A Diagnostics & Imaging Week

DALLAS – Several imaging product manufacturers were among the firms using the American Heart Associ-ation (AHA; Dallas) scientific sessions being held here this week as a podium from which they could report new product introductions.

The Philips Medical Systems (Andover, Massachusetts) unit of Royal Philips Electronics introduced new healthcare solutions that it said "quickly and more easily capture vital cardiac assessment and measurement information."

The new technologies include the Philips HD11 XE, an "all-in-one" ultrasound system designed to serve diverse patient populations, as well as Philips ST Map, a new addition to the growing set of clinical decision support tools available on Philips IntelliVue patient monitors, providing what the company termed "an innovative graphical display of the heart rhythm's ST segment."

Philips also is demonstrating the MRx defibrillator/monitor with Q-CPR, the first technology cleared by the FDA that provides cardiopulmonary resuscitation (CPR) monitoring and feedback for advanced life support-trained responders, along with the Philips HeartStart FR2+ with SMART CPR, which the company said is the first automated external defibrillator that advises the user whether to provide an immediate defibrillation shock, or CPR followed by a shock, to a victim of sudden cardiac arrest.

John Desch, vice president marketing, North America, for Philips Medical Systems, said, "We recognize that our larger responsibility is to ensure these technologies are easy to use and designed around the needs of clinicians so they can strengthen their focus on patient care."

The HD11 XE is designed to work with a broad range of transducers – more than 20 – allowing clinicians to select the transducer that best fits their patient without having to change systems. The HD11 XE adds a variety of features to help physicians more accurately measure heart chambers, wall motion and ejection fraction.

Philips' new ST Map displays ST segment changes, with the goal of helping clinicians recognize patterns and track patient progress more easily.

In addition to featuring new products, Philips technology also has been featured in a variety of research studies being presented during this year's meeting, including "Reducing the Effective Radiation Dose in Cardiac Multi-Detector Computed Tomographic Angiography: Utility of Tissue Doppler Imaging Guided Tube Current Modulation," scheduled for presentation by a Cleveland Clinic rese-arch group today, and "Triage and Management of Patients Presenting to the Emergency Room with Chest Pain of Uncertain Etiology Using 64-Slice Cardiac CT," set for presentation Wednesday by a group from Carmel Medical Center (Haifa, Israel).

Another major player in the imaging sector, Siemens Medical Solutions (Malvern, Pennsylvania), is introducing syngo BEAT at AHA. Siemens said that syngo BEAT, available with the Tim (Total imaging matrix) technology application suite, "combines the best of cardiac MRI – morphology, function, tissue characterization and 3-D coronary anatomy – in one simple tool."

That, the company said, "enables cardiologists to detect and diagnose cardiovascular disease earlier and offer more treatment options, thus increasing positive clinical outcomes."

Siemens said syngo BEAT combines everything needed to diagnose cardiac disease, allowing providers to change parameters with a click of the mouse - from 2-D to 3-D, breath-hold to free-breathing, and morphology to functional or tissue characterization. "These features allow syngo BEAT to adapt to bariatric and pediatric patients, as well as to those who have arrhythmia or shortness of breath, or who are difficult to manage," said the company.

Doctors can now use syngo BEAT on more than 80 percent of their cardiac referrals.

"With all the innovations in imaging technology, cardiac MRI today is still seen as a complicated examination that requires a variety of techniques to effectively detect, diagnose and treat cardiac disease states," said Nancy Gillen, vice president of Siemens' MRI Division.

The company said the Tim technology and iPAT (integrated Parallel Acquisition Techniques) enable syngo BEAT to provide high-resolution acquisitions at high speed for both cardiac and vascular exams, with most completed within 10 to 30 minutes. "This also extends cardiac MRI, such as cardiac function, whole-heart coronary tree and cardiac morphology, into the realm of 3-D," according to Siemens.

It said that syngo BEAT can be used in precise therapy planning for electrophysiology ablation with syngo InSPACE, providing high-resolution data in 3-D without the use of contrast agents.

Tim is a whole-body matrix surface coil design that combines up to 102 seamlessly integrated coil elements with up to 32 radio frequency (RF) channels. Siemens said the technology enables flexible coil combinations to encompass local high-resolution imaging to large anatomical coverage up to 205 cm (6'9"), adding that other systems require the radiologist to change coils and reposition the patient three times for a whole-body MRI procedure.

"As a result, image quality is increased by up to 100% signal-to-noise ratio (SNR), and acquisition times are shortened," the company said.

Leading hand-carried ultrasound provider SonoSite (Bothell, Washington) said that it is initiating a multi-center study to determine whether the addition of an ultrasound examination evaluating carotid artery wall thickness, performed in the office setting, will provide a more effective tool for risk assessment and prevention of cardiovascular disease than current clinical methods alone.

Called OPACA (for Office Practice Assessment of Carotid Atherosclerosis using Handheld Ultrasound Study), the trial will enroll 525 patients at six U.S. medical centers. Data collection and analysis is expected to be completed by June 2006. The study will use SonoSite's MicroMaxx system with embedded SonoCalc software, a hand-carried ultrasound system weighing just under eight pounds, and a L38 linear array transducer. The noninvasive ultrasound examination can be completed in about 15 minutes and does not expose a patient to radiation.

SonoSite said that more than 20 years of clinical research has shown that the thickness of the two innermost layers of the carotid artery wall, the intima and media, begins to increase before plaque is evident within the vessel.

"IMT [intima media thickness] addresses the need to identify those patients who are asymptomatic or have limited risk factors, such as moderately elevated cholesterol levels, who may be at greater than apparent risk for a cardiovascular event," said James Stein, MD, associate professor at the University of Wisconsin Medical School (Madison). He is the director of the University of Wisconsin Atherosclerosis Imaging Research Program and principal investigator of the study.

"Although IMT is recognized as a valuable adjunct in cardiovascular risk stratification, it primarily has been used as a research tool," Stein said. "With the advent of high-resolution, hand-carried ultrasound systems and software algorithms, it is more practical to incorporate this tool into clinical practice. Through this trial, we hope to determine if health care professionals can accurately perform this exam in the office setting and thereby detect cardiovascular disease before it causes a heart attack or stroke."

SonoSite said measuring cholesterol or C-reactive protein (CRP), an indicator of blood vessel inflammation, have been among the few options in evaluating the risk of cardiovascular disease. But, according to the company, recent clinical studies have suggested that IMT may be more predictive and specific to cardiovascular risk than either CRP or traditional lipid profile alone.

Introduced at the 2004 AHA scientific sessions, SonoSite's SonoCalc IMT automated edge detection technology provides physicians with the ability to analyze the IMT of a patient's carotid artery.

SonoSite is offering IMT screenings in its booth on the Dallas Convention Center exhibit floor.

The company also reported at the addition of new cardiology transducers and other imaging enhancements for its recently introduced, third-generation MicroMaxx system. Existing MicroMaxx systems are compatible with the new capabilities.

The company said the MicroMaxx system, the size of a notebook and weighing less than eight pounds, delivers image resolution and performance comparable to costly, conventional cart-based ultrasound systems weighing more than 200 pounds.

SonoSite announced the addition of two new cardiology transducers to the MicroMaxx system – the P10/8-4 for pediatric cardiology imaging and the D2/2MHz CW Pedof for non-imaging, continuous wave Doppler to provide improved access to obtain peak velocities within the heart. Customer deliveries of the P10/8-4 transducer are scheduled to begin in December and in 1Q06 for the CW Pedof probe.

The upgrade also includes Pulsed Wave Tissue Doppler Imaging (TDI) for velocity mapping of cardiac tissue. TDI is offered on the P10 and P17 transducers as well as the system's multiplane transesophageal (TEE/8-3) transducer. TDI is available immediately and is a software upgrade to existing MicroMaxx systems.