February 4, 2019 — Canon Medical Systems USA recently introduced its next generation of interventional systems– the Alphenix platform. The new flagship platform of systems incorporates all-new features that enable clinicians to deliver images with clarity and precision without compromising workflow and while prioritizing low dose.

With the launch of the Alphenix family, Canon Medical is also unveiling its new Alphenix Hi-Def Detector (High-Definition Flat Panel Detector), which is available on the all-new Alphenix Biplane and Alphenix Core + systems. Made up of what Canon calls the world’s first high-definition detector – with 76 micron resolution – for resolving fine details, the hybrid 12 x 12-inch panel is combined with high-definition flat panel technology that results in resolutions of 2.6 lp/mm (Standard) and 6.6 lp/mm (Hi-Def Detector). The Alphenix Hi-Def Detector technology helps clinicians see finer details during complex interventional procedures such as stent positioning and stent apposition, wire and catheter navigation through the stent struts, and observation of coil deployment.

In addition to the new Alphenix Hi-Def Detector, the Alphenix family includes the following new features:

• Next-generation Illuvis technology to reduce image noise with less lag time, and provide clearer images at steep angles while delivering a decreased frame rate that can help reduce dose;
• Real-Time Auto-Pixel Shift to automatically correct misalignment between the contrast image and mask image during digital subtraction angiography and 2-D roadmapping utilization; and
• (Optional) Tablet touch-screen to optimize tableside workflow with simplified control functions and the option to assign “favorites” to customize the interface, per physician.

Canon showcased the new Alphenix and Alphenix Hi-Def Detector technology, available with the Alphenix Biplane and Alphenix Core + systems, at the 2018 Radiological Society of North America (RSNA) annual meeting, Nov. 25-30 in Chicago.

For more information: www.us.medical.canon

February 6, 2019 — Canon Medical Systems USA Inc. recently introduced a new angiography configuration featuring its Alphenix Sky + C-arm and Hybrid Catheterization Tilt/Cradle Table for interventional procedures with its Aquilion One/Genesis Edition computed tomography (CT) system. The new pairing, called the Alphenix 4-D CT, allows clinicians to efficiently plan, treat and verify in a single clinical setting. The flexible hybrid system enables streamlined workflow and extensive range of patient access and coverage.

Benefits include:

• DoseRite technology designed to help clinicians minimize patient X-ray exposure while maintaining optimum image quality;
• Outstanding patient access, enabling clinicians to move the system, not the patient, and utilizing the new tilting cradle table;
• Greater control for the clinician with the tableside Alphenix Tablet to deliver a fast, seamless and rich workflow experience (optional);
• Flexibility with C-arm flip, right or left lateral flexibility, speed and full-body 3-D imaging capability; and
• Boosted productivity with the new Alphenix Workstation that integrates applications to help clinicians plan, analyze and perform interventional procedures

The new 4-D CT configuration is part of the new family of Alphenix angiography systems that delivers images with clarity and precision. The new family combines dose optimization technologies, enhanced workflow and innovative features to help clinicians provide patients with safe and fast treatment.

Canon Medical showcased its next-generation Alphenix platform at the 2018 Radiological Society of North America (RSNA) annual meeting, Nov. 25-30 in Chicago.

For more information: www.us.medical.canon

February 18, 2019 — Philips announced the launch of Philips Zenition, its new mobile C-arm imaging platform. Mobile C-arms are X-ray systems that are brought into the operating room (OR) to provide live image guidance during a wide range of surgeries including orthopedic, trauma and vascular procedures. The Zenition mobile C-arm platform brings together innovations in image capture, image processing, ease-of-use and versatility pioneered on Philips’ Azurion platform. Zenition allows hospitals to maximize OR performance, enhance their clinical capabilities and offer their staff a high-quality user experience. Zenition will be introduced in the U.S., Germany, Austria and Switzerland in the first half of 2019, and will subsequently be rolled out in further markets.

The scope and complexity of surgical interventions– especially in the rapidly growing area of image-guided minimally invasive surgery – continues to increase, as does the number of patients requiring treatment. In order to treat more patients at a lower cost, hospitals require a versatile fleet of C-arms with varying capabilities that easily adapt to the needs of different types of surgery and different operators. Zenition mobile C-arms are easy to move between operating rooms, simple to position around the patient and intuitive to operate.

Read the article "Mobile C-Arms Mature But Improving"

“The Philips Zenition is a user-friendly system that’s intuitive to use for both surgeons and nursing staff,” said Nikolaos Bonaros, associate professor of cardiac surgery at the Medical University of Innsbruck, Austria. “Its simplified workflow means that we can convert a room from a conventional OR to a high-quality interventional room more quickly. At the same time the system provides high image quality at the level required for hybrid OR procedures.”

Philips Zenition supports increased OR performance across the healthcare facility. The platform’s tablet-like user interface and simple Unify workflow mean that once an operator has learned to use one system on the platform, it is easy for them to operate them all. The systems make point-and-shoot image capture fast and intuitive during any interventional or surgical procedure. Zenition’s compact design, Position Memory feature (only available on Zenition 70) and BodySmart software, which captures fast and consistent images even at the edge of the image intensifier or flat detector, reduce the need for C-arm repositioning by 45 percent [1].

For crisp high-quality image viewing, Zenition C-arm systems incorporate the same image processing algorithms used on the company’s Azurion platform, offering high-definition visualization of patient anatomies and a greater viewing area. Image quality is assured by features such as Philips’ MetalSmart software, which automatically adjusts the contrast and brightness of images to improve image quality when metal objects such as implants are present in the field of view – a feature that makes Zenition systems especially useful in orthopedics.

The Philips Zenition platform is designed for the future, allowing for longer clinical relevance of the systems. With two different detector and image intensifier options and the ability to subscribe to Philips’ Technology Maximizer program, Zenition offers users the latest software and hardware technology releases for a fraction of the cost of purchasing them individually.

Philips’ Zenition C-arms are CE marked and have received 510(k) clearance from the U.S. Food and Drug Administration (FDA). They will be showcased at the 2019 European Congress of Radiology (ECR) exhibition, Feb. 28 – March 3 in Vienna, Austria.

Read the article "Mobile C-Arms Going Digital"

For more information: www.usa.philips.com/healthcare

Reference

[1] Results obtained during user tests performed in November 2013 by Use-Lab GmbH, an independent company. The tests involved 30 U.S.-based clinicians (15 physicians teamed up with 15 nurses or X-ray technicians), who performed simulated procedures in a simulated OR environment. None of them had worked with a Philips C-arm or with each other before.

February 25, 2019 — Philips will unveil a new mixed reality concept developed together with Microsoft that the company says is designed for the operating room of the future. Based on Philips’ Azurion image-guided therapy platform and Microsoft’s HoloLens 2 holographic computing platform, the companies will showcase novel augmented reality applications for image-guided minimally invasive therapies. The technology will debut at Mobile World Congress (MWC) Barcelona, Feb. 25-28 in Barcelona, Spain.

In contrast to open surgery, minimally invasive therapies only require a small incision. Dedicated instruments such as catheters are inserted through the incision and guided to the treatment area, which can include the heart, blood vessels, brain, liver and other major organs. During minimally invasive procedures, physicians cannot directly see and touch the treatment area. Instead they rely on advanced medical imaging technologies such as ultra-low dose X-ray imaging and ultrasound, as well as other navigation technologies, to see inside the patient and guide their actions.

The Philips and Microsoft augmented reality concept, built for HoloLens 2, brings live imaging and other sources of vital data currently displayed on large 2-D screens into a 3-D holographic augmented reality environment that can be ergonomically, easily and intuitively controlled by the physician. The concept is being used to gather further clinical insights to support the development of future commercially-available augmented reality solutions for use in image-guided procedures.

Watch the VIDEO: Editor's Choice of the Most Innovative New Imaging Technology at RSNA 2017 to see the technology in action.

Microsoft unveiled HoloLens 2 at MWC Barcelona. It is a self-contained holographic computer that enables hands-free, heads-up interaction with three-dimensional digital objects. HoloLens 2 builds on the technology of HoloLens and is even more immersive, more comfortable and delivers more value right out of the box, according to Microsoft. The device is complemented by existing and new Azure cloud services, and features built-in artificial intelligence (AI).

Philips launched the Azurion platform globally in February 2017, powered by ConnectOS that allows the integration of advanced digital innovations.

Since its global launch in February 2017, over half a million patients have been treated in more than 80 countries using the Azurion platform, which is powered by Philips’ proprietary ConnectOS and combines technical innovations in both software and hardware. ConnectOS allows the integration of advanced digital innovations on the Azurion platform.

For more information: www.usa.philips.com/healthcare

Related VR and AR Content:

VIDEO: Using Virtual and Augmented Reality to Examine Brain Anatomy and Pathology at MD Anderson

Virtual Reality Boosts Revenues and Patient Understanding

Augmented Reality is Taking Over Radiology Training

VIDEO: Augmented Reality for Surgical Planning Example

Philips and Microsoft Showcase Augmented Reality for Image-Guided Minimally Invasive Therapies

Reimagining Brain Surgery 

VR in the OR 

Radiologist Uses Virtual Reality as Interventional Radiology Teaching Tool 

March 1, 2019 — iSchemaView announced the release of RAPID Angio, a complete neuroimaging solution for the angiography suite that integrates iSchemaView’s RAPID software with syngo DynaCT Multiphase from Siemens Healthineers. The syngo DynaCT Multiphase is a three-dimensional image acquisition technique employing multiple rotations of a C-arm system to acquire a multi-phasic 3-D representation of the brain and its perfusion. This technology, when combined with the RAPID platform’s CTP product, delivers a powerful imaging solution to the angio suite for acute stroke patients.

The RAPID Angio module, by combining the syngo DynaCT system with the RAPID platform, allows for the direct evaluation of acute stroke patients in the angiography procedure room, saving precious time. The RAPID platform automatically provides clear, easy-to-interpret computed tomography (CT) perfusion maps that readily identify brain regions with reduced cerebral blood flow and blood volume as well as delayed contrast arrival. It is the only neuroimaging platform that is U.S. Food and Drug Administration (FDA)-cleared for a thrombectomy indication. In addition to identifying irreversibly damaged brain tissue and salvageable areas, the CTP module includes hypoperfusion intensity ratio (HIR) and cerebral blood volume (CBV) indices for the assessment of collateral blood flow and the rate of infarct growth, as well as a “golden hour” index for ultra-early patients. RAPID CTP helps physicians with patient triage and clinical decision making.

“RAPID directly in the angio suite will help our specialists treat the right patients even faster,” said Prof. Jian Ming Liu, director of Neurosurgery Center, Changhai Hospital, China. “Having the most advanced RAPID technology available in both the radiology department and the operating theater provides the best options for our doctors and patients.”

RAPID Angio runs on the RAPID artificial intelligence (AI) framework. Developed by leading stroke experts, the RAPID AI framework combines deep learning, machine learning and expert feature extraction. Together these provide high sensitivity and specificity across stroke modules. Results are then delivered by the RAPID Intelligence Services Platform via picture archiving and communication system (PACS), email, text, the RAPID App or corporate partner workflow systems.

For more information: www.i-rapid.com, www.usa.healthcare.siemens.com

March 4, 2019 — Artificial intelligence (AI) radiology solution provider Aidoc announced the commercial release of its CE-marked product for the identification and triage of pulmonary embolism (PE) in computed tomography (CT) pulmonary angiograms. By flagging obstructions in blood-flow to the lungs, Aidoc prioritizes radiologists’ work queues and helps them detect critical conditions faster, leading to quicker treatment and saving lives.

In the United States alone, up to 600,000 people are diagnosed with PE annually and it is estimated to be responsible for 100,000 annual deaths, making it the third most common cause of cardiovascular death. PE diagnosis can be highly challenging due to its variable and non-specific presentation, making the case that it can truly benefit from AI-driven workflow triage.

At the 2019 European Congress of Radiology (ECR), Feb. 27-March 3 in Vienna, Austria, Aidoc ]demonstrated its suite of AI-based workflow solutions. The diagnostic performance of Aidoc’s PE solution at the University Hospital of Basel was presented as part of the ECR scientific sessions, demonstrating research concluding that Aidoc can complement conventional workflows with worklist prioritization and has the potential to improve the quality of healthcare by accelerating the diagnostic process and communication.

Read the abstract and watch the recorded ECR presentation here.

For more information: www.aidoc.com

April 4, 2019 — The U.S. Food and Drug Administration (FDA) granted Omega Medical Imaging 510(k) clearance to offer their artificial intelligence (AI)-powered region of interest (ROI) radiation exposure reduction solution FluoroShield for interventional X-ray imaging on their flat panel detector CS-series product lines.

FluoroShield combines AI, an ultra-fast collimator and advanced image processing to deliver an ROI solution that has shown to reduce radiation exposure up to approximately 84 percent. The AI helps minimize X-ray dose to patients and staff while TruBlock technology completely blocks radiation. This delivers maximum radiation reduction while optimizing workflow, helping interventional clinicians better reach their ALARA (as low as reasonably achievable) goals.

For more information: www.omegamedicalimaging.com

This is a view inside one of the 11 cath labs at Baylor, Scott, White Heart and Vascular Hospital in Dallas, Texas. This room is used as a combo cardiac cath lab and electrophysiology (EP) room. It is equipped with a bi-plane Philips Allura Clarity angiography system. There is a cath lab control room behind the widow in the back of the room and the EP control area is located to the right inside the lab. There is an anesthesia machine and two boom mounted surgical lights in the room.There are no storage cabinets in this room, so commonly used catheters are mounted along the back wall by the EP workstation and go along that wall into the cath lab control room. The table has a lead skirt mounted to reduce operators exposure to scatter X-ray radiation during procedures. 

Watch the VIDEO: Implementation of New Cardiovascular Technologies at Baylor Scott White Heart Hospital — interview with Jeffrey Schussler, M.D., FACC, FSCAI, FSCCT, FACP, interventional cardiologist at Baylor Scott White Heart and Vascular Hospital, Dallas.

May 23, 2019 — ControlRad Inc. announced that the U.S. Food and Drug Administration (FDA) granted 510(k) clearance for its ControlRad Trace and the company has initiated its commercial launch. The ControlRad Trace is the only technology, according to the company, that can be integrated into existing mobile C-arms to reduce radiation in any fluoroscopic imaging procedure.

“Radiologists and our teams have grave concerns about the long-term effects from radiation exposure,” said John A. Carrino, M.D., MPH, vice chairman of radiology, Hospital for Special Surgery. “I am excited that new technology for mobile C-arms is now available because it has the potential to drastically improve our radiation safety while maintaining image quality so we can continue to effectively diagnose and treat our patients. I believe these new products should become the standard of care for fluoroscopic procedures.”

Fluoroscopically guided procedures (FGP) with C-arms have allowed for major advances in treating countless diseases. However they expose patients and medical staff to ionizing radiation, which may increase a person’s lifetime risk of developing cancer.1 For example, an interventional fluoroscopy procedure is roughly equivalent to the adult effective dose of between 250-3,500 chest X-rays.2

With its proprietary semi-transparent filter, tablet and image processing technology, the ControlRad Trace solution can be retrofitted on existing C-arms, reducing the barrier to adopting the technology in order to reduce unnecessary radiation up to 89 percent,3 without compromising image quality in the region of interest (ROI) and overall workflow. The medical staff draws an ROI on a ControlRad tablet, which in real time optimizes image quality in the ROI while reducing unnecessary radiation in the periphery.

For more information: www.controlrad.com

References

1.  https://www.fda.gov/radiation-emitting-products/initiative-reduce-unnecessary-radiation-exposure-medical-imaging/white-paper-initiative-reduce-unnecessary-radiation-exposure-medical-imaging, p. 1

2. Ibid, p. 3

3. Data on file

June 24, 2019 — Siemens Healthineers and Mentice AB announced the collaboration to fully integrate Mentice’s VIST Virtual Patient into the Artis icono angiography system from Siemens Healthineers. The VIST Virtual Patient thus becomes a fully integrated simulation solution for the angio suite, according to the companies. The global partnership between the two companies will allow interventional radiologists, neuroradiologists, and cardiologists to perform vascular and cardiac interventions on a virtual patient inside the angio-suite.

Interventionalists may now perform simulated cardiac and vascular procedures by using the Artis icono controls to angulate the C-arm, move the angiography table, use the foot pedals and review fluoroscopic images on the Artis icono screens while deploying actual medical devices in a radiation-free environment. The integrated solution will allow clinicians to perform procedures either by using Mentice’s extensive library of patient cases or by importing actual magnetic resonance (MR) and computed tomography (CT) patient data for case training and rehearsal. Transesophageal echocardiography (TEE), intravascular ultrasound (IVUS), optical coherence tomography (OCT) and fractional flow reserve (FFR) procedures are also available.

The Artis icono system is not commercially available in all countries and future availability cannot be guaranteed, according to Siemens. The artis icono and its features are pending 510(k) clearance and are not yet commercially available in the United States.

The VIST Virtual Patient, VIST simulators, and VIST skill acquisition software are currently commercially available through Mentice globally.

For more information: www.mentice.com, www.siemens-healthineers.com

July 11, 2019 — Mednax Inc. and Mednax Radiology Solutions announced that Chief Medical Officer Ricardo C. Cury, M.D., FSCCT, will present at the 14th Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography (SCCT), July 11-14 in Baltimore. His session is titled “Building a National Centers of Excellence in Coronary Computed Tomography Angiography (CCTA) to Support Implementation in Clinical Practice.”

“Many emergency departments lack standardized CCTA care processes or have outdated ones. This results in significant patient care variations, which ultimately leads to longer lengths of stay that decrease patient satisfaction and increase costs,” said Cury. “The Mednax Radiology Solutions Cardiac Centers of Excellence Program and Baptist Health South Florida in Miami led the way to develop new CCTA protocols, subspecialist interpretation coverage, and training programs for emergency department physicians, hospitalists, cardiologists, nursing staff and technologists in appropriate CCTA utilization. As a result, Baptist Health realized dramatic gains in efficiency, cost savings and patient satisfaction, including a decrease in the average per-case episode cost by more than $1,000.”

In addition to the decrease in episode cost, Baptist Health’s new CCTA protocols lead to a:

• Fifty (50) percent decrease in length of stay;
• Low rate for major adverse cardiac events (MACE) with a negative predictive value of 99.8 percent; and
• Significant (58.3 percent) decrease in effective radiation dose using iterative reconstructions and tailored protocols. 

CCTA is a contrast-enhanced radiographic assessment of the coronary arteries. It is a non-invasive alternative that can show narrowed or blocked blood vessels. Although CCTA has been endorsed by several guidelines from the American College of Cardiology/American Heart Association, CCTA has been slow to be adopted for low- to intermediate-risk chest pain patients. Through its Centers of Excellence, Mednax works to leverage such best-practice programs across its national network and expand services and technology nationwide to provide better and faster care for patients.

Watch the VIDEO: Trends In Cardiac CT Imaging at SCCT 2015, an interview with Cury

For more information: www.mednax.com/radiology