. Photon-counting is a technology for better images, lower dose and fundamental advantages in several advanced applications, such as contrast mammography, dual-energy and tomosynthesis, the company says.
Siemens Medical Solutions (Booth 7713) is introducing enhancements to its Mammomat Novation DR full-field digital mammography system based on amorphous selenium detector technology. The system features a paddle design for comport. Novation allows clinicians to image a larger range of patient sizes because of its 24-by-29-cm detector, and the unit is packaged with syngo MammoReport, the company's dedicated workstation for mammography.
Siemens also is highlighting its MammoTest prone table, which offers clinicians the choice of upright or prone stereotactic systems. The technology features 360-degree lesion access and an ergonomically designed table for increased patient comfort. In addition, polar coordinate targeting and a high-resolution, fiber-optic camera enable an increased number of biopsies to be performed, enhancing facility workflow and throughput, the company says.
Siemens is showcasing its syngo MammoCAD is Siemens CAD solution for full-field digital mammography that is available for sale outside the U.S. market. syngo MammoCAD is validated for use with the Mammomat Novation full-field digital mammography system and the syngo MammoReport softcopy reading and reporting workstation. With the newest version of syngo MammoCAD, up to 40 percent of normal cases show no false-positive CAD marks, saving the radiologist interpretation time during the second-read phase.
In its P-Class, Siemens is demonstrating how the industry’s first pocket ultrasound system, the Acuson P10, can be used to complement diagnostic care and triage, in cardiology, emergency care and obstetrics. The system weighs 1.6 pounds, and fits easily into a lab coat pocket, allowing physicians to bring the system to patients. Its emergency applications include FAST (focused assessment with sonography for trauma) to detect fluid, determine cardiac activity and pericardial effusion, as well as detect abdominal aortic aneurysms and perform pelvic exams. Specifically, the device can determine fetal viability, fetal positioning and amniotic fluid volume.
Toshiba America Medical Systems (Booth 7130) is introducing its 4D volume imaging applications for ultrasound at RSNA 2007. The new 4D applications help physicians to better perform transvaginal/OB, small parts and abdomen imaging procedures, resulting in less variation in the acquired images, the ability to analyze data after a patient is discharged, improved productivity and ultimately, a better diagnosis, the company says.
The 4D transducers on display include:
- Microconvex, a transducer unique to Toshiba, which can better image the abdomen and also be used for guidance in R/F ablations.
- Endocavity, which provides 4D images for transvaginal and OB procedures.
- Linear, for imaging small parts of the anatomy, including the testes, thyroid and breasts.
Zonare Medical Systems (Booth 5305) is showcasing its new z.one ultra system, the company’s next-generation convertible ultrasound platform. Based on Zone Sonography technology, the z.one ultra system features advanced software and hardware and transducer technology. With the touch of a button, clinicians can convert the z.one system from a full-featured, cart-based system into a premium compact ultrasound system.
The z.one system’s Zone Sonography software-based architecture allows its performance to be upgraded. System upgrades can be downloaded via the internet, allowing for fast, convenient advances in clinical capabilities and clinicians to cost-effectively maintain the system, according to Zonare.
Another software upgrade introduced in 2007 is a new comprehensive obstetrical calculations package. The upgrade includes Nuchal Translucency and nasal bone length measurements. In addition, cerebella diameter, humeral, radius and ulnar measurements have been added to the OB calculation package, as well as measurements for fetal fibula.