by Cat Vasko

· Volunteer Program Uses ECG and Echo to Diagnose Cardiac Conditions in Student Athletes
· EDAP Spreading HIFU for Prostate Cancer in European Market
· New from GE Healthcare at AIUM: ViewPoint 2007 and LOGIQ i
· Duke University Researchers Unveil 3D Fetal Imaging

Volunteer Program Uses ECG and Echo to Diagnose Cardiac Conditions in Student Athletes

On April 28, the Team of Physicians for Students (TOPS), led by founder Paul Steingard, DO, held its annual screening event for high school students in Phoenix. Using electrocardiogram and echocardiogram devices donated by Philips Medical Systems, Andover, Mass, almost 300 volunteer cardiologists, radiologists, physicians, and techs screened more than 2,500 student athletes?identifying 385 students who required follow-up examinations and eventually finding 114 who were not cleared to participate in sports due to potentially fatal heart conditions.

“We started doing physicals for students back in the sixties,” recalled Steingard, who is Team Physician Emeritus for the Phoenix Suns. “We started this program 7 or 8 years ago, in which we expanded our physicals into areas of preventive medicine. We include electrocardiograms in our examination, and those that are suspicious by history or examination are followed by echocardiograms.”

More than 60 high schools from the Phoenix area participated in this year’s event, where students were tested using the Philips PageWriter ElectroCardiographs and the iE33 ultrasound system. “We use all Philips equipment,” Steingard explained. “We got a grant from one of the local hospitals, and Philips was able to give us an in-kind donation, so we were able to buy 35 ECG machines, and now we’re trying to raise some money to buy echo machines. We also lend these ECG machines out to other cities that are trying to start programs.”

In fact, Steingard said, the program is already going national, with screenings taking place in Des Moines, Iowa, Philadelphia, Harrisburg, Pa, and elsewhere. Philips started its Save an Athlete campaign in 2006 to help sponsor TOPS and other testing programs around the country.

Volunteers with the Team of Physicians for Students used electrocardiogram and echocardiogram devices to screen more than 2,500 student athletes in Phoenix.

“The use of cardiac testing with ECG and echo exams in sports physicals can help identify heart conditions that could trigger sudden death and would not be otherwise identified through an ordinary physical examination or medical history,” said William Rappaport, MD, FACC, of the Arizona Heart Institute, Phoenix, which this year dispatched several cardiologists to the TOPS program to help interpret ECG and echo exams.

“Now in our ninth year since adding cardiac testing, the TOPS event is one of the country’s largest sports physicals of its kind and provides athletes, their coaches, and their physicians with simple and effective health tests that may ultimately help prevent a terrible tragedy,” Rappaport said.

The program is volunteer-driven, and Steingard encourages clinicians?especially techs?to get involved in their communities. “The ECG techs and the echo techs helping us are invaluable,” he said. “I don’t know what we would do without them. We hope that people will volunteer to help in their cities. This has really evolved into a great program.”

EDAP Spreading HIFU for Prostate Cancer in European Market

EDAP TMS SA, Lyon, France, developer and distributor of the Ablatherm-HIFU device for high- intensity focused ultrasound (HIFU) treatment of prostate cancer, will host 40 mini-conferences throughout Europe this year in an aggressive attempt to disseminate the technique, which has yet to take a real foothold in the market. Prostate HIFU is not approved by the FDA for United States use.

“The program is based on 40 meetings, which will take place in France, Germany, Italy, and the UK,” explained Romano Sabrice, at EDAP. “We invite urologists from the region around the city where the meeting will take place, using both ads in magazines and mailings, so if they come, they do so on their own, because they are interested in the topic of the meeting, which is everything they want to know about the HIFU technique.”

Ablatherm-HIFU has yielded high success rates with minimal side effects in multicenter clinical trials and can offer a noninvasive alternative to external beam radiation therapy. “HIFU is not surgery, and urologists are surgeons,” Sabrice says. “This is brand new for them. Everything is automatic and very high tech; it’s different compared to what they do daily with their knife. We have to go deeper and faster to explain detail by detail why HIFU is the future for the surgery.”

Designed to accelerate the process of converting urologists to looking at HIFU as the standard of care for localized prostate cancer, the mini-conferences last a few hours and are run by urologists, not EDAP staff. “When we meet urologists during commercial meetings or a congress, those meetings are very short, and we don’t have time to go in-depth about the technique,” Sabrice said. “And we are not urologists. We can tell them how it works, but we lack the critical credibility to tell them how they can treat patients better with this machine. So in these meetings, we don’t speak. We only have specialists in HIFU present.”

Sabrice and his colleagues hope to reach 1,000 urologists in Europe this year. “Patients are looking for these new techniques with fewer side effects, offering a better quality of life,” he noted. “I receive e-mails from patients every day asking me, is HIFU for me? Where is HIFU available? Patients want us to spread this technique.”

EDAP hopes to commence similar programs in the United States, pending FDA approval of the technique and the device.

New from GE Healthcare at AIUM: ViewPoint 2007 and LOGIQ i

At the annual meeting of the American Institute of Ultrasound in Medicine (AIUM), held in New York in March, GE Healthcare, Waukesha, Wis, showcased two new products for the ultrasound market: the ViewPoint 2007 comprehensive data management solution for OB/GYN practices, vascular labs, and diagnostic ultrasound users; and the LOGIQ i laptop-sized portable ultrasound system.

ViewPoint 2007 combines reporting and image archiving capabilities for clinicians, while also facilitating faster and easier ultrasound workflow. New workflow-enhancing features include split-screen mode and dual monitor support; image comparison functionality; and new integrated 4D View version 6.0, which is fully compatible with images from GE’s Voluson E8 and Voluson 730.

ViewPoint also incorporates several reporting improvements, such as fetal growth overview, fetal anatomy overview, and laboratory test overview; a detailed fetal anatomy screen; second trimester risk assessment; and report export. The Insite Express Connect remote service enables real-time remote monitoring and support, allowing the field service team to troubleshoot issues more quickly.

The LOGIQ i laptop-sized ultrasound system weighs just 10 pounds and features volume imaging. Its portability allows clinicians to use high-performance ultrasound imaging at the point of care?even in areas with constricted space, such as the ICU or neonatal ICU. LOGIQ i also can store raw ultrasound data and transmit it wirelessly to a workstation.

“GE’s advanced image-optimization tools on the LOGIQ i help clinicians possess image quality and portability in an ultrasound system; they won’t have to sacrifice one for the other,” said Terri Bresenham, vice president of GE’s global diagnostic ultrasound business. “In 2,800 of our clinical exams using the LOGIQ i, 98% of the exams gave the necessary diagnostic information for the clinician to complete the ultrasound study, with no need to rescan.”

Features on the LOGIQ i include raw data imaging; speckle reduction imaging in high definition for organ-specific imaging; CrossXBeam imaging; and a wide range of transducers for abdominal, small parts, vascular, neonatal, OB/GYN, and intraoperative applications. Imaging applications customized for general imaging, breast imaging, vascular imaging, neonatal imaging, and musculoskeletal imaging round out the package.

Duke University Researchers Unveil 3D Fetal Imaging

Godzilla has nothing on these three-dimensional stars. Student researchers at Duke University’s Pratt School of Engineering, Durham, NC, have developed technology that will allow expectant parents to slip on a pair of 3D glasses to see the fetus in pop-off-the-screen IMAX-style.

The new imaging can help detect certain kinds of birth defects much earlier than other technologies, the researchers said.

“To our knowledge, this is the first time it’s been made possible to display real-time stereo image pairs on a clinical scanner,” said Stephen Smith, PhD, professor of biomedical engineering at Duke. “We believe all 3D scanners could be modified in this way with only minor software changes.”

Smith and his students developed the original real-time, three-dimensional ultrasound imaging. By modifying the commercial version of that scanner with software upgrades, technicians will be able to produce an even more realistic perception of depth, according to Duke.

The technology assists the human eye, which perceives depth by marrying slightly different perspectives from the right and left eyes. Stereoscopic images take two views of an object. Using special glasses, the two images are fused, gaining a three-dimensional effect.

Stephen Smith PhD
Stephen Smith, PhD, and a team of Duke University researchers have deployed an updated 3D fetal monitor.

“Thousands of 3D ultrasound systems in clinics could be upgraded with such new software, and stereoscopic goggles could be issued to them as well. Keepsake DVDs of the fetal exam could also be viewed at home in 3D stereo,” Smith said. The glasses will become obsolete as new monitors capable of fusing stereo 3D images are in development.

The Duke research team, which also included Joanna Noble, an undergraduate student, and Matthew Fronheiser, a graduate student, reported its findings in the April edition of Ultrasonic Imaging, although their work dates back to July 2006. The research was supported by the National Institutes of Health.

Researchers said the enhanced imaging capability can improve early detection of birth defects of the face and skull and can improve a surgeon’s depth perception in performing tumor biopsies and robot-assisted surgeries.

To demonstrate the new technology, the research team first generated stereo ultrasound images of a small metal cage, then of a heart valve and blood vessels of animals. The team has since recorded ultrasound images of a model human fetus that is used in traditional testing of fetal ultrasound devices.

View a video clip of the model fetal examination above