Despite the economic downturn and global credit crunch, medical imaging professionals showed up at RSNA, where the focus was on cost-effective solutions.

In Day Two of the 94th Scientific Assembly and Annual Meeting of the Radiological Society of North America, financial services powerhouse JPMorgan Chase & Co announced it would be laying off 9,200, or 21%, of Washington Mutual Inc’s employees by the end of the following year. A couple of weeks earlier, embattled banking giant Citigroup unveiled plans to slash 50,000 jobs. A little over a week later, Bank of America said it would cut up to 35,000 jobs over the next 3 years as it absorbs Merrill Lynch.

Mindful of the economic downturn and the global credit crunch, medical imaging professionals still recovering from the Deficit Reduction Act came out to Chicago to hear about the newest research and view the latest technologies, albeit in lesser numbers than years past. Specifically, unaudited figures from RSNA indicated that attendance fell 5% compared to last year, with exhibitor attendance representing the biggest drop. A total of 24,683 vendor registrants were in the halls, dipping 12% from 2007. Nevertheless, the lower turnout wasn’t as dramatic as some had feared, and vendors were in agreement that booth traffic among the expanded three-hall setup was plentiful. Here is a recap of trends and technologies that took center stage at RSNA.

IT Vendors Address Cost Concerns

It’s no surprise that the most common marketing angle for IT products was their “cost-effectiveness.” This buzzword was popularly uttered by IT exhibitors in data storage, archiving, and disaster recovery.

Disk storage system developer ProStor Systems displayed its ProStor InfiniVault-DICOM storage system, an intelligent long-term storage solution that offers scalability and affordability for organizations that are facing increasing image loads. The system stores and retains electronic medical records and business files, managing DICOM objects over the network for modalities, RIS, HIS, and PACS. Acuo Technologies, which offers medical image management software, announced an integrated solution with two different hospitals that allows them to gain control of more than 60 terabytes of medical data. The Acuo DICOM Assisted Migration, the company says, will provide the hospitals with business continuity and result in a lower cost of ownership. Nuance Communications Inc talked about a new technology integration between its RadWhere for Radiology speech reporting solution and DeJarnette’s PACSware Intelligent Router, a partnership formed in response to the demand for a single point of access to patient information and images across disparate systems. Radiologists will then need only a single workstation of choice, which improves users’ ability to view images quickly and easily and report findings with the referring physician or hospital. Candelis’ iMed-Stor 300, a dedicated DICOM-compliant archive appliance, does not require costly installation, according to the company. Instead, it is designed to connect to existing networks, providing secure, cost-effective management of digital medical images and studies from multiple modalities for stand-alone operations. InSite One demonstrated enhanced features to its InDex managed storage services, which now include identity management services for patient reconciliation, alerts and notifications, record location, and store and retrieve for clinical data. The Web service also permits users to view studies and reports remotely on multiple Web browsers.

Other storage vendors with cost-efficient solutions include CoActiv and its expanded Exam-PACS, McKesson and its Horizon Medical Imaging PACS integration with Iron Mountain’s Digital Record Center for Medical Images, as well as Sorna, showing its eXpedo 21t CD/DCD publishing system and Reviewer DICOM software.

GE Healthcare announced the release of three brand-new product families, including Discovery, Brivo, and Optima, seen here.

Capitalizing on the iPhone

Picking up on the increasing ubiquity of the iPhone, several businesses raffled off the gadget to booth visitors who left contact information or viewed demonstrations. Additionally, numerous companies have integrated their solutions with the Apple technology for the tech-savvy radiologist on the go. Merge Healthcare demonstrated mobile technology that enabled health care providers, and patients, to look at digital medical images on an Apple iPhone or iPod touch. Again, the product is intended to “reduce costs,” according to Merge, adding that it improves responsiveness to patients by granting radiologists the ability to forward critical findings directly and securely to referring physicians. MimVista discussed how Mobile MIM for the iPhone and iPod touch gave users remote access to medical images. Mobile MIM offers a subset of the functionality of the company’s MIM 4.1 workstation, equipped with tools for radiation oncology, radiology, and nuclear medicine. M*Modal debuted a real-time speech-understanding iPhone application based on its AnyModal Conversation Documentation Services, and TeraRecon showcased a mobile version of its AquariusWEB, a fully browser-based viewer that delivers live, interactive 3D to users. Apple even led a session at the conference titled “The Mobile Radiologist: Using iPhone to Connect, Collaborate, and Work.”

Introducing newly developed technologies in the women’s health arena, Toshiba demonstrated expanded applications for its 1.5T Vantage Titan, which now supports the Radiance Plus Breast Imaging Suite.

Better Productivity, Work-Life Balance

Often referenced during sessions and lectures, the coupling of a radiologist shortage and an aging population is a concern prevalent among radiologists. Attendees wondered about how to deal with an increasing image load while maintaining a healthy work-life balance that allowed them to come home in time for dinner.

Addressing this issue, IT firms displayed numerous solutions intended to expedite the data distribution process and to allow for seamless workflow operations. Compressus announced the first installation of its next generation MEDxConnect version 2.5, which looks to seamlessly integrate disparate information systems so that physicians can read from anywhere, automatically prefetch prior exams, and efficiently transmit images and cases between sites. TeraMedica’s Evercore system, serving as a central repository for image studies, is designed to handle large image data storage with a network that scales from 100,000 imaging procedures per year to more than 6 million. Agfa Healthcare’s SE Suite of software provides a comprehensive archiving and distribution solution for managing imaging data in a CR setting. The software was developed to help users make the transition to digital imaging, managing rapidly increasing information volumes and increasing efficiency.

Other IT solutions for maximizing productivity include Ramsoft’s PowerServer 4.6, which allows images to be preloaded in advance and users to define rules; Softek’s Illuminate, which gives Philips iSite PACS users the ability to quickly locate radiological reports and their corresponding images using a free text-based search paradigm; and MedQuist’s SpeechQ, whose new integrations with a range of products from leading vendors aim to eliminate manual processes in dictation and reporting.

Modalities and the Major Players

Instead of continuing with slice wars, the big players among radiology vendors opted to home in on their existing technologies, for the most part displaying enhanced versions of already introduced modalities. Company executives mentioned that the nation’s hospitals, now with limited budgets, are restricted to careful spending, while imaging centers are dealing with the effects of the DRA on top of a struggling market. Of course, that isn’t to say that the financial circumstances quelled the innovative drive of GE, Siemens, Toshiba, and Philips, which all showcased top-of-the-line, advanced technologies. Many of their new products focused on women’s imaging, a topic that dominated the halls.

Siemens introduced new dedicated breast coils for imaging and biopsy on its 1.5T and 3T Tim systems. The company also displayed  the first quantitative MR breast spectroscopy, syngo GRACE @ 3T, which acts as a biomarker to provide information on the biochemical composition of breast lesions. The Siemens booth housed the MAGNETOM Espree-Pink, which combines the 70-cm open-bore design of the MAGNETOM Espree with the Sentinelle Vanguard breast coil, designed for all patient sizes. A works-in-progress full-field mammography, breast tomosynthesis acquires 2D projection images of a compressed breast at multiple angles during a sweep of the x-ray tube. The ACUSON S2000 Automated Breast Volume Scanner was dubbed “the world’s first multi-use automated volume breast ultrasound system,” whose features reduce operator dependence and variability. Moving beyond women’s health, Siemens showcased its Biograph mCT, the world’s first integrated imaging device to offer routine, whole-body PET scanning in just 5 minutes, according to the company. It also introduced the SOMATOM Definition Flash, a new dual source CT that requires a fraction of the radiation dose that systems previously used.

Referring physicians can download MedWeb’s DICOM archive slimPACS free of charge, an attractive feature that radiology practices hope will boost their revenues.

For customers on tight budgets, Philips showed a works-in-progress low-cost 16-slice scanner called the MX CT, which company reps say is ideal for customers looking to replace current scanners or add a second one. The product can perform routine applications, including CT angiography and virtual colonoscopy. The company also unveiled a new 3T MR scanner called the Achieva 3.0T TX, which is said to provide up to 40% greater scanning speed and aids in ensuring fewer retakes. The company’s latest proprietary MultiTransmit technology looks to overcome the challenges of dielectric shading effects and local specific absorption rates. Philips released a new version of its iSite PACS, which features enhanced mammography reading capabilities. Furthermore, a new MammoDiagnost VU mammography workstation can automatically align the “left” and “right” breast images based on tissue images.

Toshiba America Medical Systems displayed new digital upgrades for its Infinix VF-i/BP Vascular X-ray system, with new features that include an improved user interface, processor upgrades to the new Dual Xeon Server PC, and a mid-size, high-resolution 12- x 12-inch detector panel (works in progress). The interface now comes with larger icons and tabs among other improvements, allowing physicians to view images easily tableside during procedures. The system is floor-mounted frontal/ceiling-mounted lateral, with multiaxis positioners that allow unique movement capabilities, according to Toshiba. The company showcased the Kalare R&F system, which brings together an enhanced user interface and feature set with true all-digital imaging for fluoroscopic and radiographic exams. Executives say the removable, integrated DR panel dramatically improves patient care and speeds up overall workflow. For women’s imaging demands, Toshiba developed a new ultrasound technique called MicroPure, which lets physicians detect breast lesions and microcalcifications more clearly. Additionally, it previewed ElastoQ, a noninvasive technique that evaluates tumors based on stiffness and compares them to normal tissue. The company also displayed a new high-frequency 18 MHz Dynamic Micro Slice transducer for imaging superficial structures.

GE held a press conference to introduce its latest diagnostic imaging product lines, Discovery, Optima, and Brivo, which all serve different markets. Optima is targeted at clinicians’ need to accommodate high patient volumes, while Brivo products are designed as a straightforward and practical package. The Discovery line aims “to push the boundaries,” according to GE, with products that offer breakthrough applications. Included in these product lines are the Optima XR640, which features a moveable detector that mimics traditional patient exam workflow, the Discovery MR450, GE’s new 1.5T MR scanner, and the Discovery PET/CT 600, which seeks to deliver the highest sensitivity, next generation MotionFree technology, high-def imaging, and fast reconstruction. GE displayed its small footprint LOGIQ E6, as well as its LOGIQ E9, a new ultrasound system for radiology and vascular applications that merges real-time ultrasound images with images from other modalities. As its latest advancement for breast biopsy, the Senographe Essential Interventional, is designed to improve clinical confidence, accuracy, and comfort. The OEC 9900 Elite C-arm is GE’s state-of-the-art fluoroscopy device equipped with radiation dose control dependability and versatility.

Barco showcased a range of new innovations at RSNA 2008, including a high-performance 4D CT rendering platform, a three-in-one generalpurpose GPU platform, and the latest version of its MICB-1340 Image Compression Board.

Portable Products, Teleradiology, Women’s Imaging

The ability to move imaging units from room to room, and, most importantly, to the patient, is an attractive selling point for many radiologists, as shown by a large number of solutions that met this need, including Canon’s portable flat-panel detector to Neurologica’s portable CT, not to mention portable ultrasound systems from Ultrasonix and Zonare. Again making a strong presence at the show were a range of teleradiology providers, including Nighthawk, Nightrays, Teleradiology Solutions, U.S. Radiology on Call, and Virtual Radiologic. Contrast agent manufacturers, such as Bracco, Covidien, Medrad, and Meta Imaging Solutions, showcased their latest delivery systems, designed to automate the injection process, reducing manual steps and therefore the risk for human error.

But perhaps the biggest force of all at RSNA was the area of women’s imaging. In addition to technologies from the four biggies, other leading, and smaller, players brought with them an array of equipment, devices, and solutions targeting women’s health. Attendees flocked to Hologic’s spacious booth, where the company displayed its digital mammography suites. Hologic reps discussed the workflow benefits of the SecurView line of diagnostic and technologist workstations, talked about how the MammoPad breast cushion attempts to make the mammography experience a more comfortable one for women, and highlighted Selenia Breast tomosynthesis. As for CAD solutions, iCad demonstrated SpectraLook and VividLook, which are said to use innovative algorithms that produce colorized MRI images and enhancement curves on a pixel-by-pixel basis for contrast kinetic assessment of lesions in the breast and prostate. Also, the company showed new customized CAD solutions for Agfa CR, Sectra, Philips CR, and Planmed digital mammography systems.

Konica Minolta’s booth housed the FDA-cleared FlexDR, an ergonomic, upright, flat-panel digital radiography system, as well as the DRYPRO 873 Laser, which delivers image stability for mammography images. Three Palm Software released version 1.3 of its WorkstationOne mammography reading software, while Emageon described how its MammoSuite Desktop Integration permits radiologists to access advanced diagnostic breast imaging tools in real time. Other products on the floor included Infinitt’s MammoVisualgate, Carestream Healthcare’s work-in-progress DirectView CR feature for mammography, Naviscan’s newly launched PEM Flex Solo II, Beekley Corp’s skin markers and biopsy devices, Broadwest Corp’s InsightMRI Breast MR package, Dilon Technologies’ updated molecular breast imaging gamma camera, and Aurora Imaging’s SpiralRODEO Edge technology for its 1.5Tesla dedicated breast MRI system.

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