The latest innovations address hot-button issues: from reducing radiation dosage to increasing revenue.

Under the slogan of “Connecting Radiology,” this year’s annual meeting of the Radiological Society of North America drew more than 61,000 attendees who gathered information on a host of industry trends: The bevy of PACS/RIS companies brought with them solutions tailored to improve productivity and workflow, with many allowing for remote access; reducing radiation dose was a major theme addressed by manufacturers; ergonomic products and portable products both took center stage; and teleradiology was a hot topic.

Here is a brief look at some of the most inspired technological developments and emerging industry trends witnessed at RSNA.

Efficiency, Workflow, Cost Savings

PACS/RIS companies were a dominant presence. Manufacturers presented innovations, but also announced new partnerships designed to offer comprehensive, cost-effective solutions. Here are just a few highlights from the informatics arena.

There is speech recognition, and then there is “speech understanding.” M*Modal’s speech technology incorporates context-based understanding versus standard single-word recognition, enabling the system to identify phrases instead of simple audio that often comes with background noise. The solution comprehends and transforms dictated reports into electronic files that can be shared across multivendor health care facilities. The audio files can be accessed locally or by any authorized user over the Internet, providing for efficiency, undisrupted workflow, and cost-effectiveness.

According to Candelis, of Irvine, Calif, a paradigm shift was needed to dramatically lower the cost of PACS. As a result, the company developed a fully integrated multimodality PACS, one that is compatible with most DICOM viewing workstations. The ImageGrid manages and archives studies from data-intensive modalities, such as CT and MRI, and offers a versatile, tailored solution for a variety of different facilities at an affordable price.

Medical software developer Thinking Systems released a new version of its Thinking PACS with enhanced support for PET-CT fusion, now featuring ModalityBroker and ThinkingAddOn functions. With the data verification additions, the company’s software can further integrate all imaging modalities into one enterprise radiology PACS and provide a centralized archive—another dominant need manufacturers were addressing at RSNA.

Also displaying PET/CT functionality is the IntelePACS of Intelerad Medical Systems Inc. Its native viewer, the InteleViewer, possesses the capabilities of a dedicated PET/CT fusion workstation, with Advanced Region of Interest functionality as well as sagittal, coronal, transverse, and oblique views. Working with Convergent Imaging Solutions Inc, Intelerad is looking to eliminate the need for dedicated PET/CT workstations while gaining the flexibility of enterprise-wide availability, which will bring significant cost savings.

As an enterprise archive service, InSite One’s InDex delivers many of the storage and archiving features of a full-blown PACS, and it has capabilities for on-site and off-site infinite storage, high-speed accessibility, built-in understanding of DICOM data format, and disaster recovery. For hospitals already with an existing PACS, InDex allows the facilities to cost-effectively outsource the system’s storage and archiving component. Offered as a pay per study, the technology aims to reduce costs for hardware, software, and staff. Its latest enhancements introduce a pathway to patient-centric object libraries and clinical information life-cycle management in a digital framework.

Automation, Customization

Modality manufacturers were focused on helping providers speed workflow, optimize efficiency, and reduce unnecessary costs.

This year’s RSNA drew more than 61,000 attendees.

Carestream Health debuted a pair of compact, single-cassette CR systems for general radiology, long-length, dental, and mammography exams. These two units exemplify the industry’s growing emphasis on automation and customization. The KODAK DIRECTVIEW Classic and Elite CR systems are equipped with automatic image rendering, so that technologists do not need to identify each exam project. Instead, users can create customized settings for image presentation, by exam type or body part. Designed for facilities large and small, the CR systems’ automated features help to speed workflow and reduce the possibility for errors.

By combining CR and DR solutions, Konica Minolta Medical Imaging USA strove to overcome the problems associated with designing an all-DR room, which can be cost-prohibitive and impractical for some. The REGIUS Digital Imaging Suite “brings together the versatility of CR systems with the throughput of DR into one unified imaging platform,” according to the company. Its key components are an x-ray system called the REGIUS 370 Digital Radiography, a float-top table, the NANO CR system, and a control station. Marketed as a new approach to digital x-ray room design, the suite optimizes clinical efficiency and capital expenditure.

Siemens Medical Solutions ushered in the world’s first adaptive CT scanner. The new SOMATOM Definition AS goes beyond the capabilities of current state-of-the-art scanners by adapting to the patient’s clinical situation, transforming from a stroke unit to a noninvasive cath lab to a therapy management tool to an interventional suite. Pending FDA approval, the unit will be available in multiple configurations that can be customized to fit a facility’s workflow and clinical needs.

Reducing Radiation Dosage

Time and again, manufacturers told us about products designed to reduce radiation dosage. Here’s how some of the latest stack up on safety.

One of the biggest news items to come out of the RSNA meeting was the unveiling of Toshiba America Medical Systems Inc’s AquilionONE, the world’s first dynamic volume CT system that has been a decade in the making. Physicians are able to view a three-dimensional depiction of an organ, such as the heart and brain, in addition to the organ’s dynamic blood flow and function. Covering up to 16 cm of anatomy using 320 ultra-high-resolution 0.5 mm detector elements, the AquilionONE can scan the organ in one rotation at one moment in time, reducing critical exam time, radiation, and contrast dose. Toshiba foresees a reduction in health care costs because multiple tests and invasive procedures can be eliminated.

Philips also focused on reducing radiation dose, specifically with CT products that seek to make a difference in how radiologists can prevent, diagnose, treat, and monitor disease. For example, the Brilliance iCT scanner produces high-quality images of the heart and brain, while reducing dose by up to 80%, the company estimates. New x-ray tubes, detectors, and reconstruction design elements are included in both the Brilliance iCT and a new 64-channel system, and the technology allows for detailed 3D images of an entire organ. Furthermore, scans are produced much quicker, with the unit’s gantry rotating four times in a single second—about 22% faster than current systems.

With a focus on early health and patient safety, GE Healthcare, too, has improved dose reduction results for both diagnostic cardiac and neuro perfusion exams through two new technologies. The company said its SnapShot Pulse technology, a prospectively gated diagnostic cardiac CT exam, has been shown to increase the quality of an image while reducing a patient’s radiation exposure by up to 83%. Furthermore, its VolumeShuttle technology was developed to deliver twice the anatomical coverage of a conventional 40 mm cine perfusion protocol while emitting nearly a quarter less radiation.

Patient Comfort, Portability, Ergonomics

Physicians are seeking smart design, and manufacturers have responded. The RSNA floor included an array of products designed to improve patient comfort as well as ergonomic innovations that can keep staff more productive.

Toshiba’s work-in-progress Vantage Titan MR system addresses the concerns of claustrophobic, as well as larger, patients. The open bore of the 1.5T system is 18% larger than comparable products on the market, and it also limits MR acoustic noise using the company’s Pianissimo technology.

Ergonomic features of Confirma’s Access Breast Coil, such as a cushioned, adjustable headrest, flexible torso pads, and large apertures, provide for maximum patient comfort during diagnostic and interventional procedures. The product has a four-channel, phased-array coil architecture, which produces high-quality parallel imaging of the breast, chest wall, and axillary tissue. In addition to the comfort level of the patient, the breast coil allows for easy interventional access, letting health care providers perform procedures from both lateral and medial approaches.

Geared toward allaying possible technician woes is the Pixium Portable 3543 detector, a wireless digital imaging solution from Thales. The low-power Wi-Fi connection takes away the burden of cables so that professionals can work closely with their patients in any setting, from the ICU to the OR. With the ability to capture difficult or unusual x-ray projections, the detector is light, compact, and easy to handle.

Another portable solution on display was Siemens’ pocket ultrasound, the ACUSON P10, which weighs a mere 1.6 pounds. The company envisions the handheld technology to be used in the same fashion as today’s stethoscopes, intended for initial diagnostic care and triage in emergency care, obstetrics, and cardiology.

Productivity and Profitability

Outsourcing and teleradiology were hot topics at RSNA. We discovered new services—like the one offered by Merge—designed to help providers improve productivity and profits.

Providing services 24 hours a day, 7 days a week, for 700 radiology group customers, NightHawk, a leading teleradiology service provider, discussed the results of a recent survey it commissioned. Conducted by JD Power and Associates, it found that the sample of radiologists and managers value shorter turnaround times of accurate reports they get from overseas.

Offering a genuine advance in the teleradiology trend, Merge Healthcare announced Merge TeleRead and Consult PreReads. The latter is a consulting service that gives a preliminary report of a medical imaging study that is then prepared and revised by two offshore radiologists. Including references to prior studies and reports and relevant patient clinical information, the preread may be accessed through TeleRead by a US radiologist prior to writing up their final diagnostic report. According to Gary Bowers, president of Merge Healthcare North America, Consult PreReads will accelerate report turnaround time. He also expects a reduction in overall transcription costs, as well as labor and error. The technology, he said, “will allow our customers to leverage automation to streamline the distribution of images and relevant clinical data.” Practices, therefore, can become more productive and, at the same time, more profitable.

Elaine Sanchez is associate editor for Axis Imaging News. For more information, contact .