Medical Imaging International June 2017

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Vol.27 No.2 5-6 / 2017 ISSN 1068-1779

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2017

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IN THIS ISSUE Clinical News . . . . . . . . . 3-21 PACS/IT Update . . . . . . 23-24 Product News . . . . . . . . 8-24 Buyer’s Guide 2017 . . . 25-33

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Dose Reference Levels Set for Common CT Exams esearchers have laid down new Diagnostic Reference Levels (DRL) for the ten most common head, neck, and body Computed Tomography (CT) exams to prevent unnecessary radiation exposure, and reduce overall radiation dose for patients. The DRLs and Achievable Dose (AD) guidelines will enable healthcare facilities to optimize and personalize the exam protocols and radiation dose a patient receives, as well as the range of doses used in the facility.

Researchers with the University of Washington School of Medicine (UW Medicine; Seattle, WA, USA; www.uwmedicine.org) used data from the American College of Radiology (ACR) CT Dose Index Registry, the largest CT dose index registry in the world, for the two-year study. The study was published online in the February 2017 issue of the journal Radiology. Previous DLRs provided only one value for a standard average-sized patient while the new DRLs are based on patient size. Healthcare facilities can now use these DRLs to compare the radiation doses they use with US national benchmarks, and optimize their CT protocols accordingly.

Kalpana M. Kanal, PhD, medical physicist and professor at UW Medicine Department of Radiology, said, “This extensive participation and totally automated complete capture of all patient examinations enabled the development of robust,

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clinically based national DRLs and ADs. Both ADs and DRLs are provided to encourage facilities to optimize dose to a lower level than that indicated by the DRL. Image quality must be taken into consideration when using DRLs and ADs to evaluate CT protocols on each scanner to determine if protocols are optimized. DRLs and ADs are not intended to be used for comparisons with dose indexes for individual patients. Implementation of DRLs and ADs is most effective if the facility has a system to automatically monitor patient dose indexes so that aggregate results may be evaluated.”

Image: Researchers have established national dose levels for common adult CT exams based on patient size, which will assist in avoiding unnecessary radiation exposure (Photo courtesy of ITN).

Trends in Mammography Show Improved Cancer Detection Rates major new study has shown that the move from film to digital mammography has improved the rates of cancer detection by nearly 10%, and the rate of biopsies by nearly 3% rise.

The shift from film to digital mammography also increased the abnormal interpretation rate, and this might lead to more biopsies for benign tumors.

The US Breast Cancer Surveillance Consortium (BCSC) researchers from the University of Vermont Cancer Center (UVM; Burlington, VT, US; www. uvmhealth.org) published the results of their study online in the February 2017 issue of the journal Radiology. The results showed that cancer detection rates increased to 34.7 per 1,000, from 25.3 per 1,000 in 2005, while the recall rate to perform biopsies increased to 12.6%, from 8.0% in 2005. The researchers also discovered that the Positive Predictive Value (PPV) fell by 4% in the same.

Brian L. Sprague, PhD, lead author of the study, said, “Our goals in this study were to produce benchmarks that individual radiologists and breast imaging facilities can use to compare with their own practices and to convey trends in how the metrics have changed over the past 10 to 15 years. While the improvements in cancer detection rates are encouraging, the increased abnormal interpretation rate is somewhat troubling in that we’re trying to keep this rate down. The results of the study highlight specific areas where quality improvement initiatives should focus. Overall, there is a lot of good performance out there, but there are definitely areas for improvement in positive predictive value and abnormal interpretation rate.”

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Laser Microscopy Examines Blood Vessels in Brain n innovative technique to perfuse the brain vasculature helps quantify blood vessels using three dimensional (3D) image analysis procedures.

Developed by researchers at the University of Surrey (Guildford, United Kingdom; www. surrey.ac.uk) and the Federal University of São Paulo (Brazil; www.unifesp.br), the technique involves dissolving China Ink with gelatin to create a solution that makes blood vessels more visible when viewed with a confocal microscope, enabling clinicians and pathologists to make an accurate reading of the number, length, and surface area of the brain vasculature. They can also create 3D images, which can help identify changes in their shape and size, key indicators of a number of circulation-related diseases of the brain.

The innovative technique, a modification of the so-called Spalteholz method, will also facilitate a greater understanding of how exercise affects the brain by examining the circulatory effects of increased or decreased heart rate and arterial pressure on the brain. It will also help in investigating angiogenesis in cortical, hippocampal, and cerebellar tissue samples, including stereological estimations of total volume and length and of surface area of vessels. The study was published on January 5, 2017, in the Journal of Anatomy.

“Previously, we have been unable to fully sample

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and perform a quantification of the circulation of the brain in 3D as we simply could not see all vessels, due to their minute size and sometimes due to their irregular spatial distribution,” said study co-author Augusto Coppi, MD, of the University of Surrey.

“This new technique will allow us to sample, image, and count blood vessels in 3D, giving us a greater mechanistic comprehension of how the circulation of the brain works, and how brain diseases such as dementia and stroke affect this organ.”

Confocal laser-scanning microscopy is a useful tool for visualizing neurons and glia in transparent preparations of brain tissue from laboratory animals. Currently, imaging capillaries and venules in transparent brain tissues requires the use of fluorescent proteins.

Image: A mouse brain imbued with China Ink to enhance vasculature (Photo courtesy of the University of Surrey).

Ultrasound Helps Detect Dysfunction Following Coarctation Surgery chocardiography can non-invasively evaluate deformation of the heart muscle in neonates following surgery for coarctation of the aorta (CoA), according to a new study.

Researchers at Umea University (Sweden; www.umu.se) and Sahlgrenska University Hospital (Göteborg, Sweden; www.sahlgrenska.se) conducted a retrospective study involving 21 pediatric patients (median age at procedure nine days) with surgically repaired CoA at three time points: just before intervention, at short-term follow-up, and at medium-term follow-up after intervention.

The aorto-septal angle (AoSA) was measured from the parasternal long axis view, at three time points – during the cardiac cycle – end diastole, the beginning of systole, and at peak ejection in the descending aorta.

The results showed that AoSA was significantly wider before intervention, in particular at peak ejection in the descending aorta, and correlated with the CoA pressure gradient, severity of obstruction, left ventricular (LV) dysfunction, and compromised LV global deformation. After the surgical intervention, AoSA normalized, and was significantly correlated with the increase of LV

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cavity function and overall LV deformation parameters. The study was published on November 22, 2016, in Congenital Heart Disease.

“The best method to assess the impact of aortic coarctation on heart function post-surgery is the non–invasive ultrasound method, equipped with recent echocardiographic modalities. This widely used method is radiation free, inexpensive and patient–friendly,” said lead author Haki Jashari, MD, a PhD student at the Umeå department of public health and clinical medicine. “Our research suggests that patients who have been operated for aortic coarctation should receive lifelong follow-up.”

CoA is a congenital heart disease, where the main artery coming out of the heart is narrowed just after it branches for the upper body. The narrowing results in high blood pressure in the upper body and low pressure in the lower body. Severe cases presented in the neonatal period can lead to heart failure, while mild narrowing may go unnoticed and is often first diagnosed in childhood or even later. Usually by then, the heart has already responded to the increased pressure with wall thickening.

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ISSN 1068-1779 Vol.27 No.2. Published, under license, by Globetech Media, LLC. Copyright © 2017. All rights reserved. Reproduction in any form is forbidden without express permission.

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Results of PROMIS Prostate Cancer Trial Announced he results of the long-awaited Prostate MRI Imaging Study (PROMIS) trial have been released and are expected to lead to dramatic changes in the way suspected prostate cancer is investigated.

The goal of the trial was to find out whether performing a Multi-Parametric MRI (MP-MRI) scan of the prostate gland before prostate biopsy could safely exclude significant prostate cancer, and prevent the need for an unnecessary biopsy procedure. The researchers recruited 561 men from 11 hospitals.

The men underwent MP-MRI scans, template prostate mapping biopsies, and TRUS biopsies. The results of the PROMIS trial were welcomed by the

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UK Royal College of Radiologists (RCR; London, UK; www.rcr.ac.uk).

The results of the study showed that MP-MRI is nearly twice as sensitive as Transrectal Ultrasound (TRUS) guided biopsies at detecting cancer. MPMRI had a negative predictive value of 89%, and could form part of a triage helping clinicians decide which patients need a TRUS biopsy reducing the number of biopsies by 25%. MP-MRI would also nearly double the number of correct diagnoses of significant cancers, and reduce false positive diagnoses by around 33%. The inclusion of diagnosis using MP-MRI before biopsy would require more specialized radiologists, and more scanners, but would

improve prostate cancer diagnosis significantly, and prevent unnecessary biopsies.

Image: A patient undergoing a prostate MRI scan (Photo courtesy of iStock).

MPI Technology Now Available to Medical Researchers in Australia edical researchers in Australia now have access to a new imaging technology called Magnetic Particle Imaging (MPI) that can give researchers improved insight into organ and tissue function, with sensitivity comparable to that of nuclear medicine, the speed of Computed Tomography (CT), and the resolution of Magnetic Resolution Imaging (MRI).

MPI provides improved sensitivity, resolution, and contrast over existing imaging technologies, by using Super Paramagentic Iron Oxide (SPiO) nanoparticles to tag cells anywhere in the body, at any tissue depth. MPI enables researchers to quantify what is actually happening in real time, and in vivo. In addition, MPI does not expose patients to ionizing radiation.

The new technology was part of a partnership agreement between AXT (Warriewood, NSW, Australia; www.axt.com. au) and Magnetic Insights (Alameda, CA, USA; www.magneticinsight.com). Momentum, the first MPI system can be used to generate quantitative images that analyze functional responses to drugs and treatments, in oncology, immunology, vascular function, and stem cell research, amongst others. The MPI technology could be used in the future to enable early detection and monitoring of neurovascular diseases such as stroke.

CEO of Magnetic Insight, Dr. Anna Christensen, said, “We are changing the landscape of diagnostic imaging with the impact of what MRI, PET and CT offered over 30 years ago. MPI complements many of the existing imaging modalities but also provides researchers and doctors levels of information that were not previously possible, all without radiation. We look forward to working with the team at AXT to bring this technology to Australia.�

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Research Indicates Brain Imaging May Predict Response to Psychotherapy review of current research on the topic indicates that brain scans may in the future be used to help clinicians predict the response to psychotherapy, of patients with various anxiety and depression-related disorders. The review was published in the November/December 2016 issue of the journal Harvard Review of Psychiatry. For example, specific “neuroimaging markers” could be used to help predict whether a patient with Major Depressive Disorder (MDD) and similar diagnoses will respond well to psychotherapy, or whether they need psychotherapy, or even medications. The researchers found 40 studies that included patients with various diagnoses such as MDD, Obsessive-Compulsive Disorder (OCD), and PostTraumatic Stress Disorder. Some of the researchers used structural brain imaging, while others used functional scans that can visualize brain activity.

The studies found that psychotherapy response could be linked to activity in the amygdala and the anterior insula. Higher activity in the amygdala of patients with MDD indicated an increased likelihood of response to psychotherapy. Patients with anxiety disorders and less activity in the amygdala were also likely to have improved psychotherapy outcomes.

Lead author of the study, Dr. Trisha Chakrabarty, University of British Columbia (UBC; Vancouver, BC, Canada; www.ubc.ca), said, “While some brain areas have emerged as potential candidate markers, there are still many barriers that preclude their clinical use. Future studies of psychotherapy response may focus further on these individual regions as predictive markers.

Additionally, future biomarker studies may focus on pretreatment functional connectivity between these regions, as affective experience is modulated via reciprocal connections between Image: Brain imaging could be used to help predict a patients’ response to psychotherapy (Photo courtesy of Fotolia). brain areas such as the ACC and amygdala.”

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Innovative MRS Study of Stuttering in Adults and Children

MRI Studies Show Changes in Adolescent Brains as Result of Alcohol Consumption

esearchers in the USA have conducted an innovative study to investigate brain regions in adults and children who stutter using proton Magnetic Resonance Spectroscopy (MRS).

The researchers confirmed, as had been shown in previous functional MRI studies, that stuttering is linked to neuro-metabolite changes in brain circuits related to speech, attention, and emotions. The results of the study were published online in the November 2016 issue of the Journal of the American Medical Association (JAMA). The unique MRS study confirmed that the development of stuttering was related to disturbances in membrane or neuronal metabolism.

The researchers from the Children’s Hospital Los Angeles (Los Angeles, CA, USA; CHLA; www.researchlablog.org) carried out proton shift brain scans of 47 children, and 47 adults, with and without stuttering and found that the brain regions affected included the Bohland speech-production network, the defaultmode network, and the emotional-memory network.

Research lead, Bradley S. Peterson, MD, Director, Institute for the Developing Mind, CHLA, said, “That stuttering is related to speech and language-based brain circuits seems clear. Attention-regulating portions of the brain are related to control circuits that are important in governing behavior. People with changes here are more likely to stutter and have more severe stuttering. And emotions like anxiety and stress also tend to make stuttering worse, likely because this network interacts with language and attention control circuits.”

esearchers in Finland have found that heavy alcohol consumption during adolescence results in cortical thinning and alters brain development. The research was published in the December 2016 issue of the journal Addiction. The study group included young people who had been drinking alcohol heavily throughout adolescence.

The researchers from the University of Eastern Finland (Joensuu, Finland; www.uef.fi/fi/etusivu) and Kuopio University Hospital (Kuopio, Finland; www.psshp.fi) used Magnetic Resonance Imaging (MRI) scans to assess brain development in the study participants. The MRI scans showed a statistically significant decrease in grey matter volume in the anterior cingulate cortex bilaterally of the brain, and in the right insula, in those participants with a history of heavy alcohol consumption during adolescence.

First author of the study, Noora Heikkinen, said, “The maturation of the brain is still ongoing in adolescence, and especially the frontal areas and the cingulate cortex develop until the twenties. Our findings strongly indicate that heavy alcohol use may disrupt this maturation process. The exact mechanism behind these structural changes is not known. However, it has been suggested that some of the volumetric changes may be reversible if alcohol consumption is reduced significantly. As risk limits of alcohol consumption have not been defined for adolescents, it would be important to screen and record adolescent substance use, and intervene if necessary.”

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Less Readmissions for Patients that Underwent CT for Atraumatic Headaches in ER Visits new study in the US has shown that patients admitted to an Emergency Room (ER) for atraumatic headaches who also underwent a Computed Tomography (CT) scan were less likely to return within 30 days.

The retrospective observational study, performed at Northwestern Memorial Hospital (Chicago, IL, USA; www.nm.org/locations/northwesternmemorial-hospital), was published in the December 2016 issue of the American Journal of Roentgenology (AJR).

The researchers studied 80,619 patient visits to the ED in the study period, including 922 ED patients complaining mainly of headaches. A total of

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15.1% (139 patients) returned to the ED within 30 days. Nearly twice as many (21.1%) of patients who did not undergo CT during their initial visit, returned to the ED within 30 days, compared to 11.2% for patients who underwent a CT scan.

Possible explanations for the results put forward by the researchers included that a CT scan reassured the patients of their health, or that primary care clinicians, could rule out emergent pathologies, and manage the symptoms of acute headaches better with the help of the CT scan results.

Coauthor of the study, assistant professor Brian W. Patterson, University of Wisconsin School of Medicine and Public Health (UWHealth; Madison,

WI, USA; www.med.wisc.edu), said, “I think it would be easy to misinterpret this study as a call for increasing the practice of ordering CT scans for atraumatic headache. Our findings do not support such a recommendation. Rather, we are calling attention to the downstream effects of these scans, and suggesting that future attempts to define appropriateness of imaging within the ED will need to account for their potential to lessen future care utilization. This conflict creates a need to evaluate the value added by advanced imaging performed during ED visits, and to better understand how imaging use at an initial ED visit influences subsequent resource utilization and outcomes.”

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Augmented-Reality Technique Enhances Surgical Navigation new augmented-reality surgical navigation technology intended for the image-guided minimally invasive surgery market has been announced.

The technology combines 3D X-Ray imaging, with optical imaging, and gives surgeons an augmented-reality view of a patient during both minimally invasive, and open spine surgery.

Royal Philips (Amsterdam, the Netherlands; www.philips.com) announced the development of the new technology that can be used for imageguided surgical procedures of the spine, cranium and complex trauma fractures.

The technology combines 3D images from the Philips low-dose X-Ray system with images from high-resolution optical cameras, and constructs a real-time 3D augmented-reality view of the patient’s anatomy. This 3D view of the inside and outside of the patient is intended to help surgeons improve

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procedure planning, facilitate tool navigation, improve the accuracy of implants, and reduce procedure times.

Philips will install the new technology for use in Philips hybrid operating rooms for ten of their clinical collaborators. The results of the first pre-clinical study of the technology, published in the November 2016 issue of the journal Spine, indicated that the new technology provided significantly improved overall accuracy compared to pedicle screw placement without the technology.

Business Leader, Image-Guided Therapy Systems at Philips, Ronald Tabaksblat, said, “This unique augmented-reality technology is an example of how we expand our capabilities with innovative solutions in growth areas such as spine, neuro and trauma surgery. By teaming up with clinical innovation

leaders, we continue to find ways to convert open surgery to minimally-invasive treatment to reduce post-operative pain and expedite recovery.”

Image: The new augmented-reality surgical navigation technology for spinal surgery (Photo courtesy of Royal Philips).

Fear Over Low-Dose Imaging Radiation is Overstated he long-held belief that even low doses of radiation, such as those received in diagnostic imaging, increase cancer risk is based on an inaccurate, 70-year-old hypothesis, according to a new study.

Researchers at Nuclear Physics Enterprises (Marlton, NJ, USA) and the U.S. Food and Drug Administration (FDA; Silver Spring, MD, USA; www.fda.gov) argue that the claim that radiologic imaging carries an iatrogenic risk of cancer is based on an uninformed commitment to the 70-year-old linear no-threshold hypothesis (LNTH). The argument asserts that LNTH and its offspring, the low as reasonably achievable (ALARA) theory, are fatally flawed, focusing only on molecular damage while ignoring protective, organismal biologic responses.

The researchers show that credible evidence of imaging-related low-dose (i.e., lower than 100 mGy) carcinogenic risk is nonexistent, and it is a hypothetical risk derived from the demonstrably

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false LNTH. On the contrary, they claim, low doses of radiation stimulate protective responses, providing enhanced protection against additional damage over time, including damage from subsequent, higher radiation exposures. In essence, low-dose radiation does not cause, but more likely helps prevent cancer. The study was published in the January 2017 issue of The Journal of Nuclear Medicine.

“We have shown that the claim made by Hermann Muller during his 1946 Nobel Lecture that all radiation is harmful, regardless of how low the dose and dose rate was a non-sequitur unrecognized by the radiation science community,” said lead author Jeffry Siegel, PhD, president and CEO of Nuclear Physics Enterprises. “It has repeatedly been shown that the dose-response relationship may reasonably be considered to be linear but only down to a threshold, below which there is no demonstrable harm and even often benefit. Yet, the LNTH still rules radiation regulatory policy.”

“The task before us is to undo the public’s groundless fears of low-dose radiation exposure.

The medical profession must be properly re-educated, beginning with diagnostic radiologists and nuclear medicine physicians, and only then can the public be given valid information that they can trust,” concluded Dr. Siegel. “Furthermore, defeating the LNTH and its offspring ALARA may lead to new ways of diagnosing and treating illness, and, even more importantly, preventing it.”

Data from the atomic-bomb survivor life span study (LSS) show the LNTH-predicted, low-dose carcinogenicity is invalid below approximately 200 mGy. The effective dose of a typical computed tomography (CT) scan is about 10 mSv; a positron emission tomography (PET) brain scan, 5-7 mSv; and a routine whole-body F-18 FDG PET/CT scan, 12-15 mSv. The researchers therefore feel confident that medical imaging’s much lower doses for children or adults should not be feared or avoided for radio-phobic reasons.

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CT Scans Help Detect Blunt Injury in Trauma Patients dvances in diagnostic imaging technology over the past 30 years have led to a six-fold increase in blunt cerebrovascular injury (BCVI) detection rates, according to a new study.

Researchers at the University of Tennessee Health Science Center (UTHSC; Memphis, TN, USA; www.uthsc.edu) conducted a study to identify patients with BCVI between 1985 and 2015, who were then stratified by age, gender, and injury severity score (ISS). In all, 564 patients (65% male, mean age 41) were diagnosed with BCVI; 508 with carotid artery and 267 with vertebral artery injuries. BCVI-related stroke and mortality rates were then calculated, and the patients were divided into five eras based on changes in technology, screening, or treatment algorithms.

The results showed that the percentage of blunt trauma patients diagnosed with BCVI increased from 0.33% to 2% during the study period. However, the percentage of these patients who went on to have a stroke due to the injury declined from 37% to 5% over the same period, and those who died from BCVI declined from 24% to zero. The researchers attribute these results to CT-scanning and its availability in hospitals large and small. The study was published on January 19, 2017, in the Journal of the American College of Surgeons (JACS).

“Clearly the advances in CT-scanning technology that developed since the first CT scanners came out to being able to do CT angiography, which is really a noninvasive form of angiography, have significantly improved diagnosis,” said lead author Louis Magnotti, MD, of the UTHSC department of surgery. “It is important to not get bogged down in managing or treating or diagnosing patients the same way as times change.

Even though you may have had good results, you should always look to do better.”

“Not every hospital is going to have access to digital subtraction angiography, which needs to be performed by an interventional radiologist or vascular surgeon or neuro-interventionist, but the majority of hospitals, even small hospitals, have CTscanning ability,” concluded Dr. Magnotti. “They can diagnose these injuries on the front end, and even if they cannot treat them, they can at least refer these patients to centers that can treat them.”

BCVI is primarily caused by longitudinal stretching and injury to the carotid or vertebral vessels.

Motor vehicle accidents (MVA) resulting in acceleration-deceleration can cause rotation and hyperextension of the neck, stressing the craniocervical vessels, the mechanism for the most common cause of BCVI. A direct blow to the neck or base of the skull may injury the carotid or vertebral arteries. BCVI is diagnosed in approximately 0.1% of patients hospitalized for trauma in the United States, unless a screening program has been initiated. Most cases are diagnosed following development of symptoms secondary to central nervous system ischemia, with a resultant neurologic morbidity of up to 80% and associated mortality of up to 40%.

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Image: New research asserts that CT scans can help detect blunt injury in trauma patients (Photo courtesy of GE Healthcare).

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Fractionated Radiotherapy Improves Cancer Surgery Results hort-course preoperative radiotherapy (RT) combined with delayed surgery reduces the adverse side effects of rectal cancer surgery, according to a new study.

Researchers at Karolinska Institutet (KI; Stockholm, Sweden; www.ki.se), Uppsala University (Sweden; www.uu.se), and other institutions conducted a phase 3 non-inferiority trial involving 840 patients from 18 Swedish hospitals who were randomized to three different RT regimens, with respect to fractionation and time to surgery. All patients suffered from biopsy-proven adenocarcinoma of the rectum, without signs of non-resectability or distant metastases, without severe cardiovascular comorbidity, and with planned abdominal resection.

The participants were randomly assigned with permuted blocks, stratified by participating center, to receive either 5 × 5 Gy radiation dose with surgery within one week (short-course radiotherapy), or after 4–8 weeks (short-course radiotherapy with delay), or 25 × 2 Gy radiation dose with surgery after 4–8 weeks (long-course radiotherapy with delay). The primary endpoint was time to local recurrence, as calculated from the date of randomization to the date of local recurrence.

The results showed that in patients with any local recurrence, median time from date of randomization to local recurrence in the short-course RT comparison was 33.4 months; in the short-course RT group, it was 19.3 months; and in the long-course RT with delay group it was 33.3 months. Postoperative complications were similar between all three arms; however, the risk of postoperative complications was significantly lower after short-course RT with delay. The study was published on February 9, 2017, in The Lancet Oncology.

“The results of the study will give rise to improved therapeutic strategies, fewer complications with a sustained low incidence of local recurrence, and better survival rates for rectal cancer patients,” said senior author Professor Anna Martling, PhD, of the KI department of molecular medicine and surgery. “It also showed that there is no difference between long-course and short-course

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radiotherapy, other than that the former considerably lengthens the time for treatment.”

When the total dose of radiation is fractionated into several, smaller doses over a period of several days, there are fewer toxic effects on healthy cells. Typical fractionation schemes divide the radiation dose into units delivered every weekday over about six weeks. The logic behind the treatment is that applying greater amounts of radiation works to lower the effects of accelerated tumor growth that typically occurs during the later stages of RT. Image: New research shows fractionating radiation therapy improves surgery results (Photo courtesy of iStock).

New Technology Enables Precise Drug Delivery to Brain Using Ultrasound esearchers have demonstrated that they can use ultrasound pulses to activate the release of drugs from nanoparticles in the brain of laboratory animals. The researchers released the concentrated drug doses temporarily in specific localized regions of the brain from inside minute biodegradable “nanoparticles” by means of precisely targeted ultrasound waves.

According to the researchers from the Johns Hopkins University School of Medicine (Baltimore, MD, USA; www.hopkinsradiology.org), the method

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could be used to deliver most psychoactive and other drugs, and advance therapies and research studies for the brain and other organs. The research results were published in on January 23, 2017, in the journal Nano Letters.

The new method could reduce the side effects of drugs considerable, because of the way it releases a much lower but concentrated dose a drug in a specific region. This results in a much lower overall drug doses for the patient during therapy treatment. The technology uses biomaterials, drugs ap-

proved by the US FDA, and ultrasound methods that have been tested, and found to be safe for humans. The researchers hope to start the regulatory approval process of their new technology for clinical applications within one or two years.

Associate professor of biomedical engineering, Jordan Green, PhD, said, “If further testing of our combination method works in humans, it will not only give us a way to direct medications to specific areas of the brain, but will also let us learn a lot more about the function of each brain area.”

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The Mammography system uses the "Isocenter rotation" technique to take pictures from different angles without the need for the patient to move. Full automatic exposure technology provides minimum radiation, while a touch operating panel makes the system convenient to operate.

The IMAGYNE features a 19-inch adjustable LCD monitor along with a backlit and height-adjustable keyboard, providing exceptional image quality for reliable and quick diagnosis. Its range of compatible probes and variety of imaging modes make it suitable for all clinical applications and demands.

The IZI 120P has a lightweight, compact design and uses mono-block technology for elimination of high-voltage cable. Its specially designed wheels for optimum coefficient of friction aid in easy maneuverability, while the mono-block HFG improves efficiency with less dosage.

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Deep-Learning Algorithm Detects Vertebral Compression Fractures novel algorithm can differentiate between a vertical compression fracture (VCF) and more ubiquitous degenerative endplate changes and osteophytes.

The Zebra Medical Vision (Shefayim, Israel; http://zebra-med.com) VCF algorithm automatically segments the vertebral column in order to identify and localize compression fractures. Diagnosing VCF’s is of critical importance for implementation of both primary (therapeutic) and secondary (preventative) osteoporotic interventions. As such, implementation of the algorithm can help prevent a large number of VCFs, allowing for better preventative and overall care, as well as reducing long term healthcare costs for providers.

The algorithm was developed utilizing a combination of traditional machine vision segmentation and convolutional neural net (CNN) technology, and can be applied to any

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computerized tomography (CT) scan of the chest, abdomen, and/or pelvis.

As such, it will become the latest addition to a line of automated tools announced by Zebra Medical Vision, among them algorithms that automatically detect low bone mineral density, breast cancer, fatty liver, coronary artery calcium, emphysema, and more.

“Radiology is headed for a personnel crisis for a number of reasons: the increase in population, especially the elderly and ill, increased exposure of the developing countries to radiology services, and the increase in the quantity of information from imaging devices, while the number of radiologists has not changed,” said Elad Benjamin, co-founder and CEO of Zebra Medical Vision. “We want to help radiologists analyze the images, while saving time, and to free them, so that they can devote their efforts to the more complex cases.”

“Research has shown that radiologists miss up to 50% of vertebral fractures, since they are usually focused on looking for other features,” added Kassim Javiad, MD, of Oxford University Hospitals (United Kingdom).

“In the UK, with our proven coordinated care programs for effective fracture prevention, we believe that early detection of such fractures can yield both better care and significant healthcare cost savings.”

VCFs are a direct cause of morbidity, decreasing mobility and functional status particularly among the elderly. Osteoporotic VCFs affect up to one

in four of post -menopausal women and nearly one in seven men over the age of 65. Timely surgical or minimally invasive treatment of VCF’s is effective but under-utilized, in part because less than one third of VCF’s are effectively diagnosed. Although VCF’s may be the result of infection, trauma or malignancy, the vast majority are a manifestation of osteoporosis, especially in individuals over the age of 50.

Image: A novel algorithm helps detect vertical compression fractures (Photo courtesy of Zebra Medical Vision).

Next Generation Image-Guided Therapy Platform Launched n innovative new next-generation ImageGuided Therapy (IGT) platform intended to enhance patient care and optimize laboratory productivity has been launched.

The platform was the fruit of a collaborative development between several hospitals around the world, and an international healthcare equipment manufacturer.

The Royal Philips (Amsterdam, the Netherlands; www.philips.com) Azurion integrates a number of advanced interventional tools, and helps physicians perform procedures by optimizing the performance of an interventional lab, and reducing radiation exposure for patients. The

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platform is powered by the Philips ConnectOS operating system, which provides real-time information on a number of work spots in the interventional laboratory. The Azurion also includes procedure cards enabling clinicians to pre-program user preferences, and routine vascular surgery, neuroradiology, interventional cardiology, and oncology tasks.

Azurion was developed in response to the rise in hospital IGT procedures, increased costs, and the need for improved care standards, and uses performance dashboards, and workflow optimization to solve these problems.

Andy Rogers, Nottingham University Hospi-

tals NHS Trust, said, “We are proud to partner with Philips UKI and to be one of the first centers in the world to receive this new advanced concept in IGT. We have found the pairing of excellent image quality with low radiation dose a great advantage when undertaking complex and lengthy cardiac procedures, while Azurion’s ease of use has let us quickly train staff on the system and integrate it into the cardiac catch lab environment. We are very excited with the future possibilities of integrating more of our equipment into a single touch-screen user interface, which will drive improvements in lab efficiency and superior patient care.”

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Medical Imaging International

Implementation of Medical Imaging Workflow Solution Results in Savings nterprise medical imaging workflow solutions enable healthcare institutions to improve patient care and reduce costs.he workflow solutions enable the transport of non-DICOM (Digital Imaging and Communications in Medicine) files, routing of Health Level 7 (HL7) messages, nested rules processing, advanced Transport Layer Security (TLS) encryption, support for routing all DICOM message types, DICOM load balancing with study persistence, extraction of DICOM SR data, and integration of dictation systems.

The Laurel Bridge Software (Newark, DE, USA; www.laurelbridge.com) workflow solutions include the scalable Compass Routing and Workflow Manager, and the Navigator image retrieval workflow manager. Compass automates the intake and distribution of medical imaging studies between multiple different clinical and Enterprise Imaging Systems (EIS), and can be used to create sitespecific workflows for interoperability between modalities and systems from different technology domains, and increase the productivity of radiology departments. Compass also acts as a gateway for medical imaging studies, and can automatically distribute DICOM, and non-DICOM imaging studies, and HL7 files, to multiple reading and archiving locations. Compass also automatically includes DICOM SR measurement data in clinical reports, and facilitates the teleradiology workflow. The Navigator is intended to solve complex enterprise imaging workflow problems, including the retrieval and normalization of imaging studies from different facilities, Picture Archiving and Communication System (PACS), or Vendor Neutral Archives (VNA).

Laurel Bridge Software grew considerably in the year 2016, following on from growth in 2015 through it’s ability to provide scalable workflow layer solutions that enhance interoperability between complex healthcare IT systems, but also from mergers and acquisitions and through the signing of new OEM agreements and partnerships.

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Image: The diagram shows how the Laurel Bridge Software layer solution can be implemented in a hospital with an outpatient center (Photo courtesy of Laurel Bridge Software).

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Radiopaque Clad Wire Improves Stent Visibility nnovative radiopaque clad wires improve device visibility under fluoroscopy, and serve as an effective alternative to marker bands.

Anomet (Shrewsbury, MA, USA; www.anometprodcuts.com) Radiopaque Clad Wire is suitable for use with stents, guide wires, and other medical devices, and can be manufactured with different degrees of visibility by modifying the alloy composition and cladding thickness. The clad composite wire is less expensive than solid wire with marker bands, and can be manufactured to precise original equipment manufacturing (OEM) specifications and supplied on spools. The premium medical-grade wires do not flake, blister, or delaminate.

The wire is available in diameters ranging from 0.05 to 1.52mm, and can incorporate gold, platinumiridium, tantalum, tantalum-tungsten, and similar alloys bonded to high strength wires such as 316LVM stainless steel, nitinol, and MP35N, with a cladding thickness of 2% or more. Wires can include precious metal cores or claddings, such as platinum for oxidation-corrosion resistance and biocompatibility, gold for contact resistance, tantalum for radiopacity under fluoroscopy, and silver or conductivity. Examples of medical-grade clad wires include Tantalum cored stainless steel and Gold clad nitinol.

Clad-wires feature a complete metallurgical bond between layers, providing a highly reliable and cost effective alternative to solid wire, while at the same time offering higher ductility and greater formabilty than filled or plated wire.

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The Epsilon RF console offers simple control of the EPS 45-80 generator and manages six configurable workstations for more than 2,000 exams. It offers exposure buttons, optical density correction, and feedback from the X-ray room/tube, along with a built-in service/diagnostic mode.

The GC70 features cutting-edge digital enhancements, such as the S-Vue imaging engine, which provides high image quality for more precise diagnoses. It simplifies operation with auto-tracking, smart control and S-Guide, and reduces diagnostic time for a more streamlined workflow.

The SIGNA Premier 3T offers a 70-cm bore, highhomogeneity magnet, and new digital RF transmit/receive architecture. It is intended to improve diagnostic confidence for clinicians and is based on the SignaWorks productivity platform, which is designed to improve user productivity.

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Targeted Radiosurgery Superior to WBRT for Treating Brain Tumors new study suggests that stereotactic radiosurgery (SRS) provides better outcomes for patients with metastatic brain tumors than whole-brain radiation therapy (WBRT).

Researchers at the University of Missouri (MU, Columbia, USA; www.missouri.edu) conducted a retrospective study among 83 patients who received post-surgical care for the removal of a metastatic brain tumor between January 2010 and December 2014; 46 of the patients received WBRT, while 37 others underwent SRS. The study compared patient data for local control, distant brain recurrence, overall survival, and radiation therapy complications.

The results showed that SRS controlled the spread of the cancerous cells as effectively as WBRT; in addition, the patients who received radiosurgery experienced less cognitive decline compared to those who received WBRT. Overall, 34% of the SRS patients experienced local recurrence, compared to 55% of WBRT patients; but the medi-

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an survival rate for those patients receiving SRS was 440 days, compared to just 202 days for patients who received WBRT. The study was published on November 19, 2016, in Cureus.

“For patients with metastatic cancer of the brain, the importance of surviving for a longer period of time cannot be overstated,” said senior author Scott Litofsky, MD, chief of the division of nurological surgery at MU School of Medicine. “We now treat patients almost exclusively with radiosurgery following their surgery. Although this therapy does cost more, results often can be achieved in one to three visits, compared to 10 to 12 visits for wholebrain radiation. With these considerations, we strongly suggest physicians consider radiosurgery as an initial radiation treatment after surgery.”

Since WBRT treats the entire brain, it is thought to control tumor progression by treating identifiable metastases and otherwise unidentifiable micrometastases. However, WBRT has become increasingly implicated with global cognitive impairment

that persists after cessation of treatment, thereby expanding concerns regarding quality of life, despite reducing tumor burden. SRS delivers highdose radiations to a discrete volume within the brain; because it spares healthy brain parenchyma, it confers a theoretically favorable alternative to WBRT, and is being increasingly utilized in the management of brain metastases.

Image: A patient undergoing SRS following brain surgery (Photo courtesy of DioMedia).

Laser-Based Angioscope Improves Carotid Artery Scanning novel scanning fiber endoscope (SFE) acquires high-quality images of atherosclerotic lesions in the carotid artery that may not be detected with conventional radiological techniques.

Developed by researchers at the University of Michigan (U-M; Ann Arbor, USA; www.umich. edu) and the University of Washington (UW; Seattle, USA; www.washington.edu), the SFE system consists of an ultrathin, highly flexible catheter that scans blue, green, and red laser beams in a spiral pattern on the tissue surface, collecting reflectance and fluorescence images through a ring of optical fibers. The multimodal images are then reconstructed in real time with a large field of view (FOV) and projected with high spatial resolution.

By combining reflectance and laser-induced

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emission of intrinsic fluorescent constituents in vascular tissue, the SFE generates endoscopic videos capable of discriminating early, intermediate, advanced, and complicated atherosclerotic plaques. In addition, by targeting proteolytic activity of complicated atherosclerotic plaques with a fluorescence agent activated by matrix metalloproteinases (MMPs), vulnerable regions of the weakened fibrous cap can be detected at a resolution far beyond clinically available technology.

According to the researchers, the superior image resolution of the technology reveals intravascular thrombi and surface thrombogenic lesions, even in cases not detected by conventional diagnostic modalities, and claim that multimodal laser-based SFE angioscopy has the potential to become a powerful platform for research, diagnosis, prognosis, and image-

guided local therapy in atherosclerosis and cardiovascular disease. The study was published on February 10, 2017, in Nature Biomedical Engineering.

“The ability to identify and monitor the biological markers that render a plaque unstable and at risk for rupture could enable the detection of individuals within high-risk populations who are most likely to suffer from cardiovascular events, and therefore benefit the most from preventive treatment during the asymptomatic stage,” said senior author Professor Gregory Thompson, MD, of U-M. “In addition, plaque-specific data could help physicians modulate treatment intensity of atherosclerosis, which is currently based on systemic surrogates such us cholesterol and blood sugar levels and occurrence of cardiovascular events such as stroke or myocardial infarction.”

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Retinal Imaging Technique Could Revolutionize Eye Care new study describes a noninvasive method to image individual cells in the human retina, which are implicated in the vision loss associated with glaucoma and other diseases.

Researchers at the University of Rochester (NY, USA; www.rochester. edu), the University of Pittsburgh School of Medicine (Pitt; PA, USA; www.medschool.pitt.edu), and other institutions modified adaptive optics scanning light ophthalmoscopy (AOSLO) in order to successfully image somas of neurons within the retinal ganglion cell (RGC) layer in both monkeys and humans. They also showed that the same technique, when applied to the photoreceptor layer, could resolve ambiguity about cone survival in age-related macular degeneration (AMD).

The researchers reported that while currently, the human images did not match the quality of monkey images for safety reasons involving light intensity, the capability to noninvasively image RGC layer neurons in the living eye may one day allow for a better understanding of diseases such

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as glaucoma, and accelerate the development of therapeutic strategies that aim to protect these cells. This method may also prove useful for imaging other structures, such as neurons in the brain. The study was published on December 6, 2016, in Proceedings of the National Academy of Sciences (PNAS).

“Retinal ganglion cells are the primary output neurons of the retina that process visual information and transmit it to the brain. The death of these cells causes vision loss in glaucoma, the second leading cause of blindness worldwide,” concluded lead author Ethan Rossi, PhD, assistant professor of ophthalmology at Pitt. “The ability to image these cells in the living eye could accelerate our understanding of their role in normal vision and provide a diagnostic tool for evaluating new therapies for retinal disease.”

Although imaging of the living retina with AOSLO provides access to individual photoreceptors, retinal pigment epithelial cells, blood cells in the retinal vasculature, and RGCs, have proven much more challenging to im-

age. The near transparency of inner retinal cells is advantageous for vision, as light must pass through them to reach the photoreceptors, but it has prevented them from being directly imaged in vivo. As a result, glaucoma is currently diagnosed by assessing

the thickness of the nerve fibers projecting from the RGCs to the brain.

Image: Ganglion cell layer neurons in the temporal retina from two different human eyes (Photo courtesy of the University of Rochester).

Cause of Blurry Vision on Long Space Missions Found cientists studying the cause of visual impairments suffered by astronauts during long space missions have discovered that the problem is related to changes in the volume of CerebroSpinal Fluid (CSF), flattening of the eyeballs, and increased protrusion of the optic nerves.

The researchers carried out highresolution Magnetic Resonance Imaging (MRI) scans of the eye orbits and the brains of seven astronauts before and shortly after long-duration missions on the International Space Station (ISS). The researchers compared the results with those of astronauts from nine short-duration missions in space. The MRI results were analyzed using advanced quantitative imaging algorithms.

Flight surgeons and scientists at the US National Aeronautics and Space Administration (NASA; Washington, DC, USA; www.nasa.gov) had already observed for ten years that nearly two-thirds of astronauts on long ISS missions suffered from Visual Impairment Intracranial Pressure (VIIP).

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The results showed significantly increased post-flight flattening of the eyeballs and increased CSF volume in astronauts on long-duration flights compared to those on short-duration flights. Brain grey or white matter volume was not significantly different between the groups.

Lead author of the study, Noam Alperin, PhD, University of Miami Miller School of Medicine (Miami, FL, USA; http://med.miami.edu), said, “People initially didn’t know what to make of it, and by 2010 there was growing concern as it became apparent that some of the astronauts had severe structural changes that were not fully reversible upon return to earth. On earth, the CSF system is built to accommodate these pressure changes, but in space the system is confused by the lack of the posture-related pressure changes. If the ocular structural deformations are not identified early, astronauts could suffer irreversible damage. As the eye globe becomes more flattened, the astronauts become hyperopic, or farsighted.”

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The Supria 64 offers high-speed scanning with less than 1 sec/rot and a 75-cm bore, which is one of the widest among 64-slice CT systems, for a precise and comfortable exam. It achieves the minimum dose and reduces image noise and artifact to provide higher quality images.

The EPIQ 5 features nSIGHT, designed to improve spatial, temporal, and contrast resolution. It also includes high-end imaging technologies including PureWave transducers, MicroCPA for better lowflow angio, ShearWave elastography, compound imaging, and speckle-reduction imaging.

The DelftDI Trauma DR Plus offers motorized support for Z-movement and an improved C-arm that allows for easy and better positioning. It is available with an extensive portfolio of Canon CXDI flat-panel detectors, and offers fast and efficient workflow for trauma examinations.

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New Radiotracer Diagnoses Prostate Cancer Faster new study describes a radioactive tracer that targets two different biomarkers, gastrin-releasing peptide receptor (GRPR) and integrin αvβ3, which often indicate prostate cancer (PC).

Developed by researchers at Peking Union Medical College Hospital (PUMCH; Beijing, China; www.pumch.cn) and the U.S. National Institute of Biomedical Imaging and Bioengineering (NIBIB; Bethesda, MD, USA; www.nibib.nih.gov), the new dual-receptor 68Ga-labeled heterodimeric peptide BBN-RGD radiotracer was designed to identify tumors at all PC stages by binding to the target receptors or biomarkers in primary tumors, metastatic lymph nodes, and metastatic bone lesions.

The radioactive atoms enable positron emission tomography (PET) or single photon emission computed tomography (SPECT) scanners to image the areas where the tracers have collected in large numbers. In a Phase I clinical trial in 13 PC patients, the tracer was able to successfully identify three of four primary tumors, all 14 metastatic lymph nodes and, significantly, was also able to identity all 20 of the metastatic bone lesions. In contrast, only two of the primary tumors, five lymph nodes, and 12 bone lesions were positive using the 68Ga-BBN single receptor tracer. The study was published in the February 2017 issue of The

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Journal of Nuclear Medicine.

“We are far from finding one method to diagnose and monitor prostate cancer, but this is a step in that direction. Targeting multiple biomarkers could potentially allow us to identify prostate cancer at its early stages as well as after metastasis in one scan,” said senior author Xiaoyuan Chen, PhD, chief of the laboratory of molecular imaging and nanomedicine at NIBIB. “Dual-receptor targeting tracers could one day be the primary method for diagnosing and monitoring prostate cancer, reducing the amount of medical scans a patient would be forced to undergo and streamlining the diagnostic and therapeutic process.”

A variety of imaging techniques and tests are currently used to diagnose and monitor prostate cancer, including prostate specific antigen (PSA) blood tests, magnetic resonance imaging (MRI), PET and SPECT, and computerized tomography (CT) scans. Each method has strengths and weaknesses, but there is no single method that is able to successfully identify and monitor primary tumors, metastatic lymph nodes, and bone lesions, which can cause the patient to undergo unnecessary treatments or painful biopsies.

Image: The new tracer shows tumors in a 64-yearold man with PC (Photo courtesy of NIBIB).

Increased NIV Molecular Imaging Technologies Needed for Cancer Care ccording to researchers in the US, new molecular imaging technologies can facilitate the diagnosis, monitoring, and treatment of cancer, while at the same time reducing the frequency of unnecessary or ineffective therapies and minimizing side effects.

The new non-invasive molecular imaging technology can also complement biopsy data in cancer care, in cases where multiple examinations are necessary.

The researchers from the Abramson Cancer Center (PENN Medicine; Philadelphia, PA, USA; www.pennmedicine.org/cancer), and the Perelman School of Medicine, University of Pennsylva-

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nia, (Philadelphia, PA, USA; www.med.upenn.edu) published the review online on December 29, 2016, in the journal JAMA Oncology.

According to the authors, molecular imaging can have several significant impacts. These include helping identify patients that would benefit from targeted therapy, monitoring drug movement in the body and helping to guide drug dosing while minimizing side effects. Molecular imaging can also be used to monitor the effectiveness of drug treatments. The combined data can help predict patient outcomes and overall survival.

Lead author of the study, David A. Mankoff, MD, PhD, said, “Many of these methods are al-

ready being studied in clinical trials, but the path from clinical trials to routine clinical use is seldom easy. Molecular imaging methods face some particularly challenging hurdles such as the need to deliver the short-lived imaging probes to centers performing the imaging. We don’t have a good framework yet for moving these potentially powerful diagnostic tools into routine clinical use. Among other things, we need to bring the imaging and oncology communities together to find the best way forward. In that case, molecular imaging could have directed treatment to patients highly likely to benefit and spared many other patients the toxic effects and costs of ineffective therapy.”

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Brain Disconnections Could Be Cause of Musical Anhedonia esearchers have discovered that musical anhedonia, may be related to reduced functional connectivity between cortical regions in the brain that are responsible for processing sound, and reward-related subcortical regions.

The researchers recruited 56 healthy participants for their study and used functional Magnetic Resonance Imaging (fMRI) data to try to understand where specific musical anhedonia originates. Participants were required to complete and then listen to music clips while inside an fMRI machine. The participants provided pleasure ratings while listening to the music.

The researchers conducting the study published in the November 2016 issue of the Proceedings of the National Academy of Sciences, were from the University of Barcelona (Barcelona, Spain; www.ub.edu),

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and from the Montreal Neurological Institute and Hospital of McGill University McGill University (Montreal, Quebec, Canada; www.mcgill.ca).

The researchers analyzed the fMRI data and found that specific musical anhedonics presented reduced activity of the Nucleus Accumbens while listening to music. This group also showed reduced functional connectivity between auditory processing-related cortical regions of the brain, and the Nucleus Accumbens. On the other hand the subjects with high musical sensitivity showed enhanced connectivity. The results demonstrated that those subjects insensible to music were still responsive to other stimuli. This suggests different reward pathways for different stimuli.

One of the paper’s co-authors, Robert Zatorre, MNI neuroscientist, said, “These findings not only

help us to understand individual variability in the way the reward system functions, but also can be applied to the development of therapies for treatment of reward-related disorders, including apathy, depression, and addiction.”

Image: Researchers analyzed fMRI data and discovered that specific musical anhedonics show a reduction in Nucleus Accumbens activity, while listening to music (Photo courtesy of Hans Braxmeier).

Advanced Imaging Aids Treatment of Lymphatic Plastic Bronchitis new study describes how lymphatic imaging can help surgeons perform percutaneous embolization to remove the branching casts that form in the airways of plastic bronchitis patients.

Researchers at the Children’s Hospital of Philadelphia (CHOP, PA, USA; www.chop.edu) and the University of Cincinnati (OH, USA; www.uc.edu) used dynamic contrastenhanced MR lymphangiography (DCMRL) and intranodal lymphangiography to investigate the mechanism of cast formation in seven adults patients (mean age 50 years) with plastic bronchitis, and to evaluate the therapeutic outcome of percutaneous lymphatic embolization for these patients, which involved inserting a combination of glue and coils through catheters to halt the abnormal flow of lymphatic fluid.

The researchers found that DCMRL established the presence of abnormal pulmonary lymphatic flow in six of the patients, which was confirmed by intranodal lymphangiography and thoracic duct injection that demonstrated lymphatic reflux, a communication of abnormal lymphatic channels with airways. The researchers then treated six of the seven with lymphatic embolization, using a combination of endovascular glue and coils.

After lymphatic embolization, five of the patients reported immediate and complete resolution of symptoms, and the sixth patient reported significant partial improvement. Four

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patients had transient abdominal discomfort, which was treated with analgesics and resolved before discharge in all subjects. The average follow-up period was 11 months after initial treatment. The study was published in the October 2016 issue of Annals of the American Thoracic Society.

“Based on these data, we postulate that many cases of idiopathic plastic bronchitis in adults have a lymphatic basis, and propose that the diagnosis be renamed ‘lymphatic plastic bronchitis’ in those subjects, to distinguish the disorder from the other forms,” concluded lead author radiologist Maxim Itkin, MD, of CHOP. “Percutaneous transabdominal catheterization and embolization of the pulmonary lymphatics is a safe and effective treatment for the acute manifestation of this disorder, but additional studies are needed to determine the long-term safety and durability of this approach.”

Plastic bronchitis is a condition characterized by expectoration of branching bronchial casts. Although the mechanism of cast formation in adults with plastic bronchitis remains poorly understood, abnormal pulmonary lymphatic flow resulting in molding of congealing lymphatic fluids in the airway can cause lifethreatening respiratory distress, especially in children. In adults, the condition may go undiagnosed for years in patients who may initially be diagnosed with asthma or chronic cough.

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The RadioLogiX Rad System offers a compact tube stand and wall stand to fit into smaller X-ray room settings. It features the Stylix table with a large tabletop and extended travel to allow full coverage with minimal patient movement, while its high-frequency generator minimizes exposure.

The AirDRc Gadox is powered by a scintillator that provides integrated AED to allow for seamless integration into new or existing X-ray rooms. Its active area of 17-inches x 17-inches eliminates the need for rotation and makes its workflow and throughput more efficient.

The InnovaXion DR Series is available in a fixed 17-inch x 17-inch format in both CsI and GdOS platforms, and portable 14-inch x 17-inch option only in CsI. Its performance and image quality make it particularly suitable for use in countries where CCD technology may not be an option.

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Researchers Recommend MRI for Supplemental Breast Cancer Screening esearchers have shown that MRI screening can improve the early diagnosis of breast cancer for all women, not only those at high risk, and is a useful supplemental screening tool. The study showed that women at average risk, and those with dense breast tissue, could benefit more from Magnetic Resonance Imaging (MRI) as a supplemental screening tool than ultrasound.

The study was carried out by researchers at the University of Aachen (Aachen, Germany; www.rwth-aachen.de) and published online in the February 2017 issue of the journal Radiology.

Current guidelines limit MRI screening partly because of higher costs, however with the continued high levels of mortality in women from breast cancer improved screening methods are still necessary. MRI is also able of detecting more aggressive types of breast cancer that occur in women – also know as interval cancers – that may affect those with dense breast tissue.

Christiane Kuhl, MD, said, “The faster a cancer grows and the better it is in seeding metastases, the better will it be picked up early by MRI. In our cohort, cancers found by MRI alone exhibited features of rapid growth at pathology. The interval cancer rate in our study was zero percent. Not a single cancer was undetected that became palpable. This suggests that MRI finds breast cancers that also mammography would find, but MRI detects them earlier, and it finds the cancers which, if MRI had not been done, would have progressed to interval cancers.”

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Image: A new study indicates women can benefit from MRI screening more than ultrasound for supplemental breast cancer screening (Photo courtesy of Breastlink).

Compact Synchrotron Simplifies Coronary Angiography n innovative miniature particle accelerator could significantly reduce the amount of contrast agents needed for coronary angiography by generating monoenergetic X-rays.

Developed by researchers at Munich Technical University (TUM; Germany; www.tum.de) and Klinikum rechts der Isar (Munich, Germany; www.mri.tum.de), the Munich Compact Light Source (MuCLS) mini-synchrotron can generate Xrays that have an exact monoenergetic optimal energy level. While this was previously possible only with circular particle accelerators with a diameter of several hundred meters, the MuCLS is a lot smaller, about the size of a car.

Contrast agents such as iodine and gadolinium have an energy absorption edge, which means that when the substance is exposed to X-rays of certain energy level, image contrast in the marked organ is very good. But when energy levels are below the absorption edge (30 keV for iodine), contrast dete-

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riorates rapidly. The contrast also becomes weaker at energies far above the absorption edge. Consequently, conventional broad-spectrum X-ray sources require an adequate quantity of contrast agent in order to offset this effect and obtain a sufficiently sharp image for diagnosis.

According to the researchers, using monoenergetic X-rays would make it possible to decrease the required concentration of contrast agents significantly. Iodine levels could be reduced by about one third with no loss of contrast, while for gadolinium the reduction could even greater, around 50%. The researchers added that the experimental approach can be extended in the future to dual-energy K-edge subtraction angiography, where the beam energy is oscillated rapidly between above and below the energy absorption edge. The study was published on February 9, 2017, in Nature Scientific Reports.

“Conventional X-ray sources generate a relatively broad range of energy levels. By contrast, the en-

ergy of X-rays produced by the MuCLS can be controlled much more precisely,” said lead author physicist Elena Eggl, PhD, of TUM. “The MuCLS is the very first machine of its kind; moreover, it is designed for fundamental research, and not for examining patients. But with detailed computer simulations and tests with a pig’s heart, using blood vessels dyed with iodine, [we] were able to demonstrate feasibility of the method.”

“Soft tissues such as organs and blood vessels are nearly impossible to examine in X-ray images; to detect a narrowing or other changes in coronary blood vessels, patients are therefore usually injected with an iodinated contrast agent,” said senior author Daniela Münzel, MD, an adjunct teaching professor for radiology at Klinikum rechts der Isar.

“These substances can sometimes be hazardous to health, particularly in patients with kidney insufficiency; complications may arise, in some cases even kidney failure.”

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Medical Imaging International

Twice-Daily Radiation Therapy Reduces Cancer Mortality plitting daily radiation therapy (RT) treatment into two portions allows more effective treatment of head and neck squamous cell carcinoma, according to a new study.

Researchers at the Gustave Roussy cancer center (Paris, France; www.gustaveroussy.fr), Aarhus University Hospital (Denmark; www.au.dk), and other institutions conducted a literature review based on a relatively new technique called network meta-analysis in order to bring together data from 117 different trials that included 28,804 patients from around the world. The data compilation allowed the researchers to compare 16 different treatment strategies in order to find out which was best at reducing cancer spread and mortality.

The results showed that hyper-fractionated RT, when combined with chemotherapy, cut mortality rates by 20% when compared to the current best standard of treatment, ad-

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New Heart Disease Risk Factor Found in Post-Menopausal Women esearchers have found that an increased volume of paracardial fat around the heart poses a significantly higher risk of heart disease for postmenopausal women, as well as for midlife women with lower levels of estrogen.

The study included 478 menopausal women in the US who were enrolled in the Study of Women’s Health Across the Nation (SWAN) program. The women were 51 years old on average, and were not on hormone replacement therapy. The researchers used blood samples and Computed Tomography (CT) scans of the heart to determine the epicardial and paracardial fat levels.

The researchers from the University of Pittsburgh Graduate School of Public Health (Pittsburgh, PA, USA; www. publichealth.pitt.edu) published the results of the study online in the January 20, 2017, issue of the Journal of the American Heart Association.

The results indicated that a 60% increase in paracardial fat volume was associated with a 160% increase in the risk of coronary artery calcification.

Samar R. El Khoudary, PhD, MPH, lead author of the study, said, “For the first time, we’ve pinpointed the type of heart fat, linked it to a risk factor for heart disease and shown that menopausal status and estrogen levels are critical modifying factors of its associated risk in women.

Clearly, epicardial and paracardial fat are distinct types of heart fat that are found to be greater in postmenopausal women for different reasons with different effects on heart disease risk – and thus should be evaluated separately when searching for ways to help women avoid heart disease.”

ministration of daily RT combined with chemotherapy. In fact, hyperfractionated radiotherapy with concomitant chemotherapy was ranked as the best treatment in all analyses. Hyper-fractionated RT also reduced the risk of the cancer getting worse by 23%.

The study was presented at the European Cancer Organization (ECCO) annual congress, held during January 2017 in Amsterdam (The Netherlands).

“There are a number of new treatments that have shown promise in head and neck cancer trials. This large study has enabled us to compare several of these treatments to see which is the best overall in terms of reducing mortality,” concluded lead author and study presenter radiation oncology resident Claire Petit, MD, of Gustave Roussy. “Some of the studies we

looked at did not include data on side effects; others did not follow patients long enough to pick up longterm side effects. This will be the focus of more research over the next year.”

Most cancers of the head, mouth, nasal cavity, nasopharynx, throat, and associated structures histologically belong to the squamous cell type, and are the 6th most common cancers worldwide and 3rd most common cancers in developing world, accounting for about 5% of all malignancies worldwide. Risk factors include tobacco consumption (chewing or smoking), alcohol consumption, Epstein-Barr virus (EBV) infection, human papilloma virus (HPV) infection, betel nut chewing, wood dust exposures, consumption of certain slated fish, and others.

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MOBILE DR SYSTEM

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The Trauma and Emergency Radiographic Room comprises an X-ray ceiling-suspended telescopic tube stand on roof rails, with a dedicated console to manage X-ray tube movements. Its tilting multifunctional stand with motorized functions allows for any kind of exam.

The Keen Ray DR50M is a mobile digital radiography system featuring a lightweight design and a user-friendly workstation with a 15-inch LCD touch screen. Its foldable arm allows for fast bedside imaging, making it suitable for X-ray in a vehicle, the patient’s house, and outside areas.

The EPS 45-80 RF features an output frequency of up to 240 kHz and 19-inch rack compatibility for installation inside OEM cabinets. Its modular design allows an existing generator to grow from 45 kW to 80 kW with the simple addition of inverter boards.

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Macrocyclic MRI Contrast Agent Launched new Magnetic Resonance Imaging (MRI) gadolinium-based contrast agent intended for the visualization of brain, spine and related tissues, has been launched.

There has been a significant increase in demand for new contrast media in the last ten years. The demand is related to the increasing rate of MRI procedural advancements, as well as diagnostic procedures.

The new MRI contrast agent, called Clariscan (gadoteric acid) was developed by GE Healthcare (Chalfont St Giles, Buckinghamshire, UK; www3. gehealthcare.co.uk), and adds to the range of MRI contrast media options GE already provides.

Clariscan was initially approved in Norway, and will be introduced for the European market during 2017. Gadolinium-based contrast agents (CGCA) are the gold-standard tool used in MRI and enable the rapid detection of abnormalities by providing improved contrast between normal and pathological tissues.

Emmanuel Ligner, GM Core Imaging, GE Healthcare Life Sciences, said, “Gadolinium-based agents are known to be a gold-standard detection tool in MR imaging, offering improved contrast between normal and pathological tissue to enable rap-

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Image: The Discovery 3.0 Tesla MRI scanner (Photo courtesy of GE Healthcare).

id detection of abnormalities. It is important that radiologists are able to make a contrast media selection dependent on the needs of individual patients.

We believe macrocyclic Clariscan, manufactured

using a proprietary GE process, extends choice for radiology professionals, backed by the well-established quality, reliability and surrounding services GE customers have come to expect.”

Head and Neck Cancer Patients Can Benefit from Increased Radiation Therapy esearchers have shown that treating head and neck cancer patients twice daily with radiation therapy, combined with chemotherapy, could benefit these patients and save more lives.

The study included patients with mouth, throat, or voice box tumors that already spread to adjacent tissue. The twice-daily treatment, called hyperfractionated radiotherapy, enables patients to receive a higher dose, and more effective radiotherapy treatment, possibly without increasing side effects.

The study was led by researchers at the Gustave Roussy Cancer Center (Villejuif Cedex, France; www.gustaveroussy.fr/en) and carried out together

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with the European CanCer Organization (ECCO; www.ecco-org.eu). The results were presented at the European Cancer Congress 2017 meeting.

The researchers used data from 117 different trials, and 28,804 patients worldwide for their study, and were able to compare 16 different treatments.

The results showed that hyperfractionated radiotherapy together with chemotherapy, reduced cancer deaths by 20% compared with standard once-daily radiotherapy and chemotherapy. The treatment also reduced the risk of the cancer deteriorating by 23%.

Study leader, Dr Claire Petit, Gustave Roussy Cancer Center, said, “There are a number of new treatments that have shown promise in head and

neck cancer trials. This large study has enabled us to compare several of these treatments to see which is best overall in terms of reducing mortality. Some of the studies we looked at did not include data on side effects; others did not follow patients long enough to pick up long-term side effects. This will be the focus of more research over the next year.

Moreover, the method we used, network metaanalysis, which combines direct and indirect treatment comparisons, is a new method that needs to be interpreted with prudence. However, this is an important finding for this group of patients who have a higher risk of their cancer recurring following treatment.”

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Medical Imaging International

Higher Levels of Heart Disease Protein Associated with Early-Stage Brain Damage he results of a large-scale study have shown that blood serum levels of a cardiac wall stress protein, NT-proBNP (N-terminal ProB-type natriuretic peptide), are linked to brain damage as well. The study group consisted of 2,397 middle-aged and elderly people, from a suburb in Rotterdam, the Netherlands. None of the people had dementia, or a clinical diagnosis of heart disease. Previous studies indicated a link between heart disease and brain disease, but the new study for the first time has shown the association between the NT-proBNP protein and sub-clinical brain damage, including a change in brain volume, and the in integrity of brain white matter. The study was published in the December 2016 issue of the journal Radiology.

One hypothesis for the results put forward by the researchers included the possibility that decreased blood flow could lead to cerebral microvascular damage, or create problems for the functioning of the Blood-Brain Barrier (BBB).

Lead author of the study, neuroradiologist Meike W. Vernooij, MD, PhD, Erasmus MC University Medical Center (Rotterdam, Netherlands; www. erasmusmc.nl/?lang=en), said, “We found that high-

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MRI Studies Show Changes in Adolescent Brains as Result of Alcohol Consumption esearchers in Finland have found that heavy alcohol consumption during adolescence results in cortical thinning and alters brain development.

The research was published in the December 2016 issue of the journal Addiction. The study group included young people who had been drinking alcohol heavily throughout adolescence.

The researchers from the University of Eastern Finland (Joensuu, Finland; www.uef.fi/fi/etusivu) and Kuopio University Hospital (Kuopio, Finland; www.psshp.fi) used Magnetic Resonance Imaging (MRI) scans to assess brain development in the study participants.

The MRI scans showed a statistically significant decrease in grey matter volume in the anterior cingulate cortex bilaterally of the brain, and in the right insula, in those participants with a history of heavy alcohol consumption during adolescence.

First author of the study, Noora Heikkinen, said, “The maturation of the brain is still ongoing in adolescence, and especially the frontal areas and the cingulate cortex develop until the twenties. Our findings strongly indicate that heavy alcohol use may disrupt this maturation process. The exact mechanism behind these structural changes is not known. However, it has been suggested that some of the volumetric changes may be reversible if alcohol consumption is reduced significantly. As risk limits of alcohol consumption have not been defined for adolescents, it would be important to screen and record adolescent substance use, and intervene if necessary.”

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er serum levels of NT-proBNP were associated with smaller brain volumes, in particular with smaller gray matter volume, and with poorer organization of the brain’s white matter. We cannot rule out that the observed subclinical brain damage led to increased levels of NT-proBNP. However, from a bio-

logical perspective, and based on animal studies, it is more likely that cardiac dysfunction affects brain changes rather than vice versa.”

Image: The structural MR imaging markers of subclinical brain damage (Photo courtesy of RSNA).

High-Resolution Scans Combined with Analysis to Help Detect Concussions esearchers in the Canada have found that there is a better chance of detecting concussion in the brain when patients undergo high-resolution Magnetoncephalography (MEG) scans, than if they undergo standard MRI or CT imaging.

The study was published in the December 2016 issue of the journal PLOS Computational Biology, and showed that MEG, which maps interactions between different brain regions, can be used to detect neural changes better than standard imaging.

Mild Traumatic Brain Injuries (MTBI), a frequent injury in American football players, are also not easily detected by conventional imaging scans.

The researchers from the Simon Fraser University (SFU; Burnaby, BC, Canada; www.sfu.ca)

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took MEG imaging scans of 41 men between 20 and 44 years old, half of who had a diagnosis of concussion in the three months prior to the scan, and found observable changes in communication between different areas of the patient’s brains.

MEG functional neuroimaging is an imaging technique used for mapping brain activity that currently uses extremely sensitive magnetometers called Superconducting Quantum Interference Devices (SQUIDs).

One of the researchers, Vasily Vakorin, from the Behavioral and Cognitive Neuroscience Institute at the SFU, said, “Changes in communication between brain areas, as detected by MEG, allowed us to detect concussion from individual scans, in situations where MRI or CT failed.”

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IMAGE MANAGEMENT SYSTEM

DIGITAL ROOM UPGRADE KIT

Focus Diagnostics

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Canon

The FS-L3202D reproduces multi-modality imaging using a selection of input connections, and comprehensive signal timing tables. It allows picture-in-picture or picture-by-picture screen layouts to be fully adjusted, allowing surgeons to work with video images tailored to their preference.

The JiveX Enterprise PACS applies standards such as DICOM and HL7 and implements several IHE profiles for accessibility of all modalities. Subsidiaries/external partners can also be integrated into the workflow via JiveX Multi-Site-Query or DICOM e-mail.

The Digital Room Upgrade Kit for is meant for upgrading existing rooms with compatible X-ray systems from CR to DR without having to upgrade the entire room. It offers a choice of wireless, tethered, or fixed Canon CXDI DR system to suit different budgets.

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Research Visualizes Hydraulic Forces and Cardiac Blood Flow esearchers have discovered that the ventricles of the heart are filled with the help of hydraulic forces, similar to those used in hydraulic brakes in vehicles and other mechanical devices.

Until today, blood flow mechanics during diastole have only been partially understood. The new discovery suggests that hydraulic forces, together with the heart muscle protein titin both help fill the ventricles with blood. Hydraulic forces are the pressure that liquids exert on an area. The forces are affected by blood pressure in the heart, as well as the difference in size between the ventricles and the atria. The hydraulic forces that were found to exist are a result of the fact that the ventricle is larger than the atrium.

The discovery was made by researchers at the

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Karolinska Institutet (Stockholm, Sweden; http:// ki.se/english), and the KTH Royal Institute of Technology (Stockholm, Sweden; www.kth.se/en) and was published online, in the March 3, 2017, issue of the journal Nature Scientific Reports. The researchers enlisted healthy participants for the study, and used Cardiovascular Magnetic Resonance (CMR) imaging to measure the size of both heart chambers during the diastole phase. The results showed that the atrium was effectively smaller during the filling process. According to the researchers, it is import to measure both the atrium and ventricle, and look at their relative dimensions during heart failure, rather than focusing only on the size of the ventricles.

Dr. Martin Ugander, physician and associate professor at the Karolinska Institutet, said, “Al-

though this might seem simple and obvious, the impact of the hydraulic force on the heart’s filling pattern has been overlooked. Our observation is exciting since it can lead to new types of therapies for heart failure involving trying to reduce the size of the atrium.”

Image: New research shows the relationship between hydraulic forces and cardiac blood flow (Photo courtesy of the KTH Royal Institute of Technology).

New Features Added to Radiologist Workflow Tool Set n expanded workflow tool set intended to provide a more intuitive workflow, and enhance and personalize the way radiologists read images, has been released.

The new additions to the tool set will help reduce the radiologists’ workload, provide improved control over the brightness of non-diagnostic displays, increase the visibility of subtle details in images, and provide better control over the radiologists’ reading environment.

Barco (Kortrijk, Belgium; www.barco.com), developed the new tool set, which includes the SpotView functionality. SpotView is used to create a focal spot in an image and highlight a specific area of interest for example in chest images, for breast calcifications, and pediatric extremities.

Radiologists can use the new SpotView Invert function to invert the grayscales and reverse whites and blacks to help them visualize details in an image. The new SpotView Mag feature increases detail inside the focus area by magnifying it to twice its original size. The SpotView Align feature now provides a bar or V-shape that enables radiologists to segment an image for review. Another new feature called DimView reduces peripheral ambient light from other displays during image reading, by linking multiple non-diagnostic displays at the workstation.

The features are all controlled using the Barco touchpad that integrates

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standard mouse functions with custom swipe motions to provide an improved ergonomic experience and a more effective workflow. The new tools are powered by the Barco MXRT display controllers, and use the AMD FirePro hardware. The tool set was launched in 2015 to accelerate the radiologist workflow, and improve reading ergonomics.

Image: The new expanded workflow tool set is intended to enhance and improve the way radiologists read images (Photo courtesy of Barco).

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New 4D Flow Software Platform Showcased ew 4D cardiac-flow qualification software has received marketing clearance by US FDA. The software was showcased at the annual Radiological Society of North America (RSNA 2016) meeting.

The Arterys 4D Flow software was developed by Arterys (San Francisco, CA, USA; www.arterys.com), a company that develops quantitative imaging tools for supporting treat-

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ment decisions. The Arterys 4D Flow platform uses cloud computing and advanced analytics techniques.

The 4D cardiac flow quantification technique uses phase-contrast Cardiac Magnetic Resonance (CMR) 3D data that is velocity-encoded in three spatial directions. The data is resolved relative to the 3 spatial dimensions, and time, for the duration of the cardiac cycle, and enables cli-

nicians to visualize, and measure blood patterns in the 3D volume. The 4D Flow sequence is faster and simpler than conventional MRI scans.

CEO of Arterys, Fabien Beckers, said, “This year, RSNA is focusing a lot of attention on breakthrough technological developments that are moving medical imaging into a new era where it’s possible to analyze data to help diagnose conditions much quicker, align various stakeholders in the health ecosystem, and mobilize

IT/PACS Update

on personalized treatment paths. We believe the Arterys platform will transform clinical practice through powerful, quantitative imaging tools that rapidly generate and analyze unprecedented amounts of data and insights that can support treatment decisions and the delivery of patient care.”

Image: An image generated by the 4D Arterys cardiac flow quantification software (Photo courtesy of Arterys)

Medical Monitor Combines 4K and 3D Imaging wo advanced medical monitors combine 4K color and three-dimensional (3D) imaging technologies to deliver high brightness, enhanced resolution, and increased depth of field for a range of applications.

The new Sony (Tokyo, Japan; www.sony.com) 55-inch and 31-inch medical monitors are designed for use with surgical microscopes and 3D endoscopes in operating rooms (ORs), as well for medical facilities in training and education. The new monitors will display 2D and 3D content in 4K or high definition (HD). In addition to side-by-side, line-by-line, and top and bottom imaging, the 3D transmission method allows SDI dual streaming, making it possible to connect with a wide range of equipment via SDI (3G), DVI, and HDMI terminals.

Features include 2D image display in picture-in-picture (PIP) mode, with the ability to display reference images; in addition, 3D images can be flipped or rotated in 180°. An Advanced Image Multiple Enhancer (AIME) feature allows operators to adjust the profiles and colors of 4K images from endoscopes and surgical microscopes for more comfortable viewing. The monitors also will come equipped with compatible and disposable 3D eyeshields.

OptiContrast technology replaces the layer of air between the panel and the glass with a layer of resin specially formulated to match the refractive properties of glass, thus reducing glare and reflection and helping to eliminate internal condensation. The panel also helps establish dark backgrounds for high-contrast images, even in brightly lit rooms. In

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addition, edge-to-edge screen protection and corner-to-corner uniformity help to maintain the monitor scratch-free and water resistant for easy cleaning.

“Combining 3D’s exceptional depth of field with 4K’s incredible resolution and clarity can change the way medical teams approach their work,” said Julie Holodak, senior marketing manager for the Sony Medical Systems Division.

“Building on the design and construction highlights of previous generations of Sony’s imaging technologies, these new medical monitors give surgeons greater precision and enhanced visualization to help them navigate through a procedure easily, and also provide more immersive and detailed training and education.”

The 4K resolution is a generic term for display devices or content having horizontal resolution on the order of 4,000 pixels, the standard for ultra-high definition (UHD). Using horizontal resolution to characterize the technology marks a switch from previous definitions, which categorized media according to vertical resolution (1080i, 720p, 480p). 4K UHD has twice the horizontal and vertical resolution of the 1080p, high-definition (HD) format, with four times as many pixels overall.

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MEDICAL DISPLAY

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The Merge RIS is an outpatient system that helps outpatient radiology centers compete and thrive.

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The IMAGE DISPLAYS 2in1 is designed for simultaneous assessment of two images, allowing for more reliable and accurate diagnosis. The homogeneous color and grayscale across the whole display, along with a 4MP resolution, makes it ideal for processing radiological and NM images.

The AeroDR Portable Retrofit turns an existing portable X-ray unit into a digital wireless solution.

It has a very small footprint, which allows for installation and storage inside the cassette storage bin, and is completely self-contained and includes two long-life batteries.

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Innovative Virtual Reality Tool Under Development esearchers are in the process of developing a tool that combines a virtual reality headset and anatomical 3D modeling of imaging data, to enable clinicians to navigate through the colon and search for polyps and other tumors.

The tool is one several innovations resulting from several decades of research that is currently focused on developing software to help doctors, surgeons, and radiologists perform diagnoses and make decisions using 3D modeling, Virtual Reality (VR) and big data. The researchers from the GE Healthcare (Chalfont St Giles, Buckinghamshire, UK; www3.gehealthcare.co.uk) Global Center of Excellence in Medical Imaging Software are located in Buc, France, and are using images from GE scanners for targeted 3D modeling of organs in the human body using virtual reality, and VR headsets.

The new technology enables a clinician to observe

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an organ or structure from all angles, in cross-sectional view, in 3D and in flat mode. In addition, a surgeon can combine this with the use of a 3D printer to be able to handle a replica of an organ before an operation. The researchers are using the Internet cloud to share images from 30,000 imaging scanners for their research that also includes machine-learning techniques.

Software Director, Jérôme Gonichon, at GE Healthcare, said, “This is an ongoing development process. Today, we are collecting data from the way that we are using our equipment so that we can improve it. Tomorrow, we can teach the machine to recognize cancer by itself.”

Image: The animation shows how researchers are using 3D virtual reality, and machine learning for diagnosis (Photo courtesy of GE Healthcare).

Image-Guided Surgery System Awarded US and Canada Clearance n innovative spinal surgery platform has received US 510(k) clearance, and a medical device license from Health Canada. The system uses 3D optical technologies and machine vision algorithms to help register spinal surgery patients automatically. The system uses visible light and is intended to replace conventional Image-Guided Surgery (IGS) systems that require intraoperative radiation.

Regulatory clearance of the Machine-vision Image Guided Surgery (MIGS) platform was announced by 7D Surgical (Toronto, ON, Canada; www.7Dsurgical. com) and will enable the commercial launch of the system in North American.

Prototype MIGS technology has been used in clinical trials involving more than 160 patients at the Sunnybrook Health Sciences Centre (Toronto, Canada; http://sunnybrook.ca). The 7D Surgical system requires less than 20 seconds for de novo spinal registration, compared to current spinal IGS system, which require registration times of up to 30 minutes during surgery. The MIGS system is embedded in an onboard overhead surgical light preventing line-of-sight problems for surgeons in the operating room. The MIGS software is controlled by a surgeon using a foot pedal.

CEO of 7D Surgical, Beau Standish, said, “When navigating the spine, surgeons traditionally have had two time-consuming and expensive IGS options: systems that rely on intraoperative radiation emitting devices or systems that

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utilize laborious manual point matching techniques. We believe the inefficiencies of these systems have limited the adoption of IGS in spine procedures to less than 20%. 7D Surgical’s MIGS system has now removed these barriers, providing surgeons and their hospitals with a superior product option.”

Image: The MIGS system for spinal surgery (Photo courtesy of 7D Surgical).

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BC Technical

ATLAIM

USA • West Jordan, UT Tel: (1) 801-280-2900 bctechnical.com sales@bctechnical.com

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.

25

Medical Imaging International May-June/2017

LINKXPRESS COM

2017

200

ALPHABETICAL LISTING OF COMPANIES

MII-17-06 125

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

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

Medical Imaging 200 Biomedical Equipment USA • Miami, FL Tel: (1) 305-463-9447 4biomed.com sales@4biomed.com

Block Imaging International

Bracco

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

Tel: (27) 21-7024-299 caperay.com kit@caperay.com

sales@chili-radiology.com

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

Candelis

Capintec

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

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

Canon Europe

Carestream Health

Medical Systems Division

USA • Rochester, NY Tel: (1) 585-627-1800 carestreamhealth.com/m edical health.imaging.tsc@carestream.com

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

Burlington Medical

CapeRay

USA • Newport News, VA

South Africa • Cape Town

Chison Medical Imaging Control-X Medical USA • Columbus, OH Tel: (1) 614-777-9729 cxmed.com sales@cxmed.com SEE AD ON PAGE 21

CIRS

Cook Medical

USA • Norfolk, VA

USA • Bloomington, IN Tel: (1) 812-339-2235 cookmedical.com customersupport@cook medical.com

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

CHILI

▲

Italy • Milan Tel: (39) 02-2177-1 bracco.com info@bracco.com

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

Tel: (1) 757-888-8994 burmed.com info@burmed.com

▲

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

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

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

Civco Medical Instruments

SEE AD ON PAGE 15

Cool Pair Plus

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

Clear Image Devices

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

CPI Canada • Georgetown, ON Tel: (1) 267-483-8081 cpii.com joanne.hunter@cpii.com

CurveBeam

USA • Ann Arbor, MI Tel: (1) 734-474-6537 clearimagedevices.com sales@ clearimagedevices.com ▲

SEE AD ON PAGE 23

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

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

Complete Medical Services 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

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

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

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

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

DMS Topline Medical USA • Fargo, ND Tel: (1) 701-237-9073 dmshealth.com info@dmshealth.com

DoseMonitor USA • Scottsdale, AZ Tel: (1) 602-903-4384 dosemonitor.com support@pacshealth.com

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

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

ECM France • Angoulême Tel: (33) 545-920-358

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Refurbished Equipment

aadcomed.com accuramed.de acem.it acimedical.com adanisystems.com advanced-inst.com advantech.eu 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 atlaim.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 bkultrasound.com blockimaging.com bracco.com brit.com broadwest.com usaxray.com burmed.com candelis.com canon-europe.com/medical caperay.com capintec.com carestream.com/medical chili-radiology.com chison.com cirsinc.com civco.com clearimagedevices.com coactiv.com codonics.com completemedicalservices.com conquestimaging.com contecmed.com.cn ambisea.com cxmed.com cookmedical.com coolpair.com cpii.com curvebeam.com datcard.com delmedical.com direxgroup.com dms.com dmshealth.com dosemonitor.com dunlee.com echoson.com.pl ecmscan.com ecoray.kr edan.com.cn eizoglobal.com elmed-as.com elsmed.com emd-technologies.com

Radiation Safety

AADCO Medical Accura Medizintechnik ACEM ACI Medical ADANI Advanced Instrumentations Advantech Europe Agfa HealthCare Agsa Gomma Albatross Projects AllTech Medical Systems ALMA Medical Imaging Amber Diagnostics AMD Technologies Ampronix Analogic Antmed ARCOMA ATLAIM 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 BK Ultrasound Block Imaging International BRACCO Brit Systems Broadwest Burkhart Roentgen International Burlington Medical Supplies Candelis Canon Europe.

CapeRay Capintec Carestream Health CHILI Chison Medical Imaging CIRS Civco Medical Instruments Clear Image Devices CoActiv Medical Codonics Complete Medical Services Conquest Imaging Contec Medical Systems Continuum Healthcare Control-X Medical Cook Medical 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

CT

BUYER’S GUIDE 2017

Radiography

Film & Image Mgmt Systems

Medical Imaging International

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ecmscan.com ecm@ecmscan.com

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

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

Eizo Germany • Karlsruhe Tel: (49) 721-20321-0 eizoglobal.com dt-contact@eizo.com

ElsMed Israel • Holon

Tel: (972) 3-558-4839 elsmed.com info@elsmed.com

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

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@pec.esaote.com

ETS Lindgren RF Enclosures USA • Wood Dale, IL Tel: (1) 630-307-7200 ets-lindgren/medical.com

Everbrite Lighting USA • Greenfield, WI Tel: (1) 414-529-3500 everbrite.com sales@everbrite.com

flukebiomedical.com sales@ flukebiomedical.com

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

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

Faxitron Bioptics

Fukuda Denshi

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

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

Fluke Biomedical USA • Everett, WA Tel: (1) 425-347-6100

Gammex

▲

SEE AD ON PAGE 28

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

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

Japan • Tokyo Tel: (81) 422-45-6049 hitachi.com/healthcare

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

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

USA • San Jose, CA Tel: (1) 800-241-4002 hospira.com supportservices@ hospira.com

Huqiu Imaging

Italy • Seriate Tel: (39) 035-452-5311 gmmspa.com international.sales@ gmmspa.com

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

Gilardoni

iCAD

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

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

ICRco

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

SEE AD ON PAGE 36

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 LINKXPRESS COM

MII-17-06 127

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

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

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

Hospira Worldwide

Guerbet

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

Inomed Medizintechnik

Hitachi Aloka Medical

GE Healthcare

General Medical Merate

sales@ imagingdynamics.com

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

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

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

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

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

USA • Melbourne, FL Tel: (1) 321-259-6862 gammex.com sales@gammex.com

Haiying Enterprise Group

SEE AD ON PAGE 30

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

JADAK Europe Netherlands • Breda Tel: (31) 76-522-5588 jadaktech.com info@jadak.eu

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

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

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

JW Medical Korea • Seoul Tel: (82) 2-2109-7700 jw-medical.co.kr export@jw-medical.co.kr

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

Medical Imaging International May-June/2017

28

Emperor Electronic Technology china-emperor.com Esaote esaote.com ETS Lindgren RF Enclosures ets-lindgren.com/medical Everbrite Lighting everbrite.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 Haifu haifu.com.cn Haiying Enterprise Group haiyingmedical.com.cn Heartland Medical heartlandmedical.com Hillusa hillusa.com Hitachi Aloka Medical hitachi.com/healthcare 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 & Graphic Imaging Europe konicaminolta.eu/en/healthcare Kopp Development koppdevelopment.com Koven Technology koven.com KPI Ultrasound kpimed.com Kubtec Digital X-Ray kubtec.com Landwind Medical landwindmedical.com Lessa - AB Medica Group 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 maxerendoscopy.com MedGyn medgyn.com Medical Imaging Innovations medicalii.com Medimar medimarcorp.com Medion Healthcare medion.co.in 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

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PET

MR

Ultrasound

CT

Radiography

BUYER’S GUIDE 2017

Film & Image Mgmt Systems

Medical Imaging International

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Kernel Medical Equipment

kpimed.com info@kpimed.com

info@lodox.com

China • Xuzhou Tel: (86) 516-8773-2209 kernelmed.com admin@kernelmed.com

Lutech

MediSono

Kubtec Digital X-Ray

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

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

Mallinckrodt Pharmaceuticals

Medonica

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

Netherlands • Amsterdam Tel: (31) 65-759-8882 konicaminolta.eu/en/ healthcare/home.html caroline.arts@ mg.konicaminolta.eu ▲

SEE AD ON PAGE 11

Koven Technology USA • St, Louis, MO Tel: (1) 314-542-2101 koven.com info@koven.com

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

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

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

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

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

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

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

Maxer Endoscopy Germany • Wurmlingen Tel: (49) 7461-1407965 maxerendoscopy.com info@ maxerendoscopy.com

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

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

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

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

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

USA • Irvine, CA Tel: (1) 949-465-6000 me-vis.com

NDS Surgical Imaging USA • San Jose, CA Tel: (1) 408-776-0085 ndssi.com info@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 support@ neurologica.com

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

Nilymed

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

Metaltronica

NordicNeuroLab

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

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

Metropolis International

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

Mindray Medical International China • Shenzhen Tel: (86) 755-8188-8998 mindray.com intl-market@mindray.com

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

MIPM Germany • Mammendorf MII-17-06 128

Mitsubishi Electric Visual and Imaging Systems

Israel • Tel-Aviv Tel: (972) 74-703-2220 nilymed.com office@nilymed.com

Merge

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

LINKXPRESS COM

Tel: (49) 814-592-090 mipm.com international@mipm.com

Nordion

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

O-Two Medical Technologies

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

PACSHealth USA • Scottsdale, AZ Tel: (1) 602-903-4384 pacshealth.com info@pacshealth.com ▲

Konica Minolta Medical & Graphic Imaging Europe

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

nikunj@medion.co.in

SEE AD ON PAGE 9

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

Paxeramed USA • Newton, MA Tel: (1) 888-430-0005 paxeramed.com sales@paxeramed.com

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

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

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

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

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

Poskom

Canada • Brampton, ON Tel: (1) 905-792-6896 otwo.com resuscitation@otwo.com

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

Primedic

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

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

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nilymed.com nordicneurolab.com nordion.com novarad.net otwo.com or-technology.com pacshealth.com parkerlabs.com paxeramed.com pcicharts.com pekato.com perlong-china.com philips.com/medical planmed.com poskom.com primedic.com ptw.de questinc.com radcal.com ramsoft.com reinmedical.com rellhealthcare.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 ulrichmedical.com umgxray.com raysafe.com unimaging.com umiultrasound.com vacutec-gmbh.de vareximaging.com varian.com viatronix.com vieworks.com villasm.com vitalimages.com vomark.com w7global.com wandong.com.cn wardray-premise.com weigaogroup.com welld.com.cn wolfxray.com china-mri.com kxele.com ziehm.com zoncare.com

PACS / IT

Nilymed NordicNeuroLab Nordion Novarad O-Two Medical Technologies OR Technology PACSHealth Parker Laboratories Paxeramed PCI Precision Charts Pekato Enterprises Perlong Medical Philips Healthcare Planmed Poskom Primedic PTW-Freiburg Quest International Radcal RamSoft Rein Medical �Richardson Electronics 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 Ulrich UMG/Del Medical Unfors RaySafe United Imaging Healthcare United Medical Instruments VacuTec Messtechnik Varex Imaging Varian Interay Viatronix Vieworks Villa Sistemi Medicali Vital Images Vomark Technologies 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 ZonCare Electronics

Radiography

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

questinc.com

Rein Medical

RamSoft

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

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

PTW-Freiburg

Quest International

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

USA • Irvine, CA Tel: (1) 949-581-9900

Radcal

SEE AD ON PAGE 25

Schaerer Medical

RSTI

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

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

Richardson Electronics

RTI Electronics

USA • La Fox, IL Tel: (1) 630-208-2874 rellhealthcare.com healthcare@rell.com

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

Roesys

Samsung

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

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

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

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

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

SG Healthcare Korea • Seoul Tel: (82) 70-4264-9704 sghealthcare.net sales@sghealthcare.com

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

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

ShinYoung For M Korea • Namyangju Tel: (82) 2-3423-3057 syfm.co.kr chrisoh@syfm.co.kr

Siemens Healthcare

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

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

info@roesys.de

SEE AD ON PAGE 7

SonoSite 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

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

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

SEE AD ON PAGE 5

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

Supersonic Imagine

Sino-Hero Bio-Medical Electronics China • Shenzhen Tel: (86) 755-2640-8541 sinoheromed.com sales@sinoheromed.com

France • Aix-en-Provence Tel: (33) 04-88-19-68-55 supersonicimagine.fr contacts@ supersonicimagine.fr

SIUI

Swissray Global

China • Shantou Tel: (86) 754-8825-0150 siui.com siui@siui.com

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

Medical Imaging International May-June/2017

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Teknova Medical Systems China • Beijing Tel: (86) 10-5768-2233 teknova.cn international@teknova.cn

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

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

TeraRecon

United Imaging Healthcare

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

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

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

Terason Ultrasound

United Medical Instruments

Vomark Technologies

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

USA • Wheeling, IL Tel: (1) 312-253-9892

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

Thales Electron Devices France • Velizy-Villacoublay Tel: (33) 01-57-77-80-00 thalesgroup.com xrayimaging.marketing@ thalesgroup.com

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

Varex Imaging

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

USA • Salt Lake City, UT Tel: (1) 801-972-5000 vareximaging.com info@vareximaging.com

TXR

Varian Interay

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

USA • Palo Alto, CA Tel: (1) 650-493-4000 varian.com/interay interay.sales@varian.com

Ulrich Medical

Viatronix

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

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

UMG/Del Medical

Korea • Anyang Tel: (82) 70-7011-6161 vieworks.com sales@vieworks.com

USA • Bloomingdale, NY Tel: (1) 847-288-7000 umgxray.com

Vieworks

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W7 Global USA • Louisville, KY Tel: (1) 888-210-1059 w7global.com info@w7global.com

Wandong Medical Equipment China • Beijing Tel: (86) 10-8457-9688 wandong.com.cn info@wandong.com.cn

Wardray Premise UK • Surrey

Tel: (44) 208-398-9911 wardray-premise.com sales@ wardray-premise.com

Well.d Medical Electronics

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

Ziehm Imaging

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

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

Wolf X-Ray

ZonCare Electronics

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

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

Companies

by Country AUSTRALIA Imaxeon

BELARUS ADANI

BELGIUM Agfa Healthcare Barco

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

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

Ecoray 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

VacuTec Messtechnik Ziehm

Electronics XGY Medical ZonCare Electronics

KOREA

INDIA

FINLAND

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 Siemens Healthcare Ulrich Medical

MEDICAL IMAGING INTERNATIONAL

ElsMed Nilymed Shina Systems

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

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Companies

by Country BC Technical BK Ultrasound Beekley Medical Biomedical Equipment Block Imaging International Brit Systems Broadwest Burkhart Roentgen International Burlington Medical Supplies Candelis Capintec Carestream Health CIRS Civco Medical Instruments Clear Image Devices CoActiv Medical Codonics Complete Medical Services Conquest Imaging Control-X Medical Cook Medical Cool Pair Plus CurveBeam Datcard DMS Topline Medical DoseMonitor Dunlee ETS Lindgren RF Enclosures

Everbrite Lighting Faxitron Bioptics Fluke Biomedical Fonar Gammex Guided Therapeutics Heartland Medical Hologic Hospira Worldwide iCAD ICRco ImageWorks Imaging Diagnostic Systems Imaging Specialists Group JD Honigberg International Kopp Development Koven Technology KPI Ultrasound Kubtec Digital X-Ray Lutech Mallinckrodt Pharmaceuticals MedGyn Medical Imaging Innovations Medimar MediSono Medtronic Medvix Merge Metropolis International

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Medical Imaging International May-June/2017

Medical Imaging International Inq.No.

Advertising Index

Vol. 27 No.2 5-6/ 2017

Advertiser

Page

P O R T A L

2 E ASY WAYS

1

MinXray Mitsubishi Electric Visual and ImagingSystems NDS Surgical Imaging NeuroLogica Novarad PACSHealth Parker Laboratories Paxeramed PCI Precision Charts Pekato Enterprises Print Media Quest International Radcal Richardson Electronics RSTI SonoSite Star X-Ray Sunnex TeraRecon Terason Ultrasound TXR UMG/Del Medical United Medical Instruments Varian Interay Varex Imaging Viatronix Vital Images Vomark Technologies W7 Global Wolf X-Ray

103 102 117 – 115 – 122 121 – – 127 136 128 111 – 109 125 105 107 –

Ampronix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Antmed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 Atlaim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 CCR 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . .35 CIRS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 CIRSE 2017 . . . . . . . . . . . . . . . . . . . . . . . . . .32 Clear Image Devices . . . . . . . . . . . . . . . . . . . .23 Control-X . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 ESC 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . .26 EUROSON 2017 . . . . . . . . . . . . . . . . . . . . . . .33 Gammex . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 Gourbet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36 Italray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 Konica Minolta . . . . . . . . . . . . . . . . . . . . . . . . .11 MedImaging.net . . . . . . . . . . . . . . . . . . . . . . .13 PACS Health . . . . . . . . . . . . . . . . . . . . . . . . . . .9 Radcal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25 Siemens Healthineers . . . . . . . . . . . . . . . . . . . .5 Sonoscape . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 TradeMed.com . . . . . . . . . . . . . . . . . . . . . . . .19 Provided as a service to advertisers. Publisher cannot accept responsibility for any errors or omissions.

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