orr.jpg (8823 bytes)Just when you thought your to-do list from the RSNA was complete, suddenly it’s February and time for the annual trek to the SPIE (International Society of Optical Engineering) Medical Imaging meeting in San Diego (Feb. 12-17, 2000).

If you’ve ever attended this relatively quiet and esoteric meeting, then consider yourself an insider who knows some of the fascinating behind-the-scenes work and personalities of the imaging business. This meeting is a step ahead of the modality shows that focus on current developments rather than future direction. More than 1,000 attendees from all over the world traditionally include scientists, physicians, physicists and engineers from the research, university and clinical environment to discuss their latest efforts to harness and utilize advanced technology related to medical imaging.

At six days long, this highly technical meeting requires a hearty appetite for all things scientific, theoretical and physical in the medical imaging domain. Individual conferences are held within the meeting that highlight developments from seven major research and application categories.

Physics of Medical Imaging – 81 papers. X-Ray Detectors, Imaging Physics, Fluoroscopic Imaging, Mammography, Chest Radiology, Microscopy, CT and MRI, New Frontiers, Volume Imaging and Optimization of Image Quality. The growth in presentations on X-ray detectors five years ago signalled the start of the race to digital X-ray. Predictably for medical imaging, the race has turned out to be a marathon, with the front-runners still battling.

Image Display and Visualization – 74 papers. Volume Visualization and Clinical Applications, Image Visualization, Factors Affecting CRT Display Performance, Virtual Reality, Image Guided Procedures, Telemedicine and Computer Aided Diagnosis. Image Guided Procedures looks most appealing in relation to near-term impact on clinical medicine.

Image Processing – 183 papers. Computer Aided Diagnosis, Image Segmentation, Image Registration, Image Processing Algorithms, Spiral and Cone-Beam CT, Image Reconstruction, and Image Shape and Scale. The highlight work in this area should be the advances in breast and lung cancer screening using computer assisted diagnosis (CAD).

Image Perception and Performance – 40 papers. Computer Aided Diagnosis, Image Quality Assessment, Visual System and Observer Performance, ROC Analysis and Observer Performance and Expertise. This session breaks out the links in the medical imaging chain – the imaging technology, the radiologist, the computer and the patient – in an effort to identify and evaluate improvements systematically. ROC (Receiver Operator Characteristic) curves are a central part of this performance-based analysis.

Physiology and Functions from Multi-Dimensional Images – 43 papers. Brain Imaging, Lung Imaging, Virtual Endoscopy (General, Colon and Bronchosopy), Imaging Cardiac Vessels and Cardiac Walls, Functional MRI, Small Animal Imaging and Quantitative Assessment of Dynamic Images. The Virtual Endoscopy applications are developing some excellent clinical utility. Cardiac MRI is also sprinting ahead.

PACS Design and Evaluation – 68 papers. Historical and Clinical Perspectives, DICOM, Image Compression and Presentation, Cardiac PACS, Integrating the Healthcare Enterprise (IHE), Web-based PACS Access, Image Access and Security and Operational Experience. On the image side, compression technologies hold the key to rapid and full access to patient image files, while the IHE begins its push to standardize the links between patient information systems and image systems.

Ultrasonic Imaging and Signal Processing – 50 papers. Three-dimensional imaging, Transducers and Arrays, Tissue Characterization, Elasticity Imaging and Contrast Agents, Novel Imaging and Beam Forming. It’s interesting to note that the most recent singular development to revolutionize this part of the industry, miniature and portable ultrasound systems, is not even on the agenda!

In addition to the above listed conference specialty areas, SPIE offers a collection of in-depth short courses and workshops. The most interesting of this group include Texture Analysis in Medical Imaging and Medical Imaging Processing Algorithms.

Britton Chance, Ph.D., of Philadelphia, a highly distinguished scientist and researcher for more than 40 years, provides a keynote talk. His presentation, “Brain Functional Imaging in Problem Solving Using Near Infrared Imaging” will address the tremendous advances in NIR spectroscopy and imaging during the past decade. NIR uses light photons in place of X-ray photons, and is capable of providing information on tissue function and anatomy. The initial applications of this technology, as demonstrated by the 12 existing imaging systems operating worldwide, is focused on tumor evaluation (especially in the breast), brain function (cognitive processes) and muscle function (sports and disability applications). The applications to functional brain analysis may begin providing insights into the organ with which we have the least knowledge, and possibly the most need for information – the brain.

For anyone interested in the engineering and physics of medical imaging, this meeting is far more important than RSNA. For anyone interested in the location, San Diego is at least 70 degrees warmer than Chicago as well! end.gif (810 bytes)

Doug Orr, president of J&M Group (Ridgefield, Conn.), consults with medical device companies in strategy and business development for emerging growth markets, notably radiology and cardiology. Comments and suggestions can be sent to [email protected].