Medical Imaging International August 2016 by Globetech

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Vol.26 No.4 7-8 / 2016 ISSN 1068-1779

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2016

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IN THIS ISSUE Clinical News . . . . . . . . . 3-21 PACS/IT Update . . . . . . 22-23 Product News . . . . . . . . 8-22 Buyer’s Guide 2016 . . . 25-33

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Researchers Find Low-Cost Way to Improve Patient Comfort and Decrease Scan Times esearchers in the US have developed flexible and light Magnetic Resonance Imaging (MRI) coils that can decrease MRI scanning times while still providing high-quality MRI images. MRI scans can take more than an hour, during which time a patient is not allowed to move. This can be challenging for children and often clinicians resort to using anesthesia for infants, which can be an additional risk factor. The scans take long because of the low sensitivity of MRI technology, and if a patient moves during the scan the image may even contain artifacts. One possible solution is to use a stronger magnet, but this is costly. Another way is to use high-density MRI coil arrays that can increase the strength of the received MRI signal and accelerate signal acquisition.

To solve these issues researchers at the Department of Electrical Engineering and Computer Sciences at the University of California (Berkeley, CA, USA; http://engineering.berkeley.edu) developed flexible MRI RadioFrequency (RF) coils using a screen-printer. The coils are light, and flexible, and can be wrapped around a patient’s body to increase the sensitivity of an exam. The coils are designed to work with 1.5T and 3T scanners and are reusable. The researchers teamed-up with clinicians at the Lucile Packard Children’s Hospital (Palo Alto, CA, US; www.stanfordchildrens.org), and GE Healthcare (Chalfont St Giles, Buckinghamshire, UK; www3. gehealthcare.co.uk) to develop the new the technology for clinical practice. Guoying Liu, at the US National Institute of Biomedical Imaging and Bioengineering (NIBIB),

which funded the research, said, “This technology could greatly increase patient comfort at a relatively low cost. Not having to experience the trauma of long MRI exams is a significant benefit to pediatric patients and their parents during what is often a trying time. This new development is an excellent example of how new technologies can come together to create a better experience for the patient.” Image: An MRI image showing the result of moving a coil array a small distance away from a patient (L), and an image showing results of using one of the new coils wrapped tightly around the patient (R) (Photo courtesy of University of California, Berkeley).

Ventilation Percussion Improves Cardiac MRI Accuracy novel ventilation technique allows cardiac magnetic resonance (CMR) imaging to be performed in virtual lack of motion. Developed at University Hospital Lausanne (CHUV; Switzerland; www.chuv.ch), the percussive ventilation (VP) technique involves the patients wearing a mask over their mouth, which is connected to a ventilator that delivers small volumes of air (percussions). Instead of the 10-15 large breaths patients would take naturally per minute, air is provided in 300-500 small VP pulses per minute. The air volumes inhaled are so small the chest does not move, allowing acquisition of higher quality images in less time. In a study designed to test the feasibility and tolerability of high frequency PV during CMR, the researchers recruited two patients, one healthy volunteer and one patient with a thymic lesion. The procedure was well tolerated, and there was no need to correct for respiratory motion. Lung volumes were “frozen” in full inspiration, allowing the researchers to see both coronary arteries and pulmonary vessels. The study was presented at EuroCMR, held during May 2016 in Florence, Italy. “The possibilities with high frequency PV are huge. You could run all the CMR sequences in one batch, which would be much faster; data could be acquired constantly with fewer artifacts,” said lead author and study presenter Professor Juerg Schwitter, MD, director of the CHUV CMR Centre. CMR is a medical imaging technology for the non-invasive assessment of the function and structure of the cardiovascular system that is based on the same basic principles as magnetic resonance imaging (MRI), with optimizations that use rapid imaging sequences. As a result, CMR images are currently acquired in steps. Patients breathe in and then hold their breath for each image, then recover before repeating the process for the next image. PV could offer the potential to acquire all images in one go, with no need to correct for respiratory motion.

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Advanced Ultrasound Technology to Provide Optimized Rehabilitation for Athletes company specializing in medical ultrasound imaging equipment has announced that two major sports medicine organizations have adopted their new ultrasound system to optimize rehabilitation for athletes with musculoskeletal injuries. When a professional athlete is injured, rapid recovery is critical to enable them to return to their sport. To facilitate this, sports medicine practitioners can make use of the new ultrasound system to quantify muscle and tendon tissue loading before and after an injury, and control the recovery process. The tool provides objective data to help clinicians prevent injuries, and facilitate rehabilitation, and recovery for athletes. The SuperSonic Imagine (Aix-en-Provence, France; www.supersonicimagine.com) Aixplorer ultrasound system with real-time ShearWave Elastography (SWE) was adopted by the Portuguese Lisboa Benfica (Lisbon, Portugal; www.slbenfica.pt) soccer team, and the Pure Sport Medicine (London, UK; www.puresportsmed.com) organization. The Aixplorer also uses the new Angio PL.U.S. (PLanewave UltraSensitive imaging) imaging mode that improves color Doppler sensitivity, and the spatial resolution of a scan. The new technique also enables sports medicine practitioners to identify low-grade tendon or muscle inflammation. Jacques Souquet, SuperSonic CIO and founder, said, “Sports doctors need to be able to continuously monitor athletes’ injuries from initial diagnosis through to recovery. If players return to work-

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outs too quickly, the injuries could become more serious and permanent. Having the most advanced tools at hand is key for enabling clinicians to know when it is time to change the course of treatment and when it is safe for athletes to return to their active careers. We are proud to provide such tools for athletic organizations across Europe.”

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Image: The Aixplorer ultrasound system with realtime ShearWave Elastography (Photo courtesy SuperSonic Imagine).

Innovative Collimator Improves Breast Screening with Less Radiation dding a variable angle slant hole (VASH) collimator to an existing breast molecular imaging system provides better contrast of cancer lesions while potentially reducing radiation doses by half, according to a new study. Developed by researchers at the Thomas Jefferson National Accelerator Facility (JLab; Newport, VA, USA; www.jlab.org), Dilon Technologies (Newport, VA, USA; www.dilon.com) and the University of Florida (UF, Gainesville, USA; www.ufl.edu), the new VASH collimator is constructed from a stack of 49 tungsten sheets, each one a quarter of a millimeter thick containing an identical array of square holes. The sheets are stacked like a deck of cards, with angled edges on two sides; the angle of the array in the stack can be slanted by two small motors that slide the individual sheets. The result is a systematic varying of the focusing angle of the collimator during the imaging procedure. In a study to test the system, the researchers evaluated the spatial resolution and contrast-tonoise ratio in breast phantom of a breast, with four beads inside that simulated cancer tumors of varying diameter and marked with a radiotracer. They found that when using the VASH collimator with an existing breast molecular imaging system, they got an image with six times better contrast, which

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could potentially reduce the radiation dose by half, while maintaining the same or better image quality. The test results were presented at the Society of Nuclear Medicine and Molecular Imaging annual meeting, held during June 2016 in San Diego (CA, USA). “While a mammogram uses X-rays to show the structure of breast tissue, molecular breast imagers show tissue function. A radiotracer attached to the molecule gives off gamma rays, which can be picked up by the molecular breast imager,” said Drew Weisenberger, PhD, leader of the JLab radiation detector and imaging group. “Now, you can get a whole range of angles of projections of the breast without moving the breast or moving the imager. You’re able to come in real close, you’re able to compress the breast, and you can get a oneto-one comparison to a 3D mammogram.” Mammography is the gold standard of breast cancer screening; but about half of all women who follow standard screening protocol for 10 years will receive a false-positive result that will require additional screening. Used in conjunction with mammography, imaging based on nuclear medicine is a successful secondary screening technique to reduce the number of false positive results in women with dense breasts and at higher risk for developing breast cancer.

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Research Suggests fMRI May Not Map Neuronal Circuitry Precisely esearch results published ahead of print, in the May 25, 2016, online issue of Nature, suggest that discrepancies between vascular and neural responses could point towards limits in the use of functional MR Imaging (fMRI) for precise imaging of neural networks in the brain. The researchers found that increases in blood flow were not precisely “tuned” to local neural activity during sensory stimulation. Until now vascular and local neural responses were thought to be tightly coupled and scientists using fMRI and other brain-imaging techniques depended on the assumption that vascular changes were directly reflected in a proportional change in local neural activity. The researchers from the Medical University of South Carolina (MUSC; Charleston, SC, USA; http://academicdepartments.musc.edu/musc) concluded there was not a tight correlation between local neural activity and blood flow, and therefore fMRI and similar techniques could reveal information about the general functioning of an area in the brain, but cannot provide precise maps of neuronal circuits. Prakash Kara, PhD senior author of the article, and associate professor at MUSC, said, “Because there isn’t enough blood to send everywhere in the brain at the same time with the optimal levels of oxygen and glucose needed to support neural activity, it is widely accepted that the brain has a built-in auto-regulatory mechanism for

increasing blood flow to regions with increased activity. The blood vessel dilation triggered by local, selective neural activity does not remain entirely local. From a vessel deep within the brain, the dilation propagates up along the vessel walls into a surface vessel and then down into other vessels that enter neighboring columns. Our team has just tak-

en the first step, albeit an important one, in untangling the spatial precision of neurovascular coupling using very high-resolution imaging. Image: The illustration shows communication in the brain between neurons and blood vessels (Photo courtesy of Emma Vought, Medical University of South Carolina).

Researchers Demonstrate Faster and More Accurate Cardiac MRI Technique

Poor Positioning Responsible for Most Mammogram Deficiencies

esearchers in Switzerland have presented a new cardiac MR technique that makes use of a high-frequency percussive ventilator to prevent chest motion during scans, resulting in higher quality images and shorter scanning times. The new technique was presented at the annual European Society of Cardiology EuroCMR meeting in Florence, Italy, that took place between May 12 and 14, 2016. The research was designed to test the feasibility, and tolerability, of CMR scanning with high-frequency percussive ventilation, and was presented by researchers from the Cardiac MR Center at the University Hospital Lausanne (Lausanne, Switzerland; www.unil.ch/cvmr/en). The study included a healthy 38-year-old volunteer and a 55 year-old patient suffering from a thymic lesion. The researchers asked the patients, who were conscious and not sedated, to wear masks, connected to a ventilator, over their mouths. The ventilator was configured so that it delivered small volumes of air in 300 to 500 ventilations per minute, without any chest movement. The ventilator had to be adapted for use in the CMR environment, by the replacement of metal components with MR-compatible ones. During the study there was no need to correct for respiratory motion. The new technique enabled clinicians to acquire all images in one session, without correction for respiratory motion. Professor Juerg Schwitter, director, Cardiac MR Centre, University Hospital Lausanne, said, “We have made promising first steps with high frequency percussive ventilation in CMR. In future we could even imagine that if the patient is not breathing for 20 minutes or even longer this technique could give a precise 3D representation of cardiac structures and help guide electrophysiology procedures such as ablation. Patients do not need to breathe naturally and no correction for respiratory motion is required. This enables the physicians to more accurately plan the field of radiation to apply in each patient. This technique would help us to collect high-resolution images where we want millimetric precision, for example to localize scar in the myocardium or to see the anatomy of coronary arteries or valves and malformations. We would have much better conditions because we would not need to correct for motion.”

new report by the U.S. Food and Drug Administration (FDA, Silver Spring, MD, USA; www.fda.gov) suggests that proper patient positioning remains one of the most important aspects of high-quality mammography imaging. The FDA report notes that patient positioning according to guidelines set out in the Mammography Quality Standards Act (MQSA) is important, because only those portions of the breast, which are included on the mammographic image, can be evaluated for signs of cancer. Any portion of the breast not imaged cannot be evaluated, and cancers in those portions of the breast can be missed. The report cites a study from 2002 that found that the sensitivity of mammography dropped from 84.4% among cases with passing positioning to 66.3% among cases with failed positioning. The report also clarified that although the technologist performs the mammogram, the responsibility for correct positioning is shared by the technologist and the interpreting physician, and emphasizes that the physicians are the final arbiters of the quality of mammography images, and that they should communicate their satisfaction or dissatisfaction with the quality of the images. According to the FDA, this is the crucial first step in the identification of problems and the initiation of corrective actions. Technologists should also be trained in proper positioning, and should seek feedback from fellow technologists and interpreting physicians. Since the consequences of poor positioning can be very significant not just for individual patients, but for mammography facilities as well, affecting their MQSA accreditation, the physicians should in turn review the elements of proper patient positioning, and give constructive feedback to technologists on the mammograms that are presented to them for interpretation. The MQSA, passed in 1999, is the primary mechanism for enforcing compliance with quality standards for mammography facilities. The FDA reports that as of May 1, 2016, there were a total of 8,738 certified facilities in the United States sporting a total of 16,042 accredited units. Of those certified facilities, 8,493 had full field digital mammography (FFDM) units.

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Links Found Between Leakages in Blood-Brain Barrier And Early Alzheimer’s he results of a new study using contrast-enhanced MRI show that the leakage rate in the blood-brain barrier of patients with early Alzheimer’s disease was significantly higher than in a healthy control group. The Blood-Brain Barrier (BBB) allows nutrients into the brain, removes surplus substances, and prevents neurotoxins from entering the brain. The study was published online in the June 2016, issue of the journal Radiology. The researchers used contrast-enhanced Magnetic Resonance Imaging (MRI) for the study, and recruited 16 patients with early Alzheimer’s and 17 healthy controls with matched ages. The researchers measured the leakage rates at the BBB and generated a histogram to help find how much brain tissue was leaking. The results showed that the leakage rate was significantly higher in patients with Alzheimer’s compared to the controls, and occurred throughout the cerebrum. Alzheimer patients also had a significantly higher leakage of brain tissue in the gray matter, and in the cortex. The BBB in the white matter of the brain also showed a very subtle impairment. The researchers concluded that increased permeability of the BBB may be one of the key mechanisms in the early stages of Alzheimer’s disease. Walter H. Backes, PhD, the author of the study, Maastricht University Medical Center (Maastricht, Netherlands; www. maastrichtuniversity.nl), said, “Bloodbrain barrier leakage means that the brain has lost its protective means, the stability of brain cells is disrupted and the environment in which nerve cells interact becomes ill-conditioned. These mechanisms could eventually lead to dysfunction in the brain. For Alzheimer’s research, this means that a novel tool has become available to study the contribution of bloodbrain barrier impairment in the brain to disease onset and progression in early stages or pre-stages of dementia.”

Image: The blood-brain barrier leakage maps of an 80-year-old healthy control subject (Photo courtesy of RSNA).

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3D Digital Imaging Benefit Podiatry Clinics new scanning system captures high-resolution, full-color three-dimensional (3D) models of the foot in a range of positions to enable dynamic orthotics. The CryoScan3D system is a highly versatile device that can scan the foot in full-, semi- and non-weight bearing positions, removing the need for plaster casts or foam boxes, and providing a scalable and fast solution for digital capture of patient foot data. The system uses Fuel3D scanning technology to deliver high-level precision, capturing 3D data (in color), in less than 0.1 seconds, a time short enough to remove distortions resulting from patient movement. With a scan accuracy of 250 microns and no moving parts, the scanner offers high reliability. When used together with the CryoVizion postural condition assessment system, the CryoScan3D can also provide podiatrists with a complete solution for assessing, capturing, and creating custom dynamic orthotics, which can guide the foot to its proper movement without immobilizing it, preserving and stimulating foot strength, flexibility, and mobility while being corrected. The CryoScan3D and CryoVizion systems are products of Cryos Technologies (Joliette, Canada; www.cryosadvanced.com). “The CryoScan3D is a real game-changer for podiatry, and will allow us to offer Cryos dynamic orthotics to even more clinics across North America,” said John Stimpson, President of Cryos Technologies. “3D scanning allows you to capture patient data anywhere and transmit it electronically. With this new system in place, what you scan is exactly what you will get from a Cryos orthotic – a fully customized device, rather than the closest match from a template library.”

Orthotics is concerned with the design, manufacture, and application of orthoses, externally applied devices used to modify structural and functional characteristics of the neuromuscular and skeletal system. An orthosis may be used to control, guide, limit or immobilize an extremity, joint or body segment; restrict movement in a given direction; aid rehabilitation from fractures after the removal of a cast; and provide easier movement capability or reduce pain by postural correction. Image: A foot being scanned in the CryoScan3D (Photo courtesy of Cryos Technologies).

Scientists Propose New Ultrasound Video Process Using a Wavelet Variational Model cientists have developed a new ultrasound video image segmentation model that can be used in medical image analysis to recognize Regions of Interest (ROI) and facilitate the interpretation of ultrasound images. Real-time applications require efficient image segmentation algorithms. Ultrasound videos often suffer from a low contrast level, shadow effects, and complex ‘noise’ statistics. The research was published online in the April 7, 2016, issue of the SIAM Journal on Imaging Sciences and proposes a model for tracking moving boundaries in ultrasound video, using a mathematically sound framework. The model uses wavelet frames and noise statistics under a variational framework. The efficiency of the variational model

makes it useful for real-time clinical applications. Such models are commonly used in motion tracking or edge detection, and have been shown to be robust and effective for complex image segmentation tasks. Wavelet frame regularization allowed the scientists to track and sharpen geometric shapes in the videos, while they were segmented automatically through sequential images. The model was designed to segment ultrasound videos sequentially and collectively, and to include shape priors during segmentation of a single image. Consecutive shape priors are then calculated automatically for subsequent segmentations. Jiulong Liu, PhD student, Department of Mathematics, Shanghai Jiao Tong University (Shanghai,

China; http://en.sjtu.edu.cn), said, “Ultrasound imaging is an important modality in clinical application due to its low cost and portability. However, its related analysis for accurate diagnosis and monitoring is still challenging due to low image quality, artifacts, and noise. The numerical results on real ultrasound data sets demonstrate that the proposed wavelet frame model with distance prior can track the regions of interest effectively, in terms of both segmentation quality and computational time. The results compare favorably with other approaches. The model can be further extended to other imaging modality or to locate multi-region simultaneously. More geometric and prior information can be used to enhance the robustness of the method.” Medical Imaging International July-August/2016

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Medical Imaging International

Electrophysiological High Resolution Imaging and Mapping System company specializing in electrophysiology solutions has announced that it has received the CE Mark approval for its 3D high resolution imaging and mapping system and catheter, intended for imaging, diagnosing and treating complex arrhythmias. The CE Mark (Conformité Européenne) will enable the company to begin commercial activities in Europe. This is the only system of its kind that can detect and display voltage-based, and high-resolution dipole-density charge-source maps. The system can also generate real-time 3D ultrasound images of heart chambers, that are comparable to those acquired by Magnetic Resonance Imaging (MRI), and Computed Tomography (CT) scanners. The Acutus Medical (Carlsbad, CA, USA; www. acutusmedical.com) AcQMap high-resolution imaging and mapping system, and the AcQMap Catheter, can be used to map and display stable, and unstable cardiac arrhythmias. By mapping complex arrhythmias in real-time, and finding cardiac activation mechanisms, the system can provide an accurate guide for ablation therapy. The system is

Image: Three-dimensional images from the AcQMap high-resolution imaging and mapping system (Photo courtesy of Acutus Medical).

not currently sold in the US. Andrew Grace, MD, PhD, Papworth Hospital (Cambridgeshire, UK; www.papworthhospital.nhs. uk), said, “During a recent AcQMap procedure, we were able to systematically map Atrial Fibrillation

(AF) and eliminate the identified sites of interest, ultimately restoring the patient to their native rhythm. The ability to map and quickly re-map after each set of ablations makes it possible to truly visualize AF and to achieve sinus rhythm.”

FDA Clears Smart Mobile-Connected High-Res Bladder Scanner DA clearance has been accorded to a new urologic visualization device that can improve point-of-care clinical decision-making. The device is the first mobile-connected ultrasound visualization device targeted at urologic care to receive US Food and Drug Administration (FDA) 510(k) clearance. The Uscan device developed by Signostics (Bothell, WA, USA; www.signosticsmedical.com) has a removable probe, a high-resolution tablet with a touch screen, and handheld displays. The Uscan is compatible with the Android operating system, features built-in WiFi and Bluetooth connectivity, and is interoperable with Electronic Health Record (EHR) systems. The device does not require annual calibration, and provides real-time user guidance. The Uscan can acquire up to 256 bladder slices, and uses algorithms to actively recognize bladder contours in 3-D providing accurate volume measurements. The device can also be used for real-time ultrasound imaging of the bladder stones, gallbladder, prostate, pelvic floor, kidneys, for the placement of catheters, and for rapid visual tracking, and observation. The device can also be used in emergency departments, maternity wards, for pediatrics, oncology, rehabilitation, in home nursing, and in geriatrics. CEO of Signostics, Kevin Goodwin, said, “Uscan doesn’t just scan; it sees – providing intelligent urologic visualization by leveraging science from current-day computer vision algorithms aimed at more efficient and confident point-of-care clinical decisionmaking. Uscan will exceed historical industry standards for bladder volume measurement accuracy yet will also enable use for other urologic imaging needs, reducing the delays and expense of engaging specialized ultrasound equipment or sonographers.”

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New 3D Tool Predicts Patients at Higher Risk from Lethal Arrhythmias esearchers in an interdisciplinary team have developed a non-invasive 3D assessment tool to help clinicians find patients most at risk from lethal arrhythmias, and those who need a defibrillator implant. The proof-of-concept study was published online in the May 10, 2016, issue of the journal Nature Communications. The researchers reported that the new digital technique provided a more accurate assessment of which patients were most at risk, and needed a defibrillator, than current blood pumping measurements. The landmark study was carried out by researchers at the John Hopkins University (Baltimore, MD, USA; www.jhu.edu). The researchers used Magnetic Resonance Imaging (MRI) scans and computer-modeling techniques to build a personalized geometrical replica of each patient’s heart. The researchers then added representations of the electrical processes, and were able to discover which virtual heart developed an arrhythmia, and which did not. The technique, called Virtual-heart Arrhythmia Risk Predictor (VARP), enabled the researchers to take account of the specific geometry of the heart of each patient, the electrical impulses, and the impact of scar tissue left by a previous heart attack.

The VARP technique was able to predict arrhythmia occurrence in patients four-to-five times better than current ejection fraction techniques, and other non-invasive and invasive clinical risk predictors. The technique was able to eliminate unnecessary implantations of defibrillators, and could also be used to save the lives of a much larger number of at-risk patients. Professor Natalia Trayanova, John Hopkins University, said, “Our virtual heart test significantly outperformed several existing clinical metrics in predicting future arrhythmic events. This non-invasive and personalized virtual heart-risk assessment could help prevent sudden cardiac deaths and allow patients who are not at risk to avoid unnecessary defibrillator implantations. We demonstrated that VARP is better than any other arrhythmia prediction method that is out there. By accurately predicting which patients are at risk of sudden cardiac death, the VARP approach will provide

the doctors with a tool to identify those patients who truly need the costly implantable device, and those for whom the device would not provide any life-saving benefits.” Image: The graphic shows how the VARP 3D computer model was used to classify patients at high risk and low risk for heart arrhythmia (Photo courtesy of Royce Faddis / JHU).

Hybrid Imaging Technology Developed for Improved Identification of Atherosclerotic Plaques

ollaborative research between two US NIBIB-funded laboratories has resulted in a new method for identifying atherosclerotic

plaques. The technique uses two different types of imaging, and provides significantly more depth and detail than existing methods. The technique provides clinicians with an improved diagnostic tool for finding problematic plaques, for example the Thin-Cap Fibroatheroma (TCFA). The hybrid imaging technology called IntraVas-

cular Ultrasound and Optical Coherence Tomography (IVUS-OCT) is licensed by OCT Medical Imaging (Irvine, CA, USA; http://octmedical imaging.com), and consists of an ultrafast opticalultrasonic system, and a miniaturized catheter that can be used to image and characterize atherosclerotic plaques in vivo. The research by the US National Institute of Biomedical Imaging and Bioengineering (NIBIB; Bethesda, MD, USA; www.nibib.nih.gov) laboratories was published in the December 18, 2015,

issue of the journal Scientific Reports. Zhongping Chen, PhD, senior author of the paper, said, “This work has overcome many of the challenges of doing IVUS and OCT simultaneously. When you use a single catheter, you don’t have to worry about matching two images, which enables physicians to look at co-registered ultrasound and OCT images simultaneously in real time. It will make identifying plaques easier and more precise, allowing for better treatment decisions.” Medical Imaging International July-August/2016

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Medical Imaging International

Next-Generation Echocardiography Reporting Modules Showcased next-generation cardiology image management and reporting solution, with new echocardiography module enhancements was showcased at the annual ASE Annual Scientific Sessions, June 2016, in Seattle, Washington, USA. The Synapse Cardiovascular cardiology image management and reporting solution was developed by FUJIFILM Medical Systems (Stamford, CT, USA; www.fujifilmusa.com). The company is promoting integration of ultrasound solutions, such as the SonoSite iViz, with medical Internet Technology (IT). The iViz is the first such system on the market that can accept patient demographics from and send reports too an Electronic Medical Record (EMR) using the FUJIFILM Synapse EMR gateway. Updates to the Synapse Cardiovascular solution include an enhanced workflow, image review, cardiology reporting, and redesigned Echocardiography Advanced Reporting (EAR) modules. Additional features include auto-summary statements, configurable macros, Z-scores, an updated measurement package, and data trending. The modules were redesigned using ASE standards for adult, pediatric, fetal, and stress studies. Bill Lacy, VP, Medical Informatics, FUJIFILM Medical Systems U.S.A, said, “Recent research shows that from 2001 to 2011, approximately 7,669,000 echos were performed nationwide on hospital inpatients alone, representing an average annual rate of increase of echocardiography of 3.41%.

Image: The Synapse Cardiovascular cardiology image management and reporting solution (Photo courtesy of Fujifilm Medical Systems).

With Synapse Cardiovascular, clinicians and sonographers can expect a streamlined and efficient clinical

experience – leaving them more time and energy to do what they do best, which is care for patients.”

Molecular Imaging Could Become the Standard for Prostate Cancer Tumor Staging esearchers have shown that molecular imaging can help oncologists accurately detect and delineate prostate tumors during biopsies, and can also be used for pre-operative planning. The researchers used Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography/ Computed Tomography (PET/CT) imaging and histopathology to evaluate prostate tumors of study participants. The researchers found that by using PET/CT imaging to evaluate Ga-68 PSMA tumor up-

take, they were able to find all 67% of tissues found to be cancerous in a histological evaluation. PSMA is found on the surface of prostate cancer cells. The researchers used a combination of radioactive gallium68 (Ga-68), and PSMA-HBED-CC a molecular compound to detect prostate cancer cells. The researchers presented the results at the annual meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI 2016). Wolfgang P. Fendler, MD, NM department, Ludwig-Maximilians Universitat Munchen (LMU; Mu-

nich, Germany; www.en.uni-muenchen.de), said, “PSMA shows significant over-expression on prostatic cancer cells and Ga-68 PSMA PET/CT demonstrates a high rate of detection in patients with recurrent, metastatic prostate cancer. However much less research has been conducted for the accuracy of PSMA imaging at the start of the disease. The results of our study indicate that Ga-68 PSMA PET/CT accurately identifies affected regions of the prostate and might thus present a promising tool for non-invasive tumor characterization and biopsy guidance.”

New Imaging Agent Detects Rare Neuroendocrine Tumors novel radioactive probe will help locate tumors in adult and pediatric patients suffering from somatostatin receptor positive neuroendocrine tumors (NETs). Netspot, a product of Advanced Accelerator Applications (AAA; Saint-Genis-Pouilly, France; www. adacap.com), is a sterile, single-dose kit for the preparation of Ga 68 dotatate injection, a radioactive diagnostic agent used in positron emission tomography (PET) imaging. The imaging agent functions as an analogue of somatostatin, with uptake of the dotatate reflecting levels of somatostatin receptor density in NETs. As Netspot contributes to the overall long-term cumulative radiation exposure, patients should drink and urinate as often as possible during the first hours following administration

Medical Imaging International July-August/2016

to help reduce risk. “Use of advanced imaging techniques to detect rare neuroendocrine tumors at an early stage in patients is critical,” said Libero Marzella, MD, PhD, director of the division of medical imaging products at the U.S. Food and Drug Administration (FDA, Silver Spring, MD, USA; www.fda.gov) Center for Drug Evaluation and Research (CDER). “Netspot provides another diagnostic tool whose results will help clinicians determine the location and extent of the tumor. This information is important for planning the appropriate course of therapy.” “The FDA approval of Netspot is a key milestone in our mission of improving the lives of NET patients,” said Stefano Buono, CEO of AAA. “NETSPOT has the potential to significantly im-

prove the accuracy of NET diagnosis, while reducing radiation exposure for patients. We believe that the use of Netspot should also offer increased comfort for patients by potentially shortening a procedure that is currently performed over 24 hours or more to just a few hours.” NETs are rare benign or malignant tumors that develop in the hormone-producing cells of the body’s neuroendocrine system. These cells are found throughout the body in distinct organs, such as the stomach, intestines, pancreas, lungs, and other locations. NETs have receptors for somatostatin, a hormone that regulates the endocrine system. The estimated incidence of NETs for the combined populations of the United States and the European Union is approximately 47,300 patients per year.

PRODUCT NEWS PET/CT SCANNER

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PORTABLE ULTRASOUND

REMOTE-CONTROLLED TABLE

GE Healthcare

Hitachi Aloka Medical

Villa Sistemi Medicali

The Discovery IQ PET/CT is powered by the GE LightBurst PET detector, which can perform scans at half the dose and in half the time compared to conventional systems. It offers an axial field-ofview of up to 26 cm, allowing radiologists to visualize smaller lesions with smaller doses.

The ARIETTA Prologue features rapid boot time, built-in battery and a monitor, which can be attached and detached freely. It can be used by combining it with the cart or the transducer tray, making it ideal for all sorts of examinations in various use environments.

The Apollo DRF Open table features a single-side suspended tabletop for direct and easy access to the patient from all sides, and a 43x43 cm flat panel detector for a high frame rate and low dose requirement. It also offers solutions for reducing the dose, making it ideal for a range of studies.

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Longer Breath-Holds Allow Targeted Radiotherapy in a Single Session esearchers in the UK have demonstrated that by training breast cancer patients to hold their breath for over five minutes, targeted radiotherapy can be administered in one single dose in a daily session. It takes two minutes to deliver a typical shaped radiation beam that is used to treat cancerous tumors. Currently most radiotherapy treatments are delivered while patients are breathing and their chests are moving, increasing the risk of damage to healthy tissues surrounding the tumor. The research was carried out by clinical teams from the University of Birmingham (Birmingham, UK; www.birmingham.ac.uk) and the UK National Health Service (NHS) Foundation Trust, and published in the May 2016, issue of the British Journal of Radiology. The trial included 15 patients all of whom were undergoing radiotherapy. Thirteen of the patients also underwent chemotherapy, and two patients were taking Herceptin. The patients were trained how to maintain a relaxed posture, practice inhal-

ing and exhaling to maximum effect, and naturally raise blood oxygen levels, and reduce blood carbon dioxide levels, using mechanically induced hypocapnia, and preoxygenation techniques. The training enabled the patients to hold their breath for 5.3 minutes on average. According to the researchers assisting patients to achieve a single breath-hold could significantly improve long-term survival, and improve the quality of life of patients with breast cancer. Dr Mike Parkes, from the University of Birmingham, said, “The physiology of breath holding is well understood on the whole, but has been somewhat overlooked in medical research because until now it hadn’t any obvious clinical application. Following on from our preliminary work on healthy subjects, we wanted to see if we could help patients with breast cancer to achieve a breath hold of over two minutes to allow a radiotherapy treatment to be de-

livered in a single breath-hold. Being able to hit the cancerous tumor accurately is essential to avoid damage to other areas, including the heart muscle. Having a stable chest that we can target in one dose could be invaluable in protecting the surrounding tissue.” Image: Breast cancer patients that can hold their breath over five minutes allow targeted radiotherapy to be administered with just one dose in each daily session (Photo courtesy of the University of Birmingham).

Small Model MRI Uses High-Temperature Coils groundbreaking 3-tesla magnetic resonance imaging (MRI) system uses hightemperature superconducting coils that do not require cooling with increasingly scarce liquid helium. Developed by Mitsubishi Electric Corporation (Tokyo, Japan; www.mitsubishielectric.com), Kyoto University (Japan; www.kyoto-u.ac.jp), and Tohoku University (Japan; www.tohoku.ac.jp), the small model MRI has an imaging space 25 millimeters in diameter with field homogeneity of less than twomillionths, the same level required for commercialsize MRI with a 230-mm diameter. The model succeeded in imaging a 25-millimeter mouse fetus at 3 tesla. The size of the system will be increased to one half of a full-size MRI scanner by 2020, with the aim of commercializing a full-size version from 2021.

The strong, stable, 3 tesla magnetic field was achieved by increasing the precision of the coil winding. Commercially available MRIs use lowtemperature superconducting wires with a 2-3 mm round or square cross section wound several hundred times to create a pancake coil. Small discrepancies in the thickness and width of the wire give the coil an uneven height that can disrupt the magnetic field and distort imaging. This is overcome in the small model MRI by using high-temperature superconducting wires 0.2 millimeter thick and 4-5millimeters wide. Laser displacement meters were used to measure the coil height and then adjust it with correction sheets. This resulted in a winding accuracy of 0.1 millimeter for pancake coils with an outer diameter of about 400 millimeters, achieving the

magnetic field homogeneity required for commercial imaging. Since the high-temperature superconducting wires used can direct more current than low-temperature ones with the same cross sections, and are able to generate magnetic fields with smaller coils, the size of the electrical circuits’ of the MRI can be reduced. Superconducting coils are differentiated into low-temperature and high-temperature systems. In low-temperature MRI systems, the superconducting coils and analytical instruments are cooled to minus 269 degrees Celsius by applying liquid helium. However, liquid helium is a limited and depleting resource, due to the low number of gas fields and rising demand from developing countries. The use of high-temperature superconducting coils is therefore expected to increase. Medical Imaging International July-August/2016

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Medical Imaging International

Play-Based Preparation Helps Children Undergoing Radiation Therapy upport interventions by child life specialists decrease sedation use and costs associated with radiation therapy (RT) for brain cancer, according to a new study. Researchers at St. Jude Children’s Research Hospital (St. Jude; Memphis, TN, USA; www. stjude.org) conducted a retrospective chart review of 116 children aged 5–12 years in order to examine the relationship between play-based procedural preparation and support intervention, and use of sedation in children with central nervous system (CNS) tumors during RT. Outcome measures included the total number of RT sessions, the number of treatments received with and without sedation, and the type and duration of interventions, which consisted of developmentally appropriate play, education, preparation, and distraction provided by a certified child life specialist. A secondary objective was to analyze the cost-effectiveness of the intervention, compared to costs associated with daily sedation alone. The results showed that age and tumor location affected sedation use. Each one-year increase in patient age was associated with significantly higher odds of receiving cranial RT without any sedation. After adjusting for age, tumor location, and craniospinal radiation, each additional intervention session with the child life specialist was associated with a 23% increase in the odds of receiving cranial radiation with partial sedation over full sedation. The study was published in the June 2016 issue of Supportive Care in Cancer. “The child life specialist will set up practice sessions where the patient will have the opportunity to lie on the table to see what it will be like before the actual radiation therapy session,” said lead author Shawna Grissom, director of Child Life at St. Jude. “The specialist will work with the child to practice lying still and will work with the patient on coping skills. Child life specialists can also help during radiation sessions by reading books to the children, leading them through guided imagery or checking on them during breaks to make sure they are coping well.” “Play-based programming implemented by a certified child life specialist can help provide a sense of accomplishment for the patients that they can get through these treatment sessions often with less or no sedation,” concluded Ms. Grissom, who added that “less sedation for the children means fewer clinical risks, less time in treatment sessions, and reduced health care costs that can approach USD 80,000 per patient.” CNS tumors are the most commonly diagnosed solid tumors in childhood, accounting for nearly 20% of all pediatric cancers in the U.S. Although RT is effective, it is stressful for children who must lie still throughout the process to avoid unintended exposure to their developing brains. Sedation is often used to ensure precise positioning, but on the other hand, sedation in children may be associated with several health risks, including respiratory ailments and cognitive functioning deficits.

Medical Imaging International July-August/2016

Image: Child Life Specialist Amy Kennedy helps a patient prepare for RT (Photo courtesy of St. Jude Children’s Research Hospital).

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The GIOTTO CLASS offers digital breast tomosynthesis, synthetic 2D mammography, and biopsy procedures. It is built on the amorphous selenium-based digital detector technology, and acquires images in a step-and-shoot mode with a 30degree angle, and only 11 exposures required.

The RF-5000 digital fluoroscopy and radiography system features advanced flat-panel technology, image intensifier, and CCD camera. It offers a fluoroscopic bed with automatic movement for quick switching from flat panel to work position, and is suitable for a wide range of clinical applications.

The Acclarix LX8 comes with a touch screen user interface, tilt-and-swivel monitor, motorized 20-cm console height adjustment, needle visualization technology, and application-specific exam presets. It has seven fully optimized transducers to cover all general imaging applications.

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MRI Helps Identify High-Risk Heart Disease Patients new study concludes that magnetic resonance imaging (MRI) scans are the safest and most effective way to identify patients with suspected coronary heart disease (CHD). Researchers at the University of Leeds (United Kingdom; www.leeds.ac.uk) conducted a study involving 752 patients being investigated for suspected CHD to establish the ability of cardiovascular magnetic resonance (CMR) and singlephoton emission computed tomography (SPECT) to predict major adverse cardiovascular events (MACEs), which include cardiovascular death, acute coronary syndrome, unscheduled revascularization, or hospital admission for cardiovascular cause. The patients were followed for a minimum of five years. The results showed that 99% of the recruited patients had complete follow-up. Of 628 patients who underwent CMR, SPECT, and a standard X-ray angiography, 16.6% had at least one MACE. The researchers found that abnormal findings on CMR and SPECT were both strong and independent predictors of MACE, but after adjustment, only CMR remained a significant predictor for MACE. The study was published on May 10, 2016, in Annals of Internal Medicine. “The benefits of cardiac MRI are not limited to reducing exposure to ionizing radiation. The non-invasive cardiac MRI test, which is not only more diagnostically accurate and cost effective for the NHS than SPECT, is also potentially better at forecasting the outcome of the disease,” said lead author Professor John Greenwood, MB ChB, PhD. “Although SPECT is currently more widely available than MRI, the use of MRI across a wide spectrum of diseases means that it will be much more readily available for heart disease investigation in coming years.” “This research shows that MRI is the best non-invasive way to diagnose significant coronary heart disease in people with chest pain,” commented Profes-

sor Peter Weissberg, MD, medical director at the British Heart Foundation (Birmingham, United Kingdom; www.bhf.org.uk). “Having an MRI scan does not involve radiation and the scanners are already widely available in heart centers across the UK, which should aid its rapid adoption in UK diagnostic guidelines.” Image: The results of MRI scans are expected to inform future clinical guidelines for heart disease (Photo courtesy of the University of Leeds).

Strain Echocardiography Predicts Hypertrophic Cardiomyopathy Risk new study shows that strain echocardiography can accurately predict which patients are likely to have complications resulting from hypertrophic cardiomyopathy (HCM). Researchers at Johns Hopkins University (JHU, Baltimore, MD, USA; www.jhu.edu) conducted a study in 400 HCM patients who were followed for 37 months, and who underwent both conventional and strain echocardiography to obtain global longitudinal strain (GLS) data, an objective and reproducible imaging modality than can be used to quantify subtle disturbances in left ventricular (LV) function by detecting sub-endocardial contractility and viability, which often precede an overt impairment of LV func-

tion, as measured by ejection fraction (EF). The results showed that GLS measured by strain echocardiography can be used as a cardiovascular diagnostic technique that is a sensitive and powerful way to assess patient HCM outcomes, which are a common, but often undetected, leading cause of sudden cardiac death (SCD) in young adults. The study was presented as a poster session at the American Society of Echocardiography (ASE) 27th annual scientific sessions, held during June 2016 in Seattle (WA, USA). “HCM is the most common inherited cardiac condition, with several disabling and life-threatening complications. Global longitudinal strain was able to independently predict key outcomes in

HCM, and therefore has the potential to become an essential tool in HCM risk assessment,” said lead author and study presenter Hongyun Liu, MD, of the JHU HCM Center of Excellence. HCM is a primary disease of the myocardium in which a portion of it becomes hypertrophic without any obvious cause, creating functional impairment of the cardiac muscle. It is a leading cause of SCD in young athletes, and indeed in any age group, and a cause of disabling cardiac symptoms. HCM is frequently asymptomatic until SCD, and for this reason some suggest routinely screening certain populations for this disease, as the prevalence is about 0.2% to 0.5% of the general population. Medical Imaging International July-August/2016

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Medical Imaging International

Exclusive Research Partnership To Bring MR Fingerprinting To Clinical Application Stage new partnership between a major medical imaging provider and a leading university in the US aims to bring a new Magnetic Resonance (MR) quantitative tissue analysis technique that can identify individual disease tissues, to clinical application. The goal of the researchers is to provide software that can reliably distinguish between healthy and diseased tissue and help identify disease tissues earlier and faster than existing techniques. The MR Fingerprinting (MRF) software package has already been evaluated successfully by several research facilities. The partnership between Siemens Healthcare (Erlangen, Germany; www. healthcare.siemens.com) and Case Western Reserve University (CWRU; Cleveland, OH, USA; www.case.edu) was announced in Singapore at the

Annual Meeting of the International Society for Magnetic Resonance in Medicine (ISMRM). MRF provides a non-invasive quantification of tissue properties and can be used to measure multiple parameters simultaneously. The technique provides a unique fingerprint for each type of tissue, disease, or material in the body. MRF can provide a low level of variance across many exam types, different MR scanners, and institutions, and could help clinicians monitor and evaluate patient treatments with greater accuracy. MRF has previously been used for cardiac examinations and for multiple sclerosis patients. The CWRU research team has successfully used the technique for patients with brain tumors, prostate tumors, and breast cancer patients with liver metastases. Prof. Siegfried Trattnig from the

Medical University of Vienna, who has done initial research with brain tumor and glioma patients, said, “The MR Fingerprint technique lets us see more details than the standard imaging process, and has the potential to redefine MRI. In this way, MRF could help us, as radiologists, to make the para-

digm shift from qualitative to quantitative imaging and to incorporate quantitative data into our daily routine.” Image: MR Fingerprinting (MRF) can be used to identify individual tissues and diseases quantitatively (Photo courtesy of Siemens Healthcare).

Gadolinium Contrast Agent Approved for Supra-Aortic MRI Angiography gadolinium-based contrast agents (GBCA) indicated for use with magnetic resonance angiography (MRA) has been approved for evaluating supra-aortic or renal artery disease. Gadavist, a product of Bayer (Leverkusen, Germany; www.bayer.com) was previously indicated for use with magnetic resonance imaging (MRI) in adult and pediatric patients (including term neonates) to detect and visualize areas with disrupted blood brain barrier (BBB) and/or abnormal vascularity of the central nervous system (CNS). It is also indicated for use with MRI to assess the presence and extent of malignant breast disease. In MRI, visualization of normal and pathologi-

cal tissue depends on variations in the radiofrequency (RF) signal intensity that occurs with differences in proton density, differences of spin-lattice (longitudinal) relaxation times (T1), and differences in the spin-spin (transverse) relaxation time (T2). When placed in a magnetic field, Gadavist shortens the T1 and T2 relaxation times, depending on the concentration in the tissue, the field strength of the MRI system, and the relative ratio of the longitudinal and transverse relaxation times. “Until now, no contrast agents were FDA-approved for use with MRA of the supra-aortic arteries,” said Elias Melhem, MD, chair of the department of diagnostic radiology & nuclear medicine at

the University of Maryland, lead investigator for the Gadavist-Enhanced MRA of the Supra-Aortic Vessels (GEMSAV) study. “With FDA’s action, radiologists now have an approved MRA contrast agent to help visualize supra-aortic arteries in patients with known or suspected supra-aortic arterial disease, including conditions such as prior stroke or transient ischemic attack.” GBCAs increase the risk for nephrogenic systemic fibrosis (NSF) among patients with impaired drug elimination of the drugs. NSF may result in fatal or debilitating fibrosis affecting the skin, muscle, and internal organs. The risk for NSF appears highest among patients with chronic, severe kidney disease or acute kidney injury (AKI).

Device Significantly Reduces Volume of Dye Needed for CA or PCI Interventions he results of a large, late-breaking, clinical trial have demonstrated a new device that can significantly reduce the volume of radiographic dye required for patients who undergo a coronary angiography, or Percutaneous Coronary Intervention (PCI), but who are at risk of developing acute kidney injury (AKI). The device was not able to reduce the sudden deterioration in renal function, called Contrast-Induced AKI (CI-AKI), which can occur following the administration of radiographic dye or Contrast Media Volume (CMV) during interventional cardiac procedures. CI-AKI affects around 20 – 30% of patients, especially those with previous renal impairment, or diabetes, and can cause increased morbidity and mortality. The results of the study were presented at the

Medical Imaging International July-August/2016

Society for Cardiovascular Angiography and Interventions (SCAI) 2016 Scientific Sessions (Orlando, FL, USA; www.scai.org/SCAI2016). The operator of the AVERT device can control how much dye is injected in the coronary artery, and can dispose of the remaining dye into a reservoir. The prospective, randomized multi-center study took place at 39 sites, and included 578 patients who needed to undergo a coronary angiography and/or PCI, but who were at risk of CI-AKI. The use of the AVERT device resulted in a relative reduction of 15.5% in CMV in all patients and a relative reduction of 22.8% in CMV for PCI patients. The researchers found no significant differences in CI-AKI, or adverse event rates, in both groups. Roxana Mehran, MD, FSCAI, lead author of

the study, from the Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai Hospital (SMMS; New York, NK, USA; http:// icahn.mssm.edu), said, “Physicians are extremely careful about the volume of dye they administer to patients; the greater the volume, the more problems a physician can encounter. The bottom line is the AVERT system is safe, easy to use and reduces contrast media volume without sacrificing image quality. While the use of this device did not result in a significant reduction of CI-AKI, there was one exception. A post-hoc analysis showed that in certain groups – patients with a GFR between 4060 – CI-AKI was significantly reduced. The next step would be to study patients with moderate chronic kidney disease in a prospective randomized trial.”

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The SPINEL II features multi-frequency ultrasound probes from 2 MHz to 15 MHz and offers multi-operating diagnostic modes. It comes with a full HD panoramic 21.5-inch LED monitor, functional desktop, and alphanumeric keyboard on drawer system and is ideal for many applications.

The RadPRO Solegra 500 is equipped with the Canon CXDI-50RF dynamic/static DR system, and provides enhanced image quality for fluoroscopy/static exams. It comes with auto stitching capability, and also offers a removable digital detector, making it ideal for high-volume facilities.

The Pixium RAD 4343 C-E features CsI scintillator and provides high image quality at low dose due to its excellent conversion factor and perfectly controlled signal-to-noise ratio. Its simplified design facilitates integration in X-ray systems, and makes it ideal for various applications.

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Novel Imaging Technique Could Predict Brain Bleeding Following a Stroke cientists in the US have used MRI brain scans of stroke patients to confirm the relationship between the extent that the Blood-Brain Barrier (BBB) has been disrupted, and the severity of bleeding, after invasive stroke therapy. The researchers analyzed Magnetic Resonance Imaging (MRI) scans of more than one hundred stroke patients. The scans were taken before clinicians treated the patients with endovascular therapy, within 12 hours of the onset of the stroke. The study was carried out by scientists at the US National Institutes of Health (NIH) National Institute of Neurological Disorders and Stroke (NINDS; www.ninds.nih.gov/index.htm) and published online before print on June 17, 2016, in the journal Neurology. The study authors concluded that the extent of disruption to the brain BBB, as revealed in MRI image scans, could help clinicians determine which patients would be unlikely to benefit from endovascular therapy. Richard Leigh, M.D., scientist at NINDS, and one of the study authors, said, “The biggest impact of this research is that information from MRI scans routinely collected at a number of research hospitals and stroke centers can inform treating physicians on the risk of bleeding. It is too early to say how these images will be able to help guide clinical decisions, but they can expand how we think about stroke, especially as we try to broaden treatment options for this disease that can have devastating consequences.”

Image: The image shows MRI scans of one patient, taken before and after treatment, and reveals the correlation between the area and size of bleeding after treatment, and the disruption to the blood-brain barrier before therapy (Photo courtesy of Dr. Richard Leigh, NINDS).

Migraines with Aura Unrelated to Brain Anomalies new magnetic resonance imaging (MRI) study found no association between silent brain infarcts or white matter hyperintensities (WMHs) and migraines with aura. Researchers at Odense University Hospital (OUH; Denmark; www.en.ouh.dk) and the University of Southern Denmark (SDU; Odense, Denmark; www.sdu.dk) conducted a population-based study to identify the relationship between silent brain infarcts, WMHs, and migraine. Via the Danish Twin Registry, they identified 172 twins (30-60 years of age) with migraine with aura and 34 cotwins who, unlike their participating twin sisters, did not suffer from migraine with aura. A further 139 twins served as controls. Based on questionnaire responses, the twins

were invited to participate in a telephone-based interview. Women with migraine with aura, their cotwins, and unrelated migraine-free twins were invited to a brain MRI scan, which was assessed for the presence of infarcts and WMHs, and blinded to headache diagnoses. The results showed no differences between women with migraine with aura and those without, with regard to number of silent infarcts and WMHs. The study was published on May 3, 2016, in Brain. “We found no evidence of an association between migraine with aura and silent brain infarcts or white matter hyperintensities,” said lead author David Gaist, MD, of OHU and SDU. “This held true for the main analyses comparing cases with unrelated controls, and for analyses focusing on twin

pairs where one twin suffered from migraine with aura, and the other did not. We believe patients suffering from migraines with aura and their physicians should find these results reassuring.” Migraine is a common disorder afflicting about 10–15% of the population. One-third of migraineurs experience transient neurological symptoms known as auras. Population-based studies have indicated that migraine, and in particular migraine with aura, may be a risk factor for subclinical (silent) brain infarcts and WMHs, which have been associated with an increased risk of stroke, dementia, and death. This raised the question whether migraine, a condition so common as to be encountered by all physicians regardless of specialty, is a chronic progressive brain disorder. Medical Imaging International July-August/2016

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Medical Imaging International

Smallest Mobile PET/CT System Introduced mobile configuration of the Biograph Horizon positron emission tomography/computed tomography (PET/CT) system delivers high-end functionality at an attractive total cost of ownership. The mobile-ready version of the Biograph Horizon introduced by Siemens Healthineers (Erlangen, Germany; www.healthcare.siemens.com) is intended for cost-conscious healthcare facilities that do not yet possess the patient volume to support installation of a fixed PET/CT. The system is also suitable for consolidated health

systems looking to tailor their imaging delivery strategy in diverse service areas, with clinical indications in oncology, neurology, and cardiology. With the addition of the mobile version of the Biograph Horizon, the entire line of Biograph PET/CT systems from Siemens Healthineers is now available in both mobile and fixed configurations. The system’s 4 mm lutetium orthosilicate (LSO) crystals scintillate faster and boast a higher light output than commonly used bismuth germanate oxide (BGO) crystals, yield-

Novel System Upgrades CRT Imaging Devices to LCD Display new device helps shift imaging systems dependent on cathode ray tube (CRT) displays to liquid crystal diode (LCD) displays. The Modalixx LCD display system is compatible with Cath Lab, magnetic resonance imaging (MRI), computerized tomography (CT), radiofrequency (RF) treatment rooms, Mobile C-Arms, positron emission tomography (PET) scanners, and nuclear medicine modalities. The technology allows Modalixx to convert small matrix pictures from analog to two megapixel digital images, thus converting medical renderings without compromising the integrity of images, allowing medical professionals to zoom-in or zoom-out at their choosing.

The system can replace all types of modality CRT’s, offering in return brighter resolutions, lower power consumption, and no radiation emissions. Modalixx can synchronize to an existing technology set-up, and receive any video signal parameters; with inputs ranging from one to five BNCs and 15 pin D-Sub connectors, a range of analog connectivity is provided. Optional docking solutions are available for mounting the Modalixx LCD display on almost any medical modality system. The Modalixx LCD display system is a product of Ampronix (Irvine, CA, USA; www.ampronix.com), and is compatible with systems from Eizo, GE, Phillips, Siemens, and Toshiba, among others.

Image: The Biograph Horizon PET/CT (Photo courtesy of Siemens Healthineers).

ing high image resolution and better image quality, thus enabling physicians to visualize small lesions earlier and contributing to a more accurate disease staging and a more accurate evaluation of therapy response. The system also enables Time-of-Flight (ToF) acquisition and offers built-in capabilities to automate routine tasks in order to increase productivity and streamline workflows. The Biograph Horizon utilizes the new iteration of the Siemens Healthineers syngo.via molecular imaging workplace image processing solution, which offers – for the first time – sin-

gle photon emission computed tomography (SPECT). The new iteration offers four new features; for SPECT, organ processing for nuclear medicine helps physicians visualize and quantify the physiological characteristics of organs such as the lungs, kidneys, and stomach; For PET, tMolecular Tumor Volume (MTV) and Total Lesion Glycolysis (TLG) features enable physicians to measure the standardized metabolic activity of the entire tumor mass; and hybrid gating four-dimensional (4-D) visualization of PET and CT supports therapy planning and delivery.

Fate of Penumbra After Stroke Dependent on Blood Flow Restoration study investigating the fate of brain tissue that is at risk of dying after a stroke, has found that damage outcomes are association with collateral flow rather than time. The researchers found that treatment of the tissue at risk after a stroke, the penumbra, may need to be changed if the time of the stroke is unknown or treatment was delayed. The study that included 110 patients was led by an associate professor from the University of Cincinnati College of Medicine and radiologist at UC Health (UC; Cincinnati, OH, USA; www.med.uc.edu). The results were presented at the annual meeting of the American Society of Neuroradiology on May 25, 2016, in Washington, DC, USA. The researchers did not find any significant correlation between sal-

Medical Imaging International July-August/2016

vaged penumbra tissue and time, but did find a correlation between the salvaged penumbra and the amount of collateral blood flow. Study leader Achala Vagal, MD, said, “Using a large, multicenter stroke registry, we analyzed all untreated acute stroke patients who received baseline CT angiogram, an XRay that uses a dye and camera (fluoroscopy) to take pictures of the blood flow in an artery, and CT perfusion, to show which areas of the brain were getting blood, within 24 hours of the onset of stroke, and follow-up CT angiogram or MR angiogram within 48 hours. Baseline CT angiogram results were reviewed for artery blockages and rerouting of blood flow, and follow-up imaging was reviewed to determine if blood flow was restored.” LINKXPRESS COM

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ULTRASOUND SYSTEM

MOBILE DR SYSTEM

Analogic

Alpinion Medical Systems

Samsung

The Sonic Window allows intuitive sub-surface imaging which is similar to looking through the skin into the underlying anatomy. It enables clinicians to detect the locations and sizes of fistulas and grafts of dialysis patients, thereby helping them ease and improve the process of cannulation.

The E-CUBE 11 uses an advanced signal algorithm to provide images with exceptional detail, clear border definition, and a wider grayscale in tissue. Its 10.4-inch touch screen interface reduces reach and button pushes and it has a wide range of transducers for multiple applications.

The GM60A features S-Detector and S-Vue imaging technologies to deliver high-quality images directly at the patient’s bedside. A motorized moving system enables access in tight spaces and slightly inclined hallways, while its telescopic column provides a clear view while moving.

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Structural MRI Can Help Predict Outcomes of Electroconvulsive Therapy esults from a non-randomized prospective study have shown that neuroimaging techniques can be used to predict the therapeutic effectiveness of ElectroConvulsive Therapy (ECT) in individuals. ECT therapy treatment involves intentionally triggering a short seizure in the brain using small electric currents, and is performed under general anesthesia. The procedure can be used to treat certain mental illnesses, including acute major depressive disorder. The research was published online in the May 4, 2016, issue of the journal JAMA Psychiatry. The goal of the researchers from the University of Muenster (Muenster, Germany; www.uni-muenster.de/en) was to find out whether structural Magnetic Resonance Imaging (MRI) could identify biomarkers that could accurately predict the response to ECT treatment. In the study, the structure of grey matter of inpatients from Department of Psychiatry at the University of Muenster was assessed twice using a 3-T MRI scanner and voxel-based morphometry, at intervals of approximately 6 weeks. The study took place between March 11, 2010, and March 27, 2015. The patients included two groups with acute major depressive disorder, one of which received a series of ECT treatments and antidepressants (n = 24). The second group was treated with antidepressants (n = 23) alone. The researchers then compared both groups with a healthy control group (n = 21). The researchers found that successful treatment with ECT therapy could be linked to a relatively small degree of structural impairment in the sub-genual cingulate cortex observed in neuroimaging before treatment.

Image: A patient undergoing ECT treatment, which involves using small electric currents to trigger a short seizure in the brain (Photo courtesy of BBC Newsnight).

PET Imaging Can Detect and Diagnose Early Alzheimer’s Disease novel tracer called Pittsburgh Compound B (PiB) binds to the amyloid plaques in the brain that are a characteristic cause of Alzheimer’s disease (AD), according to a new study. Professor Ann Cohen, MD, PhD, of the department of psychiatry at the University of Pittsburgh (Pitt, PA, USA; www.pitt.edu) has presented a review that focuses on the use of PiB-PET across the spectrum of AD pathogenesis. PiB, a radioactive analog of thioflavin-T (ThT) known to bind to amyloid beta (A )proteins, can be used to image the brains of AD patients using positron emission tomography (PET) scans in order to image the accumulation of A plaques in neuronal tissue. The review found that PiB can provide early, per-

haps even preclinical, detection of disease, and accurately distinguishes AD from dementias of other etiologies in which the diagnostic distinction is difficult to make clinically. According to the study author, using imaging agents can be used to study the relationships between A pathology and changes in cognition, brain structure, and function across the continuum from normal aging to mild cognitive impairment (MCI), and on to AD. The review was published in the June 2016 issue of Technology & Innovation. “PiB retention in AD patients was generally most prominent in cortical areas and lower in white matter areas of the brain, consistent with postmortem studies of A plaques in the AD brain,” said study author Professor Cohen. “Major chal-

lenges ahead include finding ways to determine the earliest signs of amyloid accumulation, associating amyloid accumulation with cognitive impairments, and determining whether early amyloid deposition will lead to clinical dementia.” “These challenges will likely require us to continue to focus on cognitively normal elderly and the detection of the earliest signs of amyloid deposition, along with markers of neurodegeneration...to determine the clinical significance of pre-symptomatic pathology,” concluded Professor Cohen. “As anti-amyloid clinical trials begin in asymptomatic people, it will be critical to effectively identify the earliest changes in amyloid deposition and the significance of such changes on downstream neurodegenerative processes.” Medical Imaging International July-August/2016

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Medical Imaging International

Redesigned CT Scanner to Provide Improved Image Quality and Lower Dose new CT scanner boasts improved X-ray detector functionality, a flared gantry, and a 30 degrees bi-directional tilt to reduce radiation exposure to sensitive organs. The scanner features scan protocols that use Model Based Iterative Reconstruction (MBIR) technology, and can be applied in clinical workflows to rapidly reconstruct a volume scan, providing improved spatial resolution, with less radiation dose. The system also includes the world’s first laser collimator that does away with the need for a scanogram, and speeds up the CT scan. The Aquilion ONE/GENESIS Edition Computed Tomography (CT) scanner is made by Toshiba Medical Systems Europe (TMSE; Zoetermeer, The Netherlands; www. toshiba-medical.eu), which markets, sells, distributes, and services radiology and cardiovascular systems, and coordinates research for clinical diagnostic imaging for all modalities in Europe. Mr. Henk Zomer, general manager of CT-BU, Toshiba Medical Systems Europe, said, “GENESIS Edition offers improved X-ray detector functionality through a complete redesign of the system together with high-quality image processing and lower radiation doses than ever before. GENESIS Edition is smaller, lighter and requires less power than any other Area Detector CT. Designed for an installation space of just 19m2, GENESIS Edition can be installed in most existing CT rooms, reducing costly renovations and transforming the workspace.”

Image: The Aquilion ONE Premium CT scanner (Photo courtesy of Toshiba Medical Systems).

FDA Approves Innovative Spinal Cord Stimulator for Full-Body MRI Scanning atients that suffer from chronic pain now have the option to use a new spinal cord stimulator, and still be able to undergo fullbody Magnetic Resonance Imaging (MRI) exams. Chronic pain affects some 1.5 billion people around the world including 100 million Americans, and 95 million Europeans, and costs the European healthcare systems alone EUR 300 billion every year. Inaccessibility to MRI scans is a barrier preventing such patients from benefitting from SCS therapy. Boston Scientific (Marlborough, MA; www. bostonscientific.com) received US Food and Drug Administration (FDA) approval for the new Precision Montage MRI Spinal Cord Stimulator (SCS) System. The system provides customized relief for chronic pain, while at the same enabling patients’ safe access to full-body 1.5-Tesla MRI scans, when conditions of use are met. Boston Scientific launched the system in May 2016. The Precision Montage MRI SCS system uses MultiWave technology and can deliver pain relief throughout the day in multiple waveforms, in multiple locations, and with fluctuating intensity and type. The SCS system also uses the Illumina 3D algorithm, a 3D computer model that helps clinicians target and treating chronic pain. A survey of 800 patients showed that 72% used multiple waveforms to customize and optimize their therapy, and pain relief. Salim Hayek, MD at the University Hospital, Cleveland, Ohio, said, “The Boston Scientific Illumina 3D portfolio allows me to tailor therapy for each patient consistently and effectively. With the approval of the Precision Montage MRI SCS System, more of my patients can benefit from this powerful technology since they can now have access to future MRI scan needs.”

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Medical Imaging International July-August/2016

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MOBILE X-RAY SYSTEM

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Intermedical

Shimadzu Medical Systems

Teknova Medical Systems

The Radius XP100 Cardio C-arm is available with a 9-inch or 13-inch image intensifier, and features a liquid cooled X-ray tube with a 4-inch graphite rotating anode. Its slim-line design offers excellent maneuverability, and it is available in both ceilingsuspended and floor-based versions.

The MobileArt Evolution EFX offers excellent image quality and short exposure times, ensuring sharp images with minimal blurring. It features inch-mover buttons to enable precise positioning in confined spaces, and a power-assist function to help the operator move the unit smoothly.

The TH-5500 features high-precision DBF, DRF, RDA, and dynamic apordization for detailed images. It supports various types of probes, including linear and convex types, and can be used in a wide range of diagnostic applications.

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Successful Scan Using Novel 3T MRI Scanner leading manufacturer of electrical and electronic products, and systems, and two Japanese universities have successfully imaged a mouse fetus using a small model of a new 3T Magnetic Resonance Imaging (MRI) scanner that uses high-temperature superconducting coils. Most MRI scanners in use today have magnets that are cooled by liquid helium, a gas that is becoming increasingly scarce. The new technology uses high-temperature superconducting coils that do not require cooling. The company expects to develop a half-size MRI scanner by 2020, and to be able to commercialize a full-size scanner within five years, in 2021. Mitsubishi Electric (Tokyo, Japan; www.mitsubishielectric.com), Kyoto University and Tohoku University, successfully developed the 3T magnetic field by increasing the precision of the coil winding. The company used laser displacement meters to measure the coil height and then adjusted it with correction sheets. The researchers succeeded in developing a pancake coil with a winding accuracy of 0.1 mm and an outer diameter of approximately 400 mm, and were able to achieve sufficient magnetic field homogeneity for use in commercial imaging. The model scanner has an imaging space with a diameter of 25 mm – the same level as that in a 230mm diameter and 650-mm cylinder commercial-sized MRI scanner. Mitsubishi Electric used the 3T scanner model to successfully image a 25-millimeter mouse fetus.

Image: The model of the first 3T MRI scanner with high-temperature coils (Photo courtesy of Mitsubishi Electric).

Dual-Energy CT Scans for Simultaneous Evaluation of Krypton and Iodine Concentrations he results of an experimental study aimed at evaluating the feasibility of using a simultaneous single dual-energy Computed Tomography (CT) scan to evaluate regional krypton and iodine concentrations have been released. The researchers enrolled 10 beagle dogs for the study that was approved by the institutional animal experimental committee. The researchers first made an airway obstruction model in the dogs, and then after a week they induced a pulmonary arterial occlusion. The researchers then performed three sessions of dual-energy CT (80% krypton CT, 80% mixed–contrast agent CT, and iodine CT). Next the

researchers made krypton maps from krypton and mixed–contrast agent CT, and iodine maps from iodine and mixed–contrast agent CT. For each map observers measured overlaid Hounsfield units of diseased and contralateral segments, and compared the values using the Wilcoxon signed-rank test. The results showed that overlay Hounsfield units of diseased segments were much lower in krypton maps of airway obstruction compared with those of contralateral segments in both mixed–contrast krypton and agent CT. On the other hand, for both segments the values of mixed–contrast agent CT were significantly more than those of krypton

CT. Iodine maps of pulmonary arterial occlusion showed significantly lower values in diseased segments than in contralateral segments. There was no significant difference between mixed–contrast agent CT and iodine for both segments. The researchers from the Department of Radiology at the Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine (Seoul, Korea; http://medicine. yonsei.ac.kr/en) found that despite certain possible limitations, it is possible to analyze regional krypton and iodine concentrations simultaneously by using a single dual-energy CT scan. Medical Imaging International July-August/2016

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Medical Imaging International

Shorter Radiation Course Recommended For Breast Cancer Treatment new study suggests that early-stage breast cancer (BC) patients who receive shorter radiation therapy (RT) treatments with higher doses per fraction show cosmetic, functional, and pain outcomes similar to those receiving a conventional longer, lower-dose per fraction courses of treatment. Researchers at the University of Texas MD Anderson Cancer Center (Houston, USA; www.mdanderson. org) conducted a study involving 287 women with stage 0 to stage II BC, who were randomized to receive conventionally fractionated whole-breast irradiation (CF-WBI, 149 patients) or hypo-fractionated whole-breast irradiation (HF-WBI, 138 patients) following breast-conserving surgery between 2011 and 2014. Longitudinal patientreported outcomes and physician-rated cosmesis were assessed at 0.5, 1, 2, and 3 years after RT.

The results showed that patientreported functional status and breast pain improved significantly following both radiation schedules, and there were no significant differences in physician-reported cosmetic evaluations at any time point. In a previously published study, the authors showed that patients receiving HFWBI experienced less acute toxicity and post-radiation fatigue compared to those treated with CF-WBI. The study was published on June 15, 2016, in Cancer. “This trial is particularly important, because there is still some hesitation among clinicians in the U.S. about adopting the hypofractionated schedule,” said lead author Cameron Swanick, MD. “The results of this and previous studies further support the use of HFWBI as the preferred radiation therapy for early-stage breast cancer pa-

tients; at MD Anderson these shorter courses have become the standard of care,” said study co-author Benjamin Smith, MD, an associate professor of radiation oncology. “This was the first investigator-initiated randomized trial conducted in the network. It was a success because of the support of our

Radiotherapy Twice A Day Halves Treatment Time adiotherapy (RT) once a day for six and a half weeks or twice a day for three weeks offer equal benefit in non-metastatic small cell lung cancer (SCLC), according to a new study. Researchers at the University of Manchester (United Kingdom; www.manchester.ac.uk), the Catalan Institute of Oncology (ICO; Barcelona, Spain; http://ico.gencat.cat), and other institutions conducted a study that recruited 550 patients diagnosed with SCLC from 74 centers in eight countries between 2008 and 2013. The patients were randomized to receive either concurrent twice-daily RT over three weeks or concurrent once-daily RT over 6.5 weeks, both starting on day 22 of cycle 1. Patients were followed up until death. The primary end point was overall survival. The results showed that survival in both groups was similar, with 56% of patients who had RT twice a day surviving for two years, compared with 51% of those given it once a day. The majority of side effects from RT were similar in both groups, apart from neutropenia, which happened more often in twice daily treatment group. The trial also identified the optimum amount of RT as 66 grays once a day and 45 grays twice a day. The study was presented at the American Society of Clinical Oncology (ASCO) cancer conference, held during June 2016 in Chicago (IL, USA). “Before this study, it was unclear whether having radiotherapy once or twice a day helped more patients survive for longer, and what level of side effects was expected with modern radiotherapy techniques,” said lead author Professor Corinne FaivreFinn, MD, PhD, of the University of Manchester. Primary lung cancers are malignant carcinomas that derive from epithelial cells, with the main types being SCLC and non-small-cell lung carcinoma (NSCLC). The most common symptoms are coughing (including coughing up blood), weight loss, shortness of breath, and chest pains.

Image: An X-ray of the lungs showing cancer (Photo courtesy of Getty Images).

Medical Imaging International July-August/2016

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partners and illustrated the potential, promise and power of our network to help achieve our mission.” Image: A shorter radiation course is recommended for early-stage breast cancer patients (Photo courtesy of the University of Texas MD Anderson Cancer Center).

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MEDICAL DISPLAY MONITOR

PORTABLE RADIOLOGY TABLET

IMAGE Information Systems

Totoku

IMAGE Information Systems

The iQ-RIS 3.3 radiology information system for optimization of radiological workflow allows for integration with almost any PACS. Since iQ-RIS is available as a modular system, it is flexible enough to be customized to meet the individual requirements of any hospital or imaging center.

The CCL550i2 5MP monitor can accommodate images from ultrasound, CT, MRI, pathology and digital mammography on a single screen. It automatically recognizes color images to provide optimized contrast, brightness and gamma, all without user intervention.

The MED-TAB is designed for medical image analysis with a 13.3-inch anti-glare touch screen display, custom measuring pen and DICOM grayscale calibration. It utilizes the Android 4.4 operating system and supports most major PACS vendors using HTML5 zero footprint technology.

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UK Radiologists to Pilot Cloud-Based PACS Platform For Online Case Reviews large UK society of musculoskeletal radiologists has announced that it will pilot a new platform to facilitate on-line discussions of cases between the society’s 400 members. The Picture Archiving and Communication System (PACS)-based platform developed by a UK healthcare communications technology company includes a zero-footprint fully diagnostic display of complete Digital Imaging and Communications in Medicine (DICOM) datasets, and a secure blog that enables radiologists to review and comment on patient cases. The PACSMail Cloud eMDT platform developed by Sybermedica (Cambridge, UK; www.sybermedica.com) will be accessible to radiologists from the website of the British Society of Skeletal Radiologists (BSSR; UK, www.bssr.org.uk) a professional body of more than 400 muculoskeletal (MSK) radiologists in the UK. The BSSR provides a UK national forum enabling radiologists to discuss issues related to MSK radiology imaging and practice. The PACSMail Cloud eMDT platform will enable BSSR members to review anonymized cases they have uploaded with other radiologists in the network. The platform enables multi-disciplinary teams of clinicians to share patient notes, and related diagnostic information online. The platform allows real-time collection and dissemination of clinical comments by using an innovative secure ‘Case Blog’. BSSR member radiologists will also be able to make use of the growing library of cases, as they are uploaded, for educational purposes.

Image: The PACSMail Cloud enables “zero footprint” viewing, storage, and reporting of patient case files (Photo courtesy of Sybermedica).

Latest Release of Enterprise Imaging Platform Demonstrated at ACR 2016 newly-released Enterprise Imaging Platform features thin-client, server-side processing, and simple diagnostic mobile access. The system was unveiled at the annual meeting of the American College of Radiology (ACR 2016) in Washington, DC, USA, on May 16 and 17, 2016. In April 2016, the Enterprise Imaging Platform (EIP) provider signed two large deals for its EIP system that included 51 acute care and specialty hospitals in 5 US states, a network of more than 4,000 physicians, and more than 15 million interpreted exams, using the EIP, during the terms of the contracts.

The Visage Imaging (Richmond, VIC, Australia; www.visageimaging.com) Visage 7 EIP features an intelligent thin-client viewer for rapid streaming of server-side rendered images. The system provides radiologists and referring physicians with a customized, protocol-driven workflow for native viewing of multi-dimensional images on a single desktop. The Visage 7 features enterprise viewing and interpretation, image enablement of Electronic Health Records (EHR), Vendor Neutral Archives (VNA), Healthcare Information Exchange (HIE), portals, Radiology Information Systems, and Picture Archiving and Information Systems (RIS/PACS), and mobile diagnostic access.

Visage Imaging is a wholly owned subsidiary of Pro Medicus (Richmond, VIC, Australia; www. promed.com.au), which provides integrated software products and services to hospital, imaging centers and healthcare providers. Dr. Sam Hupert, CEO, Visage Imaging, said, “These new signings further demonstrate that Visage has unique technology ideally suited to address the enterprise imaging needs of the North American market. We look forward to discussing our differentiated experience and acclaimed technology with leading institutions at ACR 2016 as the industry continues to invest in enterprise imaging.” Medical Imaging International July-August/2016

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IT/PACS Update

Vendor Selected for Cloud-Based Image Sharing Project in France medical imaging systems and Information Technology (IT) solutions provider has been selected to implement the Shared Regional Medical Imaging Services (S-PRIM) project in the large Île-de-France region in France. The S-PRIM project follows on from the Region Without Film (RSF) project and will enable rapid implementation of a shared medical imaging infrastructure in the Île-de-France region. The project will include migration of archiving and Picture Archiving and Communication System (PACS) systems, and innovative new services for public and private organizations in the region. Groupement de Coopération Sanitaire (GCS) Service Numérique de Santé (GCS Sesan; Paris, France;

www.sesan.fr) awarded the tender to Carestream (Rochester, NY, USA; www.carestream.com). The award includes Carestream’s Software as a Service (SaaS) Vue Cloud platform. The cloud-based services will include secure medical imaging data sharing and exchange to facilitate collaboration in the Île-de-France region. The services will also include creation of a unique and holistic patient folder, the ability to create integrated clinical pathways and treatment plans, and results sharing with prescribing doctors and patients using a secure portal. Dynamic multimedia enhanced reporting and advanced post-processing tools natively integrated in the diagnostic viewer are also included in the project. Patrick Koch, managing director, Carestream France and Benelux,

Enterprise Workflow Solutions Provider Announces New Options software company that provides enterprise medical imaging workflow solutions has announced that it has added new workflow features for the company’s routing and workflow management system. The company will also release a new enterprise version of the system in late summer 2016. The enterprise system will include a modular scalable architecture, and will support unrestricted Digital Imaging and Communications in Medicine (DICOM) message types. The new features will allow healthcare providers to enhance interoperability between multiple Picture Archiving and Communication Systems (PACS) systems, clinical Information Technology (IT) environments and a Vendor Neutral Archive (VNA). The new workflow capabilities of the Compass Routing and Workflow Manager, developed by Laurel Bridge

Software (Newark, DE, USA; www.laurelbridge.com) include routing of HL7 messages, integration of a dictation system, DICOM load distribution and balancing, and transport of non-DICOM files. Laurel Bridge will present the enhancements at the annual meeting of the Society for Imaging Informatics in Medicine (SIIM) in Portland, OR, USA between June 29, and July 1, 2016. The Compass system can be integrated with other Laurel Bridge software to retrieve and normalize imaging studies from different facilities, VNAs or PACS systems. Mark Blair, CEO, Laurel Bridge Software, said, “The imaging workflow needs of healthcare providers are more complex than ever. We provide centralized, scalable solutions for ingesting, routing and retrieving all medical images across the clinical enterprise and the varied IT systems they encompass.”

said, “We are proud to welcome GCS Sesan, with the S-PRIM project, into the community of partners putting their confidence in Carestream. This includes the hospitals in the AP-HP hospital group (the Greater Paris University Hospitals – the largest hospital group in Europe), the Midi-Pyrenees, Central, Pays de la Loire and Provence-Alpes-Côte d’Azur. Subscribing hospitals will be connected

gradually to our Vue Cloud platform, which is already being used by more than 100 healthcare establishments in France and for which we have accreditation from the French government to host personal medical data.” Image: The Vue Cloud Software as a Service (SaaS) platform showing an example of a collaborative workflow (Photo courtesy of Carestream Health).

Image: New workflow options are available for the Compass Routing and Workflow Manager (Photo courtesy of Laurel Bridge Software).

Medical Imaging International July-August/2016

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World Imaging Center News

First Installation of New Spectral Detector-Based CT System he first installation of a new spectral Computed Tomography (CT) system was announced at a leading university medical center in the Netherlands. The system has been integrated into existing hospital system protocols and can provide multiple layers of retrospective, diagnostic data after only one scan, and a minimal radiation dose. The system recently received the CE Mark (Conformité Européenne) for diagnostic use and is currently available for sale in 36 countries round the world. Royal Philips (Amsterdam, the Netherlands; www.philips.com) announced the installation of the IQon Spectral CT scanner at the University Medical Center Utrecht (UMC; Utrecht, Nether-

lands; www.umcutrecht.nl). The reduction in scanning time can help speed up diagnoses, and lower costs. This is the first IQon system that Philips has installed anywhere in the world. Prof. Tim Leiner, from the Imaging Division, at UMC Utrecht, said, “Unlike traditional CT images, which can be limited in structural detail and require additional scans, Philips’ IQon Spectral CT allows our clinicians to identify the composition of materials in the body in one scan. In a patient-focused care environment, comprehensive solutions that enable ‘first-time right’ testing and diagnostics without compromises can be revolutionary in addressing many of our greatest challenges, including workflow and patient satisfaction.”

Image: The IQon Spectral CT scanner can provide diagnostic data in one low-dose scan (Photo courtesy of Philips Healthcare).

World’s First UHF Clinical Ultrasound Installed in Naples

Pediatric Mission Uses Portable Ultrasound for Corrective Surgeries in Tanzania

he installation of an Ultra High Frequency (UHF) ultrasound imaging system was announced for a hospital in Naples, Italy. UHF systems have been used successfully for pre-clinical research for around 10 years, and are now for the first time being marketed for the clinical market. The system has the European Conformité Européenne CE Mark of approval. FujiFilm VisualSonics (Toronto, Canada; www.visualsonics.com), a subsidiary of FujiFilm SonoSite (Bothell, WA, USA; www.sonosite.com) developed the Vevo MD UHF ultrasound system. The system was designed for neonatology, musculoskeletal, vascular, and dermatology imaging, and operates at frequencies up to 70 MHz, much higher than conventional ultrasound systems. The Vevo MD has a maximum image resolution of 30 microns and can be used with FujiFilm VisualSonics UHF transducers. Dr. Roberto Grassi, professor of radiology, Second University of Naples (Naples, Italy; http://international.unina2.it/index.php/en), said, “Preclinical research is a crucial step toward establishing clinical applications, but until the launch of the Vevo MD, there were no clinically-approved ultra high frequency systems for human studies. The Vevo MD is the world’s first CE-marked, ultra high frequency ultrasound imaging system – up to 70 MHz – for clinical use, and will transform our clinical studies, enabling visualization of superficial structures in the human body. The beauty of the Vevo MD is that it is non-invasive for our patients and allows us to examine the superficial strata, visualizing structures that we could not see using conventional ultrasound. It has enabled us to determine the finer upper limb damage that occur in arthritis, allowing us to investigate the effectiveness of human drug treatments for these conditions. We are now starting to perform vascular assessment of diabetic patients, and also plan to study dermatological and systemic diseases.”

taff from a US hospital, along with an international non-profit organization and a leading medical imaging equipment provider, are working together to correct devastating malformations in children in Tanzania. The teams are cooperating to perform life-changing corrective surgeries for children with devastating anorectal malformations. Toshiba America Medical Systems (Tustin, CA, USA; http://medical.toshiba. com) donated its Viamo ultrasound system for use during the mission led by Mending Kids (Burbank, CA; USA; www.mendingkids.org) and surgeons from Cincinnati Children’s Hospital Medical Center (Cincinnati, OH, USA; www.cincinnatichildrens.org). Mending Kids provides life-saving surgical procedures for children around the world to correct congenital heart defects, and significant cranial facial deformities, orthopedic abnormalities, and severe scoliosis. Medical staff from the Cincinnati Children’s Hospital used the Viamo ultrasound system to evaluate children with anorectal malformations. The staff also trained local medical personnel, and performed 15 life-saving surgeries in a large Tanzanian medical center that serves around 13 million people. Dr. Steven J. Kraus, radiologist, Department of Radiology, Cincinnati Children’s Hospital, said, “Through Mending Kids we were able to provide much needed medical technology to assist in the reconstructive training and best practices to treat anorectal malformation, which is commonly done in developed countries, but not easily achievable to many underdeveloped communities like Tanzania. Toshiba ultrasound’s excellent image quality and ease of use enabled our team to successfully assist in the workup for all of the anorectal surgical procedures performed. We were also able to conduct other valuable exams, including identifying tethered spinal cords, helping to find veins for IV access in the ICU and the imaging of conjoined twins.”

University Hospital in Finland to Install First Fully Digital Pathology Department university hospital in Finland plans to extend its existing PACS to include pathology images significantly improving hospital workflow and diagnostics by facilitating cooperation between radiologists and pathologists in the hospital. The inclusion of digital pathology in the hospital workflow is a critical step towards improving patient care because it brings improved efficiency in pathology image storage, image review, and sharing. Sectra’s (Linköping, Sweden; www.sectra.com) digital pathology solution will be installed at the Diagnostic Imaging Center at Kuopio University Hos-

pital (Kuopio, Finland; www.psshp.fi/web/en). The pathology department of the Kuopio University Hospital has a staff of eight pathologists, and currently processes approximately 100,000 glass slides, and 27,000 histological, and cytological exams every year. The Sectra digital pathology solution provides a complete primary diagnostics solution including image archiving, image storage and review workstations. The solution is based on the same platform as Sectra’s radiology Picture Archiving and Communications System (PACS), enabling images from both diagnostic specialties to be stored and displayed on one system, and facilitating multidisciplinary

rounds for integrated diagnostics. The solution will also be integrated with the hospital’s Laboratory Information Management System (LIMS). Other hospitals in Europe and Scandinavia are also in the process of digitizing their pathology departments. Digital pathology for primary diagnostics is still pending US FDA approval in the US. Vesa Kärjä, adjunct professor and chief of Clinical Pathology, Kuopio University Hospital, said, ”With this enterprise imaging solution, we will increase efficiency in pathology as well as improve overall patient care. The investment is a crucial step in our strategy to improve workflow and diagnostics for better patient care.” Medical Imaging International July-August/2016

AADCO Medical USA • Randolph, VT Tel: (1) 802-728-3400 aadcomed.com info@aadcomed.com

Accura Medizintechnik Germany • Karben Tel: (49) 6039-9201-0 accuramed.de info@accura.info

ACEM Italy • Bologna Tel: (39) 051-721-844 acem.it info@acem.it

ACI Medical USA • San Marcos, CA Tel: (1) 760-744-4400 acimedical.com info@acimedical.com

Advanced Instrumentations USA • Miami, FL Tel: (1) 305-477-6331 advanced-inst.com rafael@ advanced-inst.com

Advantech Europe

Agfa Healthcare Belgium • Morstel Tel: (32) 3444-2111 agfahealthcare.com marc.defre@agfa.com

Spain • Barcelona Tel: (34) 932-380-592 alma-medical.com info@alma-medical.com

Amber Diagnostics USA • Orlando, FL Tel: (1) 407-438-7847 amberusa.com info@amberusa.com

Ambulanc Technology China • Shenzhen Tel: (86) 755-2607-2283 ambu-lanc.com manager@ ambugroup.com

AMD Technologies USA • Los Angeles, CA Tel: (1) 310-471-8900 digitalams.com info@amdtechnologies.com

Ampronix USA • Irvine, CA Tel: (1) 949-273-8000 ampronix.com info@ampronix.com SEE AD ON PAGE 9

Analogic USA • Peabody, MA Tel: (1) 978-326-4000 analogic.com

Agsa Gomma Italy • Bologna Tel: (39) 5146-3034 agsagomma.com info@agsagomma.com

Albatross Projects

AllTech Medical Systems China • Sichuan Tel: (86) 28-8780-9200 alltechms.com alltechinquiry@ alltechmed.com

Antmed China • Shenzhen Tel: (86) 755-8606-0992 antmed.com info@antmed.com ▲

Germany • Nattheim Tel: (49) 7321 730 510 albatross-projects.de info@ albatross-projects.com

W O R L D ’ S

Aurora Imaging Technology USA • North Andover, MA Tel: (1) 877-975-7530 auroramri.com info@auroramri.com

B-K Medical Denmark • Herlev Tel: (45) 4452-8100 bkmed.com info@bkmed.com

Bahia Software

R A D I O L O G Y / I M A G I N G

belson-cn.com

info@weiko.com

Bestman

Biocare Electronics

China • Shenzhen Tel: (86) 755-2641-6184 szbestman.com szbestman@ szbestman.com

Bieffe Italia Italy • Caserta Tel: (39) 081-865-4662 weiko.com

C O M P A N I E S

China • Shenzhen Tel: (86) 755-2796-0888 biocare.com.cn sales@biocare.com.cn

Biomedical Equipment

SEE AD ON PAGE 2

ARCOMA Sweden • Växjö Tel: (46) 470-70-69-00 arcoma-imix.com office@arcoma.se

Atys Medical France • Soucieu-en-Jarrest Tel: (33) 4-7805-6969 atysmedical.com

USA • Miami, FL Tel: (1) 305-463-9447

Spain • Santiago de Compostela Tel: (34) 981-555-315 bahiasoftware.es bahia@bahiasoftware.es

Barco Belgium • Kortrijk Tel: (32) 56-233-211 barco.com China • Shenzhen Tel: (86) 755-8968-6018 basda.com.cn info@basda.com.cn

Bayer HealthCare Germany • Berlin Tel: (49) 30-468-1111 ri.bayer.com ricustomersupport@ bayer.com

BC Technical USA • West Jordan, UT Tel: (1) 888-228-3241 bctechnical.com sales@bctechnical.com

Beacon Display Technology China • Shenzhen Tel: (86) 755-2699-5355 beacon-display.cn beacon@ beacon-display.cn

Beekley Medical USA • Bristol, CT Tel: (1) 860-583-4700 beekley.com international@beekley.com

Belson Imaging Technology China • Jiangsu Tel: (86) 510-8599-9908

Although all material in this directory is compiled from sources believed reliable, publisher cannot be held liable for any errors, omissions or inaccuracies. Inclusion, or lack of it, in this directory, does not constitute any endorsement or expression of other opinion by publisher with regard to companies, their products or services.

Medical Imaging International July-August/2016

LINKXPRESS COM

4biomed.com sales@4biomed.com

Block Imaging International USA • Lansing, MI Tel: (1) 517-668-8800 blockimaging.com info@blockimaging.com

Bracco

Basda Medical

▲

Netherlands • Breda Tel: (31) 7652-33100 advantech.com mariette.dusseldorp@ advantech.nl

ALMA Medical Imaging

2016

200

ALPHABETICAL LISTING OF COMPANIES

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Italy • Milan Tel: (39) 02-2177-1

Medical Imaging 200 bracco.com info@bracco.com

Brit Systems USA • Dallas, TX Tel: (1) 800-230-7227 brit.com sales@brit.com

Broadwest USA • Denver, CO Tel: (1) 303-722-1500 broadwest.com info@broadwest.com

USA • St. Petersburg, FL Tel: (1) 800-872-9729 usaxray.com info@usaxray.com

USA • Newport News, VA Tel: (1) 757-888-8994 burmed.com info@burmed.com

Amstelveen Tel: (31) 205-458-926 canon-europe.com/ medical medical.opthalmic@ canon-europe.com

USA • Rochester, NY Tel: (1) 585-627-1800 carestreamhealth.com

C&G Technologies

Canvys

CHILI

USA • Jeffersonville, IN Tel: (1) 812-280-0048 cgtscan.com dherron@cgtscan.com

USA • La Fox, IL Tel: (1) 888-735-7373 canvys.com

Germany • Heidelberg Tel: (49) 6221-18079-10 chili-radiology.com sales@chili-radiology.com

Candelis USA • Newport Beach, CA Tel: (1) 949-852-1000 candelis.com sales@candelis.com

Canon Europe Medical Systems Division

Netherlands •

CapeRay South Africa • Cape Town Tel: (27) 21-7024-299 caperay.com info@caperay.com

Capintec USA • Ramsey, NJ Tel: (1) 201-825-9500 capintec.com

getinfo@capintec.com

Carestream Health

Chison Medical Imaging China • Wuxi Tel: (86) 510-8531-0593 chison.com export@chison.com.cn

Tel: (1) 757-855-2765 cirsinc.com admin@cirsinc.com

Civco Medical Instruments

Cool Pair Plus USA • Algonquin, IL Tel: (1) 224-293-6060 coolpair.com

CPI

USA • Kalona, IA Tel: (1) 319-248-6757 civco.com info@civco.com

Canada • Georgetown, ON Tel: (1) 905-877-0161 cpii.com joanne.hunter@cpii.com

Clear Image Devices

USA • Warrington, PA Tel: (1) 866-400-0035 curvebeam.com info@curvebeam.com

CurveBeam

CIRS

USA • Ann Arbor, MI Tel: (1) 734-780-6200 clearimagedevices.com ksquiers@ clearimagedevices.com

USA • Norfolk, VA

▲

Burkhart Roentgen International

Burlington Medical

SEE AD ON PAGE 23

Datcard USA • Irvine, CA Tel: (1) 888-263-5882 datcard.com sales@datcard.com

CoActiv Medical

DMS-Apelem

USA • Ridgefield, CT Tel: (1) 203-894-1651 coactiv.com info@coactiv.com

France • Pérols Tel: (33) 467-50-49-00 dms.com

Codonics

DMS Topline Medical

USA • Middleburg Heights, OH Tel: (1) 440-243-1198 codonics.com cberg@codonics.com

USA • Fargo, ND Tel: (1) 701-237-9073 toplinemedical.com info@dmshg.com

Complete Medical Services

USA • Scottsdale, AZ Tel: (1) 877-877-1457 dosemonitor.com support@pacshealth.com

USA • Shelby Township, MI Tel: (1) 586-532-1142 completemedical services.com info@completemedical services.com

Conquest Imaging USA • Stockton, CA Tel: (1) 209-942-2654 conquestimaging.com inquiry@ conquestimaging.com

DoseMonitor

Dunlee USA • Aurora, IL Tel: (1) 630-585-2100 dunlee.com

Echo-Son Poland • Krancowa Tel: (48) 81-886-3613 echoson.com.pl export@echoson.eu

ECM

Contec Medical Systems China • Qinhuangdao Tel: (86) 335-801-5588 contecmed.com.cn cms@contecmed.cn

France • Angoulême Tel: (33) 545-920-358 ecmscan.com ecm@ecmscan.com

Ecoray Korea • Seoul Tel: (82) 70-7510-3400 ecoray.kr sales@ecoray.kr

Control-X Medical

Edan Instruments

USA • Columbus, OH Tel: (1) 614-777-9729 cxmed.com sales@cxmed.com

China • Shenzhen Tel: (86) 755-2689-8326 edan.com.cn info@edan.com.cn

▲

SEE AD ON PAGE 21

Eizo

Cook USA • Bloomington, IN Tel: (1) 812-339-2235 cookgroup.com

Germany • Mönchengladbach Tel: (49) 2161-8210-213 eizo.de

Medical Imaging International July-August/2016

Medical Imaging 200 ElsMed

me@honda-el.co.jp

JADAK Europe

Israel • Holon Tel: (972) 3-558-4839 elsmed.com sales@elsmed.com

Hospira Worldwide

Netherlands • Breda Tel: (31) 76-522-5588 jadaktech.com erika.vanderlelij@ jadaktech.com

EMD Technologies

Emperor Electronic Technology China • Shenzhen Tel: (86) 755-2607-3285 china-emperor.com business@ china-emperor.com

Esaote Italy • Genoa Tel: (39) 010-6547-1 esaote.com esaote@esaote.com

ETS Lindgren RF Enclosures USA • Glendale Heights, IL Tel: (1) 630-307-7200 ets-lindgren.com

Everbrite Lighting USA • Greenfield, WI Tel: (1) 800-610-6053 e-l-t.com elt@everbrite.com

Faxitron Bioptics USA • Tucson, AZ Tel: (1) 520-399-8180 faxitron.com

Fluke Biomedical USA • Everett, WA Tel: (1) 425-347-6100 flukebiomedical.com sales@ flukebiomedical.com

Fonar USA • Melville, NY Tel: (1) 631-694-2929 fonar.com info@fonar.com

USA • Middleton, WI Tel: (1) 608-828-7000 gammex.com sales@gammex.com ▲

Canada • Saint-Eustache, QC Tel: (1) 450-491-2100 emd-technologies.com

Gammex

SEE AD ON PAGE 27

General Medical Merate Italy • Seriate Tel: (39) 035-452-5311 gmmspa.com info@gmmspa.com

Gilardoni Italy • Mandello del Lario Tel: (39) 03417-05111 gilardoni.it gx@gilardoni.it

Guerbet France • Villepinte Tel: (1) 314-346-0940 guerbet.com pam.pollard@ guerbet.com

Guided Therapeutics USA • Norcross, GA Tel: (1) 770-242-8723 guidedinc.com info@guidedinc.com

Haifu (HIFU) China • Chongqing Tel: (86) 23-6788-6799 haifu.com.cn sales@hifu.cn

Haiying Enterprise Group China • Wuxi Tel: (86) 510-8866-9378 haiying.com.cn hytrade@haiying.com.cn

Heartland Medical USA • Louisville, KY Tel: (1) 502-671-1014 heartlandmedical.com mdirr@ heartlandmedical.com

Fujifilm

Hitachi Aloka Medical

Japan • Tokyo Tel: (81) 3-3406-2111 fujifilm.com/products/medical

Japan • Tokyo Tel: (81) 422-45-6049 hitachi-medical.co.jp

Hologic USA • Bedford, MA Tel: (1) 781-999-7300 hologic.com info@hologic.com

GE Healthcare

Honda Electronics

France, Buc Tel: (33) 1-30709572 gehealthcare.com

Japan • Toyohashi City Tel: (81-532) 41-2514 honda-el.co.jp

Medical Imaging International July-August/2016

Huqiu Imaging China • Suzhou Tel: (86) 512-6636-8881 hu-q.com silvia@hu-q.com

iCAD USA • Nashua, NH Tel: (1) 603-882-5200 icadmed.com sales@icadmed.com

ICRco USA • Torrance, CA Tel: (1) 310-921-9559 icrco.com sales@icrcompany.com

JD Honigberg International USA • Northbrook, IL Tel: (1) 847-412-0200 jdhintl.com info@jdhintl.com

JPI Korea • Seoul Tel: (82) 2-2108-2580 jpi.co.kr postmaster@jpi.co.kr

Tel: (86) 516-8773-2209 kernelmed.com kernelmedical@yeah.net

Jumper Medical Equipment

Klarity Medical Equipment

China • Shenzhen Tel: (86) 0755-2669-6279 jumper-medical.com info@ jumper-medical.com

China • Guangzhou Tel: (86) 20-8222-6380 klaritymedical.com sales@ klarity-medical.com

Kaixin Electronic Instrument

Konica Minolta Medical Imaging

China • Xuzhou Tel: (86) 516-8773-2932 kxele.com info@kxele.com

JW Medical

Kernel Medical Equipment

Korea • Seoul

China • Xuzhou

ImageWorks USA • Elmsford, NY Tel: (1) 914-592-6100 imageworkscorporation.com

Imaging Diagnostic Systems USA • Ft. Lauderdale, FL Tel: (1) 954-581-9800 imds.com lgrable@imds.com

Imaging Dynamics Canada • Calgary, AB Tel: (1) 403-251-9939 imagingdynamics.com info@ imagingdynamics.com

Imaging Specialists USA • Miami, FL Tel: (1) 305-591-8888 tisg.net

Imaxeon Australia • Sydney, NSW Tel: (61) 2-8845-4999 imaxeon.com info@imaxeon.com

Inomed Medizintechnik Germany • Teningen Tel: (49) 7641-9414-0 inomed.com info@inomed.com

Intelerad Canada • Montreal, QC Tel: (1) 514-931-6222 intelerad.com

Italray Italy • Scandicci Tel: (39) 055-722-8511 italray.it ▲

Fukuda Denshi Japan • Tokyo Tel: (81) 3-5684-1455 fukuda.co.jp info@fukuda.co.jp

USA • Lake Forest, IL Tel: (1) 224-212-2000 hospira.com

Tel: (82) 2-2109-7700 jw-medical.co.kr export@jw-medical.co.kr

SEE AD ON PAGE 17

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Netherlands • Amsterdam Tel: (31) 20-6590-260 konicaminolta.eu/ healthcare info-nl@ mg.konicaminolta.eu

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aadcomed.com acem.it acimedical.com accuramed.de advanced-inst.com advantech.com agfahealthcare.com agsagomma.com albatross-projects.de alltechms.com alma-medical.com amberusa.com digitalams.com ampronix.com analogic.com antmed.com arcoma-imix.com auroramri.com bahiasoftware.es barco.com crbard.com basda.com.cn ri.bayer.com bctechnical.com beacon-display.cn beekley.com belson-cn.com szbestman.com weiko.com biocare.com.cn biodex.com 4biomed.com bkmed.com blockimaging.com bracco.com brit.com broadwest.com usaxray.com burmed.com cgtscan.com candelis.com canon-europe.com/medical canvys.com caperay.com capintec.com carestreamhealth.com chili-radiology.com chison.com civco.com clearimagedevices.com coactiv.com codonics.com completemedicalservices.com conquestimaging.com contecmed.com.cn ambisea.com cxmed.com cookgroup.com coolpair.com cpii.com curvebeam.com datcard.com delmedical.com direxgroup.com dms.com toplinemedical.com dosemonitor.com dunlee.com echoson.com.pl ecmscan.com ecoray.kr edan.com.cn radiforce.de elmed-as.com elsmed.com emd-technologies.com china-emperor.com

Nuclear Medicine

AADCO Medical ACEM ACI Medical Accura Medizintechnik Advanced Instrumentations Advantech Europe Agfa HealthCare Agsa Gomma Albatross Projects AllTech Medical Systems ALMA Medical Imaging Amber Diagnostics AMD Technologies Ampronix Analogic Antmed ARCOMA Aurora Imaging Technology Bahia Software Barco Bard Basda Medical Bayer HealthCare BC Technical Beacon Display Technology Beekley Medical Belson Imaging Technology Bestman Bieffe Italia Biocare Electronics Biodex Medical Systems Biomedical Equipment B-K Medical Block Imaging International BRACCO Brit Systems Broadwest Burkhart Roentgen International Burlington Medical Supplies C&G Technologies Candelis Canon Europe. Canvys CapeRay Capintec Carestream Health CHILI Chison Medical Imaging Civco Medical Instruments Clear Image Devices CoActiv Medical Codonics Complete Medical Services Conquest Imaging Contec Medical Systems Continuum Healthcare Control-X Medical Cook Cool Pair Plus CPI CurveBeam Datcard Del Medical Direx DMS - Apelem DMS Topline Medical DoseMonitor Dunlee Echo-Son ECM Ecoray Edan Instruments Eizo ELMED Lithotripsy Systems ElsMed EMD Technologies Emperor Electronic Technology

Radiography

BUYERâ&#x20AC;&#x2122;S GUIDE 2016

Film & Image Mgmt Systems

Medical Imaging International

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Medical Imaging 200 Kopp Development USA • Jensen Beach, FL Tel: (1) 772-225-6932 koppdevelopment.com info@ koppdevelopment.com

KPI Ultrasound USA • Yorba Linda, CA Tel: (1) 714-696-3434 kpimed.com info@kpimed.com

Kubtec Digital X-Ray

Landwind Medical China • Shenzhen Tel: (86) 755-839-33788 landwindmedical.com sales@ landwindmedical.com

Lessa Papeles Registrales Spain • Barcelona Tel: (34) 93-729-94-00 lessap.com export@lessap.com

Listem Korea • Wonju Tel: (82) 1577-8522 listem.co.kr

LMT Medical Systems

Merge USA • Chicago, IL Tel: (1) 312-565-6868 merge.com

Maxer Endoscopy

Italy • Pomezia Tel: (39) 06-6616-0206 metaltronica.it metaltronica@ metaltronica.com

Germany • Wurmlingen Tel: (49) 7461-1407965 maxendoscopy.com marketing@ maxendoscopy.com

MedGyn USA • Addison, IL Tel: (1) 630-627-4105 medgyn.com asingh@medgyn.com

Medical Imaging Innovations USA • Boynton Beach, FL Tel: (1) 855-644-9729 medicalii.com

Medimar USA • Miami, FL Tel: (1) 305-406-3931 medimarcorp.com sales@medimarcorp.com

Medion Healthcare India • Mumbai Tel: (91) 99-8764-2222 medion.co.in nikunj@medion.co.in

MediSono USA • Wilmington, DE Tel: (1) 302-451-9234 medisono.com info@medisono.com

Medonica

Germany • Lübeck Tel: (49) 451-580-98-0 lmt-medicalsystems.com info@ lmt-medicalsystems.com

Korea • Daejeon Tel: (82) 2-808-0234 medonica.com info@medonica.com

Lode

Medset Medizintechnik

Netherlands • Groningen Tel: (31) 50-571-2811 lode.nl ask@lode.nl

Germany • Hamburg Tel: (49) 4072-5822-0 medset.com info@medset.com

Lodox Systems

Medtronic

South Africa • Johannesburg Tel: (27) 11-4449-118 lodox.com info@lodox.com

USA • Minneapolis, MN Tel: (1) 763-514-4000 medtronic.com

Lutech USA • Ronkonkoma, NY Tel: (1) 631-584-6688 lutechmedical.com info@lutechmedical.com

Mallinckrodt Pharmaceuticals USA • St. Louis, MO Tel: (1) 314-654-2000 mallinckrodt.com

Medvix USA • Irvine, CA Tel: (1) 949-273-8000 medvix.com info@ampronix.com

Meike Electronic Equipment China • Mianyang Tel: (86) 8166-355-073 bladder-scanner.com meike01@ bladder-scanner.com

Medical Imaging International July-August/2016

Metaltronica

Metropolis International USA • Long Island City, NY Tel: (1) 718-371-6026 metropolisint.com info@ metropolismedical.com

Mindray Medical International China • Shenzhen Tel: (86) 755-2658-2888 mindray.com intl-market@mindray.com

nilymed.com marketing@nilymed.com

NordicNeuroLab Norway • Bergen Tel: (47) 5570-7095 nordicneurolab.com sales@nordicneurolab.com

O-Two Medical Technologies Canada • Mississauga, ON Tel: (1) 905-677-9410 otwo.com resuscitation@otwo.com

Nordion Canada • Ottawa, ON Tel: (1) 613-592-3400 nordion.com isotopeorders@ nordion.com

Novarad USA • American Fork, UT Tel: (1) 801-642-1001 novarad.net info@novarad.net

kara@olberon.com

OR Technology Germany • Rostock Tel: (49) 381-36-600-500 or-technology.com heide.hardt@ or-technology.com

PACSHealth OKI Electric Industry Co. Japan • Tokyo Tel: (81) 3-3501-3111 Web: oki.com ▲

USA • Milford, CT Tel: (1) 203-364-8544 kubtec.com kubtec@kubtec.com

MAVIG Germany • Munich Tel: (49) 894-2096-0 mavig.com info@mavig.com

SEE AD ON PAGE 25

Olberon UK • Nottingham Tel: (44) 0115-8022025 olberon.com

MinXray USA • Northbrook, IL Tel: (1) 847-564-0323 minxray.com jkoplos@minxray.com

MIPM Germany • Mammendorf Tel: (49) 814-592-090 mipm.com international@mipm.com

Mitsubishi Electric Visual and Imaging Systems USA • Irvine, CA Tel: (1) 949-465-6000 me-vis.com

NDS Surgical Imaging Netherlands • Zevenhuizen Tel: (31) 180-63-4356 ndssi.com marketing-emea@ ndssi.com

NeoRad Norway • Oslo Tel: (47) 21-62-79-80 neorad.no mail@neorad.no

NeuroLogica USA • Danvers, MA Tel: (1) 978-564-8500 neurologica.com

Neusoft Medical Systems China • Shenyang Tel: (86) 24-8366-7788 neusoft.com service@neusoft.com

Nilymed Israel • Tel-Aviv Tel: (972) 74-703-2220 LINKXPRESS COM

MII-08-16 129

USA • Scottsdale, AZ Tel: (1) 877-877-1457 pacshealth.com info@pacshealth.com

Parker Laboratories USA • Fairfield, NJ Tel: (1) 973-276-9500 parkerlabs.com jbartello@parkerlabs.com

Esaote esaote.com ETS Lindgren RF Enclosures lindgrenrf.com Everbrite Lighting e-l-t.com Faxitron Bioptics faxitron.com Fluke Biomedical flukebiomedical.com FONAR fonar.com Fujifilm fujifilm.com/products/medical Fukuda Denshi fukuda.co.jp Gammex gammex.com GE Healthcare gehealthcare.com General Medical Merate gmmspa.com Gilardoni gilardoni.it Guerbet guerbet.com Guided Therapeutics guidedinc.com Heartland Medical heartlandmedical.com Haifu haifu.com.cn Haiying Enterprise Group haiying.com.cn Hillusa hillusa.com Hitachi Aloka Medical hitachi-medical-systems.com Hologic hologic.com Honda Electronics honda-el.co.jp Hospira hospira.com Huqiu Imaging hu-q.com iCAD icadmed.com ICRco icrco.com ImageWorks imageworkscorporation.com Imaging Diagnostic Systems imds.com Imaging Dynamics imagingdynamics.com Imaging Specialists tisg.net Imaxeon imaxeon.com Inomed Medizintechnik inomed.com Intelerad intelerad.com Italray italray.it JADAK Europe jadaktech.com JD Honigberg International jdhintl.com JPI jpi.co.kr Jumper Medical Equip. jumper-medical.com JW Medical jw-medical.co.kr Kernel Medical kernelmed.com Klarity Medical Equipment klaritymedical.com Konica Minolta Medical Imaging konicaminolta.eu Kopp Development koppdevelopment.com KPI Ultrasound kpimed.com Kubtec Digital X-Ray kubtec.com Landwind Medical landwindmedical.com Lessa Papeles Registrales lessap.com Listem listem.co.kr LMT Medical Systems lmt-medicalsystems.com Lode lode.nl Lodox Systems lodox.com Lutech lutechmedical.com Mallinckrodt Pharmaceuticals mallinckrodt.com MAVIG mavig.com Maxer Endoscopy maxendoscopy.com MedGyn medgyn.com Medical Imaging Innovations medicalii.com Medion Healthcare medion.co.in Medimar medimarcorp.com MediSono medisono.com Medonica medonica.com Medset Medizintechnik medset.com Medtronic medtronic.com Medvix medvix.com Meike Electronic Equipment bladder-scanner.com Mennen Medical mennenmedical.com Merge merge.com Metaltronica metaltronica.it Metropolis International metropolisint.com Mindray Medical International mindray.com MinXray minxray.com MIPM mipm.com Mitsubishi Electric Visual and Imaging Systems me-vis.com NDS Surgical Imaging ndssi.com NeoRad neorad.com Neurologica mercurymed.com Neusoft Medical Systems medical.neusoft.com Nilymed nilymed.com NordicNeuroLab nordicneurolab.com

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PET

Ultrasound

Radiography

BUYERâ&#x20AC;&#x2122;S GUIDE 2016

Film & Image Mgmt Systems

Medical Imaging International

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Medical Imaging 200 Paxeramed USA • Newton, MA Tel: (1) 888-430-0005 paxeramed.com mike.george@ paxeramed.com

PCI Precision Charts

Pekato Enterprises USA • Miami, FL Tel: (1) 305-594-8565 pekato.com flavio@pekato.com

Perlong Medical China • Nanjing Tel: (86) 25-52635350 perlong-china.com perlong@ perlong-china.com

Philips Healthcare

PHS Technologies USA • Scottsdale, AZ Tel: (1) 602-903-4384 dosemonitor.com mike.battin@ phstechnologies.com

Planmed Finland • Helsinki Tel: (358) 20-7795-300 planmed.com sales@planmed.com

Poskom

Primedic Germany • Rottweil Tel: (49) 741-257-0 primedic.com info@primedic.com

Print Media

Germany • Freiburg Tel: (49) 7614-9055-0 ptw.de info@ptw.de

Quest International USA • Irvine, CA

Shina Systems

Canada • Toronto, ON Tel: (1) 416-674-1347 ramsoft.com marketing@ramsoft.com

Israel • Caesarea Tel: (972) 4-6277203 shina-sys.com info@shina-sys.com

Rein Medical Germany • Moenchengladbach Tel: (46) 2161-6984-0 reinmedical.com info@reinmedical.com

ShinYoung For M Korea • Gyeonggi-do Tel: (82) 2-3423-3057 syfm.co.kr isales@syfm.co.kr

Roesys Germany • Espelkamp Tel: (49) 5772-9155-00 roesys.de info@roesys.de

Siemens Healthcare Germany • Erlangen Tel: (49) 69-6682-6602 siemens.com/healthcare

RSTI USA • Solon, OH Tel: (1) 440-349-4700 rsti-training.com rsti@rsti-training.com

Sino-Hero Bio-Medical Electronics

RTI Electronics Sweden • Molndal Tel: (46) 31-746-3600 rtigroup.com sales@rtigroup.com

SEE AD ON PAGE 3

China • Shenzhen Tel: (86) 755-2640-8541 sinoheromed.com manager@ sinoheromed.com

Samsung Korea • Seoul Tel: (82) 2-2194-1000 samsungmedison.com

Schaerer Medical Switzerland • Munsingen Tel: (41) 31-720-2200 schaerermedical.ch

SIUI China • Shantou Tel: (86) 754-8825-0150 siui.com siui@siui.com SEE AD ON PAGE 5

SonoScape Schiller Switzerland • Baar Tel: (41) 41-766-42-42 schiller.ch jenny.beeler@schiller.ch

China • Shenzhen Tel: (86) 755-2672-2890 sonoscape.com market@sonoscape.net ▲

PTW-Freiburg

Japan • Kyoto Tel: (81) 75-823-1111 shimadzu.com

RamSoft

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USA • Miami, FL Tel: (1) 305-884-0700 printmedia-inc.com service@ printmedia-inc.com

Shimadzu Medical Systems

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Korea • Goyang-City Tel: (82) 31-906-9007 poskom.com

SEE AD ON PAGE 29

SG Healthcare Korea • Hanam-Si Tel: (82) 31-790-0647 sghealthcare.net sales@sghealthcare.com

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Netherlands • Eindhoven Tel: (31) 40-27856-00 healthcare.philips.com healthcare@philips.com

Radcal USA • Monrovia, CA Tel: (1) 626-357-7921 radcal.com sales@radcal.com ▲

USA • Bohemia, NY Tel: (1) 631-567-6100 pcicharts.com info@pcicharts.com

Tel: (1) 949-581-9900 questinc.com

SEE AD ON PAGE 7

SEE AD ON PAGE 36

SonoSite Sectra Sweden • Linkoping Tel: (46) 132-35200 sectra.com info@sectra.com

Sedecal Spain • Algete Tel: (34) 91-6280-544 sedecal.com info@sedecal.com

Medical Imaging International July-August/2016

USA • Bothell, WA Tel: (1) 425-951-1200 sonosite.com ultrasound@sonosite.com

Sony UK • Surrey Tel: (44) 0-1256-483-481 pro.sony.eu/medical stefanie.richter@ eu.sony.com

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Refurbished Equipment

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Radiation Safety

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Ultrasound

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nordion.com novarad.net otwo.com oki.com olberon.com or-technology.com pacshealth.com parkerlabs.com paxeramed.com pcicharts.com pekato.com perlong-china.com philips.com/medical dosemonitor.com planmed.com poskom.com primedic.com ptw.de questinc.com radcal.com ramsoft.com reinmedical.com ritamedical.com roesys.de rsti-training.com rtigroup.com samsungmedison.com schiller.ch sectra.com sedecal.com sghealthcare.net shimadzu.com shina-sys.com syfm.co.kr siemens.com/healthcare sinoheromed.com siui.com sonoscape.com sonosite.com pro.sony.eu/medical soyee.co.kr starxray.com stephanix.com sterylab.it strong.cn sunnexmedical.com supersonicimagine.fr swissray.com teknova.cn terarecon.com terason.com thalesgroup.com toshiba-medical.co.jp trimedic.com turkuazsaglik.com.tr txr.com raysafe.com unimaging.com ulrichmedical.com ultrasonix.com umiultrasound.com vacutec-gmbh.de varian.com varian.com viatronix.com vieworks.com villasm.com vitalimages.com w7global.com wandong.com.cn wardray-premise.com weigaogroup.com welld.com.cn wolfxray.com china-mri.com kxele.com ziehm.com zonare.com zoncare.com

PACS / IT

Nordion Novarad O-Two Medical Technologies OKI Electric Industry Co. Olberon OR Technology PACSHealth Parker Laboratories Paxeramed PCI Precision Charts Pekato Enterprises Perlong Medical Philips Healthcare PHS Technologies Planmed Poskom Primedic PTW-Freiburg Quest International Radcal RamSoft Rein Medical Rita Medical Systems Roesys RSTI RTI Electronics Samsung Schiller Sectra Sedecal SG Healthcare Shimadzu Medical Systems Shina Systems ShinYoung For M Siemens Healthcare Sino-Hero Bio-Medical Electronics SIUI SonoScape SonoSite Sony Soyee Products Star X-Ray Stephanix Sterylab Strong Electronics Sunnex Supersonic Imagine Swissray International Teknova Medical Systems TeraRecon Terason Ultrasound Thales Electron Devices Toshiba Medical Systems Trimed Turkuaz Medikal TXR Unfors RaySafe United Imaging Healthcare Ulrich Ultrasonix Medical United Medical Instruments VacuTec Messtechnik Varian Interay Varex Imaging Viatronix Vieworks Villa Sistemi Medicali Vital Images W7 Global Wandong Medical Equipment Wardray Premise Weigao Medical System Well.d Medical Electronics Wolf X-Ray XGY Medical Xuzhou Kaixin Electronic Instrument Ziehm Imaging Zonare ZonCare Electronics

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Medical Imaging 200 Soyee Products Korea • Seoul Tel: (82) 2551-5631 soyee.co.kr shk@soyee.co.kr

Star X-Ray USA • Farmingdale, NY Tel: (1) 631-842-3010 starxray.com erosen@starxray.com

Stephanix France • La Ricamarie Tel: (33) 4-77-47-81-60 stephanix.com contact@stephanix.com

Sterylab Italy • Milan Tel: (39) 02-93-50-84-27 sterylab.it info@sterylab.it

Strong Electronics China • Wuhan Tel: (86) 27-8781-3880 strong.cn sales@strong.cn

Sunnex USA • Charlotte, NC Tel: (1) 800-445-7869 sunnexmedical.com customer.service@ sunnex.com

Supersonic Imagine France • Aix-en-Provence Tel: (33) 4-42-99-24-32 supersonicimagine.fr contacts@ supersonicimagine.fr

Swissray Global Taiwan • Taipei City Tel: (886) 2-8792-2671 swissray.com info.asia@swissray.com

Teknova Medical Systems China • Beijing Tel: (86) 10-5768-2230 teknova.cn international@teknova.cn

TeraRecon USA • San Mateo, CA Tel: (1) 650-372-1100 terarecon.com info@terarecon.com

Terason Ultrasound USA • Burlington, MA Tel: (1) 781-270-4143 terason.com

Thales Electron Devices France • Velizy-Villacoublay Tel: (33) 1-30-70-35-58

thalesgroup.com xrayimaging.marketing@ thalesgroup.com

Toshiba Medical Systems

vieworks.com sales@vieworks.com

Villa Sistemi Medicali

Japan • Tokyo Tel: (81) 287-26-6211 toshiba-medical.co.jp

Italy • Buccinasco Tel: (39) 02-48-8591 villasm.com sales@villasm.com

TXR

Vital Images

USA • Cottondale, AL Tel: (1) 205-556-3803 txr.com joyce@txr.com

Ulrich Medical Germany • Ulm Tel: (49) 731-9654-0 ulrichmedical.com info@ulrichmedical.com

Ultrasonix Medical Canada • Richmond, BC Tel: (1) 604-279-8550 ultrasonix.com info@ultrasonix.com

Unfors RaySafe Sweden • Billdal Tel: (49) 31-719-97-00 raysafe.com info.se@raysafe.com

United Imaging Healthcare China • Beijing Tel: (86) 10-8282-5101 unimaging.com sales@unimaging.com

United Medical Instruments USA • San Jose, CA Tel: (1) 408-278-9300 umiultrasound.com sales@umiultrasound.com

VacuTec Messtechnik Germany • Dresden Tel: (49) 351-317-240 vacutec-gmbh.de info@vacutec-gmbh.de

Varian Interay USA • N. Charleston, SC Tel: (1) 843-767-3005 varian.com/interay david.hurlock@varian.com

Varex Imaging USA • Palo Alto, CA Tel: (1) 650-493-4000 varian.com

A Toshiba Company

USA • Minnetonka, MN Tel: (1) 952-487-9500 vitalimages.com info@vitalimages.com

W7 Global USA • Louisville, KY Tel: (1) 812-206-5980 w7global.com info@w7global.com

Wandong Medical Equipment China • Beijing Tel: (86) 10-8457-5793 wandong.com.cn international@ wandong.com.cn

Wardray Premise UK • Surrey Tel: (44) 208-398-9911 wardray-premise.com sales@ wardray-premise.com

Well.d Medical Electronics China • Shenzhen Tel: (86) 755-2607-3350 welld.com.cn export@welld.com.cn

Wolf X-Ray USA • Deer Park, NY Tel: (1) 631-242-9729 wolfxray.com info@wolfxray.com

XGY Medical China • Yuyao Tel: (86) 574-6273-0899 china-mri.com sales@china-mri.com

Ziehm Imaging Germany • Nuremberg Tel: (49) 911-217-20 ziehm.com info@ziehm-eu.com

Zonare

Viatronix

USA • Mountainview, CA Tel: (1) 650-230-2800 zonare.com info@zonare.com

USA • Stony Brook, NY Tel: (1) 631-444-9700 viatronix.com

ZonCare Electronics

Vieworks Korea • Gyeonggi-do Tel: (82) 70-7011-6161

Medical Imaging International July-August/2016

China • Wuhan Tel: (86) 27-8777-0203 zoncare.com info@zoncare.com

Companies by Country AUSTRALIA Imaxeon

BELGIUM Agfa Healthcare Barco

CANADA CPI EMD Technologies Imaging Dynamics Intelerad Nordion O-Two Medical Technologies RamSoft Ultrasonix Medical

CHINA AllTech Medical Systems Ambulanc Antmed Basda Medical Beacon Display Technology Belson Imaging Technology Bestman Biocare Electronics Chison Medical Imaging Contec Medical Systems Ecoray

XGY Medical ZonCare Electronics

Edan Instruments Emperor Electronic Technology Haifu Technology Haiying Enterprise Group Huqiu Imaging Jumper Medical Equipment Kaixin Electronic Instrument Kernel Medical Klarity Medical Equipment Landwind Medical Meike Electronic Equipment Mindray Medical International Neusoft Medical Systems Perlong Medical Sino-Hero Bio-Medical Electronics SIUI SonoScape Teknova Medical Systems United Imaging Healthcare Wandong Medical Well.d Medical Electronics Wuhan Strong Electronics

Toshiba Medical Systems

Siemens Healthcare Ulrich Medical VacuTec Messtechnik Ziehm

DENMARK B-K Medical

Medion Healthcare

Planmed

ISRAEL

FRANCE Atys Medical DMS-Apelem ECM GE Healthcare Guerbet Stephanix Supersonic Imagine Thales Electron Devices

GERMANY Accura Medizintechnik Albatross Projects Bayer HealthCare CHILI Eizo Inomed Medizintechnik LMT Medical Systems MAVIG Maxer Medizintechnik Medset Medizintechnik OR Technology Primedic PTW Freiburg Roesys

MEDICAL IMAGING INTERNATIONAL

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ITALY ACEM Agsa Gomma Bieffe Italia Bracco Esaote General Medical Merate Gilardoni Italray Metaltronica Sterylab Villa Sistemi Medicali

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Medical Imaging International Inq.No.

Vol. 26 No.4 7-8/ 2016

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