Feature | November 15, 2006 | Rick Dana Barlow

RSNA highlights IT, oncology partnerships

The Radiological Society of North America’s annual post-Thanksgiving scientific assembly gave thousands of radiologists and other related healthcare professionals in blustery and frigid Chicago a taste of what’s ahead in the diagnostic imaging market.
Among the noteworthy highlights:
• RSNA is making a considerable effort to reach out to radiation oncologists and physicists in medicine in an effort to encourage more interaction between diagnostic and therapeutic medical specialties. In fact, many of the larger multifaceted company exhibitors not only showcased traditional imaging modalities and related devices, but also featured radiation oncology equipment and related supplies.
• Information technology (IT) applications and capabilities steadily have nudged their way into the pre-eminent diagnostic imaging show for nearly two decades now. But this year IT’s dominance has emerged more overtly as the imaging industry continues its migration toward digital practices and away from film and print media. Because many of the more advanced digital imaging modalities (such as multi-slice computed tomography (CT) and ultrasound, as well as fusion units like PET/CT and SPECT/CT) generate scores of data, more electronic horsepower is required for computing, storage and transmission of images and records.
• Three-dimensional, high-resolution, four-color rendering and visualization of bones, organs and tissues and real-time virtual tours of vascular flow drew oohs and aahs as a variety of vendors touted less-than-a-minute Ethernet downloading speeds of nearly a Gigabyte of imaging data. Some also promoted their partnerships with gaming graphics card manufacturers servicing the video game industry, bringing Nintendo, Playstation and Xbox capabilities to high-tech medical hardware and software.
• Computer-aided detection, which debuted nearly a decade ago to serve as a secondary screen to standard mammography procedures and to spot cancerous tissue at an earlier and more treatable stage, is moving beyond breast imaging. Many of the top CAD vendors demonstrated the efficacy of using CAD for chest, lung and even colon imaging. Several companies offering computer visualization systems tied to radiology information systems (RIS) and picture archiving and communication systems (PACS) even incorporated CAD software into their products. In fact, one firm that offers magnetic resonance imaging of both breasts simultaneously incorporated CAD into its product package and is preparing to debut spiral MRI capabilities to speed up the process. Another prominent CAD vendor talked about increasing imaging sensitivities while reducing false positives to the point that CAD eventually could stand for “computer-assisted diagnosis.”
• Most of the big modality players touted tomosynthesis as the newest wave of digital breast imaging within the next two years. The technique generates a three-dimensional image of the breast through multiple X-rays from different angles, while standard mammography only produces two-dimensional images. Tomosynthesis also reduces the need for conventional breast compression, requiring only a little pressure to keep the breast stable.
• Although the overall industry widely acknowledges and accepts its migration to digital from analog and film-based modalities, it isn’t ready to stick a fork in film and film digitizing yet. The scores of film, film processing, lightbox, printers, laser imagers, computed radiography (CR) and digital radiography (DR) vendors aren’t willing to let film die. In fact, one of the major players offered seemingly unconditional support behind CR as an economically justifiable and effective technology. By the same token, the more high-end DR technology, typically employed by the larger institutions, is making its way down to smaller facilities, courtesy of higher demand, product flexibility and relaxed price points.
• RSNA 2004 saw the emergence of the CT “Slice Wars” with market-ready 64-slice capabilities on display, 128- and 256-slice capabilities highlighted as works-in-progress and 512-slice capabilities cited as drawing board potential. At RSNA 2005, however, most of the major imaging modality vendors toned down the pomp and circumstance in favor of emphasizing logical applications. Hence, vendors steered curious conventioneers and potential buyers toward investing in the technologies that make the most sense for their intended use. For example, they stressed the use of 64-slice CT for cardiac, vascular and neurological applications, instead of simply trumping the competition. The same for the new 3 Tesla MRI machines over the market-leading 1.5T and 2T models of the previous year.

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