Medical Imaging International June 2018 by Globetech

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MedImaging DAILY RADIOLOGY NEWS

Vol.28 No.2 5-6 / 2018 ISSN 1068-1779

200

2018

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IN THIS ISSUE Clinical News . . . . . . . 4-21 PACS/IT Update . . . . . 23-24 Product News . . . . . . . 6-26 Buyer’s Guide 2017 . . 27-35

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Medical Imaging International

New Compact CT System Receives FDA Clearance new 64-slice Computed Tomography (CT) system was awarded US FDA 510(k) clearance. The Supria True64 was developed by Hitachi Healthcare Americas (Twinsburg, OH, USA; www. hitachi.us), has a compact design, and is economical to operate. The system is the premier model in the company’s compact CT family of products, and features a 64-slice discrete detector and processing power that can provide fast, and thin 64-slice imaging for full 40mm-detector coverage. The system provides enhanced workflow capabilities, and is XR-29 Smart Dose compliant. The Supria True64 provides enhanced patient access by virtue of a large 75cm aperture, and a weight capacity table. According to the manufacturer, the system provides True 64 slice scanning compared to some other compact CT products that actually acquire only 32 slices. These 32-slice systems then use software upscaling techniques to provide 64-slice results. The Supria True64 also features Eco-Mode functionality that can reduce power consumption by up to 55% when the system is idle, providing environmentally efficient operation. Hi-

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tachi Healthcare Americas offers a wide range of diagnostic imaging equipment that includes Magnetic Resonance Imaging (MRI), ultrasound, as well as CT imaging systems. VP and GM for MR/CT, at Hitachi Healthcare Americas, Sheldon Schaffer, said, “The SupriaTrue64 continues Hitachi’s commitment to providing imaging solutions with enhanced speed, comfort and quality. Being mindful of the intense economic and workflow pressures being experienced by CT providers, Hitachi once again is demonstrating our ability and commitment to provide a higher level of CT capabilities at an economic price point.” Image: The Supria True64 CT system (Photo courtesy of Hitachi Medical Systems Europe).

Dan Gueron Andrew Deutsch Daniel Beris Joseph Ciprut Brenda Silva Theresa Herman Dr. Jutta Ciolek Nadia Liefsoens Parker Xu Katsuhiro Ishii David Gueron Arda Turac

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Novel PET Tracer Identifies Majority of Bacterial Infections new positron emission tomography (PET) imaging agent offers a non-invasive method of detecting infection and monitoring antibiotic therapy. Developed by researchers at Stanford University School of Medicine (CA, USA; http:// med.stanford.edu) and Thermo Fisher Scientific (Hanover Park, IL, USA; www.thermofisher. com), the new PET tracer is a derivative of maltose labeled with radioactive fluorine-18 (18F). The researchers conducted several studies in relevant bacterial strains in cultures and in living mice, and found that the tracer, dubbed 6”-18F-fluoromaltotriose, appears to be specific to bacterial infections, targeting a maltodextrin transporter expressed in both grampositive and gram-negative strains of bacteria. The researchers found that 6 -18F-fluoromaltotriose was also able to detect Pseudomonas aeruginosa in a clinically relevant mouse model of wound infection. In a rat model, the new agent was able to identify small bacterial foci in a heart valve. When the same rats were treated with an antibiotic, the PET signal from the cardiac tissue disappeared. According to the researchers, the properties of the tracer include sensitivity, specificity, and low background signal, which will facilitate its translation into humans. The study was published in the October 2017 issue of The Journal of Nuclear Medicine.

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“We really lack tools in the clinic to be able to visualize bacterial infections. What we need is something that bacteria eat that your cells, socalled mammalian cells, do not,” said senior author Sanjiv Sam Gambhir, MD, PhD, chair of the radiology department at Stanford University School of Medicine. “As it turns out, there is such an agent, and that agent is maltose, which is taken up only by bacteria because they have a transporter, called a maltodextrine transporter, on their cell wall that is able to take up maltose and small derivatives of maltose.” “The hope is that in the future when someone has a potential infection, this approach of injecting the patient with fluoromaltotriose and imaging them in a PET scanner will allow localization of the signal and, therefore, the bacteria,” concluded Dr. Gambhir. “And then, as one treats them, one can verify that the treatment is actually working; so that if it’s not working, one can quickly change to a different treatment, for example, a different antibiotic.” 18F is a fluorine radioisotope that decays by positron emission 97% of the time, and electron capture 3% of the time; both modes of decay yield stable oxygen-18 (18O). 18F is an important radioisotope as a result of both its short half-life and the emission of positrons when decaying. It is primarily synthesized into fluorodeoxyglucose (FDG) for use in PET scans for cancer detection.

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Medical Imaging International May-June/2018

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MOBILE RADIOGRAPHY UNIT

X-RAY SYSTEM

ARCOMA

DMS-Apelem

Oehm und Rehbein/OR Technology

The PanoRad features maximum exam flexibility packaged in the smallest footprint. It easily fits in work areas with a ceiling of 2.4 meters as compared to 2.9 meters required for other systems, making it ideal for use in locations with ceiling height restrictions.

The SAXO 4T unit is controlled by a microprocessor and designed for emergency rooms, as well as intensive care and pediatric applications. Using a portable WIFI detector with its tablet, it is possible to easily switch to digital across the mobile fleet.

The Amadeo Cis ceiling-mounted system features a newly designed spring counterbalance system for effortless manual positioning of the X-ray tube. The floating tabletop of the height-adjustable Bucky table is perfectly suited for routine examinations.

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Brain Disconnections May Contribute to Visual Hallucinations esearchers have revealed disconnections in areas of the brain related to visual processing and attention that may be related to the visual hallucinations associated with Parkinson’s disease. The researchers used functional Magnetic Resonance Imaging (fMRI) exams for their study that was intended to help predict the development of hallucinations in Parkinson’s disease patients. The study was carried out by researchers from the Neurology, and Anatomy and Neurosciences departments, of the VU Medical Center (VUmc; Amsterdam, Netherlands; www. vumc.nl), and was published online in the September 27, 2017, issue of the journal Radiology. The researchers used resting-state fMRI exams to investigate communications, and synchronization between activation patterns of different areas of the brain. The patient co-

hort consisted of 15 patients with visual hallucinations, 40 patients without hallucinations, and another 15 healthy control subjects. The researchers found that there were several brain areas that communicated less with the rest of the brain in the group of patients with Parkinson’s disease, compared to the control group. In the patients that suffered from visual hallucinations, there were a number of additional brain areas that showed decreased connectivity with the rest of the brain. According to the researchers, there are no direct therapeutic implications for patient care as a result of the research, however future studies could show whether stimulation of areas with less connectivity could help treat the visual hallucinations. One of the authors of the study, Dagmar H.

Hepp, MD, from the VUMC, said, “Visual hallucinations in Parkinson’s disease are frequent and debilitating. Our aim was to study the mechanism underlying visual hallucinations in Parkinson’s disease, as these symptoms are currently poorly understood.” Image: The Magnetic Resonance (MR) images show reduced regional functional connectivity in patients with Parkinson’s disease (A), and in patients with the Parkinson’s as well as visual hallucinations patients (B) (Photo courtesy of RSNA).

Innovative MRI System Embraces Human Nature new magnetic resonance imaging (MRI) scanner uses BioMatrix technology to simplify and accelerate workflows while increasing exam precision and patient comfort. The Siemens Healthineers (Erlangen, Germany; www.healthcare.siemens.com) MAGNETOM Vida 3T MRI is a 70-cm bore scanner that uses BioMatrix Select&GO technology, a collection of sensors, tuners, and touch interfaces on the front of the system to enable fast, easy patient positioning. An intelligent body model correctly positions the region to be examined in the central area, adapting to the anatomical and physiological characteristics of all patients, which also enables also less experienced staff to correctly position the patient. An intuitive Dot workflow ensures consis-

tent, high-quality imaging independent of the user and the patient, using numerous automated steps such as AutoAlign, AutoCoverage, and AutoFoV, obviating the need to plan the examination manually. A wide-range of inline functionalities allows system users to enjoy automatic reconstructions in the background and ease following post-processing steps. The result is consistent, high-quality imaging, with fewer rescans, predictable scheduling and consistent, high-quality personalized exams for high-end clinical routine, and clinical research. The MAGNETOM Vida incorporates a completely new 3T magnet, which provides excellent homogeneity throughout the entire measurement volume, and a large field-ofview of 55 x 55 x 50 cm2. A gradient

strength of up to 60/200 simultaneously allows up to 25% higher signal to noise ratio (SNR) in diffusion weighted imaging, with robust and reliable fat saturation throughout the entire imaging volume, which is especially important in abdominal or off-center applications. “We can examine sick patients faster with Magnetom Vida. The scanner offers the highest degree of patient comfort with the performance of a research system, which speeds up our workflows,” said Professor Mike Notohamiprodjo, MD, head of MRI at University Hospital Tübingen (Germany). “The new scanner decreases measurement times for musculoskeletal and prostate imaging compared to previous MRI systems, and it does so with significantly improved image quality.” Medical Imaging International May-June/2018

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Advanced Technology Maps Complex Cardiac Arrhythmias n innovative high-resolution ultrasound-based electrophysiology system visualizes cardiac anatomy and maps dipole density to chart the pathway of every heartbeat. The Acutus Medical (Carlsbad, CA, USA; www.acutusmedical.com) AcQMap High Resolution Imaging and Mapping System detects and displays both standard voltage-based and higher resolution dipole density (charge-source) maps of the human heart. The system combines ultrasound anatomy construction with an ability to map the electrical-conduction of each heartbeat, in order to identify complex arrhythmias across the entire atrial chamber. Following each ablation treatment, the heart can be re-mapped in real-time in just a few seconds to continually visualize any changes from the prior mapping. Using ultrasound, electrophysiologists can acquire more than 115,000 points every minute, providing computerized tomography (CT)-quality cardiac chamber reconstructions with electrical activity displayed as waveform traces. Dynamic, three-dimensional (3D) dipole density maps are overlaid on the cardiac chamber reconstruction to show chamber-wide electrical activation. The system can be used with all existing commercially available cardiac ablation platforms, and allows remapping of the entire chamber at any time during the procedure. “The AcQMap System was designed in close collaboration with some of the most respected names in the field to provide practitioners with a suite of tools that enables them to rapidly map and re-map to visualize changes throughout the ablation procedure,” said Steven McQuillan, senior VP of regulatory and clinical affairs at Acutus Medical. “We firmly believe that by working together with EP practitioners and scientists, we will continue to uncover breakthrough innovations to improve and advance cardiac care.” “The AcQMap System is able to provide global dipole density mapping of irregular and chaotic activation in the atrial chambers, whereas conventional sequential mapping may struggle to provide us with the information that is required,” said Tom Wong, MD, of Royal Brompton Hospital (London, United Kingdom). “In the cases we have performed thus far, real-time mapping of complex arrhythmias has allowed us to focus on areas of interest and terminate the arrhythmia using ablation therapy. We can now offer individualized, tailored therapy, and are one step closer to identifying the mechanisms of complex arrhythmias.”

Medical Imaging International May-June/2018

Cardiac mapping collects and displays electroanatomical maps of the heart, and includes activation, isochronal, propagation, or voltage maps. Isochronal vector maps are commonly used to study the mechanisms and to guide the ablative therapies of arrhythmias; activation maps display local activation time, color-coded and overlaid on reconstructed 3D geometry; propagation maps show a dynamic color display of the propagation of the activation wavefront across the reconstructed chamber; and voltage map displays the peak-to-peak amplitude at each site. Image: The AcQMap high-resolution imaging and mapping system workstation (Photo courtesy of Acutus Medical).

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PRODUCT NEWS DF/RADIOLOGY SYSTEM

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ULTRASOUND SYSTEM

CT PHANTOM

Siemens Healthineers

SonoScape

Sun Nuclear/Gammex

The Luminos dRF Max offers both DF and radiography, covering all general fluoroscopic exams and radiographic exams on the table. Its 48cm table height ensures safer use, while its MAX dynamic detector delivers sharper imaging.

The X3 uses multi-beam processing technology for a more efficient scanning process. It provides a clear view of the lesions, enabling users to improve diagnosis accuracy and save scanning time.

The Mercury 4.0 Phantom meets all advanced CT testing recommended by AAPM TG-233, including automatic exposure control and noise power spectrum. It includes a stand with a handle and leveling feet, along with a wheeled case.

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Updates to CT System Aimed at ERs ew enhancements to a premium Computed Tomography (CT) system include new operational, clinical, and safety features for emergency department patients. The updates improve the system’s high-contrast spatial resolution, and low-contrast detectability, and include the Model-Based Iterative Reconstruction (MBIR), an improved workflow, and efficiency tools. The Aquilion ONE / GENESIS Edition is manufactured by Canon Medical Systems (Otawara, Japan; http://global.medical.canon). Canon Medical Systems is the new name for Toshiba Medical Systems which officially became a subsidiary of Canon Inc. as of January 4, 2018. The enhancements of the new system include Canon’s three-phase Variable Helical Pitch (vHP3) whole-body single scanning feature, which enables scanning of three different parameters, as well as helical pitch setting for distinct anatomical areas. The vHP3 allows for scanning with only one contrast injection, and in one single breath hold, that can potentially reduce radiation dose, and the amount of contrast needed, while at the same time improving image quality. The Neuro FIRST MBIR is intended for brain scanning in emergency rooms by improving low contrast detectability, and high-contrast spatial resolution for early detection of a stroke. SUREPosition enables faster and more accurate patient centering in the gantry, and potentially preventing repeated scanograms.

Senior director of Canon Medical Systems USA’s CT, PET/CT, and MR Business Units, Dominic Smith, said, “We designed the Aquilion ONE / GENESIS Edition to help providers save valuable time when every second matters in the emergency department. Our goal is to deliver flexible solutions that meet healthcare providers’ clinical needs, and the Aquilion ONE / GENESIS Edition enables faster and safer triage of patients.” Image: An enhanced version of the Aquilion ONE / GENESIS Edition for use in emergency departments has been announced (Photo courtesy of Canon Medical Systems).

Tongue Ultrasound System Improves Speech Therapy new study describes how an innovative visual biofeedback system based on an ultrasound probe placed under the jaw can help treat speech impediments. Developed by researchers at GIPSA-Lab (Saint-Martin-d’Hères, France; www.gipsa-lab.grenoble-inp.fr) and INRIA Grenoble Rhône-Alpes (INRIA; Montbonnot-Saint-Martin, France; www.inria.fr), the system uses ultrasound images to display tongues movements in real time via an animated articulatory talking head, which serves as a virtual clone of the speaker. Besides the face and lips, the avatar shows the tongue, palate and teeth, which are usually hidden inside the vocal tract. Another version of the system (under development) automatically animates the articulatory talking head not by ultrasounds, but directly by the user’s voice. The strength of this new system lies in an integrated cascaded gaussian mixture regression algorithm that can process articulatory movements required for targeted therapeutic applications. The algorithm ex-

ploits a probabilistic model based on a large articulatory database acquired from an “expert” speaker capable of pronouncing all of the sounds in one or more languages. The model is automatically adapted to the morphology of each new user, over the course of a short system calibration phase, during which the patient must pronounce a few phrases. The study was published in the October 2017 issue of Speech Communication. “Automatic animation of an articulatory tongue model from ultrasound images of the vocal tract using visual biofeedback is the process of gaining awareness of physiological functions through the display of visual information,” concluded lead author Diandra Fabre, MSc, of GIPSA-Lab, and colleagues. Speech therapists specialize in the evaluation, diagnosis, and treatment of communication disorders, cognitive-communication disorders, voice disorders, and swallowing disorders, and play an important role in the diagnosis and treatment of autism spectrum disorder. Medical Imaging International May-June/2018

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DR SOLUTION

ULTRASOUND SYSTEM

3DISC Europe

Agfa Healthcare

Samsung

The FireCR Spark provides crystal-clear image quality and accommodates a range of cassette sizes. It is small and light, allowing it to be placed on a counter or wall-mounted, and offers a variety of imaging speeds.

The DR 400 enables the transition from computed radiography to digital radiography. It offers multiple digital configurations, ranging from a CR-based solution to a single detector DR system, to a comprehensive multi-detector DR system.

The RS85A is designed to help reduce userfatigue and repetitive motions with an enhanced monitor arm and increased range of motion and tilt. It allows the user to position the monitor for optimal viewing and control.

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MRI Safe for Patients with Implanted Legacy Devices atients with a legacy pacemaker or implantable cardioverter-defibrillator (ICD) system that need to undergo a magnetic resonance imaging (MRI) scan have nothing to fear, according to a new study. Researchers at the University of Pennsylvania (Penn; Philadelphia, USA; www.upenn.edu) and Johns Hopkins University (JHU; Baltimore, MD, USA; www.jhu.edu) conducted a prospective, nonrandomized study to assess the safety of MRI at a magnetic field strength of 1.5 Tesla in 1,509 patients who had a pacemaker (58%) or an ICD (42%) that was not considered to be MRI-conditional (also known as a legacy device). Overall, the patients underwent 2,103 thoracic and non-thoracic MRI examinations that were deemed to be clinically necessary. The pacing mode was changed to asynchronous mode for pacing-dependent patients, and to demand mode for other patients, with tachyarrhythmia functions disabled. Outcome assessments included adverse events and changes in device parameters indicating lead and generator function and interaction with surrounding tissue. The results showed no reports of long-term clinically significant adverse events. Following the MRI scan, the patient’s device reset to a backup mode in nine cases (0.4%), of which eight were transient. One pacemaker reset to ventricular inhibited pacing and could not be reprogrammed. A decrease in P-wave amplitude was the most common notable

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change in device parameters (occurring in one percent of patients) immediately after MRI. At long-term follow-up, the most common notable changes from baseline were decreases in P-wave amplitude (4%), increases in atrial capture threshold (4%), increases in right ventricular capture threshold (4%), and increases in left ventricular capture threshold (3%). The study was published on December 28, 2017, in the New England Journal of Medicine (NEJM). “Patients who have pacemakers or defibrillators are often denied the opportunity to undergo magnetic resonance imaging because of safety concerns, unless the devices meet certain criteria specified by the FDA, termed MRI-conditional devices,” concluded lead author Saman Nazarian, MD, PhD, of the University of Pennsylvania, and colleagues. “No long-term clinically significant adverse events were reported, and the observed changes in lead parameters were not clinically significant, and did not require device revision or reprogramming.” Until now, patients with ICD systems have been contraindicated from receiving MRI scans because of potential interactions between the MRI and device function, which might result in risk to patients. The restriction has resulted in a critical unmet need as data have shown that within four years, 36% percent patients with ICDs in the United States are likely to need an MRI. Image: A new study shows MRI scans are safe for people with legacy ICDs (Photo courtesy of Getty Images). Medical Imaging International May-June/2018

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Medical Imaging International

7T MRI Scanner Doubles Static Magnetic Field Strength he world’s first 7 Tesla (7T) magnetic resonance imaging (MRI) scanner offers higher resolution and faster acquisition times in clinical applications. The Siemens Healthineers (Erlangen, Germany; www.healthcare.siemens.com) Magnetom Terra MRI scanner is an advanced ultra-high-field scanner for neurological and musculoskeletal (MSK) applications in the head and extremities, which has the potential to reveal functional and anatomical details not visible in devices with lower magnet field strengths. A unique “Dual Mode” feature permits the user to switch between an investigational research mode and a clinical Mode for imaging, keeping research data and clinical images safe on separate databases, respectively. The Magnetom Terra features a new magnet that is 50% lighter than any 7T magnet to date, and can be shipped cold via airfreight and integrated more easily into clinical environments, even on upper floors. In addition, a Zero Helium boil-off feature reduces evaporation in both standby and operational modes. Up to 64 receive channels and 80/200 gradients provide high levels of power, to not only perform diffusion MRI and functional MRI (fMRI), but also utilize the simultaneous multi-slice (SMS) application to accelerate advanced neurological applications for clinical routine. An ultrafine 0.2 mm in-plane anatomical resolution potentially enables visualization of previously unseen anatomical structures. For example, cerebral cortex imaging at 0.2mm in-plane resolution may yield never-before-visible clinical details in cortical structure. The scanner’s submillimeter blood-oxygen-level dependent (BOLD) fMRI contrast increases linearly with field strength; in clinical use, this could translate to INTERACTIVE higher resolution in neuroimaging, as DIGITAL EDITION compared to 3T applications.

Image: The new Magnetom Terra MRI offers powerful clinical features (Photo courtesy of Siemens Healthineers).

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“With the Magnetom Terra 7T scanner, Siemens Healthineers proudly introduces the first MRI field strength above 3T to be cleared for clinical imaging in nearly 20 years,” said Christoph Zindel, MD, senior vice president and head of MRI at Siemens Healthineers. “Armed with the Magnetom Terra’s ultra-high-field strength, clinicians may be able to achieve new, unforeseen levels of patient care and clinical advancements through improved visualization of a wide variety of neurological disease states.” The MAGNETOM Terra leverages the Siemens Healthineers syngo MR E11 software platform, enabling users to work in the same manner as they would 1.5T and 3T technology. The systems measurement and reconstruction system (MaRS) computer offers hyperfast image reconstruction technology at speeds up to 20 times faster than previous generations of 7T research scanners.

Medical Imaging International May-June/2018

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DR SYSTEM

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Control-X Medical

Italray

GE Healthcare

The Z-Table four-way float top table is specifically designed for U-Arm and Straight Arm xray systems. It offers maximum flexibility to position patients, and large casters are lockable by color-indicated foot controls.

The X-FRAME DR2T features high device automation, anatomical programs, predefined working positions and short time for imaging. It works with wireless cassette-sized detectors that can be positioned directly in contact with the patient.

The Revolution Frontier features the Performix HD Plus x-ray tube, which reduces wear and results in shorter warm-up time between patients, as well as longer tube life. The system also offers the Gemstone Clarity module for noise reduction.

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Catheter Melds Light and Ultrasound to Detect Plaque novel catheter probe combines intravascular ultrasound (IVUS) with fluorescence lifetime imaging (FLIm) in order to help predict heart attacks. Developed at the University of California Davis (UCD, USA; www.ucd.edu), the 3.7 Fr single rotational intravascular FLIm-IVUS catheter sends short laser pulses into surrounding tissue, which fluoresces in return; different tissues – such as collagen, proteins, and lipids – emit different biochemical fluorescence profiles. At the same time, the IVUS probe in the catheter records structural information on the blood vessel. The combination can provides a comprehensive insight into how atherosclerotic plaque forms, aiding diagnosis and providing a way to measure how plaques shrink in response to therapy. The researchers successfully demonstrated the ability of the system to acquire robust bi-modal data in coronary arteries in healthy swine via standard percutaneous coronary intervention (PCI) techniques in combination with a Dextran solution bolus flush. They also imaged several representative diseased human samples, showing that different types of lesions in diseased coronary arteries, as identified via histology, are also characterized by specific FLIm biochemical signatures in the first 200 m of the intima. The study was published on August 21, 2017, in Scientific Reports. IVUS enables identification of plaque burden due to its high penetration depth (up to 10 mm), but lacks the spatial resolution to identify small-scale features such as details of the intima, or the biochemical changes linked with atherosclerotic lesion formation and evolution.

FLIm, on the other hand, depends on a wealth of environmental parameters such as pH, ion or oxygen concentration, molecular binding or the proximity of energy acceptors, making it ideal for functional imaging. Image: A new combined IVUS/FLIm catheter probe can image arteries of a living heart (Photo courtesy of Marcu Lab / UCD).

Research Identifies Children at High Risk for MS esearchers in the US have found that MRI scans can help them identify children who have a high risk of developing Multiple Sclerosis (MS), even before symptoms become apparent. The study included 38 children from 16 sites, in six countries, all of whom underwent Magnetic Resonance Imaging (MRI) scans for headache or other reasons. When MS is diagnosed in children, it may already be too late to prevent MS-related relapses and disabilities. The study was carried out by researchers from the Yale School of Medicine (New Haven, CT, USA; http://medicine.yale.edu), and published in the November 2017, issue of the journal Neurology: Neuroimmunology & Neuroinflammation. The MRI brain scans showed unexpected signs of MS without the children showing any clinical symptoms of the disease. The results of the study could lead to earlier diagnosis and treatment for MS.

Around 42% of the children participating in the study who showed MRI findings of MS, developed the first clinical symptoms of MS around two years after the MRI. The children at the greatest risk of developing clinical systems of MS were those with a specific marker in spinal fluid, or those who showed changes to the spinal cord in the MRI images. Lead author of the study, Naila Makhani, MD, assistant professor of pediatrics and neurology at Yale School of Medicine, said, “For the first time we have proposed a definition of RIS in children. Children with Radiologically Isolated Syndrome (RIS) may represent a high-risk group of children that needs to be followed more closely for the later development of clinical multiple sclerosis. We hope that our work will help inform expert guidelines for how to follow up children with RIS and help us accurately inform families of the risk of later developing multiple sclerosis, something we were previously unable to do.” Medical Imaging International May-June/2018

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Medical Imaging International

Portable Ultrasound Device Scans Neonatal Brain Activity novel device uses functional ultrasound imaging (fUSI) and video electroencephalography (EEG) to monitor brain microvasculature in newborns. Researchers at Paris Sciences et Lettres Research University (PSL; Paris, France; www.univ-psl.fr), the University of Geneva (Switzerland; www.unige.ch), and other institutions used a lightweight (40 grams), flexible, and noninvasive headmount in order to simultaneously perform continuous video EEG and fUSI ultrafast Doppler (UfD) imaging of the brain microvasculature in human neonates. The system was able to detect very small cerebral blood volume variations that closely correlated with two different sleep states, as defined by EEG recordings. Using fUSI, the researchers were able to assess brain activity in two neonates with congenital abnormal cortical development, establishing neonatal seizure dynamics with high spatiotemporal resolution (200 m for UfD and 1 ms for EEG). fUSI was then applied to track how waves of vascular changes were propagated during interictal periods, and to determine the ictal foci of the seizures. The new technology may potentially pave the way to therapeutic innovations for neurological disorders. The study was published on October 11, 2017, in Science Translational Medicine. “Functional neuroimaging modalities are crucial for understanding

brain function, but their clinical use is challenging,” concluded lead author Charlie Demene, PhD, of the PSL École Supérieure de Physique et de Chimie Industrielles (ESPCI), and colleagues. “Imaging the human brain with fUSI enables high-resolution identification of brain activation through neurovascular coupling, and may provide new insights into seizure analysis and the monitoring of brain function.” Image: New research shows fusing ultrasound and EEG can help map seizures (Photo courtesy of Charlie Demene/ PSL).

Blood Sample May Establish Patient Radiosensitivity new study suggests that flow cytometry analysis can be used to measure a patient’s DNA sensitivity to radiation and chemotherapy treatments. Under development at Sahlgrenska Academy (Göteborg, Sweden; www.sahlgrenska.gu.se), the flow-cytometry-based cell division (CD) assay uses the thymidine analogue 5-ethynyl-2’-deoxyuridine (EdU) to measure the proliferative ability of cells after DNA damaging treatment. In validation studies, the CD assay measured sensitivity to radiation of human skin fibroblasts with a correlation similar to standard clonogenic survival assay, and in a relatively short time frame. Using easily sampled peripheral blood lymphocytes, the CD assay was able to identify variation in intrinsic sensitivity to radiation, and also detected increased sensitivity in patients with DNA repair defects. As exposure to ionizing radiation generates free radicals that carry out most part of the toxic effects, the researchers conducted a second study to examine if pretreating cells with an Nrf2 transcription factor activator, which regulates the cellular antioxidant system, could influence sensitivity to radiation. The results showed that repeated pretreatment of cells with Nrf2 activators, isothiocyanate sulforaphane, or synthetic triterpenoid bardoxolone methyl can enhance cytoprotection. The study was presented as a PhD dissertation in September 2017. “The main idea behind our method is to measure patient sensitivity during the planning process for the cancer treatment and to identify which patients are extremely sensitive,” study dissertation presenter Sherin Mathew, PhD. “It will be better to have this knowledge about the patients; as it stands right now we don’t know how each patient will respond when the radiation or chemotherapy is administered. The idea is that it will be possible to test sensitivity and prevent extremely sensitive patients from having serious side effects.” Flow cytometry is a biophysical technology employed in cell counting, cell sorting, biomarker detection, and protein engineering by suspending cells in a stream of fluid and passing them through an electronic laser or impedance-based detection apparatus that allows simultaneous multiparametric analysis of the physical and chemical characteristics of up to thousands of particles per second. Flow cytometry is routinely used in the diagnosis of health disorders, especially blood cancers, but has other applications in basic research, clinical practice, and clinical trials.

Medical Imaging International May-June/2018

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PRODUCT NEWS VIDEO SCALER/CONVERTER

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RADIOGRAPHY SYSTEM

CONTRAST DELIVERY SYSTEM

Ampronix

Control-X Medical

Guerbet

The Scanmaxx SD1080P allows effortless conversion of SD/HD-SDI to the output and resolution that is required up to full HD. It generates low noise levels when converting between analog and digital formats and is ideal for a variety of uses.

The Perform-X Hi-Lo offers four-way elevation for easy patient transfer and dedicated pedals for up/down motion. Other features include the WS 99 wall Bucky stand and TS 99 family of tube stands with flexible configuration options.

The Angiomat Illumena allows the user to switch between cardio, angio and CT modes with a single touch. It features hand/foot switches for added convenience, and an optional Air Detection Aid & Warning System that helps detect air bubbles.

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New Mammography System Offers Breast Stabilization new mammography system that uses breast stabilization can deliver a mammogram with the same image quality and radiation dose as conventional systems, without the physical discomfort of breast compression. The new system, now commercially available, was reported to improve the comfort of 93% of women undergoing a mammography exam, according to a recent survey. The new SmartCurve breast stabilization system was developed by Hologic (Bedford, MA, USA; www.hologic.com) and is intended for use with the company’s Genius 3D Mammography system. The Genius 3D was US FDA approved as superior to conventional 2-D mammography, including for women with dense breasts. The SmartCurve system features a special curved surface that reduces pinching and distributes the force over the whole breast. The

system also uses image-processing algorithms, which preserve image accuracy and quality, by ensuring that positioning or workflow remain unchanged. The system can also accommodate most breast sizes. The SmartCurve system is available as standard on the new Hologic 3Dimensions mammography system, and can also be added to Hologic’s Selenia Dimensions systems. Global VP, Research and Development, at Hologic, Tracy Accardi, said, “As a woman, I know firsthand that all too often, annual mammograms are considered a necessary evil. We understand the critical role the exam plays in the early detection of breast cancer, but we know how uncomfortable, and sometimes even painful, the exam can be. The associated anxiety causes many women to avoid or delay this potentially life-saving exam, something we set out to change when

developing the first-of-its-kind SmartCurve system.” Image: The SmartCurve breast stabilization system that can provide a more comfortable mammography exam for women (Photo courtesy of Hologic).

New Guidelines for Radiation Therapy in Breast Cancer new consensus statement provides updated guidelines for the appropriate and safe utilization of accelerated partial-breast irradiation (APBI). Developed by researchers at the Cleveland Clinic (Cleveland, OH, USA; www.my. clevelandclinic.org), Tufts Medical Center (Boston, MA, USA; www.tuftsmedicalcenter. org), and other members of the American Brachytherapy Society (Reston, VA, USA; www.americanbrachytherapy.org) with expertise in breast cancer and breast brachytherapy, the new guidelines are intended to provide updated data for clinicians and recommendations regarding appropriate patient selection and techniques. Appropriate candidates for APBI include patients aged 45 years or older with all invasive histologies and duc-

tal carcinoma in situ (DCIS). The guidelines suggest tumors should be three cm or less, node negative, estrogen receptor positive or negative, without lymphovascular space invasion, and with negative margins. The strongest evidence is for interstitial brachytherapy and intensity-modulated radiation therapy APBI, with moderate evidence for applicator brachytherapy or three-dimensional (3D) conformal radiotherapy APBI. Intraoperative radiation therapy and electronic brachytherapy should not be offered, regardless of technique, outside of a clinical trial. The new guidelines were published on October 23, 2017, in Brachytherapy. “The updated guidelines support clinicians by offering them the ability to appropriately select patients for APBI, and data that supports

the techniques,” said lead author Chirag Shah, MD, of the Cleveland Clinic. “Guidelines allow for the selection of patients who can finish radiation treatment in one week or less, compared to the traditional period of three to six weeks, and potentially a reduction in side effects depending on the APBI technique.” APBI is an approach that treats only the lumpectomy bed plus a 1-2 cm margin, rather than the whole breast. Hence, a small volume of irradiation at a higher dose can be delivered in a shorter period of time. There has been growing interest for APBI and other approaches developed under phase I-III clinical studies; these include multicatheter interstitial brachytherapy, balloon catheter brachytherapy, conformal external beam radiation therapy, and intra-operative radiation therapy (IORT). Medical Imaging International May-June/2018

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Medical Imaging International

Nano-CT Device Creates High-Resolution 3D X-Rays novel imaging device can produces images that approach the resolution of a scanning electron microscope, while also capturing structures under the surface. Under development at Munich Technical University (TUM; Germany; www.tum.de) and the University of Kassel (Germany; www.uni-kassel.de), the Nano-CT system is a table-top laboratory device and data processing pipeline that routinely and efficiently generates high-resolution three dimensional (3D) data at about 100 nm resolution of very small biological samples, without requiring synchrotron radiation optics. The researchers used the system to demonstrate the walking appendage of a Euperipatoides rowelli – the velvet worm – a representative of the OnyImage: A Nano-CT image of the legs of velvet worm (Photo courtesy of de Sena Oliveira / Unichophora invertebrate group, which is conversity of Kassel). sidered pivotal for understanding animal evolution. Comparative analyses proved that NE DES W IGN nano-CT depicted the external morphology of the limb with an image quality similar to scanning electron microscopy (SEM), while simultaneously visualizing internal muscular structures at higher resolutions than WORLD’S MEDICAL PRODUCT MARKETPLACE confocal laser scanning microscopy, enabling the researchers to reveal hitherto unknown aspects of the Onychophoran limb musculature SIGN UP and enabling 3D reconstruction of FOR FREE! individual muscle fibers. The study was published on October 3, 2017, in PNAS. “Our goal in the development of the Nano-CT system is not only to be able to investigate biological samples, such as the leg of the velvet worm; in the future, this technology will also make biomedical investigations possible,” said professor of biomedical physics Franz Pfeiffer, PhD, of TUM. “Thus, for example, we will be able to examine tissue samples to clarify whether or not a tumor is malignant. A non-destructive and three-dimensional image of the tissue with a resolution like that of the Nano-CT can also provide new insights into the microscopic development of widespread illnesses such as cancer.” “In contrast to arthropods, onyConnecting Buyers with chophorans do not have segmented Suppliers Worldwide limbs, as is also the case with their Reach new sources of supply presumed common fossil ancestors,” Identify latest products and technologies said senior author Georg Mayer, Send inquiries directly to suppliers PhD, of the department of zoology at Receive latest product alerts the University of Kassel. “The invesChat live with suppliers tigation of the functional anatomy of the velvet worm’s legs plays a key TradeMed provides a sophisticated yet easy-to-use global B2B platform for sourcing medical role in determining how the segequipment. TradeMed connects buyers and sellers worldwide through a safe, secure and dymented limbs of the arthropods namic network. Solely dedicated to medical products, TradeMed is the premier choice for medevolved.”

ical suppliers, hospital decisionmakers and buyers worldwide, regardless of size or budget.

Medical Imaging International May-June/2018

PRODUCT NEWS FLAT PANEL DETECTOR

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ULTRASOUND GEL

UNIVERSAL ARM SYSTEM

Konica Minolta Medical Imaging

Parker Laboratories

ATLAIM

The AeroDR 2 1417S is one of the lightest in its class, weighing only 2.5 kg (5.5 lb). It combines the ideal components, grip materials and cover design to create a durable panel, and is easy to carry and for patients to hold.

The AQUASONIC 100 is recommended for all procedures where a viscous gel is required. Completely aqueous, it does not stain clothing or damage transducers, and is acoustically correct for a broad range of frequencies.

The ATRAD U Series is a versatile system designed for small spaces in clinics and hospitals. With its ergonomic design, fully motorized movements and LSD touch screen operation console, it delivers high productivity and performance.

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Portable Bladder Scanner Improves Volume Measurements portable three-dimensional (3D) ultrasound (US) system uses deep learning technology to improve bladder volume measurement accuracy. The Verathon (Bothell, WA, USA; www. verathon.com) BladderScan Prime Plus uses a second-generation proprietary algorithm called ImageSense, which combines clinical data from thousands of scans and tens of thousands of US images with artificial intelligence (AI) deep learning in order to provide a bladder volume measurement accuracy of ±7.5% on volumes from 100-999 mL, and ±7.5mL on volumes from 0-100mL. An intuitive touch-screen interface, live B-mode scanning, and onboard self-diagnostics are used to significantly improve easeof-use with the aid of several key usability features, including: One-mode scanning for all patient types with a single fully sealed probe that protects the sensitive electronics against accidental

moisture spills. Point-and-click use that requires no manual probe fanning, minimizes user error, and optimizes clinical workflows. A BladderTraq aiming assist feature and new visual or color cues to indicate proper aiming. A durable, medical-grade design and simplified cleaning process for real-world use and in order to meet compliance with hospital disinfectant standards. Enhanced off-center scan alerts and a pubic bone interference indicator. “We have designed BladderScan Prime Plus to have the optimal combination of accuracy and ease of use across a wide range of clinical users and settings,” said Earl Thompson, President of Verathon. “It offers a streamlined workflow that can help improve patient care, and help reduce or avoid catheter-associated urinary tract infection.” Bladder volume measurement is a well-es-

tablished metric used in the diagnosis and treatment of a wide range of medical conditions. It is a critical component of comprehensive catheter-associated urinary tract infections (CAUTI) prevention programs, an area of intense focus for hospitals in the United States as a result of Medicare penalties for hospitals with high CAUTI rates. Penalties include reducing payments by one percent for hospitals with a high number of hospital acquired conditions (HACs). Image: The BladderScan Prime Plus uses AI for accurate measurement (Photo courtesy of Verathon).

Contrast-Enhanced Ultrasound Helps Detects Liver Cancer new study reveals that contrast-enhanced ultrasound (CEUS) can achieve correct diagnosis without radiation, and at lower cost. Researchers at the University of Calgary (Alberta, Canada; www.ucalgary.ca) and Stanford University (CA, USA; www.stanford.edu) conducted a study in 200 patients at risk for hepatocellular carcinoma in order to assess detection and characterization of malignant focal liver lesions using CEUS, an imaging technique that allows pathology detection without radiation, expensive magnetic resonance imaging (MRI) equipment, or biopsies. The researchers also utilized the Liver Imaging Reporting and Data System (LI-RADS), a tool used to classify liver tumors using computed tomography (CT),

MRI, and CEUS. The results revealed that CEUS can provide dynamic real-time imaging with high spatial and temporal capability, and with 97% accuracy. The researchers suggest that in liver cancer patients with lesions that are indeterminate on CT and MRI, CEUS can serve as a useful tool to improve management and assist guidance of liver biopsies and local treatment of hepatocellular cancer. The study was presented at the 32nd annual conference of the International Contrast Ultrasound Society (ICUS), held during October 2017 in Chicago (IL, USA). “Patients with hepatocellular carcinoma, the third leading cause of cancer deaths worldwide, were found to benefit from contrast-enhanced ultrasound imaging when magnetic resonance

imaging was inconclusive,” said senior author Professor Stephanie Wilson, MD, of the University of Calgary, and co-president of ICUS. “This is an exciting option, because hepatocellular carcinoma is the most common form of liver cancer, and standard imaging with MRI is often an insufficient option for characterizing the tumor.” CEUS uses liquid suspensions of miniscule gas microbubbles to improve the clarity and reliability of an ultrasound image. The microbubbles are smaller than red blood cells, and when they are injected into a patient’s vein, they flow through the microcirculation and reflect ultrasound signals, thus improving the accuracy of diagnostic ultrasound exams. The microbubbles are expelled from the body within minutes. Medical Imaging International May-June/2018

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Medical Imaging International

Orbital Microscope Promotes Ergonomic Surgery precision exoscope can enable more accurate surgery by providing high-resolution three-dimensional (3D) imaging of the structure of tissue, blood vessels, and other features. The Olympus (Tokyo, Japan; www.olympus-global.com) ORBEYE microscope uses two Sony (Tokyo, Japan; www.sony.com) 4K ExmorR complementary metal-oxide semiconductor (CMOS) sensors to deliver high-sensitivity, low-noise 3D digital images that support precision surgery. An image processing circuit designed to work across a wide color range with four times the pixel count of the High Definition (HD) standard minimizes the delay associated with the large amounts of data, providing zero image latency for smoother viewing and manipulation of the target location. The microscope, which has no eyepiece, uses a 55inch 4K 3D monitor to help reduce surgeon fatigue and facilitate team surgery by allowing a more comfortable working posture that does not require that the surgical team spend long periods of time peering into a microscope lens eyepiece. Moreover, as the large monitor enables the entire surgical team to view the same image, it allows more than one surgeon to operate and improves efficiency by allowing information to be shared with other surgical staff. In addition, the use of digital technology has made the microscope unit much smaller, helping to free up surgical space in the operating room. The reduced size also allows faster setup times by eliminating the need to make awkward adjustments to the balance of the arm, and also by allowing a smaller, easier-to-fit surgical drape to be used to keep the microscope clean. The ORBEYE microscope was developed by Sony Olympus Medical Solutions (Tokyo, Japan; www.sony-olympus-medical.com), a joint venture between Olympus and the Sony founded in 2013. “We have already received resounding enthusiasm for our 4K and 3D technology for laparoscopy and endoscopy. We are pleased that through the development of ORBEYE, this 4K-3D technology can be offered to more specialties such as neurosurgery, spine, microsurgery,

ENT, and cardiac,” said Randy Clark, group vice president of the surgical division at Olympus America. “We understood that with such complex and lengthy surgeries, the technology would have to be innovative and groundbreaking enough to entice surgeons to make a change.” “The ORBEYE exoscope represents the next generation of operative imaging, a true quantum shift,” said David Langer, MD, of Lenox Hill Hospital (New York, NY, USA; www.lenoxhillhospital.org). “Its adoption is certain and will impact the use of loupe magnification as well as the current operating microscope. The ease of use, surgeon ergonomics, and effects upon the operating team are revolutionary, and I look forward to continuing to train and develop new strategies for its adoption.” Image: The ORBEYE 4K-3D video microscope system (Photo courtesy of Olympus).

Breast Cancer Patients Report Better RT Experience new study shows that the radiation therapy (RT) experiences of breast cancer largely exceeded their expectations, and that the short- and long-term side effects are often better than anticipated. Researchers at the David Geffen School of Medicine at UCLA (USA; www.ucla.edu) sent out a survey questionnaire to all patients who received treatment for breast cancer between 2012 and 2016. Eligible patients had six or more months of follow-up, and were without tumor recurrence. A total of 327 patients responded, who represented various disease stages; 18% had stage 0 breast cancer; 38% stage I; 34% stage II; and 9% stage III. As to treatment, 82% underwent breast-conserving surgery, 13% had axillary dissection, 37% received chemotherapy, and 70% received endocrine therapy. All patients received RT, delivered as either standard whole-breast RT with or without regional nodal coverage, hypo-fractionated whole-breast RT, post-mastectomy RT or partial breast RT; the patients completed the survey a median of 31 months after completing RT. Survey questions assessed fears and beliefs about breast cancer treatment and side ef-

Medical Imaging International May-June/2018

fects, as well as how the actual experience compared to initial expectations. Specifically, patients were asked if the treatment experience, short-term side effects and long-term side effects were as expected, worse than expected or better than expected. The results showed that 90% found the actual experience of breast radiation therapy to be “less scary” than anticipated. Overall short-term and long-term side effects of radiation were better than expected or as expected for 83% and 84% of respondents, respectively. Patients also reported that side effects were less severe than or as expected for short-term breast pain, skin changes, and fatigue, as well as for long-term appearance changes, breast pain, breast size changes, and breast textural changes. More than two-thirds of the patients reported that they had little to no prior knowledge of RT at the time of their diagnosis, yet nearly half also shared that they had previously read or heard “frightening” stories of serious side effects. The most common initial fears related to RT were concerns about damage to internal organs, skin burning, and becoming radioactive, but few patients found

confirmation for these negative stories during treatment. The study was presented at the 59th annual meeting of the American Society for Radiation Oncology (ASTRO), held during September 20177 in San Diego (CA, USA). “We hope that these data, which reflect the voices of past breast cancer patients, can help to counsel future patients and their physicians on the actualities of the modern breast radiation therapy experience,” said lead author and study presenter Narek Shaverdian, MD. “Patients who have received this treatment provide the most credible account of its actual impact, and their accounts show that outdated, negative stereotypes of breast radiation are almost universally found to be untrue.” “Our study shows that women who received modern breast radiation therapy overwhelmingly found the treatment experience far better than expected. The negative stories out there are frightening and pervasive, but they generally are not reflective of the actual experience,” said Susan McCloskey, MD, MSHS, director of the Breast Service at UCLA Radiation Oncology and senior author of the study.

PRODUCT NEWS DF/RADIOLOGY SYSTEM

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FLAT PANEL DETECTOR

PHANTOM

Siemens Healthineers

Vieworks

CIRS

The VIVIX-S 1717V features AED (Automatic Exposure Detection) function with reliable performance. It has a short booting time of 15 seconds and the same size as a film/CR cassette for the easy upgrade of a conventional X-ray system.

The SRS Multi-Lesion Brain QA phantom provides a fast solution for comprehensive film dosimetry for single isocenter plans treating multiple targets simultaneously. It can be used for validation of multi-lesion treatments and for patient QA.

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Novel Imaging Technique Predicts Spinal Degeneration new magnetic resonance imaging (MRI) technique uses apparent diffusion coefficient (ADC) maps to assess water dynamics in the intervertebral disk and other spinal structures. Researchers at Irkutsk State Medical University (IRKSMU; Irkutsk, Russia; www.irksmu.com) and St. Joseph’s Hospital and Medical Center (Phoenix, AZ, USA; www.dignityhealth.org) conducted a study involving 100 consecutive patients admitted to the spinal surgery service in order to evaluate the utility of ADC maps generated from diffusion weighted (DWI) MRI in the assessment of patients with advanced degenerative lumbar spine disease. ADC values and characteristic maps were assessed in the regions of interest over different degenerative lumbar spinal pathologies. In all, the study included 452 lumbar vertebral segments. ADC map features were identified for protrusion, extrusion, and sequester types of lumbar disk herniation; spondylolisthesis; reactive Modic endplate changes; Pfirrmann grade of intervertebral disc degeneration; and compromised spinal nerves. The results showed compromised nerve roots had significantly higher mean ADC values than adjacent contralateral nerve roots. Compared to normal bone marrow, Modic I changes showed higher ADC values and Modic 2 changes showed lower ADC values, respectively. And ADC values correlated with Pfirrmann grading, but differed from herniated and non-herniated disks of matched Pfirrmann 3 and 4 grades. The study was published on August 28, 2017, in PLOS One. “We’re improving our understanding of one of the most common maladies to affect humans, which is spinal disc degeneration,” said

study author Mark Preul, PhD, of the St. Joseph’s Barrow Neurological Institute. “Imaging technology such as MRI ADC mapping will provide much greater and improved information to the physician treating patients with degenerated disc and other degenerative spine conditions.” MRI is widely used for imaging evaluation of patients with low back pain. T1 and T2-weighted MRI sequences provide anatomical information regarding the soft tissues, including fat and water content, and are usually used for the assessment of the lumbar discovertebral complex, focusing on structural changes in the intervertebral disk and zygapophyseal joints, reactive vertebral bone marrow changes, location and extent of the disk material displacement, degree of the stenosis, and location and extent of nerve root compression. Image: Sagittal ADC map (A), corresponding T2 MRI (B), and colored overlay showing distortion of the signal (C) (Photo courtesy of IRKSMU).

Optical Scintillation Detector Monitors Radiation Treatments new system provides diagnostic pinpoint accuracy measurement of the radiation treatment plan by verifying the dose delivered is consistent with the prescribed dose. The RadiaDyne (Houston, TX, USA; www.radiadyne.com) OARtrac system is a real-time in vivo dosimetry device system that uses disposable scintillating detectors during stereotactic body radiotherapy (SBRT) and intensity-modulated radiation therapy (IMRT) for prostate cancer treatment or brachytherapy. The system is based on plastic scintillation detector (PSD) probes connected to a duplex fiber-optical cable that transmits the PSD signals to a charge coupled device (CCD) camera that measures the scintillator output signal. The optical measurement is converted to an electrical signal and dis-

played on a digital readout located in the control room of the linear accelerator treatment machine. Based on the continuous review of the accumulative dose data provided by the system, radiation oncologists can adjust subsequent treatment if and when required, thus allowing for a true adaptive radiation therapy protocol. The PSD sensor cable can be used up to five times on the same patient. “Radiation oncologists can now monitor multiple radiation delivery modalities within the same treatment center, as well as reduce overall treatment costs related to routine patient dose monitoring,” said John Isham, founder of RadiaDyne. Organs at risk (OAR) are defined as normal tissues whose radiation sensitivity may significantly influence treatment planning and/or the prescribed radiation dose. Medical Imaging International May-June/2018

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Medical Imaging International

Imaging Software Analyzes Kidney Stone Composition streamlined, semi-automated tool analyzes kidney stones instantly using a patient’s computerized tomography (CT) scans. The StoneChecker (Radstock, United Kingdom; www. stonechecker.com) software, based on the TexRAD (Cambridge, United Kingdom; www.texrad.com) algorithm, examines the physical attributes of a renal stone on non-contrast enhanced CT scan slices. The patented filtration-histogram CT Texture Analysis (CTTA) algorithm highlights coarse features, using histogram analysis to quantify and assess distribution of grey-levels, coarseness, and regularity within the region of interest. Filters that extract and enhance image features at larger scales reduce noise artifacts, whilst heterogeneity in stone architecture is enhanced. Stonechecker then prepares a report of a stone’s given characteristics, such as volume, mean Hounsfield unit (HU) density, skin to stone distance, entropy, kurtosis, skew and other metrics. Each of these factors has been shown to be relevant in predicting stone-free rates and the potential outcome of a lithotripsy procedure carried out on the stone. Heterogeneity parameters at different spatial scales enable quantitative assessment of imaging biomarkers within the kidney stones, which can then be used to identify treatment failure on pre-treatment CT. “CTTA metrics reflect stone characteristics and composition and predict ease of shock wave lithotripsy fragmentation. The strongest correlation with the number of shocks required to fragment a kidney stone is mean HU density and the entropy of the pixel distribution of the stone image,” reports the company. “With the aid of multiple linear regression analysis, the CTTA metrics of entropy and kurtosis can predict 92% of the outcome of number of shocks needed to fragment the stone.” Kidney stones are often no larger than a grain of rice, yet some can

grow to a diameter of several centimeters, causing blockage of the ureters. If it cannot be dissolved chemically, the kidney stone is treated using extracorporeal shock-wave therapy or minimally invasive endoscopic modalities. Many of these patients suffer from disease recurrence and need retreatment, but new stone formation might be reduced by adapting dietary habits or the use of particular medication strategies, as based on stone composition. Image: CT texture metrics can identify kidney stone composition (Photo courtesy of StoneChecker).

MRI Study: Migraines Linked to High Sodium Levels in Cerebrospinal Fluid new sodium Magnetic Resonance Imaging (sMRI) study reveals that migraine sufferers have significantly higher sodium concentrations in their cerebrospinal fluid (CSF). Researchers at University Medical Center Mannheim (Germany; www.umm.de) and the University of Heidelberg (Germany; www. uni-heidelberg.de) conducted a study involving 12 women (mean age 34), who had been clinically evaluated for migraine, and 12 healthy women of similar ages who served as a control group. The women suffering from migraines filled out a questionnaire regarding the length, intensity, and frequency of their migraine attacks and the accompanying auras. Both groups then underwent cerebral sMRI, and sodium concentrations were compared. The results showed no statistical differences between the two groups for sodium concentrations in the gray and white matter, brain stem, and cerebellum. However, significant differences emerged when the researchers looked at sodium concentrations in the CSF – the fluid that surrounds the brain and spinal cord, which were significantly higher in the migraine patients than in the healthy control group. The study was presented at the annual meeting of the Radiological Society of North America (RSNA), held during November 2017 in Chicago (IL, USA). Although most MRI is done to image 1H nuclei, other nuclei, such as 23Na, can be visualized as well. As sodium ions (Na+) play key roles in biological processes, homeostasis, and metabolism, imaging 23Na nuclei can provide direct insights into the metabolic activity and cellular integrity of tissues. However, 23Na MRI is complicated by the low concentrations of sodium nuclei in biological tissues, compared to concentration of H2O molecules, and the lower gyromagnetic ratio of the 23Na nucleus. As a result, a stronger magnetic field is needed for higher resolution. 23Na MRI can detect Na+ levels in tissues rising sharply, and can even visualize a sodium-rich meal in a patient’s stomach.

Medical Imaging International May-June/2018

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PRODUCT NEWS DR-FLUOROSCOPY SYSTEM

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MRI SYSTEM

RADIOGRAPHY SYSTEM

Philips Healthcare

Siemens Healthineers

AADCO Medical

The ProxiDiagnost N90 two-in-one system offers the ability to perform fluoroscopy and digital X-rays in a single system. It provides lowdose, high-quality images and fast workflow, broadens clinical capacity and increases room utilization.

The Magnetom Sola 1.5T automatically adjusts to patient biovariability to overcome unwarranted variations in exams. This results in fewer rescans, higher diagnostic confidence, predictable patient scheduling, and consistent, personalized exams.

The AADCO Nova offers a simple and functional design that guarantees highly precise positioning for optimal radiographic results. It features TFT with touch screen, integration with digital imaging systems, auto-positioning and auto-tracking.

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Computer-Aided Detection Overused In Mammography Screening espite its limited accuracy, use of computer-aided detection (CAD) continues unabated at digital screening mammography facilities in the United States, according to a new study. Researchers at the Hospital of Cook County (Chicago, IL, USA; www.cookcountyhhs.org/locations/john-h-stroger-jr-hospital) and the University of Nebraska (UNL; Lincoln, USA; www.unl.edu) accessed the U.S. Food and Drug Administration (FDA) database of certified mammography facilities to generate a random sample list of 400 (out of approximately 8,500) facilities. In 2008 and 2011, a telephone survey was conducted of the facilities regarding digital mammography and CAD use; in 2016, facility websites were reviewed before calling the facilities. The researchers than assessed the proportion of CAD at the digital facilities for the three surveys. The results revealed that the mean proportion of digital facilities using CAD was 91.4% in 2008, 90.2% in 2011, and 92.3% in 2016. The difference for 2008 versus 2011 was thus 1.3%, while for 2011 versus 2016 it was -2.1%, and for 2008 versus 2016 it was -0.8%. The researchers noted that despite evidence from the Breast Cancer Surveillance Consortium (BCSC) that shows CAD reduces performance by increasing recalls, decreasing the detection of invasive cancer, and increasing the detection of ductal carcinoma in situ (DCIS), its use increased dramatically along with the conversion from film to digital. The study was published on October 6, 2017, in the Journal of the American College of Radiology. “Although computer-aided detection appeared promising in earlier studies, in our review of the literature, we could not identify recent

peer-reviewed journal articles that report results different from the BCSC,” concluded lead author John Keen, MD, of Cook County Hospital. DCIS is the most common type of non-invasive breast cancer, in which the abnormal cells are contained inside the milk ducts. If DCIS is not treated, it may eventually develop into invasive breast cancer, which can spread outside the ducts into the breast tissue and then possibly to other parts of the body. Since DCIS cannot usually be felt as a breast lump or other breast change, most cases are diagnosed following routine screening with mammograms or ultrasound, appearing as micro-calcifications. Image: New research asserts computer-aided detection of breast cancer is still being overused (Photo courtesy of Alamy).

Lower Mortality Rates Shown with Low-Dose CT Screening new study has shown that by combining Low-Dose CT (LDCT) lung cancer screening program with robust programs that help people stop smoking can reduce mortality rates, and be cost-effective. The researchers used OncoSim-LC, a microsimulation model to compare screening scenarios with smoking-cessation, to those without a cessation program, and projected this over 20 years. The findings were presented by researchers from the McMaster University (Hamilton, ON, Canada; www.mcmaster.ca) at the 18th World Conference on Lung Cancer (WCLC) organized by the International Association for the Study of Lung Cancer (IASLC), in Yokohama, Japan. The results of OncoSim-LC microsimulation model study showed that by adding a smoking-cessation program to an organized LDCT screening program

was relatively cost effective, and resulted in significantly fewer deaths. Additional research is required to determine the structure of such joint programs, to determine the detailed economic requirements, and to ensure that participants continue to adhere to both LDCT and smoking cessation programs. Dr. William Evans, from the McMaster University, said, “To achieve the maximal benefits of a LDCT screening program, it is essential to incorporate a robust smoking cessation intervention. In my long career as an oncologist, I have not been able to save any patients from advanced non-small cell lung cancer. I believe that an organized lung screening program can be used to provide teachable moments for heavy smokers and, ultimately, save lives.” Medical Imaging International May-June/2018

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Medical Imaging International

Patient-Tailored Software Helps Plan Radiosurgery Treatment wo new stereotactic radiosurgery (SRS) software applications facilitate quick planning, spare organs at risk, and create highly conformal radiation doses in the brain and spine. The Brainlab (Munich, Germany; www.brainlab.com) Elements Spine SRS offers a streamlined workflow solution that automatically produces highly conformal dose planning metrics in order to avoid critical spinal cord structures. Users need only define organs at risk (OAR) constraints once using protocols for specific fractionation schemes. Plans created include traffic-light display of clinical constraints; a specialized gradient approach for target-cord interface; and selective vertebral exposure for enhanced spinal blocking. Intuitive optimization tools enable the user to make subtle plan modifications, including spine-specific volumetric modulated arc therapy (VMAT) to create a sharp dose gradient at spinal cord interface, support for flattened and unflattened beams, pencil beam dose calculation during optimization, and Monte Carlo for the final dose calculation for fast planning. A hybrid integration method uses both pencil beam and Monte Carlo at different stages of the optimization and Monte Carlo for the dose calculation in the final optimization step. The Brainlab Elements Cranial SRS application optimizes the planning process based on a specific cranial indication, including arteriovenous malformation (AVM), pituitary adenoma, vestibular schwannoma, meningioma, and large metastases. Automatic detection of cranial OARs saves user time and enables consistency by angulating the surgical table angles is for optimal placement, based on the most critical OARs. VMAT optimization takes trajectory optimization into account to create an optimized deliverable plan. Elements Cranial SRS also includes a patented integrated 4π algorithm that optimizes beam trajectories, automatically sparing surround-

ing healthy tissue and OARs with monitor unit-efficient delivery, which can create radiosurgery plans in less than 15 minutes from start to finish. Both applications offer control over planning parameters using straightforward views and multiple dataset display of dose distribution, three-dimensional (3D) views for optimal dose analysis, and a volumetric visualization of dose interface. Image: New applications offer consistent and highly automated SRS planning (Photo courtesy of Brainlab).

New SPECT System Offers Nuclear Cardiology Solution new nuclear cardiology solution uses Single Photon Emission Computed Tomography (SPECT) technology, cardiac quantification software, and advanced reconstruction to improve the cardiac imaging workflow and diagnostic confidence. The system was designed specifically as a cardiac SPECT solution that fits the needs of healthcare institutions, both economic, and clinical. The novel CardioMD IV cardiac SPECT system was developed by Royal Philips (Amsterdam, the Netherlands; www.philips.com). The system has a small footprint, and is de-

signed to fit in an existing camera room without the need for costly room renovations. The system has a patient-friendly design, and offers improved positioning flexibility. The CardioMD IV can perform cardiac imaging much faster than previous systems. The CardioMD IV also features Philips’ Astonish reconstruction technology that can improve workflow efficiency, while providing the same image quality. The system also works with Philips’ IntelliSpace Portal advanced visualization, and analysis platform. By using IntelliSpace the CardioMD IV SPECT reporting, quantification, and review applications be-

come available to the whole enterprise, and can facilitate more efficient collaboration between referring physicians, and cardiologists. Business Leader, Advanced Molecular Imaging, at Philips Healthcare, Kirill Shalyaev, PhD, said, “Our aim is to advance molecular imaging in all disease areas, and provide dependable imaging solutions to enhance diagnostic confidence and patient care at lower costs. CardioMD IV delivers the reliable performance and the low total cost of ownership that nuclear cardiology practices need to drive clinical, financial and operational efficiencies.”

PET Scans Show Menopause May Increase Alzheimer’s Risk esearchers in the US have found that menopause causes metabolic changes in women’s brains that may increase the risk of them contracting Alzheimer’s disease. Researchers have long known that although women live longer on average than men, they are still more likely to catch Alzheimer’s disease. The team from Weill Cornell Medicine (New York, NY; USA; http://weill.cornell.edu), and the University of Arizona Health Sciences (UAHS; Tucson, AZ, USA; http://uahs. arizona.edu) published the results of their study in the October 10, 2017, issue of the journal PLoS One.

Medical Imaging International May-June/2018

The researchers used Positron Emission Tomography (PET) scans to measure the uptake of glucose, an indicator of cellular activity. The study group consisted of 43 healthy women aged between 40 and 60, of which 14 were menopausal, 14 were peri-menopausal, and 15 were pre-menopausal. The results of the study showed that perimenopausal and menopausal women had significantly lower levels of glucose metabolism, or hypometabolism, in a number of regions in the brain, compared to pre-menopausal women. Dr. Lisa Mosconi, associate professor at Weill Cornell Medicine, said, “This study suggests

there may be a critical window of opportunity, when women are in their 40s and 50s, to detect metabolic signs of higher Alzheimer’s risk and apply strategies to reduce that risk. Our findings show that the loss of estrogen in menopause doesn’t just diminish fertility. It also means the loss of a key neuroprotective element in the female brain and a higher vulnerability to brain aging and Alzheimer’s disease. We believe that more research is needed to test efficacy and safety of hormonal-replacement therapies at the very early stages of menopause, and to correlate hormonal changes with risk of Alzheimer’s.”

PRODUCT NEWS DR DETECTOR

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ULTRASOUND SYSTEM

Agfa HealthCare

Alpinion Medical Systems

Canon Medical Systems

The DR 24M is designed for DR to deliver the high image quality needed for mammography exams. The cassette-sized detector is compatible with analog X-ray modalities, enabling an easy and vendor neutral upgrade to DR.

The E-CUBE 7 provides clinicians with excellent 2D, Color Flow and CW/PW Doppler performance. It is the only system in its class that provides high-featured transducers, and comes with smart and intuitive application software.

The Aplio i600 features a small and light iSense design, which makes it easy for clinicians to adjust the console to any scanning position. The system also offers an imageguided user interface to visually guide the clinician through the exam.

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Extremity CBCT System Reduces Metal Artifacts compact cone beam computerized tomography (CBCT) system that can image extremities at the point of care (POC) now offers advanced metal artifact reduction software. The Carestream (Rochester, NY, USA; www.carestream.com) OnSight 3D Extremity System is designed to capture high-quality three dimensional (3D) images at the POC via an easily accessible open bore that allows both upper and lower extremity screening, including weight-bearing studies that are not possible with traditional CT. System features include large field isotropic images that can reveal subtle or occult fractures; reduced doses compared to conventional CT systems; image acquisition of the extremity in a single 25second rotation; and a small footprint and simplified design that cut time and cost of system installation. An optional software upgrade offers advanced metal and scatters correction algorithms and reduced noise uses iterative reconstruction techniques from the original

scan in order to eliminate the need for additional imaging studies; image processing can be easily adjusted and optimized according to the amount of metal present via an intuitive touch screen interface. For added flexibility, the metal artifact reduction software can be activated prior to the scan or may be applied after the original reconstruction is complete. “Carestream’s second generation of software takes our state-of-the-art original metal reduction software to a new level,” said Helen Titus, worldwide marketing director for ultrasound and CT at Carestream. “It provides enhanced flexibility, depending on the metal content present and reduces the visual distortion caused by screws, implants, rods, and other metal objects to create improved visibility and diagnostic confidence.” During CBCT, the region of interest is centered in the field of view. A single 200-degree rotation acquires a volumetric data set used to

produce a digital volume composed of 3D voxels of the anatomical data, which can then be manipulated and visualized. CBCT has recently become more practical thanks to the introduction of large-area high-speed digital X-ray imagers, such as hydrogenated amorphous silicon (a-Si:H) based flat-panel detectors. Image: A knee being imaged with the OnSight 3D extremity system (Photo courtesy of Carestream Health).

Imaging Technique Shows Progress of Alzheimer’s Disease yperspectral Raman imaging can help identify neuritic plaques and neurofibrillary tangles in people suffering from Alzheimer’s disease (AD), according to a new study. Researchers at the University of Twente (UT; Enschede, The Netherlands; www. utwente.nl), Paracelsus Medical University (Salzburg, Austria; www.pmu.ac.at), and other institutions evaluated frontal cortex and hippocampus samples from three brain donors and one control with AD, using hyperspectral Raman imaging in order to identify neural structures. The researchers used 12 30×30 μm unstained samples of brain tissue to gener-

ate data matrices of 64 × 64 pixels, in which different tissue components, including proteins, lipids, water, and -sheets were imaged at 0.47 μm spatial resolution. Hierarchical cluster analysis was then performed to visualize regions with high Raman spectral similarity. The results showed that Raman images of proteins, lipids, water, and βsheets matched classical brain morphology. Protein content was double, β-sheet content was X5.6 times, and Raman broadband autofluorescence was X2.4 times higher inside the plaques and tangles than in the surrounding tissue, while lipid content was equal. Broadband autofluorescence showed some correla-

tion with protein content, and a better correlation with β-sheet content. The study was published on November 15, 2017, in Nature Scientific Reports. Raman spectroscopy is an optical microspectroscopic method, in which sensitive and precise acquisition of spatial- and frequency-resolved light scattering allows the identification of groups of macromolecules with identical structural properties. Information identified by Raman spectra can be used to estimate of relative amounts of various tissue components, which can all be imaged simultaneously and used for numerical comparative analysis. Medical Imaging International May-June/2018

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IT/PACS Update

Multiparametric MRI Effective For Fatty Liver Assessment new study concludes that non-invasive multiparametric magnetic resonance imaging (MRI) liver scanning technology could halve the number of potential liver biopsies required. Researchers at the University of Birmingham (UB; United Kingdom; www.birmingham.ac.uk), the University of Oxford (United Kingdom; www.oxford.ac.uk), and other institutions conducted a study to investigate the performance and cost of the Perspectum Diagnostics (Oxford, United Kingdom; www.perspectum-diagnostics.com) LiverMultiScan multiparametric MRI device, which is designed to enable non-invasive and quantitative liver fat characterization, especially in non-alcoholic fatty liver disease (NAFLD). For the study, 50 patients and six healthy volunteers underwent multiparametric MRI, blood sampling, and transient elastography within two weeks of liver biopsy. A summary of three biochemical liver characteristics, as well as the LiverMultiScan images, was then compared to histology as the gold standard. The results revealed that LiverMultiScan accurately identified patients with steatosis, stratified those with non-alcoholic steatohepatitis (NASH) or simple steatosis, and reliably excluded clinically significant liver disease. The study was published in the March 2018 issue of Alimentary Pharmacology and Therapeutics. LiverMultiScan uses MRI data to calculate images of proton density fat fraction, T2, and T1 in the liver, which have been shown to correlate with histological measures of steatosis, hemosiderosis, and fibrosis. The strong magnetic field in an MRI machine is used to excite water and fat molecules, which relax at different speeds. As they relax, they

emit a signal, which is used to create the T1 and T2 MR images. T2 is influenced by iron deposits, which can therefore be used to assess hepatic iron overload, while T1 is influenced by the type and structural organization of a tissue. Image: A LiverMultiScan image of a post-bariatric liver (Photo courtesy of Perspectum Diagnostics).

Mobile Fluoroscopic System Continuously Images Extremities next-generation mini C-arm offers orthopedists, podiatrists and clinicians diversified imaging options, as well as upgraded storage and transport. The Hologic (Marlborough, MA, USA; www.hologic.com) Fluoroscan InSight FD Mini C-Arm extremities imaging system is designed to provide fluoroscopic imaging during diagnostic, treatment, and surgical procedures of the shoulders, limbs, and extremities. The system consists of a C-arm attached to a mobile image processing workstation with a streamlined monitor and integrated keyboard. The C-arm supports a high-voltage generator, X-ray controls, collimator, and a metal-oxide semiconductor (CMOS) flat panel detector (FPD) and an X-ray source monoblock used for image acquisition. The C-arm is capable of performing linear and rotational motions that allow the user to position the imaging components at various angles and distances with respect to patient extremity anatomy. The C-arm and support arm are mechanically balanced, allowing for ease of movement and capable of being locked in place using an electronically controlled braking system. The workstation is a stable mobile platform that supports the C-arm, image display monitor, processing equipment, recording devices, and power control systems. An intuitive 24-inch high definition (HD) touch screen controls the system, with user-friendly features that include pinch-to-zoom, notifications that allow a way to identify saved images, a save filter, and an auto-save option that saves all images acquired during an imaging session. Imaging upgrades include a low-dose rate mode that allows reduction of dose rates by up to 50% (compared to auto mode), while continuing to deliver clinically equivalent images. A high-resolution mode enables clinicians to use full detector resolution. Fluoroscopy is an imaging technique that uses X-rays to obtain realtime moving images of the internal structure and function of a patient, which is useful for general radiology, interventional radiology, and image-guided surgery. Because the patient must be exposed to a continuous source of X-rays instead of a momentary pulse, a fluoroscopy procedure generally subjects a patient to a higher absorbed dose of radiation than an ordinary (still) radiograph, is it used only when a risk-benefit threshold is exceeded.

Medical Imaging International May-June/2018

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PRODUCT NEWS MEDICAL DISPLAY

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Ampronix

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Radcal

The MODALIXX G202MDL is designed for enhanced clarity and brightness in LED-lit images offering user-friendly OSD, low power consumption, and wide viewing angle. It is ideal for cath lab, MRI, CT, CR, PET, RF, Carm, and portable X-ray applications.

The AIM-55 is designed to streamline hospital workflows and improve patient care. Its functionalities can be expanded with the addition of extension modules such as barcode scanner, magnetic stripe reader, smart card reader, and RJ45 connector.

The AGTABKEX features a 10-inch multitouch display and keyboard for additional ease of use. It comes with Excel 2013 pre-installed and is designed to run in the Windows environment and interfaces to the Accu-Gold family through USB or WiFi.

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MRI Safe for Patients with Implanted Legacy Devices atients with a legacy pacemaker or implantable cardioverter-defibrillator (ICD) system that need to undergo a magnetic resonance imaging (MRI) scan have nothing to fear, according to a new study. Researchers at the University of Pennsylvania (Penn; Philadelphia, USA; www.upenn.edu) and Johns Hopkins University (JHU; Baltimore, MD, USA; www.jhu.edu) conducted a prospective, nonrandomized study to assess the safety of MRI at a magnetic field strength of 1.5 Tesla in 1,509 patients who had a pacemaker (58%) or an ICD (42%) that was not considered to be MRI-conditional (also known as a legacy device). Overall, the patients underwent 2,103 thoracic and non-thoracic MRI examinations that were deemed to be clinically necessary. The pacing mode was changed to asynchronous mode for pacing-dependent patients, and to demand mode for other patients, with tachyarrhythmia functions disabled. Outcome assessments included adverse events and changes in device parameters indicating lead and generator function and interaction with surrounding tissue. The results showed no reports of long-term clinically significant adverse events. Following the MRI scan, the patientâ&#x20AC;&#x2122;s device reset to a backup mode in nine cases (0.4%), of which eight were transient. One pacemaker reset to ventricular inhibited pacing and could not be reprogrammed.

A decrease in P-wave amplitude was the most common notable change in device parameters (occurring in one percent of patients) immediately after MRI. At long-term follow-up, the most common notable changes from baseline were decreases in P-wave amplitude (4%), increases in atrial capture threshold (4%), increases in right ventricular capture threshold (4%), and increases in left ventricular capture threshold (3%). The study was published on December 28, 2017, in the New England Journal of Medicine (NEJM). Image: A new study shows MRI scans are safe for people with legacy ICDs (Photo courtesy of Getty Images).

Functional Neuroimaging Paves Way for Brain Mapping series of functional near-infrared spectroscopy (fNIRS) devices measure chemical changes in the brain, such as hemoglobin levels and apparent arterial oxygen saturation (aSpO2) in the frontal lobe. The Spectratech (Yokohama, Japan; www.spectratech.co.jp) OEG-APD series of encephalography instruments are based on hemodynamics modality separation (HMS), which can extract data on blood flow in the scalp that is associated with brain function activity by deducting the regional blood flow component from the total fNIRS signal. The OEG-APD series include four products, the OEG-16, OEG-16H, OEG-SpO2, and the OEG17APD devices, and are intended only for encephalography research. The OEG-16 device is designed for use on the frontal lobe, and measures changes in in-vivo blood using a multi-channel method that simultaneously utilizes light absorption characteristics of near infrared to red light, depending on the mixture of in-vivo hemoglobin and oxygen. The OEG-16H device offers ultrahigh signal to noise ratio (SNR) technology, which can display ultra-weak pulse waves, while also giving users the ability to perform multi-channel brain localization analysis. It is also provided

with monitoring and measurement tools, including an index of aSpO2. The OEG-16H facilitates constant connectivity with 6 light injection points, 6 optical light-receiving points, and 16-channel measure points in a lightweight head module that allows it to translate brain waves into data, while simultaneously measuring hemoglobin from multiple points. The device runs on proprietary software, but can also be operated under Microsoft Windows 7 or 8. The OEG-SpO2 module helps measure hemoglobin changes and aSpO2 occurring at multiple points in the brain, with an emphasis on the frontal lobe. The final device is the best-in-class OEG-17APD, which can measure the head in its entirety. The prefrontal cortex is considered to be in charge of the orchestration of thoughts and actions in accordance with internal goals, responsible for higher-level processing, such as memory, attention, problem solving and decision-making. When a person is learning a new skill, for instance, neural activity is greater in this region. Increasing evidence shows that in Parkinsonâ&#x20AC;&#x2DC;s disease, profound dopamine depletion not only occurs in the striatum of the brain, but also in the prefrontal cortex, and this may be associated with cognitive and motor deficits. Medical Imaging International May-June/2018

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IT/PACS Update

Compact Radiation System Improves Conformal Radiation Therapy ovel pencil beam scanning (PBS) technology uses hyperscanning to deliver faster, sharper, and more robust radiation therapy (RT) treatments. The Mevion Medical Systems (Mevion; Littleton, MA, USA; www. mevion.com) S250i Proton Therapy System with Hyperscan PBS technology is designed to shape the delivered radiation dose by “painting” tumors spot-by-spot and layer-by-layer with the sub-atomic proton particles. Hyperscan technology helps overcome clinical challenges faced by first generation PBS systems by reducing delivery times to less than five seconds, thus reducing errors resulting that can undermine the high precision of PBS due to the target tumor shifting under normal organ motion, such as breathing. In addition to Hyperscan, the system utilizes an adaptive, robotically controlled aperture proton multi-leaf collimator (pMLC), which is capable of trimming the edges of the beam at every layer of delivery. This capability can deliver up to a three times sharper drop off in radiation at the delivery field edge, sparing healthy tissue and limiting unnecessary radiation to sensitive locations. As other members of the S250 Series platform, the S250i includes a gantry mounted superconducting synchrocyclotron, a six degree-of-freedom treatment couch, and advanced in-room image guidance. “Delivering sharp field edges has been a real challenge for PBS, especially in shallow fields. In intracranial procedures, where critical structures are in close proximity to tumors at shallow depths, having the sharpest lateral penumbra is essential,” said Skip Rosenthal, VP of clinical education at Mevion. “The sharp penumbras of the adaptive aperture system have substantial benefits for these patients. In addition, the

enhanced speed of Hyperscan PBS could enable greater confidence in treating thoracic tumors.” Proton therapy is a precise form of RT that uses charged particles instead of x-rays. It can be a more effective form of treatment than conventional radiotherapy as it directs the RT more precisely, with minimal damage to surrounding tissue. Evidence is growing that protons can be effective in treating a number of cancers, in particular in children and young people with brain tumors, for whom it appears to produce fewer side effects such as secondary cancers, growth deformity, hearing loss, and learning difficulties. Image: The S250i proton therapy system with Hyperscan PBS (Photo courtesy of Mevion Medical Systems).

MRI Helps Determine 3D Architecture of Human Cervix new study describes how three-dimensional (3D) magnetic resonance imaging (MRI) can be used to monitor women for weaknesses in the cervix, helping to prevent miscarriage. Researchers at the University of Leeds (United Kingdom; www.leeds.ac.uk) conducted a cross-sectional study, which involved high-resolution diffusion tensor MRI (DT-MRI) ex-vivo measurements of seven cervices obtained at hysterectomy for a benign lesion, using a 9.4-T Bruker nuclear magnetic resonance (NMR) spectrometer. A deterministic algorithm was used to visualize underlying fiber organization in order to determine the microarchitecture of the human cervix, and identify occlusive structures in the region corresponding to the internal cervical os. The images revealed a fibrous structure running along the upper part of the cervix, which becomes much more pronounced near to where it joins the womb. The fibers are made of collagen and smooth muscle and form a ring around the upper aspect of the cervical canal. During pregnancy, the fibers provide a strong supporting barrier that keeps the fetus and amniotic sac in place, and prevents microorganisms from entering the uterus. During labor, the body releases chemicals that open the cervix, allowing the fetus to enter the birth canal. The study was published on December 11, 2017, in BJOG. “By applying the imaging techniques that

Medical Imaging International May-June/2018

have been used on the brain, we can get a much clearer understanding of the tissue architecture that gives the cervix its unique biomechanical properties,” said Mr. Nigel Simpson, associate professor in obstetrics and gynecology at Leeds University. Water molecules undergo random Brownian motion, also known as diffusion. MRI is sensitive to this motion, as controlled by the b-

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value. When the b-value equals zero, the images are not weighted by diffusion; when the b-value is greater than zero the images are diffusion-weighted. When the diffusion is hindered, by cellular membranes, the myelin shield, etc., the signal is higher. DT-MRI can thus be used to visualize fiber structures, as it can readily differentiate water molecule diffusivities both along and against the fiber.

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PRODUCT NEWS MAMMOGRAPHY SOLUTION

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DATA MANAGEMENT SYSTEM

SURGICAL DISPLAY

Fujifilm

Radiometer

Sony

The AMULET Bellus provides fast display of image data and customized reading protocols for precise diagnosis and streamlined workflow. It displays an outline of the breast image and allows for one-click creation of report for patients.

The AQURE Enterprise allows users to connect to, monitor and manage Radiometer America and third-party testing devices. It provides an overview of all devices and notifies immediately of an issue, ensuring seamless integration with the hospital IT platform.

The LMD-X310MD 4K delivers four times the resolution of HD for the true-to-life clarity thatâ&#x20AC;&#x2122;s critical for seeing various nuances of color and detail. The display is considered ideal for general surgery, medical education and training.

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Light and Ultrasound Waves Reveal Extent of Skin Cancer new study demonstrates that multispectral optoacoustic tomography (MSOT) allows three-dimensional (3D) imaging of deep non-melanoma skin tumors (NMSCs). Developed by the Singapore Bioimaging Consortium (SBIC; www. a-star.edu.sg/sbic), Munich Technical University (TUM; Germany; www.tum.de), the Skin Research Institute of Singapore (SRIS; www. a-star.edu.sg/sris), and other institutions, MSOT is a volumetric imaging technique that can be used to differentiate between tissue chromophores and exogenous contrast agents based on differences in their spectral signatures, and which can provide high-resolution imaging of functional and molecular contrast at centimeter scale depth, providing more precise Mohs micrographic surgery (MMS). The researchers used handheld MSOT probes for 3D imaging in 21 Asian patients with NMSC. The results showed that both tumors and their oxygenation parameters could be distinguished from normal skin endogenously. Lesion dimensions were extracted from the MSOT spectral melanin component with 3D spatial resolution of up to 80 m, with good correlation to histology of the excised tumors. Real-time 3D imaging also provided data on lesion morphology and the neovasculature, both indicators of the tumorâ&#x20AC;&#x2122;s aggressiveness. The study was published in the September 2017 issue of Photoacoustics. MMS is a surgical technique for the removal of certain cutaneous carcinomas that allows precise microscopic marginal control. It has become the treatment of choice for several NMSCs, such as basal cell and squamous cell carcinomas at high risk for local recurrence. Advantages of MMS include superior cure rates, maximal tissue conservation, low cost

relative to that of radiation therapy, excision, or surgery, and negligible risk of complications from general anesthesia. Image: A 3D rendering of a basal cell carcinoma lesion (melanin in yellow, hemoglobin in blue, and oxyhemoglobin in red) (Photo courtesy of M. Olive et al).

Overweight Women May Need More Frequent Mammograms new study suggests that women with higher body mass index (BMI) may need shorter intervals between mammography screening exams. Researchers at the Karolinska Institutet (KI; Solna, Sweden; www. ki.se) conducted a study involving 2,358 cases of invasive breast cancer incident between 2001 and 2008 in order to identify risk factors associated with tumors remaining undetected until larger than two centimeters, and to examine long-term prognosis as a factor of percent density (PD), body mass index (BMI), and patient characteristics. The main outcome measure was detection of tumor sized larger than two centimeters, as compared to smaller tumors. The results revealed that for screen-detected cancers, both BMI and PD were associated with having a large tumor at diagnosis. However, for interval cancers, only BMI was associated with having a large tumor, while PD was associated with having a small tumor. Women with a

higher BMI had a worse prognosis than women with lower BMI, but only among interval cancers, while large tumors were associated with worse prognosis than smaller ones. The study was presented at the annual meeting of the Radiological Society of North America (RSNA), held in November 2017 at Chicago (IL, USA). Numerous studies suggest that obesity increases the relative risk of postmenopausal breast cancer. A meta-analysis of 34 cohort studies that included over 2.5 million women shows that a 5-unit increase in BMI is associated with a 12% increase in risk, and that postmenopausal obese women have a 20-40% increase in risk of developing breast cancer compared with normal-weight women. The higher risks are seen mainly in women who have never used menopausal hormone therapy and for tumors that express hormone receptors. In premenopausal women, by contrast, overweight and obesity have been found to be associated with a 20% decreased risk of breast tumors that express hormone receptors. Medical Imaging International May-June/2018

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

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

ACEM

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Amber Diagnostics USA • Orlando, FL Tel: (1) 407-867-3965 amberusa.com info@amberusa.com

Ambulanc Technology

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

China • Shenzhen Tel: (86) 755-2607-3861 ambulgroup.com info@ambu-lanc.com

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AMD Technologies

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

ADANI Belarus • Minsk Tel: (375) 173490000 adanisystems.com info@adanisystems.com

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

Advanced Instrumentations USA • Miami, FL Tel: (1) 305-477-6331 advanced-inst.com info@advancedinst.com Belgium • Morstel Tel: (32) 3444-2111 agfahealthcare.com info@agfa.com

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

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ALMA Medical Imaging Spain • Barcelona Tel: (34) 932-380-592

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

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

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biocare.com.cn sales@biocare.com.cn

Bieffe Italia

Biomedical Equipment

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

Biocare Bio-Medical Equipment China • Shenzhen Tel: (82) 2-501-3939

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

BK Ultrasound USA • Peabody, MA Tel: (1) 978-326-1300 bkultrasound.com

C O M P A N I E S

info@bkmed.com

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

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

Barco Belgium • Kortrijk Tel: (32) 56-233-211 barco.com

Basda Medical China • Shenzhen Tel: (86) 755-8968-6018 basda.com.cn info@basda.com.cn

Bayer HealthCare Ampronix USA • Irvine, CA Tel: (1) 949-273-8000 ampronix.com info@ampronix.com ▲

Agfa Healthcare

W O R L D ’ S

SEE AD ON PAGE 2

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

Antmed China • Shenzhen Tel: (86) 755-86060992 antmed.com info@antmed.com

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

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

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

ARCOMA

Beekley Medical

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

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

ATLAIM Korea •Gyeonggi-do Tel: (82) 70-4846-8888 atlaim.com atlaimsales@gmail.com

Belson Medical System

Atys Medical

China • Jiangsu belsonmedical.com info@ belsonmedical.com

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

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

Bestman

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

Medical Imaging International May-June/2018

LINKXPRESS COM

2018

200

ALPHABETICAL LISTING OF COMPANIES

MII-18-06 127

Medical Imaging 200 Brit Systems USA • Kansas City, MO Tel: (1) 214-630-0636 brit.com sales@brit.com

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

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

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

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

Canon Medical Systems Japan • Tochigi Tel: (81) 287-26-6211 global.medical.canon. co.jp

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

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

Carestream Health

CIRS USA • Norfolk, VA Tel: (1) 757-855-2765 cirsinc.com sales@cirsinc.com SEE AD ON PAGE 13

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

Clear Image Devices USA • Caledonia, MI Tel: (1) 734-474-6537 clearimagedevices.com info@ clearimagedevices.com ▲

Canon Europe

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

SEE AD ON PAGE 19

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 info@codonics.com

Complete Medical Services USA • Romeo, 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

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

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

CHILI

Cook Medical

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

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

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

Ecoray Control-X Medical USA • Columbus, OH Tel: (1) 614-777-9729 cxmed.com jsweet@cxmed.com SEE AD ON PAGE 25

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

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

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

Datcard USA • Irvine, CA Tel: (1) 877-543-3898 datcard.com sales@datcard.com

Demetech Sweden • Täby Tel: (46) 8-555-79200 demetech.com john.elliott@ demetech.com

DMS Imaging France • Maugiuo 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 Germany • Hamburg Tel: (49) 40-5078-1391 dunlee.com dunlee.emeajapan@philips.com

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

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 • Petah Tikva 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) 755-3689-9066 china-emperor.com business@ china-emperor.com

ERKA Kallmeyer Medizintechnik Germany • Bavaria Tel: (49) 8041-800-922 erka.org a.mayr@erka.org

Esaote

sales@faxitron.com

Fluke Biomedical USA • Cleveland, OH Tel: (31) 40-267-5435 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/m edical

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

GE Healthcare USA • Chicago, IL Tel: (33) 1-30709572 gehealthcare.com

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

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

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

Guided Therapeutics

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

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

ETS Lindgren RF Enclosures

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

USA • Wood Dale, IL Tel: (1) 630-307-7200 ets-lindgren.com/industries/healthcare sales@etslindgren.com

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

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

Haifu (HIFU)

Haiying Enterprise Group

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

Hologic USA • Marlborough, MA Tel: (1) 508-263-2900 hologic.com customersupport@ hologic.com ▲

Burlington Medical

Chison Medical Imaging

▲

USA • St. Petersburg, FL Tel: (1) 727-327-6950 usaxray.com info@usaxray.com

customersupport@ cookmedical.com

▲

Burkhart Roentgen International

sales@ chili-radiology.com

SEE AD ON PAGE 3, 36

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

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

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

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

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

ICU Medical USA • San Clemente, CA Tel: (1) 949-366-2183 icumed.com customerservice@ icumed.com

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

Imaging Diagnostic Systems

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

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

Heartland Medical

Imaging Dynamics

USA • Louisville, KY Tel: (1) 502-438-9988 heartlandmedical.com info@ heartlandmedical.com

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

Medical Imaging International May-June/2018

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AADCO Medical aadcomed.com Accura Medizintechnik accuramed.de ACEM acem.it ACI Medical acimedical.com ADANI adanisystems.com Advanced Instrumentations advanced-inst.com Agfa HealthCare agfahealthcare.com Agsa Gomma agsagomma.com Albatross Projects albatross-projects.de AllTech Medical Systems alltechms.com ALMA Medical Imaging alma-medical.com Amber Diagnostics amberusa.com AMD Technologies digitalams.com Ampronix ampronix.com Analogic analogic.com Antmed antmed.com ARCOMA arcoma-imix.com ATLAIM atlaim.com Aurora Imaging Technology auroramri.com Bahia Software bahiasoftware.es Barco barco.com Bard crbard.com Basda Medical basda.com.cn Bayer HealthCare ri.bayer.com BC Technical bctechnical.com Beacon Display Technology beacon-display.cn Beekley Medical beekley.com Belson Medical System belsonmedical.com Bestman szbestman.com Bieffe Italia weiko.com Biocare Electronics biocare.com.cn Biodex Medical Systems biodex.com Biomedical Equipment 4biomed.com BK Ultrasound bkultrasound.com Block Imaging International blockimaging.com BRACCO bracco.com Brit Systems brit.com Broadwest broadwest.com Burkhart Roentgen International usaxray.com Burlington Medical Supplies burmed.com Candelis candelis.com Canon Europe. canon-europe.com/medical Canon Medical Systems global.medical.canon.co.jp CapeRay caperay.com Capintec capintec.com Carestream Health carestream.com/medical CHILI chili-radiology.com Chison Medical Imaging chison.com CIRS cirsinc.com Civco Medical Instruments civco.com Clear Image Devices clearimagedevices.com CoActiv Medical coactiv.com Codonics codonics.com Complete Medical Services completemedicalservices.com Conquest Imaging conquestimaging.com Contec Medical Systems contecmed.com.cn Continuum Healthcare ambisea.com Control-X Medical cxmed.com Cook Medical cookmedical.com Cool Pair Plus coolpair.com CPI cpii.com CurveBeam curvebeam.com Datcard datcard.com Demetech demetech.com Direx direxgroup.com DMS Imaging dms.com DMS Topline Medical dmshealth.com DoseMonitor dosemonitor.com Dunlee dunlee.com Echo-Son echoson.eu ECM ecmscan.com Ecoray ecoray.kr Edan Instruments edan.com.cn Eizo eizoglobal.com ELMED Lithotripsy Systems elmed-as.com ElsMed elsmed.com EMD Technologies emd-technologies.com

Radiography

BUYERâ&#x20AC;&#x2122;S GUIDE 2018

Film & Image Mgmt Systems

Medical Imaging International

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Medical Imaging 200 Imaging Specialists USA • Miami, FL Tel: (1) 305-591-8888 tisg.net

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

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

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

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

▲

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

Netherlands • Amsterdam Tel: (31) 65-759-8882 konicaminolta.eu/en/ healthcare/home.html caroline.arts@ mg.konicaminolta.eu SEE AD ON PAGE 5

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

JADAK Europe

Koven Technology

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

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

JD Honigberg International

KPI Ultrasound

USA • Deerfield, IL Tel: (1) 847-412-0200 jdhintl.com info@jdhintl.com

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

JPI

Kubtec Digital X-Ray

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

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

Jumper Medical Equipment

Landwind Medical

China • Shenzhen Tel: (86) 755-2669-6279 jumper-medical.com info@ jumper-medical.com

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

JW Medical

Lessa - AB Medical Group

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

Kaixin Electronic Instrument

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

Listem

medonica.com info@medonica.com

Lodox Systems

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

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

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

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

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

Med-X International USA • Bergenfield, NJ Tel: (1) 201-387-8556 med-x.com sales@med-x.com

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

Medical Imaging Innovations

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

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

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

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

MinXray

Medimar

MIPM

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

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

Medion Healthcare

Kernel Medical Equipment

LMT Medical Systems

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

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

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

Lode

Korea • Daejeon Tel: (82) 2-808-0234

Netherlands •

Medvix

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

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

China • Guangzhou

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

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

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

Klarity Medical Equipment

Medset Medizintechnik

India • Mumbai Tel: (91) 74-1002-6561 medion.co.in sales@medion.co.in

MediSono

Medonica

Mitsubishi Electric Visual and Imaging Systems USA • Cypress, 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

Parker Laboratories

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

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

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

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

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

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

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

▲

Inomed Medizintechnik

Konica Minolta Medical & Graphic Imaging Europe

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

SEE AD ON PAGE 7

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 overseas@ perlong.com.cn

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

Planmed

O-Two Medical Technologies

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

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

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

Poskom

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

OR Technology

Print Media

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

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

PACSHealth

PTW-Freiburg

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

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

Paxeramed

Quest International

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

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

Medical Imaging International May-June/2018

Emperor Electronic Technology china-emperor.com Esaote esaote.com ETS Lindgren RF Enclosures ets-lindgren.com/industries/healthcare Everbrite Lighting everbrite.com Faxitron faxitron.com Fluke Biomedical flukebiomedical.com FONAR fonar.com Fujifilm fujifilm.com/products/medical Fukuda Denshi fukuda.co.jp 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 haiyingtrade.com Heartland Medical heartlandmedical.com Hillusa hillusa.com Hitachi Aloka Medical hitachi.com/healthcare Hologic hologic.com Honda Electronics honda-el.co.jp Huqiu Imaging hu-q.com IBM Watson merge.com iCAD icadmed.com ICRco icrco.com ICU Medical icumed.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 Med.& Grap. Imag. Eur. 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 Med-X International med-x.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 Metaltronica metaltronica.it Metropolis International metropolismedical.com Mindray Medical International mindray.com MinXray minxray.com MIPM mipm.com Mitsubishi Electric Visual and Imaging Systems me-vis.com NDS Surgical Imaging ndssi.com NeoRad neorad.com Neurologica mercurymed.com Neusoft Medical Systems medical.neusoft.com Nilymed nilymed.com

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BUYERâ&#x20AC;&#x2122;S GUIDE 2018

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Medical Imaging International

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Medical Imaging 200 Samsung Korea • Seoul Tel: (82) 2-2194-1000 samsungmedison.com

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

SEE AD ON PAGE 27

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

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

Richardson Electronics USA • La Fox, IL Tel: (1) 704-739-3597 rellhealthcare.com healthcare@rell.com

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

RSTI

RTI Electronics

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

Siemens Healthcare

Schiller

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

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

Sino-Hero Bio-Medical Electronics

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

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

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

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

S E R V I C E

SEE AD ON PAGE 9

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

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

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