· Convertible Ultrasound Combines Performance with Portability
· Tech Zoom: GE Licenses SonoVCAD Ultrasound Protocol
· Emerging Applications for Ultrasound

Convertible Ultrasound Combines Performance with Portability

When Memorial Medical Center completed a major expansion during the early portion of last year, administrators searched for a way to provide ultrasound imaging throughout the facility. After considering their options, they decided to move forward with a solution from ZONARE Medical Systems called the z.one ultra, a system that represents the company’s next-generation premium Convertible Ultrasound platform.

The z.one ultra system from ZONARE can be set in a fully featured, cart-based configuration or it can be converted to a premium compact portable unit.

“With the z.one system’s premium compact design, we were able to replace our heavy, bulky, conventional unit without compromising image quality,” said Jana Anguis, ultrasound supervisor, Memorial Medical Center of Modesto, Calif. “The system also allows us to convert to completely portable exams, which can especially be important in locations where mobility is an issue for the patient, such as the ICU.”

Showcased at this year’s RSNA meeting, the z.one ultra system is sold primarily to radiologists, interventional radiologists, vascular labs, and emergency departments. At 5.5 pounds, it can be set in fully featured, cart-based configuration, or it can be converted to a premium compact portable unit. The system consists of advanced software, hardware, and transducer technology, which includes a new multitransducer port (MTP) and multitransducer connector for the z.one scan engine.

Hailing the z.one ultra’s versatility, ZONARE representatives say the company’s patented Convertible Ultrasound platform, brought in through Zone Sonography technology, provides customers with premium image quality and performance with portability at a great price. Furthermore, the system is environmentally friendly because it is based primarily on advanced software, instead of proprietary hardware. As a result, far less power is needed, and consequently far less heat is generated, compared with other conventional systems. According to the company, this will lead to less air conditioning use and prevent greenhouse gas emissions, which could save customers up to hundreds of dollars annually.

System costs, depending on features and transducers purchased, range from $60,000 to $90,000, according to ZONARE. The company also sells less expensive options, which are also powered by Zonare Sonography technology and the same interchangeable 5.5-pound premium compact system.

“We appreciate the financial and clinical investment our customers have made in selecting ZONARE for their ultrasound needs,” said Mark Miller, vice president of sales and marketing for ZONARE. “We take every step to maximize this investment by providing ongoing upgrades to optimize clinical data and workflow efficiencies.”

As part of the upgrades, ZONARE is providing its customers with a new comprehensive obstetrical calculations package that includes Nuchal Translucency and nasal bone length, cerebellar diameter, and humeral, radius, ulnar, and fetal fibula measurements.

Included as a new advanced hardware feature is DVD burner archive capability, which allows users to export patient studies with a DICOM viewer. Therefore, all images, clips, and reports can be reviewed through a PC. Additionally, an MTP and MTC lets clinicians easily choose between three transducers connected simultaneously to the cart-based system. All future transducers will be able to connect as well, according to ZONARE.

In related news, the company is thrilled with the results of a recent KLAS customer study, which gave ZONARE top honors in the handheld ultrasound market.

Participants in the survey were asked to give a rating on how well their hand-carried ultrasound performed specific exams, such as echo, vascular, and small parts imaging. Users also rated products based on image quality, ergonomics, durability, battery life, and part availability.

ZONARE ranked first in performance, with a score of 89.9 out of 100.

—Elaine Sanchez

Tech Zoom: GE Licenses SonoVCAD Ultrasound Protocol

In December 7, GE Healthcare, Waukesha, Wis, announced it had licensed a new technique patented by Alfred Abuhamad, MD, chairman of obstetrics and gynecology at Eastern Virginia Medical School (EVMS), Norfolk, Va. Abuhamad’s technique, known as Sonography-Based Volume Computer Aided Diagnosis (SonoVCAD), automates the acquisition of ultrasound images used to diagnose fetal heart defects.

“For the first time in ultrasound, we have a technique that allows for the display of anatomic planes that are required for the diagnostic purpose of an organ in an operator independent mode,” Abuhamad said. “That’s a big thing for ultrasound because it’s an operator dependent modality. Now we’ve made these images available in a simple, automatic fashion without having to rely on the skills of the operator.”

SonoVCAD displays all of the 2D planes needed for a complete ultrasound evaluation of the fetal heart, complying with the standard screening of the fetal heart recommended by the American Institute of Ultrasound in Medicine, the American College of Obstetrics and Gynecology, the American College of Radiology, and the International Society of Ultrasound in Obstetrics and Gynecology.

The software enables identification of the four-chamber, left outflow tract, and right outflow tract views of the fetal heart, all parts of a standard 2D exam; then, the clinician identifies a standard starting point for the four-chamber view, and SonoVCAD’s algorithms go to work generating the other planes automatically.

“We built all the mathematical relationships of the planes in space to a reference plane,” said Abuhamad. “We wrote the software to go from the reference plane and find all these other planes as dictated by the mathematical relationships. In the past, the operators would have to try and find these views, and they are not easy to get and retrieve. Now, because they’re made available without the operator being able to search for them, the detection of congenital heart disease should be enhanced.”

GE has incorporated SonoVCAD into its Voluson E8 next-generation ultrasound platform for women’s health care. “We hope that by enhancing detection of congenital heart disease, we can identify those babies sooner and direct them to tertiary centers better equipped to care for them,” said Abuhamad.

He also has high hopes that SonoVCAD and advances like it will pull 3D ultrasound into the mainstream. “2D ultrasound is still the norm,” he noted. “We’re hoping in the future that 3D ultrasound with this technique will be used more often, especially when the skills of the operator are limited. It’s very common that the operator can’t find these heart defects. The detection rate is currently about 30%, so you can see how much room for improvement exists.” Congenital heart defects currently account for nearly twice as many deaths per year than all forms of childhood cancer combined, according to the American Heart Association.

And, of course, this kind of automation could prove useful in other kinds of imaging. That’s where Abuhamad’s research will be focused next. “We’re building new algorithms for different organ systems and looking to introduce more automation into the process,” he said. “We’re looking at the brain and looking at other applications, both in the newborn and hopefully in adults.”

—Cat Vasko

Emerging Applications for Ultrasound

Ultrasound is evolving in exciting ways. Clinicians around the globe are discovering more uses for compact systems. Recognizing the demand for these kinds of technologies, GE Healthcare teamed up with anesthesiologists, emergency medicine physicians, and other specialists to develop dedicated systems streamlined for emerging care areas of ultrasound.

The company, based in Waukesha, Wis, recently launched new editions of its LOGIQ e compact, now tailored for emergency medicine in addition to anesthesia delivery. It also released an enhanced version of its LOGIQ Book XP compact ultrasound.

“We are continuing to invest in our specialized compact ultrasound strategy, further refining our customized systems to meet the unique needs of clinicians,” said Omar Ishrak, CEO and president of GE Healthcare’s Clinical Systems business unit. “We have migrated technology from our industry-leading, larger console systems to these new, miniaturized compact systems. GE is cultivating the growth of compact ultrasound and expanding the reach of these clinical technologies to more patients around the world.”

As part of its Breakthrough 2008 campaign, all three of GE’s latest systems feature higher image quality as a result of exclusive CrossXBeam software, which defines continuous boundaries of anatomy to enhance image clarity. They also are equipped with an Auto Clarity Suite for automated image optimization and a Network QuickSave, which moves patient data to a network folder for integration with relevant medical images.

Specific highlights of the LOGIQ e Anesthesia Edition include GE’s B-Steer Plus technology, designed for regional anesthesia nerve blocks and vascular access procedures. B-Steer displays both the needle and anatomy in one image, and the technology maneuvers the ultrasound beam for optimized visualization of the needle.

“I’ve found that the biggest advantage is the presets for anesthesiologists to use,” said Jeffrey Swenson, MD, professor and director of anesthesia for the orthopedic center at the University of Utah. “The presets allow for those who are not familiar with the physics of ultrasound to use the LOGIQ e easily. And, the flexibility for novices and experts to use either the presets or to manually adjust the machine allows for superior-quality images.”

Also containing dedicated software presets is the LOGIQ e Emergency Medicine Edition, created for critical care imaging for patients. The setting allows patient imaging for abdominal aortic aneurysm, ectopic pregnancy, and gallstones, among other conditions. “The new cart and docking system is a huge step up for the ED,” said John Bailitz, MD, assistant residency director and ultrasound curriculum coordinator at Cook County Hospital in Chicago. “Rapid probe changes and the large screen improve the care of critically ill patients.”

As the third major upgrade of the LOGIQ Book platform, the LOGIQ Book XP was built applying suggestions from customer feedback. New LCD technology comes with higher resolution, improved off-angle viewing for multiple users, and increased brightness. Boot-up time is improved by faster processing, which features a 30% faster mode transition.

According to GE, its global compact ultrasound products have flourished, bringing in $175 million in revenue as of third quarter close for 2007. This figure represents 65% growth compared to the same time the year prior. Industry analysts anticipated a 36% growth in the compact ultrasound industry market by the end of 2007.

One such analyst, Harvey Klein, of Klein Biomedical Consultants, predicted that worldwide market growth for emerging compact applications would reach 50% by the end of last year. GE projected its emerging application sales to grow 33 percentage points faster than market figures.

—E. Sanchez