s05a.jpg (11568 bytes)Like MRI, ultrasound is gaining market share at the expense of X-ray.

Left: Toshiba’s PowerVision 8000

Estimates are that the worldwide ultrasound market is close to or above the $3 billion mark at this point and could top $4 billion by 2004.

Ultrasound technology continues to exploit its strongholds in areas such as ob/gyn, while the modality expands into new applications with solid success. Applications such as ultrasound-guided needle biopsy, intraoperative ultrasonography and stent placement cryotherapy have led many clinicians to rely more on ultrasound than in the past. Its low cost – compared to CT and MRI – make ultrasound an attractive alternative to many clinicians.

The technological advances in ultrasound have come fast and furious in recent years – more so perhaps than any other imaging modality – and 1999 was no exception. As new technologies like power Doppler, 3D capabilities and contrast enhancements become available on the high-end machines, the mid-range systems are upgraded with the previous technologies. More portable ultrasound units also are expected to carve a new niche for the modality.

One miniaturized ultrasound system in particular was creating a buzz at RSNA this year. Terason, a Division of Teratech Corp. (Burlington, Mass.), unveiled its newly cleared hand-held ultrasound system, the Terason 2000. The system weighs a mere eight ounces and is contained in one hand-held unit, roughly the size of a transducer. The unit plugs into a PC – a laptop, palmtop, wearable PC – via a FireWire connection and images are reproduced on the screen.

“We’ve taken all the system electronics along with the array and put them into one package that connects to any PC that runs Windows 98 or above through a FireWire,” said J. Kerr Spencer, Terason’s senior vice president of marketing and sales. “Everything’s in the unit you hold in your hand – the front end pulse receivers, the beam former and the scan converter.”

The system supports color power, color velocity, spectral Doppler and steered CW Doppler, as well as curved arrays, linear arrays and phased arrays. The system may be configured for all major ultrasound applications, including cardiology with a true phased-array probe.

Cleared by the FDA on Nov. 10, the Terason 2000 is expected to start shipping in the second quarter. A list price hasn’t been established, but Spencer expects it to be between $25,000 and $50,000.

SonoSite Inc. (Bothell, Wash.) came to RSNA with an FDA-cleared product. The SonoSite 180 began shipping in September.

The system weighs 5.5 pounds with battery and transducer. SonoSite currently offers three all-digital transducers, but plans are to incorporate additional units in the future. The system can store as many as 50 images internally.

SonoSite is working on an application called PowerMap, a directional version of color power Doppler designed to provide directional information of blood flow. The color map is not FDA approved.

s05b.jpg (9811 bytes)Medison’s SonoAce 5500 digital ultrasound system

ATL Ultrasound, a Philips Medical Systems Co. (Bothell, Wash.) is teaming with Medison (Seoul) to offer an upgrade package to the lower-end HDI 1500, targeting the mid-range ultrasound market.

The Performance 2000 package provides tissue harmonic imaging capabilities to the 1500, as well as trapezoidal imaging. Trapezoidal imaging increases the field of view on the L 12-5 scanhead for small parts imaging. The result is more diagnostic information per scan with less manipulation by the clinician.

Performance 2000 also provides enhancements to the 1500’s color Doppler and grayscale imaging capabilities. The upgrade will permit the 1500 to import patient demographics from a DICOM modality worklist server and pass the data to a PACS (picture archiving and communications system).

Esaote S.p.A. (Genoa, Italy) launched its top-tier ultrasound system, the Technos, in Chicago. The Technos has multidisciplinary applications and uses a fully digital beamformer and reprogrammable microchip circuitry for high performance diagnostics.

The Technos incorporates probe technology that optimizes the lateral resolution of the system’s wide-band multi-frequency transducers. The system works on a Windows NT platform.

GE Medical Systems (Waukesha, Wis.) introduced three systems within its Logiq Pro Series – the Logiq 700, 500 and 200 systems.

The Logiq 700 Pro system features GEMS’ Digitally Encoded Ultrasound (DEU) and digital-beamforming technology, which digitally encodes transmitted signals and decodes the returning echoes, while subtracting extraneous signals, such as system noise. The result is greater penetration and sensitivity at all scanning depths.

With Auto Optimization, a user touches a button to optimize the display of B-mode and Colorflow images and Doppler spectra, based on actual acoustic data. Auto Optimization makes lesions much more apparent, according to GEMS.

All three models have 3D View and Tissue Harmonic Imaging.

Acuson Corp. (Mountain View, Calif.) used RSNA to tout its new Digital Dynamic Review concept for dynamic ultrasound images and two new transducers for the Sequoia and Aspen platforms.

Digital Dynamic Review (DDR) combines the on-board dynamic capabilities of Sequoia and Aspen with the KinetDx PACS solution to increase diagnostic confidence and productivity.

Toshiba America Medical Systems (TAMS of Tustin, Calif.) demonstrated its contrast imaging package, which will enable the company to develop digital subtraction ultrasound, a low-cost, less traumatic alternative to angiography, cardiac catheterization and other invasive imaging procedures.

The fully integrated package – available on TAMS’ PowerVision 8000 ultrasound system – incorporates the company’s Flash Echo Imaging and color harmonics imaging and serves as the basis for a digital subtraction technique.

With contrast agents for vascular studies now commercially available, researchers have used TAMS’ contrast imaging package to evaluate disease states that have been difficult or impossible to image in the past. TAMS said the technology has shown promise for quantifying blood flow and perfusion in a non-invasive manner, which could subsequently reduce healthcare costs and improve patient care.

Medison America Inc. (Pleasanton, Calif.) received some good news soon after the close of RSNA. The FDA cleared the company’s SonoAce 5500 digital grayscale ultrasound system. Priced at less than $30,000, the SonoAce 5500 is designed for individual and small group practice.

The system’s applications include diagnosis of breast lesions, gall stones and kidney stones, liver masses, vascular insufficiencies, cardiac abnormalities, aortic aneurysms, thyroid masses, ovarian cysts and pregnancy.

Siemens Medical Systems Inc. (Iselin, N.J.) expanded its product line with the Sonoline Adara, which is designed to improve productivity and make scanning easier for clinicians working in high-volume scanning environments.

The system combines advanced black-and-white imaging techniques and a user-centered ultrasound system design to streamline exams. And at 155 pounds, the system is one of the lightest systems available.

In addition, the Sonoline Omnia is a high-performance, multi-specialty ultrasound platform, which includes black and white SieScape panoramic imaging – which will be available on all transducers – and Ensemble Tissue Harmonic Imaging (THI). Siemens’ Ensemble THI enhances grayscale contrast resolution, especially in difficult-to-scan patients.

Shimadzu Medical Systems Inc. (Torrance, Calif.) showed its SDU-2200 digital color imager as a works-in-progress, as well as its SDU-350 XL and SDU-450 digital system manager with cine and the version 5.0 software. end.gif (810 bytes)