Diagnostics & Imaging Week International Editor
and D&IWs

A novel mobile gamma camera unit — designed to bring widely used scintigraphic tomography (SPECT) out of advanced radiology suites and into the emergency room and intensive care units for seriously ill patients — has taken the first steps to advance beyond Sweden and enter new markets in Germany and India.

Adolesco (Stockholm, Sweden) reported partnerships in March with Aventyn (Carlsbad, California/Bangalore, India) and with Inter Medical Medizintechnik (Luebeck, Germany) that include enhancements to the current model as well as distribution agreements in new markets.

At the center of these deals is Cardiotom, a tomographic gamma camera that can be rolled into any hospital room, plugged into a wall socket and two minutes later can begin to acquire, reconstruct and display ectomographis images for the diagnosis of disturbances in perfusion of the myocardium.

Adolesco built the self–contained Cardiotom system in tight collaboration with researchers from Karolinska Hospital, the Karolinska Institute and the Royal Institute of Technology in Stockholm, Sweden.

Adolesco and Aventyn reported their agreement at the annual meeting of the Healthcare Information and Management Systems Society (Chicago) annual meeting in Orlando in late February.

Key to the deal is Aventyn's presence in India, where the company said there is a high demand for mobile clinical imaging and where Aventyn plans to accelerate the adoption of Cardiotom.

Aventyn also will be integrating its Clinical Information Processing Platform (CLIP) into the Cardiotom unit, a software system that aggregates, filters and routes data that is interoperable with clinical systems and patient health records.

Built on widely accpeted XML technology and supporting Health Language Seven standards, integration of CLIP is expected to create a competitive advantage for Cardiotom among national and regional health systems in Europe that are increasingly specifying compatibility with hospital information systems for new imaging equipment.

CLIP also features wireless sensor and RFID technology for asset tracking systems used at hospitals, a key selling point for an expensive and mobile imaging unit.

A specialist in software and hardware for nuclear medicine, Inter Medical agreed to promote Adolesco's product in the German market and that it would begin in April, 2008 to manufacture the cameras for the Cardiotom.

Comparative studies conducted at the Stockholm hospitals of patients with suspected coronary artery disease in emergency and intensive–care settings demonstrated bedside tomographic scintigraphy is feasible, with ectomography and SPECT yielding similar diagnostic information and showing that it has been possible to use ectomography to define myocardial areas at risk and final infarct size.

A pilot study conducted at the hospitals demonstrated that brain scans also can be performed.

A cost/benefit analysis of the Cardiotom based on 79 patients showed startlingly favorable projections that an investment in the equipment would be recovered by a hospital in less than 18 months. Karolinska University Hospital and the County of Stockholm began a clinical investigation to verify these results that is expected to be completed later this year.

Wireless tracking for mobile imaging

Royal Philips Electronics (Amsterdam, the Netherlands) reported that it has developed a new product with a related service package to track and remotely repair mobile diagnostic imaging systems.

The new Philips Remote Services uses global positioning system (GPS) technology to locate the targeted mobile unit, then an Internet–base virtual private network to connect to diagnose the diagnostic equipment and repair any software related issues. A standard voice service is included to keep a human in the loop.

"What used to require hours of driving time for repairs can now be done in minutes since engineers from our remote technical operations can dial in to proactively monitor and diagnose systems," said Ketan Shah, senior manager of mobile enterprise for Philips Healthcare.

Masimo (Irvine, California) reported Japanese Ministry of Health, Labor and Welfare (MHLW) approval of its PVI measurement.

PVI is an index derived from the Masimo plethysmographic waveform, which the company said has been demonstrated to noninvasively assess fluid responsiveness in mechanically ventilated patients and can help clinicians assess if a patient's cardiac function is compromised.

The company said PVI "may help clinicians and emergency professionals to determine if a patient is dehydrated or over–hydrated — enabling more accurate fluid administration decisions — all by simply referring to the numerical Masimo PVI value that is continuously displayed on Masimo Rainbow SET pulse CO–oximeters."

It said that with one noninvasive sensor, Masimo Rainbow SET technology delivers multiple physiologic measurements that previously required invasive blood tests, including total hemoglobin and oxygen content, carboxyhemoglobin, methemoglobin, PVI, oxyhemoglobin, perfusion index and pulse rate.

Masimo said that during surgery and post–operatively, the immediate identification and rapid intervention of patients who are most likely to respond to fluid administration can enable organ preservation, while recognizing patients unlikely to respond to fluid administration can prevent pulmonary edema.

It said clinical studies have shown that current static methods for assessing fluid responsiveness, including clinical examination, arterial blood pressure, heart rate and central venous and pulmonary artery occlusion pressure, "are poor predictors of fluid responsiveness."

And dynamic indices, such as respiratory variations in arterial pulse pressure, inferior vena cava diameter, superior vena cava diameter and stroke volume, present significant limitations, "are invasive and often operator–dependent," Masimo added.

The company calls PVI "a dynamic new indicator of fluid responsiveness that does not require an invasive procedure or manual calculation, yet has been demonstrated to be sensitive to changes in preload and to be an accurate predictor of fluid responsiveness in mechanically ventilated patients."