Photo Gallery of New Imaging Technologies at RSNA 2019

GE’s 510k-pending Pristina Serena Bright contrast enhanced mammography biopsy system. The biopsy system mounts to the mammo unit to guide biopsies during patient call back.
 

Life-like, realistic 3-D printed anatomy and gross pathology is a new trend at the 2019 Radiological Society Of North America (RSNA) meeting. 

The Hitachi Scenaria View CT scanner on display at the 2019 Radiological Society of North America (RSNA) meeting in December. This workhorse 64 or 128 slice CT system, and Hitchai's portfolio of MRI and ultrasound systems, attracted the attention of Fujifilm, which does not have some of these technologies. Fujifilm purchased Hitachi in late December 2019 following RSNA in hopes of capturing a larger portion of international radiology market share. Read the story.

Orthoscan launched its new Tau 20/20 mini C-arm system for surgery in 2019, which the vendor says has the lowest dose available for a mini C-arm system. It has FDA indications for pediatrics and has a 20 x 20-inch detector.

An artificial intelligence app to auto detect areas of interest on mammograms from the vendor Lunit. The software was shown as a work in progress. The AI can perform a first pass on mammograms to flag exams and bring them to the top of reading lists, acting as a second set of eyes for the radiologist. 

This is an augmented reality (AR) training system for transesophageal echo (TEE) created by the simulation company CAE. Rather than just looking at an overhead screen, this system allows the user to see what impact their probe manipulation has on the i aging and better shows the orientation of the ultrasound probe, the 2-D image slice and the relation to the anatomy. Read more about this technology.

 

The Cianna/Merit Medical breast tumor location system that uses a radar based fiducial marker. The Scout system uses a marker that is needle injected into the tumor. A wand is moved over the breast. As it come close to the marker it makes a tone, which gets louder as the wand gets closer and is on top of the marker. The console showed the depth from the skin surface to the marker. Read more on this system

One way to reduce weight of computed tomography (CT) scanners is the use of carbon fiber based collimators. The small single detector is an example of a composite collimator. This collimator wasa displayed by Nuclear Shields at RSNA 2019. Collimators are used to filter out X-ray photons that are not in direct line with the X-ray source, helping to filtering out scatter radiation that can cause noise of images.

 

 

This is the FDA-cleared XACT Robotics system use during computed tomography (CT) guided percutaneous interventional procedures. XACT’s technology is the first hands-free robotic system combining image-based planning and navigation with insertion and steering of various instruments to a desired target across an array of clinical applications and indications. Read more about this system.

Radiology art in the making in the artificial intelligence (AI) education area at the 2019 RSNA meeting this week. The artist asked attendees what issues they encounter and how how AI May help and she drew it on the wall.

Qlarity Imaging’s QuantX artificial intelligence (AI) software is used to assist radiologists by automating the assessment and characterization of breast lesions on contrast MRI. The system has FDA clearance. Read more on this system. 

Infervision's artificial intelligence AI lung detection app. showing detection of a ground glass cancer lesion. 

An example the microvasculature visualized on Hitachi’s new ultrasound transducer CMUT Crystal technology. This is on a Arietta 850 ultrasound system.

This is the new Point of care ultrasound (POCUS) system introduced by GE Healthcare at RSNA 2019 this week. The Venue Go system offers simple operation, drop down menus for specific types of exams. Several vendors said they are seeing a large amount of growth in the POCUS market.

The 510k-pending Siemens Somatom On.site mobile CT scanner brings the system directly to the patient in the ICU. It features an integrated head rest and shoulder board, and moves to help position the head without moving the patient. The portable scanner is easy to move, and features a front camera to assist with navigation. Its simplified workflow requires minimal training. The system is also self shielded for radiation protection so it can be used in patient rooms with the tech on the room next to the machine. It has a camera on the front that allows the tech driving the unit in halls what is ahead, since the machine is about 5 feet tall.

This is a case of conjoined twins attached at the head who had their complex surgeries planned with the help of 3D printing from their CT scans. They had a shared blood supply between their brains, as seen here in the pre-procedural printed scan of their heads and brains. This required several surgical procedures to separate the vessels, which are pointed out by green markers on the 3-D printed brain scans here.  This case was displayed by the vendor 3D Systems at the 2019 Radiological Society of North America (RSNA) meeting.

Related 3D printing articles:

RSNA and ACR to Collaborate on Landmark Medical 3D Printing Registry 

3D Systems Earns Additional FDA Clearance for D2P Medical 3-D Printing Software 

The Use of 3-D Printing in Cardiology 
 

A comparison of a nuclear imaging photo multiplier tube (PMT) and a digital CZT detector used on GE Healthcare’s molecular imaging systems. This is a display at the vendor’s booth at RSNA 2019. Read more about how nuclear imaging is converting to digital detector technology.

This is the LVivo auto ejection fraction app that uses artificial intelligence (AI) from the vendor Dia. The user opens the app in a couple seconds the AI defines to myocardial border and calculates EF for the LV. It is shown here integrated into the GE Healthcare VScan point of care ultrasound system (POCUS). The company also partners with Konica-Minolta to supply auto EF on its cardio PACS. Read more about the system from an ASE 2019 study

This is an artificial intelligence (AI) of a reconstructed image of lung bronchia in one image, demonstrated by the vendor Vida in its LungPrint software. Rather than needing to follow each branch on the slice the CT study. The purpose is to offer a quick view of the airways and help quickly identify any issues. This Hyperion view is also used as a reference image when the AI identifies anything in the scan, such as suspected nodules, COPD or emphysema. 

The AI also can automatically fetch and compare prior images. It detects and color coded areas of high and low density.

The company has signed agreements to have its software available through the AI marketplaces offered by TeraRecon, IBM Watson, Blackford and Nuance. These AI “app stores” make it easier for hospitals to access the software from a known vendor using a single interface, rather than needing to work out dozens of separate contracts.

Guerbet was showing a work-in-progress next generation contrast media dose recording software that allows the hospital to enter all its contrast protocols and these will automatically upload to the injector when a patient’s imaging order is being processed for a scan. This can save programming time before each scan.
 

Here are a couple examples of dual energy digital radiography (DR) from a single X-ray image. These examples are from the start-up vendor KA Imaging. The company developed a DR detector plate that has three layers. The first layer produces a standard DR image. The second and third layers absorb low and higher energies to produce different versions of the image to better delineate soft tissue or bone. The Canadian company said it plans to submit this product for U.S. FDA in 2020.

Imaging phantoms from the vendor CIRS on the expo floor at RSNA 2019.

Philips Healthcare is using artificial intelligence (AI) to better reconstruct MRI images to remove artifacts and improve image quality. This example of how AI can remove MRI artifact was shown by the vendor during a booth tour at RSNA 2019,

Radiology AI expert Eliot Siegel, M.D. ran into ITN Editor Dave Fornell at RSNA 2019. Siegel is a radiology professor at the University of Maryland School of Medicine and chief of Imaging Services at the VA Maryland Health Care System. Watch a VIDEO with Siegel
 

A work in progress artificial intelligence app for automated assessment of breast ultrasound lesions. 

The company Brave Me offers videos, stuffed animals and other aids for help radiology departments explain imaging procedures to small children so the experience is not so scary.

A 3-D printed CoreValve TAVR device in the aorta root created from a patient’s CT imaging. It was shown by 3D Systems at the 2019 Radiological Society Of North American (RSNA) meeting. The large radiology conference this year has a section of the expo floor devoted to 3-D printing and augmented reality.

This is an example of artificial intelligence (AI) working in the background of PACS to speed imaging workflow, demonstrated at the 2019 Radiological Society Of North America (RSNA) this week. This is TeraRecon’s MRI analysis AI-based software, which automates the contouring and quantification process, taking the 20 manual process down to about 5 seconds. The imager can modify any of the AI created couture or measurements before submitting the final report. See more on the Northstar system in this VIDEO.

A 3-D printed skull still in the printer, created from a CT scan in the Envision TEC booth at RSNA 2019. 

Fujifilm's new glassless digital radiography (DR) X-ray detector. The D-Evo III panel eliminates the use of glass to make the detector more durable in case of accidental drops. It uses a flexible plastic surface rather than glass. The FDR D-EVO III detector was recently cleared by the FDA. 

This is a robotic ultrasound system that allows a sonographer to perform an exam from a remote location using an internet connection and Skype video conferencing. This technology is designed to address the need for high quality exams in remote or underserved areas. The sonographer can speak to the patient and use a special joystick to move the arm and see the arm movement in relation to the patient on video. The ultrasound imaging it streamed live to the sonographer. The joystick gives the feeling of pressure being applied when the remote transducer contacts the patient. The technology, called the Rose Robotic Sensing for Telecom-ecography, is being developed by Sensing Future Technologies. See more on this system.

Philips Healthcare is using artificial intelligence (AI) to better reconstruct MRI images to remove artifacts and improve image quality. This example was shown by the vendor during a booth tour at RSNA 2019,

Carestream's new dual-energy X-ray imaging for its room install digital radiography (DR) system. Using software, the system can show a standard DR X-ray, a bone subtraction view and high and low Kv energy images, which bring out different sets of details in the image. The idea is to offer more diagnostic information from a single exam. The FDA cleared product allows low and high energy images to be created from a conventional DR X-ray using the vendor’s ImageView software, the Evolution Plus DR system and the DRX Detector.
 

A notification on a physician's phone showing a automated potential stroke alert on their iPhone from the FDA-cleared Viz.AI app. The app can help identify potential stokes on head CT scans as these scans enter the PACS system before a human has a chance to read the exam. It automatically sends alerts to the radiologist and neurologist on call to get faster confirmation of a stroke and what type to allow faster interventions. The app can be opened on the phone to show the patient information and their imaging studies. 

Inside a mobile PET-CT system in a semi-truck trailer displayed by Shared Medical Services at the 2019 Radiological Society Of North American (RSNA) meeting. It features a United Imaging PET-CT system, which is one of the newly FDA cleared imaging systems from the Chinese company looking to break into the U.S. market.  The truck can be moved around between several hospitals to provide nuclear imaging services of certain days. It provides an economical options for lower volume hospitals. It has a lift for patients, an uptake room with. shielded radiotracer cabinet, a PET-CT system with patients t calming scenes on the wall and ceiling, and a shielded control room.

A 3-D printed meniscus made out of a flexible, biocompatible polymer and created based on a patient's CT scan of their knee. This can be implanted to replace the damage native meniscus and the bioprinted matrix allows for cellular growth. 

The new Philips Ingenia Ambition is billed as a "helium-free" MRI system on display at The 2019 Radiological Society Of North America (RSNA). Read more about this system installed at Baptist Health

Canon unveiled its new digital detector PET-CT system at RSNA 2019. The Cartesian Prime uses an air cooling system to reduce costs for installation and maintenance. It uses an Aquilion Prime CT, either 80 or 160 slice. The bore of the system is 78 cm. Canon said this is another option in its molecular imaging portfolio, which includes the Celestion PET-CT. That system uses photomultiplier tubes and has a larger bore.

GE Healthcare's newest version of its Air Coil system, its extremely flexible MRS coils. This version is still in development. Rather than traditional hard plastic, or semi-rigid coils, the Air Coil wraps around the patient like a blanket.

This is a hologram of a fracture CT scan displayed by the start up company Voxon at RSNA 2019. The technology uses a half millimeter thick glass plate that pulses up and down very rapidly while projecting 4,000 images per second. It can display DICOM or STL files used for 3-D printing.

See a live example of this technology in the VIDEO: Holographic CT Imaging Displayed at RSNA 2019.
 

Artificial intelligence Liver Multiscan assessment software from Perspectum Diagnostics at RSNA 2019. The software uses automated MRCP computational assessments of bile duct diameters, enabling a fast quantification of the pancreatobiliary system. 

This is the latest interventional lab angiography system shown by Philips Healthcare at the 2019 Radiological Society Of North America (RSNA) meeting. The Azurion 7 Flex Arm has an extra articulated arm that offers additional range of movement in the cath lab. It gained FDA clearance in early 2019 and already has about 25 installs in the U.S.  The extra arm offers 2.3 meters of lateral movement so the gantry can be parked out of the way. Read more about this system

ITN Editor Dave Fornell and Mahadevappa Mahesh, Ph.D., chief of medical physicist and professor of radiology and medical physics, Johns Hopkins University. He presented a late-breaking RSNA study on how medical imaging radiation dose has started to drop over the past decade. Watch a VIDEO interview with Mahesh. He is the co-chair of the National Council on Radiation Protection and Measures Report (NCRP), and presented the most recent NCRP data analysis at the 2019 Radiological Society of North America (RSNA) meeting. CT dose dropped about 6 percent, despite a 20 percent increase CT scans since 2006. There was a drop of more than 50 percent for nuclear imaging scans, mainly due to fewer procedures begin performed. There was a 15-20 percent decrease across X-ray imaging modalities. Mahesh says this shows the impact of using ALARA principals, new dose guidelines and programs like Image Wisely and the ACR Dose Index Registry.

GE Healthcare's Neuo Assist artificial intelligence app, which automates image reconstruction and shows the interventional neurologist the optimal vascular access route to stoke. This has the potential to speed procedures in the cath lab.

For breast imaging centers lacking volunteers to allow techs to practice mammogram breast compression on them, the vendor One World is showing strap on breasts for training on the expo floor of the 2019 Radiological Society Of North America (RSNA) meeting. They offer 3 different breast sizes so a volunteer can be the patient and allow techs to properly position and compress the realistic breasts. The company also makes realistic biopsy training breasts with masses.

Software being shown by GE Healthcare, showing how augmented reality can be used for patient education. It superimposes a full skeleton onto a patient on a large display screen and as they move the skeleton moves with them.

Artificial intelligence (AI) company qure.ai is testing its application for chest X-Rays to detect tuberculosis (TB) with mobile TB screening programs in several developing countries. This has helped qure.ai build experience and clinical case data for its AI. However, one issue the company encountered was the lack of PACS systems to run the software or the lack of internet connections in rural areas. This black box is a mini-server/computer the company provides to allow remote clinics a platform to run the AI and house the digital images.

Fujifilm showed a work in progress of integrating the Unit artificial intelligence software to detect lung anomalies into its mobile digital radiography systems. This image shows an auto detection of a pneumothorax with a color heat map to show the tech,  attending physician and radiologist where to look. The idea is to immediately alert the tech to a potentially life threatening issue so the patient can receive faster care. This will be a part of the REiLI artificial intelligence offering.

Artificial intelligence (AI) from Intrasense designed to detect bone fractures and highlight areas of interest for the radiologist as a first pass. The AI can assist as a second set of eyes to locate what might be hairline fractures, which can be difficult to see.

An example of Spectral CT showing locations of pulmonary embolisms (PE) using an iodine map overlaid on the CT anatomical imaging. The closeups show two PEs on the dual energy images, and how the iodine map can be leveled in and out to pinpoint areas of low or no perfusion. You can see the clots in the culprit vessel segments. This was demonstrated at the Philips booth showing images from the IQon scanner at RSNA 2019. 

Watch the VIDEO: Applications of Spectral CT 

A 3-D printer in action in the CAD Blu booth at RSNA 2019. There was a dedicated area in the North hall for 3-D printing and holographic imaging.