January, 2014
Rs. 100
2013 vs 2014:
Reviewing the Past, Anticipating the Future
nd Anniversary Issue
Vol 3, Issue 1, Pages 48
COLOR DOPPLER | JANUARY, 2014
India's First Complete Medical Imaging Magazine
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COLOR DOPPLER | JANUARY, 2014
January, 2014
Rs. 100
2013 vs 2014:
Reviewing the Past, Anticipating the Future
nd Anniversary Issue
Vol 3, Issue 1, Pages 48
India's First Complete Medical Imaging Magazine
Road to Future
A trip through 14 medical technologies, apps and software that would take the medical imaging sector to the next level
COLOR DOPPLER | JANUARY, 2014
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Two Good! Two years, two volumes, 24 issues, 1056 pages, 792456 words, 54 interviews, 75 new products, 56 contributing writers... and now I am two. For me, it is TWO GOOD years since my birth on January 1, 2012, as India’s first complete medical imaging magazine. Before my birth, I heard, there was a gap between the technologies and the end users. My creators envisaged me to bridge this gap. Through the-not-so-smooth terrains, I have walked TWO GOOD years, thanks to your frequent interventions, help and feedback. Without you, even the first step could have been a distant reality. I know, I am still in my infancy. But in these TWO GOOD years, I learned many things from you that keep me energetic day and night which help me keep you awake with alarming and interesting new developments. I have been given opportunities to meet you and talk to you at different conferences at every nook and corner of the country in these TWO GOOD years. Thank you very much. Now, I am spreading my wings to more academic realms. I will bring to you more journals, reference books, e-books, etc. in 2014. I would also like to join like-minded people to create more educational platforms for a better tomorrow. All of you have contributed significantly in my growth and naming each of you here is indeed a difficult task. I thank all of you for blessing me with these TWO GOOD years. Now, I am not just a magazine. I have grown into a young versatile content marketing provider for all those who somehow related to the healthcare segment in the country. And, I believe, I have adequate knowledge about the segment to deliver unimaginable result in given time and location. Also, these TWO GOOD years made me confident enough to lend you a helping hand if you are looking to reach the medical fraternity in any method — be it online or offline. Finally, as my name indicates, I always want to be jovial as well as academic to grow with you, among you. In the coming years, I will come to you with more valuable content and I expect the same warm reception from all of you. Looking forward to many more TWO GOOD years. Wish you a Happy New Year. for Color
Doppler
Joby Joseph
Editor-in-Chief
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Inside Scan Under the Scanner –
Road to Future COLOR DOPPLER | JANUARY, 2014 Volume 3 | Issue 1 KERENG/2012/41766 editor-in-chief Joby Joseph joby@colordopplermedia.com publisher Niranjan Kumar K R M niranjan@indiaultrasound.com
When the world of healthcare is reinventing itself in the dawn of 2014 — a year of hopes and aspirations — with new technologies and advanced treatment modalities, we bring to you 14 medical imaging technologies, apps and software that would take the sector to new heights
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design editor Gireesh gireesh@colordopplermedia.com
Wordsworth –
Get Set, Go
chief coordinator Saraswathy M saraswathy@colordopplermedia.com
“Despite slowdown and cost pressure, the healthcare market did show some signs of growth in 2013 and is expected to grow in the coming future,” says Richard Guest, CEO, Siemens Healthcare, India
chief correspondent Jumana Engineer jumana@colordopplermedia.com
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co-ordinating editor Rini Baby Thottil rini@colordoppleronline.com
Dreams Galore
copy writers Ria Lakshman V ria@colordoppleronline.com
Leaving behind no goals of 2013 unachieved, Teleradiology Solutions is on the move with a lot more expectations for 2014. Dr Sunita Maheshwari, the Chief Dreamer and Co-founder of TRS, talks to Color Doppler about the goals achieved during the year 2013 besides disclosing the dreams set for the year ahead
Purnima Sah purnima@colordoppleronline.com senior designer Sohan V K sohanvishnu@colordopplermedia.com designer, new media Amit Sudhans amit@colordoppleronline.com manager-product & HR Kishore Kumar P S kishore@colordopplermedia.com assistant manager, IT Swetha G swetha@colordopplermedia.com manager, accounts Hariharan V V assistant, accounts Shahana P shahana@colordoppleronline.com
page 17 Talking Point –
Taming the Heart Dr G Vijayaraghavan, Vice Chancellor and Founder Director of Kerala Institute of Medical Sciences, Trivandrum outlines the milestones in his career and elaborates on the latest advancements in cardiac medicine, treatment modalities, research and cost factor
page 28 2013 vs 2014
COLOR DOPPLER #2/1775-B, Florican Road, P O Civil Station, Calicut, Kerala - 673020, India Phone : +91 495 2378808/ 09 Email : info@colordoppleronline.com www.colordoppleronline.com Vision and opinions expressed in this magazine are not necessarily those of Color Doppler, its publisher and/or editors. Color Doppler does its best to verify the information provided but will not take any responsibility for the business moves taken by any reader on the basis of any article published in this magazine. No part of Color Doppler can be reproduced without the prior written permission of the publisher, Niranjan Kumar K.R.M. The rights to reproduce any information published in this magazine are vested with Color Doppler. The magazine is sold on the condition that the jurisdiction for all disputes will be courts/ forums/tribunals at Kozhikode, Kerala. Printed, published and owned by Niranjan Kumar K R M, 3/1614 C, Sridevi Niranjan, Near 6th Rly Gate, Nadakkave Post, Calicut-673011 and Printed at Anaswara offset Private limited, 48/2123-c Perandoor Junction, Elamakkara, Cochin 682026 and Published at 34/1347-A, Florican Road, Malaparamba, Calicut-673009. Editor: Joby Joseph.
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Reviewing the Past. Anticipating the Future. On this august beginning of yet another year, Color Doppler brings to you the thoughts and reviews of renowned medical practitioner in the field of Indian Medicine on how the year 2013 was for them and their expectations for 2014
page 33 Event Preview –
Revitalizing Radiology The 67th Annual Conference of Indian Radiological and Imaging Association, which is going to be held at Agra from January 23-26, 2014 is all set to review and revive the current radiological practice, thereby promising a giant leap towards future in the practices across the country
page 45 COLOR DOPPLER | JANUARY, 2014
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nd Anniversary Issue
[ news scan ]
IIT Kharagpur Bags GE Edison Challenge 2013
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eam SinCLAIR from IIT Kharagpur won the sixth edition of ‘GE Edison Challenge’ held at the GE India Technology Centre, Bangalore and was awarded a sum of Rs. 10 lakhs. As a part of the Challenge, students were required to create “an Idea for India and the world’ in the field of affordable and accessible healthcare. The winning team’s solution proposed a hardware-software co-designed mobile phone app for fast and accurate diagnosis of skin cancers and related abnormalities, enabling high-precision point-of-care healthcare delivery in resource constrained base of pyramid and rural populations. “The GE Edison Challenge is a unique initiative to nurture the Edisons of tomorrow. The contest aims to promote the culture of innovation among the science and engineering students of India. It is an op-
portunity for them to showcase their ideas for a better future. This year’s Challenge was to present solutions for the healthcare industry and I am impressed with the balance of innovative technology and busi-
Covidien to Acquire Given Imaging, Become a Key Player in Gastrointestinal Market
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ovidien, a leading global healthcare products manufacturing company, will acquire all of the outstanding shares of Given Imaging for $30 per share in cash, for a total of approximately $860 million, net of cash and investments acquired. Given Imaging provides a technology platform for visualizing, diagnosing and monitoring the digestive system, including its flagship PillCam, an innovative swallowed capsule endoscope. This acquisition will provide Covidien an additional scale and scope to serve the multibillion dollar global gastrointestinal (GI) market and will support the company’s strategy to comprehensively address key global specialties and procedures. “We believe GI is one of the most attractive specialty procedure areas. Acquiring Given will enable Covidien to significantly expand its presence in a $3 billion GI mar-
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ket,” said Bryan Hanson, Group President, Medical Devices, US, Covidien. “Adding Given’s portfolio of diagnostics to our portfolio accelerates Covidien’s strategy of providing physicians with products that support the patient along the care continuum from diagnosis to treatment. It also confirms our leadership in developing less-invasive screening, diagnosis and treatment solutions that can improve patient outcomes and lower healthcare costs.” “Given Imaging revolutionized GI diagnostics over 12 years ago with the launch of PillCam and created an entirely new diagnostic category — capsule endoscopy. The combination of Covidien’s established global presence and Given Imaging’s innovative capabilities has the potential to transform this market,” said Homi Shamir, President and CEO, Given Imaging Ltd. “After thoroughly evaluating our strategic options we determined that this transaction is in the best interests of Given Imaging and its shareholders.
ness strategy demonstrated by the teams,” commented Sukla Chandra, General Manager, GE Global Research Bangalore & Director, Patents and Analytics Centre of Excellence.
market scan Global MRI Market to Hit $5.24B by 2018 A recent study conducted by MarketsandMarkets predicts that the global market for MRI equipment will reach $5.24 billion by 2018 at an annual growth rate of 4.6 percent. The report, which covers a five-year forecast period starting 2013, valued the global MRI market at $4.1 billion in 2012. As of March 2013, the market is worth $4.13 billion. Introduction of MRI-compatible pacemakers and digital broadband scanners are driving the growth of the MRI market. The increase in demand due to aging population in developed countries and more cases of chronic disease in developing economies have also triggered the market growth.
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nd Anniversary Issue
face scan Anita Tripathy, President, inVentiv Health, India
Anita Tripathy joins inVentiv Health as President, India from Capgemini, India. At Capgemini, she served on the leadership team of the global provider of consulting, technology and outsourcing services. At inVentiv Health she will be responsible for the management, development and growth of all business units in India across inVentiv’s Clinical and Commercial segments.
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[ news scan ]
New Innovative Solutions for Neonatal Care
GE
Healthcare introduced a suite of new innovative solutions for the survival and growth of neonates in the primary care settings. “Innovation is critical to tackle the huge neonatal mortality in India and around the world, and GE Healthcare is on the frontline of accessible solutions,” said Rita M Barksdale, Global General Manager, Maternal Infant Care, GE Healthcare. The new Lullaby Warmer Prime is an easy to use infant warmer that makes safe and reliable thermoregulation accessible for primary care settings even in remote and rural areas while the Lullaby Resus Prime and Lullaby Resus Plus are neonatal resuscitation devices deliver simple
operation with flexible patient circuits, bag-and-mask and T-piece configurations respectively, and are intuitive to operate to accommodate virtually any level of skill. GE Healthcare’s Lullaby suite of infant care solutions are developed in India from ground up with the help and inputs from primary care and other healthcare professionals across India. The low resource settings need equipment that are easy to use, do not breakdown frequently and can be used with minimal training.
New 3T MRI System Receives FDA Clearance
iemens Healthcare has announced that the Food and Drug Administration (FDA) has cleared the MAGNETOM Prisma, a 3 Tesla (3T) magnetic resonance imaging (MRI) scanner capable of extraordinarily high spatial and temporal resolution to achieve outstanding image quality, particularly in highly demanding applications. “Siemens is proud to add the MAGNETOM Prisma 3T scanner to our portfolio of world-class MRI systems,” said Gregory Sorensen, MD, CEO of Siemens Healthcare North America. “With applications that display functional information and enable the visualization of details in the smallest anatomical structures, the MAGNETOM Prisma enables researchers to explore bold new territories and address their specific research needs.” The MAGNETOM Prisma features XR Gradients, which combine 80 milliTesla per meter (mT/m) with a 200T-per-meterper-second (T/m/s) slew rate to offer a configuration unavailable in any other commercial whole-body system. Complementing the extraordinary power of the
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MAGNETOM Prisma’s XR Gradients is the system’s exceptionally robust design. Precision is maintained throughout long, demanding applications such as functional MRI (fMRI). The power and endurance of the MAGNETOM Prisma’s XR Gradients fuel the system’s first-to-market Diffusion
Spectrum Imaging (DSI) acquisition that enables the user to potentially resolve fine anatomical details of the brain such as crossing white-matter fibers. Siemens will offer onsite upgrades to the MAGNETOM Prisma to customers who have already installed the MAGNETOM Trio, a 3T MRI system with Tim (Total imaging matrix) technology.
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nd Anniversary Issue
[ news scan ]
GE Launches Its First Life Sciences Solution: AKTA Start
GE
Healthcare recently launched ÄKTA start, a compact, affordable and easy-to-use preparative chromatography system for laboratory-scale protein
purification. ÄKTA start is the latest addition to GE’s new generation of ÄKTA systems and the first product designed and developed by the company’s research and development center in India, for the world. “ÄKTA start breaks new ground as our first India-designed Life Sciences product, improving affordability and helping accelerate research and innovation in India. We hope this will also improve access for academia and help India’s next generation of scientists get practical experience in protein purification,” said Anurag Gupta, Managing Director, Life Sciences, GE Healthcare, India. ÄKTA start helps researchers eliminate the hassle of manual protein purification, while providing automated control of the purification procedure. Its affordability will allow more researchers to take advantage of GE Healthcare Life Sciences’ protein purification expertise and experience.
book scan MRI of Sports Hernias, Thigh and Hip Injuries: Volume II
Author: Stephen J Pomeranz, MD Edited by: Malcolm Shupeck, MD, FACS Price: $250.00
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The ProScan Imaging Education Foundation introduced the 2nd Volume of its Orthopaedic and Sports Medicine Series - MRI of Sports Hernias, Thigh and Hip Injuries. The text is authored by Dr. Stephen J Pomeranz, MD. The text includes more than 100 MR imaging cases and more than 200 fully-illustrated and detailed discussions of the anatomy, etiology, clinical symptoms and signs, MRI findings, and treatment of every major type of sports hernia, thigh and hip injury. The book also covers a wide array of pelvic disorders such as labral tears, cam versus pincer impingement, avulsion fractures and much more. The text provides radiologists, orthopaedists, and other specialists with the anatomic knowledge needed to accurately diagnose musculoskeletal injuries.
event scan Comprehensive Echo Doppler Evaluation Techniques 2014 (CEDET 2014) Date: January 11th and 12th, 2014 Venue: Osler Hall, KIMS North, Trivandrum For Details: www.kimskerala.com
Breast Imaging CME and Workshop Date: 11th January 2014 Venue: Tata Medical Centre, Kolkata For Details: www.tmckolkata.com
IRIA Annual Meet
Date: January 23-26, 2014 Venue: Hotel Jaypee Palace and Convention Centre, Agra For Details: iria2014agra.com
ISEMT 2014
Date: February 12-16, 2014 Venue: Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry For Details: www.isemt2014.com
STAR PRIMER 2014 Date: January 31st to February 2nd, 2014 Venue: Stanley Medical College, Chennai For Details: www.stanleyradiology. com
INSUOG 2014 Date: May 2-4, 2014 Venue: Hotel Taj Mahal Palace, Mumbai For Details: www.insuog.com
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[ new product scan ]
nd Anniversary Issue
Artis one
State-of-the-art Technology Artis one attributes the first angiography tube, MEGALIX Cat Plus X-ray tube and the CARE+CLEAR technology that support physicians to make confident decisions in safe diagnosing and treatment of the patient.
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futuristic angiography system from Siemens, Artis one exhibits brilliant instinctive operating characteristics improved by a configurable heads-up display allowing the patients to interact with the system. The product is designed for uncompromised imaging, intuitive interaction and provides a positive impact as well. The system comes with a new on-screen menu which permits the physician to navigate straight using the heads-up display. All information about
the method is thus kept right in front
of the operator’s eyes. Artis one is engineered for routine interventions, which represent the majority of angiographic procedures. The energy consumption of this system is up to 20 percent lower than Artis zee floor-mounted system. Artis one provides the most extensive feature set for dose reduction of any angiography system available in the market.
Next-generation Imaging Tools CLEARstent Live takes stent development to real-time permitting catheter manipulation during the process of capturing clear image of positioned stent.
OTHER FEATURES
HeartSweep
With just a button sweep, HeartSweep reaches up to 10 different routes with configurable movement speeds.
Experience the 3rd Dimension The system enables parallel processing and a high-speed C-arm rotation of 60 degrees per second with integrated 3D.
Supreme Coverage
Artis one enables patient coverage up to 2.10m (6ft10�). Peripheral run-offs are
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made possible without altering the patient position.
Small and Convenient
Artis one is easy and fast to install, thereby reducing operational costs. It also saves energy by 20 percent and is a perfect fit for rooms sized 25 m2 and up.
Easy and Fast
The easy-to-understand controls allows the rotating staffs to speed up in controlling the system.
Smart Controls Artis one can easily be operated with one press of a button without causing an interruption to the diagnostic procedures. The system has got unique heads-up display together with perceptible system operation.
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[ new product scan ]
nd Anniversary Issue
MobileDaRt Evolution
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obileDaRT Evolution, the wireless FPD from Shimadzu is designed to give maximum performance and flexibility allowing easy positioning in limited. The digital mobile system with wireless compact flat panel detectors (FPD) is unified into 32 kW
X-ray system and features fast operating speed. The 3 second display time for images at the console is indeed a real virtue for fields demanding quick intervention such as emergency and pediatric medicine.
Immediacy and Workflow with Low Dose The system checks images on the 15-inch touch panel color LCD monitor right after the three seconds of radiography. MobleDaRt Evolution has the capability to store up to 3500 images. The high sensitivity of the wireless FPD also ensures low patient X-ray dose.
Compact and Lightweight The product weighs only 3.4 kg, including the battery. The wireless FPD allows easy operation and the compact FPD is premium solution for pediatric care with lower-dose.
OTHER FEATURES
Easy to Handle
The wireless FDP makes it easy to maintain the system hygiene in the operating room. It facilitates excellent positioning without leaving any worries about cables.
Image Verification and Quality Evaluation Technologists can quickly review images for alignment, artifacts and patient motion while the detector is still in its position.
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High Image Quality With MobileDaRt Evolution, a maximum output of 32 kW allows for shorter exposure times, and thus minimizing the chance of blur images.
Easy to Operate
MobileDaRt Evolution combines a digital mobile X-ray system with wireless FPD to achieve superb ease-of-use and excellent workflow in diverse medicine facilities.
State-of-the-art Control Software The advanced workflow of the product reduces steps and supports multiple study acquisition. The system also incorporates a silent motor that significantly reduces driving noise.
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[ wordsworth ]
nd Anniversary Issue
Get Set, Go “Despite slowdown and cost pressure, the healthcare market showed some signs of growth in 2013 and is expected to grow in the coming future,” says Richard Guest, CEO, Siemens Healthcare, India
Richard Guest
We will continue to work on technologies that help our customers raise quality and productivity and enable access to healthcare. Siemens will be working to expand the entry-level product offering and invest in high-throughput, cost efficient products
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eginning of a year, the perfect time for companies to look back at their performance during the foregone year and it is indeed the right time to plan for the year ahead. Despite of all the fluctuations in the global economy, healthcare industry is that one industry that showcased a positive performance throughout the year 2013. Richard Guest, the CEO of Siemens Healthcare – India, talks to Color Doppler about its contributions to the medical device market and other major landmarks the company has made in the Indian market in the year 2013. Mr Guest, in his enriching career of over 23 years, has undertaken various roles. He, successfully led teams across sales, marketing and supply chain operations. He has been serving Siemens since a decade in various roles prior to his current position as the CEO of Siemens Healthcare, India. With his immense experience, Mr Guest is credited with delivering profitable growth. Excerpts from an interview. As an established player in the healthcare industry, how does Siemens evaluate the 2013 Indian healthcare market? The year 2013 witnessed overall slowdown in the Indian economy, where the GDP growth hovered around six percent against the estimated seven-plus. This eventually affected the healthcare market growth. Investment in the industry, both from domestic and foreign investors took a set back. Consistent falling of rupee against dollar made imports prohibitively expensive. Despite slowdown and cost pressure, the healthcare market did show some signs of growth and is also expected to grow in the coming future. What are the major landmarks Siemens Healthcare has made in the Indian market during 2013?
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We received a major order from Sir H N Hospital, Mumbai comprising high-end radiology equipment like hybrid OR and cath lab for interventional procedures, portable and premium ultrasound systems, CT scanner, MRI system, digital X-rays, mammography unit, C-arms, molecular
CT and PET/CT. The order for the second PET/MR – Biograph mMR was received from NIMHANS, Bangalore. With this, Siemens has the unique distinction of installing the only 2 PET/MR
systems in the country.
Please elaborate on the major machines and technologies launched in 2013. The first one that I would like to talk about is Artis Q, which is an angiography system with unparalleled performance. The system comprises of a revolutionary all-new X-ray imaging for more precise diagnosis and therapy. The high-dose
[ wordsworth ] efficiency of the system enables better image quality at less radiation. The next one is Artis Q.zen, the first angiography system with a crystalline silicon detector for unique sensitivity enabling ultra-lowdose imaging. The system has been a visionary breakthrough in X-ray detection with unique sensitivity enabling ultra-low dose imaging. SOMATOM Perspective 128 Slice CT scanner integrates innovative technologies designed to cover routine imaging to advanced applications in Trauma, Cardiac and Neurovascular imaging. Its innovative technologies improve diagnoses while improving overall dose values. ACUSON Freestyle has been a breakthrough in the ultrasound industry. The world’s first ultrasound system with a wireless handsfree probe, ACUSON Freestyle brings a whole new level of easeof-use, improved workflow, and excellent
image quality. The system can be used for a variety of applications throughout the hospital or clinical setting. ACUSON X700 is an economical Ultrasound system with high-end specifications and features. It offers exceptional image quality, robust technologies, and intelligent workflow solutions. Many advanced imaging technologies that were previously available only on high-end, higher-cost systems are standard on the ACUSON X700 system. What can the market expect from Siemens in the coming year? Is there any novel area Siemens is entering into? We will continue to work on technologies that help our customers raise quality and productivity and enable access to healthcare. That is, Siemens will be working to expand the entry-level product offering and invest in high-throughput, cost-efficient products.
Most Memorable quotes from 2013 Wordsworth series
We are at work to develop low cost, high-end technologies that ensure mobility and access in order to provide high-quality patient care to the people in rural parts of India.
Samsung products offer doctors the technology which is easier to use, quick to perform and accurate in diagnosis, which is the most important factor in the medical field, be it ultrasound, DR or IVD.
A couple of things that I have observed in Indian market are the rising demand for quality healthcare and the increasing number of patients.
Terri Bresenham, President and CEO, GE Healthcare, South Asia
Dinesh Lodha, Vice President and Business Head, Samsung HME, India
Jeffrey M Bundy, Chief Executive Officer, Ultrasound, Siemens Medical Solutions, USA Inc.
Over the last few years, we have offered advances in image quality and patient throughput, primarily through software development.
The country with a population of over 12 billion people has a radiologist strength of nearly 10, 000, which means the ratio between doctors and patients is 1:100,000. It is absolutely inadequate.
From emergency departments in sophisticated urban hospitals to clinics in remote villages, SonoSite systems are used by over 21 medical specialties.
Bill Conn, Director of Marketing, MRI division, Esaote, North America
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Dr Arjun Kalyanpur, Chief Pusher, Teleradiology Solutions
Pavan Behl, Director and GM, India & Middle East, FUJIFILM SonoSite India Pvt Ltd
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[ wordsworth ]
nd Anniversary Issue
Dreams Galore Leaving behind no goals of 2013 unachieved, Teleradiology Solutions is on the move with a lot more expectations for 2014. Dr Sunita Maheshwari, the Chief Dreamer and Co-founder of Teleradiology Solutions, talks to Color Doppler about the goals achieved during the year 2013 besides disclosing the dreams set for the year ahead
Dr Sunita Maheshwari
We were successful in signing more than 24 teleradiology reporting contracts including a very prestigious contract with the Saudi Aramco group. RxDx Kids was opened as planned and currently delights over 100 kids of Whitefield everyday
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very yester year leaves a lot of impressions on a company’s history. One such year was 2013 for Teleardiology Solutions. Dr Sunita Maheshwari, the Chief Dreamer and Co-founder of Teleradiology Solutions, Telerad RxDx, Telerad Tech, Telerad Foundation and Image Core Labs (ICL) opens up her mind to Color Doppler about the performance of the company throughout the year 2013. A winner of ‘Young Clinician Award’ from the American Heart Association and the ‘Best Teacher Award’ at Yale University, Dr Sunita Maheshwari has many golden feathers on her hat. Born in US and brought up in Hyderabad, Dr Maheswari received her MBBS training at Osmania University. She is also trained in Pediatrics and Pediatric Cardiology at Yale University in Connecticut. Apart from her medical clinical work, she is a successful entrepreneur and helped set up Teleradiology Solutions, a one of its kind healthcare IT companies that provides teleradiologic interpretations to hospitals in the US, Singapore, Georgia, Puerto Rico and now in remote areas of India. She is currently a Senior Consultant Pediatric Cardiologist and Head of the Department at Narayana Hrudayalaya in Bangalore. An educator and innovator, Dr Maheshwari also discloses the goals set for the year 2014. Excerpts from an interview. As a teleradiology service provider, what are the services that you render and what are the products that you offer? As a group, we provide teleradiology services to hospitals and clinical trial groups. We also provide general and specialty care to Bangalore patients via RxDx clinic. We have been contributing to the healthcare industry by providing telemedicine services to the rural areas. We
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also provide educational services for the medical community. Through our software company, Telerad tech, we also provides healthcare workflow solutions for doctors.
What were the major goals set for 2013? One of the major goals set for the year 2013 was to increase our foothold in India and Africa for teleradiology services by at least acquiring 10 hospitals. Establishing a Multi-specialty pediatric outpatient center, RxDx kids, was second in the list. One another dream was to launch ECHOSpa, a tele-echo platform for cardiologists. Another goal set for 2013 was to make RADSpa, our teleradiology platform, available to more hospitals and radiologists. Increasing the number of rural patients treated through our telemedicine services was one another goal that we had in our agenda for 2013. Adding five clinical trial companies as clientele to our Image Core Lab (ICL) was also one among our goals for 2013. With a lot of goals set for the year 2013, how far could you achieve them or what were the major achievements of 2013? By God’s grace, we were able to achieve all our goals and more. We were suc-
[ wordsworth ] Increasing our teleradiology services to African and ASEAN regions is one of the goals set for 2014. We are also targeting 5 million patients on RADSpa for 2014. Training more radiologist assistants to help ease the shortage of radiologists is one another goal set for the year ahead. We also wish to set up RxDx in South and North Bangalore and increase telemedicine coverage to at least 20 sites in India and Africa by the year end cessful in signing more than 24 teleradiology reporting contracts including a very prestigious contract with the Saudi Aramco group. RxDx kids was opened as planned and currently delights over 100 kids of Whitefield everyday with its
Co-founder and Chief Pusher Dr Arjun Kalyanpur and team at work at Teleradiology Solutions
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high-quality, high-touch pediatricians and pediatric subspecialists. ECHOSpa was launched and is being used for tele-ECG reporting from Assam and Nigeria. Telemedicine consultations by our RxDx physicians for primary healthcare in India crossed 18,000 consultations. RADSpa got lapped up by distributors in the US, Poland and South America and deployments are steadily rising. Interestingly, vertical specific teleradiology software namely VETSpa and Dental Spa were released for Veterinary and Dental industries respectively, to cater to their medical imaging needs. Our doctors and staff published articles, presented at conferences and panels and contributed to healthcare technology innovation in India and globally. Telerad foundation crossed over 30,000 free reads for poor patients at charitable hospitals, making all of us feel blessed. What were the key challenges faced by you so as to achieve the set goals? We faced challenges in hiring, with the need for rapid hiring and growth coupled with a seeming shortage of well-trained healthcare professionals. In the future, unless radiologist training keeps up with the growing demand in India, we will face an acute shortage of specialists. Image core lab was only able to sign on, 2 new clients due to the slowdown in the clinical trial industry in India. Our telemedicine program, in partnership with Cisco’s Samudaya, for the PHC’s in Karnataka was suddenly shutdown by the government despite it being a wonderfully successful program and we rue its loss. However, its fate was not in our hands. We can only do what is in our power to do. What are the new major goals set for 2014? One of the goals set for 2014 is to increase our teleradiology services to African and ASEAN regions. We are also targeting 5 million patients on RadSpa for 2014. We are also looking at effectively marketing our ECHOSpa to cardiologists in order to enable them to do tele-echo and tele-cardiology. Training more radiologist assistants to help ease the shortage of radiologists is one another goal set for 2014. We also wish to set up RxDx in South and North Bangalore and increase telemedicine coverage to at least 20 sites in India and Africa by the year end. COLOR DOPPLER | JANUARY, 2014
[ under the scanner ]
nd Anniversary Issue
Road to Future
When the world of healthcare is reinventing itself in the dawn of 2014 — a year of hopes and aspirations — with new technologies and advanced treatment modalities, we bring to you 14 medical imaging technologies, apps and software that would take the sector to new heights
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nd Anniversary Issue
14 Medical Imaging Apps Diagnostic Radiology
Radiation Passport
iagnostic Radiology developed by BestApps assists the user with a dynamic approach to abdominal radiology. It is an interactive ebook on abdominal imaging and provides an efficient platform for the user to master the subject. The app includes highly annotated, real clinical data sets to demonstrate key concepts in abdominal anatomy and pathology. The app is a real asset for radiologists and clinicians interested in understanding and diagnosing abdominal diseases. Compatibility: iOS
adiation Passport is an app developed by Tidal Pool Software to educate about the radiation and cancer risks associated with medical imaging exams. The app helps in keeping track of radiology procedures and an estimate of radiation risk these procedures can cause. The app also includes average dosage values for over 140 imaging procedures and calculates total radiation exposure. It also provides graphs showing radiation exposure and cancer risks. The passcode support keep medical data secure. Compatibility: iOS
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Radiology Toolbox Pro
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esigned by a practicing radiologoist and developed by Softcode Systems Inc., Radiology Toolbox Pro is an app that functions as a radiologist’s ectopic brain. The app includes a wide array of tools necessary for a radiologist such as radiographic contrast premedication, GFR calculator, solitary pulmonary nodule criteria, gastric emptying times and radioisotope half lives. Compatibility: iOS
SonoAccess 1.5 App
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onoAccess 1.5 is a medical education app from Fujifilm SonoSite. The app acts as a direct link to SonoSite and provides the user with free helpful resources, such as videos that demonstrate specific scanning techniques, clinical images, news and more. The scanning techniques provide expert scanning procedures and tips. The videos of the case studies give an insight into specific cases that the user may come across while practicing. The clinical image gallery of the app provides the user with ultrasound images for anatomy recognition. Besides these, SonoAccess 1.5 also includes features such as testimonials, customizable interface and organizational hierarchy adjustment. Compatibility: iOS
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Centricity Radiology Mobile Access 4.0
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entricity Radiology Mobile 4.0 Access from GE Healthcare helps in delivering secure and efficient healthcare services anywhere, anytime. The AccessNow feature supports a wide range of modalities with 2D, 3D and MIP/ MPR imaging capabilities. Besides these features, the app also includes features such as reference lines, split screen comparison view with prior exams, image overlay viewing and key image object viewing. Compatibility: iOS
Radiology 2.0
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n app developed by Dr Daniel Cornfield, an Assistant Professor of Diagnostic Radiology at Yale University School of Medicine, Radiology 2.0 presents radiology teaching files in an interactive mode. It enables the user to read CT scan readings at a PACS workstation. It includes cases of common acute thoracic, abdominal and pelvic pathologies. Each case study includes labeled images that highlight pathologies and relevant findings with markings. It also provides a number of examples of each type of pathology. Compatibility: Android, iOS
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14 Medical Imaging Apps modalityBODY
Radiology Assistant
odalityBODY is an interactive anatomy, medical image reference and training solution app developed by Modality Inc., a subsidiary of Epocrates Inc. It compiles images from popular medical texts. The mobile application enables the users to search, sort, customize and store thousands of images. The user can also upload clinical case images with notes or articles from open source databases. Compatibility: iOS, Android
adiology Assistant is an app designed for radiology residents and radiologists by the Radiological Society of the Netherlands. The app concentrates at radiological issues in a problemoriented way and has a number of peer-reviewed articles of high quality. Each article is well detailed with radiological images, tables and other related information. Compatibility: iOS, Android
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iClarity Lite
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eveloped by iCRco, iClarity is an innovative radiology image viewing app that enables the receiving and viewing of images stored on a Clarity PACS. iClarity Lite has the ability to connect to multiple Clarity PACS. It can also search and sort worklist by name, ID, modality and date; rapidly zoom and pan using dual-touch; scroll images in multi-slice series. In order to reset images, all the user has to do is ‘shake’. The password-enabled linking to the Clarity PACS provides an improved security as well. The latest version of iClarity is optimized for iPad. Compatibility: iOS
MobileCT Viewer
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eveloped by Nephosity, MobileCT Viewer app enables remote diagnostic viewing of CT, MRI and X-ray images when a fixed imaging workstation is not readily available. The app has the ability to display the medical images in the DICOM format. The app also features real-time streaming of images, and enables fast and scalable collaboration of these images with other users of MobileCT Viewer. Additional features like ability to transform the view using two finger multitouch and feasibility to adjust window width and level using one finger drag enhances the usability of the app further.
Compatibility: iOS
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Aycan Mobile
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ycan Mobile is an app designed and developed by Aycan for easy, fast and secure transfer of DICOM images from hospitals and imaging centers to radiologists and referring physicians. Its robust feature and intutive user interface make the app a unique tool for remote review, interpretation and diagnosis of radiological images. Images can be easily viewed, compared and annotated as Aycan Mobile features key image processing capabilities such as zoom and pan, multiple series comparison and synchronize, and embedded dictation and text on ROIs. With Lossless JPEG2000 compression, it can quickly send and receive large amounts of images. Compatibility: iOS
Viewbox
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iewbox is a medical imaging app from Viewbox Holdings, LLC that allows the user to view, share and present medical images. It provides easy portability of teaching file images in the workplace and classroom as well. Users can search, view and edit images from several sources such as iCloud, Dropbox, Google Picasa and the Radiology Society of North America’s MIRC server. The app is indeed a boon for those in the field of radiology who require access to medical imaging. Compatibility: iOS
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Monster Anatomy HD
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OsiriX HD
eveloped by Monster Minds Media SAS, it is an app designed for radiologists, general practioners, orthopedists, surgeons and physiotherapists. It includes intuitive navigation, fluid display of images in the three anatomical planes and 3D image volume. Compatibility: iOS, Android
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n app developed by Pixmeo SARL, OsiriX HD is a full DICOM image viewer capable of displaying images from all imaging modalities in the DICOM format. Image manipulation tools such as zoom, pan cime and contrast adjustment make the app more interactive. Compatibility: iOS, Android
14 Technologies Aspire Bellus
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spire Bellus, a dedicated breast imaging workstation from Fujifilm Medical Systems is designed to enhance image quality, streamline workflow and improve patient outcomes. The workstation enables easy handling and offers enhanced image quality, improved image-reading capabilities and an integrated reporting system. The workstation also includes features such as exceptional display speed, customized reading protocols, intuitive and flexible image layout, and one-click operation for image processing adjustments.
Adaptive Diagnostics
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daptive Diagnostics is a cutting-edge CT technology from Toshiba that has the capability to simplify complex exams, lower the dose, and improve diagnostic accuracy and reproducibility. The technology includes features such as SureSubstraction, Metal Artifact Reduction, SureCardio and Variable Helical Pitch. SureSubstraction helps in removing bone and calcium from data sets. Metal Artifact Reduction helps in removing streak artifacts in images while SureCardio is an application that reduces the patient dose considerably. SureCardio can also detect and adjust to patients with irregular heartbeats thereby providing quicker, more conclusive exam results.
StarVibe MR and Twist-Vibe MR
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eveloped by Siemens Health, the two MR technologies StarVibe MR and Twist-Vibe MR allow fast body magnetic resonance imaging for all patients. Users can find both the technologies on the Magnetom Skyra 3T and Magnetom Area 1.5T MRI systems. StarVibe MR al-
lows free-breathing, contrast-enhanced liver imaging for patients who cannot manage breath-holding. Twist-Vibe MR features accurate contrast imaging in dynamic liver MRI for all patients. The technology also allows quick and robust liver imaging with complete 4D coverage.
RadiForce RX850
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adiForce RX850, a 31.1 inch color LCD monitor from EIZO Inc. enables the display of 8 megapixels for multimodality applications. The monitor successfully replaces multi-monitor setups for more user-friendly environment that enables viewing numerous medical applications on a single screen. The high-resolution screen of the monitor makes it ideal for viewing images acquired from various imaging modalities such as digital mammography, magnetic resonance imaging and ultrasound. The screen size of the monitor demands less head and eye movement making it more comfortable for viewing medical data.
Coronis Fusion 6MP and Mammo Tomosynthesis 5MP
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oronis Fusion 6MP and Mammo Tomosynthesis 5MP, the two displays from Barco increase productivity and maintain the best possible image quality. Coronis Fusion 6MP display system provides the user with an effective viewing platform that considerably increases clinical productivity. The display system reduces eye strain as well. Its features include optimized glass, intelligent sensors and other technologies that ensure clear images and accurate diagnosis experience. Designed specifically for breast tomosynthesis, Mammo Tomosynthesis 5MP provides up to four times the brightness and double the lifetime of other mammography displays.
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ASiR-V
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ext-generation iterative reconstruction technology from GE Healthcare, ASiR-V already has 3,600 installations across the globe. The technology combines the speed of GE’s ASiR dose-reduction technology with the capabilities of Veo full model-based iterative reconstruction. ASiR-V is designed to significantly lower the dose relative to filtered back-projection (FBP) for body and head modes alike. The technology also enhances low contrast detectability, spatial resolution and image noise. It even has the capability to reduce low signal artifacts.
iConnect Access Version 5.0
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Connect Access Version 5.0 is a smart solution from Merge Healthcare that combines enterprise viewing with image sharing making it easy for referring physicians to easily review the images anywhere, anytime. It is a pointof-care clinical solution for patients spread across different locations. iConnect Access 5.0 is definitely a solution that can align with an organization’s strategic goals by enhancing the performance and making it a user-friendly solution.
Intelerad Analytics
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ntelerad Analytics, a radiology solution from Intelerad Medical systems assists in optimizing performance across the organization by providing comprehensive, real-time metrics. The new module has the potential to raise the user’s practice performance and can attract new business. It fosters productivity and increases the quality of a service provided. The solution can be accessed from any location allowing the user to make correct decisions in a timely fashion.
Xineos-1515
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ineos-1515 is a CMOS image sensor technology from Teledyne DALSA. It features a combination of highsensitivty and high dynamic range operational modes from a single detector. The sensor comes with 99-micrometer resolution. It provides a switchable saturation dose enabling the X-ray technicians to select between high sensitivity and extended dynamic range depending on the requirements of the imaging procedure. It also features an extended field of view allowing the surgical team a more wide and comprehensive overview of an operating scene.
T2 Multi-touch Control Wheel (T2 MTCW)
T2
Multi-touch Control Wheel is an electronic controlling equipment that can be used in any medical imaging equipment where instinctive and intuitive finger movements are used for providing commands. Many commands such as menu search, selection, navigation and image manipula-
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tion can be executed using this controlling equipment. The device includes features such as multi-touch pad, virtual rotatory encoder and proximity sensor. T2 MTCW is rugged, scratch-resistant and can easily be integrated into any device.
Withinsight Framework 3.0
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ithinsight Framework 3.0 (WIF 3.0) is an advanced platform that boosts development of standalone, zerofootprint medical image visualization applications. WIF 3.0 comprises of tools designed to enhance rendering, segmentation tools and technologies that improve the overall imaging performance. The technology is built to address clinically focused workflow needs and will identify medical image visual landmarks.
EX3 Stepper
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X3 Stepper from Civco Medical Solutions is designed and developed for low-dose rate and high-dose rate ultrasound guided branchy therapy for prostate cancer detection and treatment. The modular design of EX3 reports angular and linear position directly to the treatment planning software. The stepper provides quick connection for data analysis and lowers the amount of clutter in the surgical suite. The stepper also features a removable electronic unit that lowers the risk of damaging transmission components.
MedicsConnect
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edicsConnect is a tool developed by Advanced Data Systems to automatically transmit radiology reports to referring physicians. It transmits the report in a HL7 format compatible with any electronic health record system. The technology completely eliminates the need for implementing multiple, expensive and customized HL7 interfaces. The technology enables the users to automatically download the data by configuring their EMRs. The technology was successful in streamlining the communication of electronic reports. It has proved a cost-effective and practical technology for radiologists by providing all the advantages of EHR-compatible radiology reports.
eHD
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HD is a technology from Esaote to innovate ultrasound imaging and improve the use of the ultrasound systems enabling more clarity at greater depth. The technology features diagnostic value enhancement and system usability optimization. It also provides increased sensitivity, increased high resolution and penetration which give the clinical user an excellent opportunity to add value in high end diagnostic therapy.
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14 Software IQQA – Liver Suite
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DDA Technology’s IQQA – Liver Suite offers complete solution for liver cancer analysis and treatment management. For better healthcare and patient management, IQQA – Liver allows a seamless integration with hospitals’ existing PACS system and provides access to the 4D application for volumetric quantitative assessment and virtual operative simulations from anywhere anytime via the IQQA On Demand Internet platform. The Suite addresses the challenges of advanced quantitative imaging evaluation that often require the sharing of results in real-time interactive fashion, simultaneously and collaboratively from multiple departments in different locations. Highly automated 3D liver segmentation, 3D vessel analysis, 3D lesion analysis and spatial relationship analysis are the major assets of this Suite.
Vertex
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he complexity of sharing medical images and documents are now simplified with Vertex. The software allows viewing, sharing, storing, importing, converting and burning of the images and documents without any hassle. Vertex, a product of Sorna Corporation, uses Sorna’s advanced technology to access files and send it to any destination. The software possesses a single-screen, drag-and-drop interface that enhances the user experience. It offers virtually limitless data profile requests for automated and user initiated image sharing. Vertex incorporates DICOM and popular image and document files with ease. When the user is ready to share data, all the person has to do is simply burn it to a CD/DVD, send to another location via Secure DICOM Share or access a popular cloud solution. Simply stated, with Vertex the user can view images from any source and send to any destination.
MUSICA
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gfa Healthcare, the global leader in the fast growing market of integrated IT and imaging systems provides a perfect solution for image clarity through its state-ofthe-art product MUSICA. This image processing software for digital radiography provides better details in images, enabling comfortable reading for the physicians. The company has intro-
duced the next generation of MUSICA that enables a balanced presentation of all tissue structures, as well as body-part independency that do not require the input of which body part has to be imaged. Automatic optimization of image quality, robustness against variations like patient size, tube quality and exposure settings are additional features of this software. By automatically analyzing the characteristics of each image and optimizing the processing parameters, it saves effort.
Navigator
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avigator is another new-comer in enterprise image workflow solution that is capable to fetch medical images from multiple medical image sources. This secure, reliable and web architected software monitors and manages fetching and sharing of images, configure sources and destinations and study match. The radiologists enjoy greater flexibility in selection of studies that can be filtered on the basis of DICOM tags, date ranges and sequence number. The software is also capable to monitor and display the status of DICOM devices on network.
OmniCare 7.5.4
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atient navigation, survivorship and high-risk management needs are the three major solutions OmniCare 7.5.4 software boasts about. In addition to its easy integration with user’s EMR, the system manages every aspect from cancer diagnosis through treatment and survivorship. Radiologists get a complete solution for tracking, follow up, documentation and quality assurance with Insight’s OmniCare.
CAIPIRINHA
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essen the pain of holding breath to grab a 3D T1 imaging! Siemens has introduced Controlled Aliasing in Volumetric Parallel Imaging Results IN Higher Acceleration (CAIPIRINHA), a software that reduces patient MR breath-hold up to 50 percent of the conventional time, without sacrificing the image quality. The software comes as a part of Siemens’ syngo MR D13A software package and acquires higher quality 3D VIBE T1 images through higher acceleration factors. It will be available with Siemens’ B19 software as an upgrade for Siemens’ MAGNETOM Avanto 1.5T and MAGNETOM Verio 3T systems.
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Intergy RIS
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itera Healthcare Solutions has designed a Radiology Information System (RIS) Intergy RIS that employs integrated financial and radiologic workflow with sophisticated features such as practice management tools for revenue cycle, transcription management system with electronic signature, automated task management system based on patient flow events and optional modality work list. In addition, seamless integration with PACS and Vitera Intergy Physician Portal, third-party speech recognition, deployable HL7 interfaces and sytem security with password protection enhances Intergy RIS.
Centricity Practice Solution
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ultrasound exams and allows the physicians to create, edit and view archived reports.
Voice2Dox 3.0
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oice2Dox 3.0, an innovative speech recognition application for clinical reporting from IDS incorporates features that improve productivity, by making reporting easier and faster for physicians. With Voice2Dox 3.0, the physicians have greater control over routine sharing. Twitter-like feature of sharing routines between the mentors and followers, explicit sharing of templates with individuals, feature to lock critical sections of report templates, embedded key images and improved application performance are the other key features of Voice2Dox 3.0.
one are the days of tiring data entry of medical providers to meet the dead requirements of ICD-10 coding. GE’s Centricity Practice Solution Electronic Medical Record (EMR) and Practice Management Solution enhance the clinical and financial productivity with its customizable features, seamless interoperability and technology like one-click problem entry and search. Though designed as an integrated unit, if preferred, the hospitals can use them independently. The company has released Centricity Practice Solution 12.0 and Centricity EMR 9.8 recently.
ICOM RadiX for Enterprise PACS, which has recently debuted at RSNA 2013 intelligently locates, analyzes and transfers images from PACS across a network to the DICOM destinations and viewer locations. With this system, the radiologists get access to every PACS archived in the network. Instant image transfer, delivery to any DICOM device, identification and transfer of relevant images from multiple PACS are the other countable features of this software.
SiteLink
SUITESTENSA
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onoSite’s SiteLink is another software package that enables the hospitals to store ultrasound images and reports on LAN computers. The software allows the doctors to generate summary reports and Emergency Medicine worksheets from the data, thus reducing the calculation time for the report generation. SiteLink is capable to connect up to five ultrasound systems to a single PC. The reports and images are automatically transferred to the PC as soon as the examinations are conducted.
Image Suite
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arestream’s Image Suite software offers flexible image acquisition, processing and storage. Radiologists can use it for easy web-based patient scheduling, review images and reporting, as well as archive them securely. This heavily reduces training time and makes the transition easier. The software, which is compatible with wireless DR and CR imaging systems, offers a comfortable platform to those who wish to shift from film to digital imaging. It is economical as the users can utilize same consoles and software platforms. Addition of a DR detector and license is the only add-ons for the purpose. The upgraded software possesses vendor-neutral exposure index value for each image that enables the radiologists to see if they are within the exposure range. It totally eliminates the manual data entry, supports enhanced image sharing capabilities, provides DICOM storage for MR, CT and
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DICOM RadiX
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ith decades of experience in CIS, RIS, PACS market, Esaote has introduced a complete cardiology imaging and information management solution through its product SUITESTENSA. The system is an integrated cardiology information and PACS that can collect, manage images from all cardiology specialties, analyze results, auxiliary data and signals, all within a single database and single user interface. Its comprehensive approach offers several advantages to the radiologists including cost-effectiveness, vendor-neutrality, multi-modality imaging management, interactive report production, seamless integration with hospital information systems and repositories and emergency management. Its integration with common software like Microsoft Excel makes the data extraction easier for the physicians.
3M ChartScriptMD
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M ChartScriptMD from 3M Health Information Systems ensures that the clinical reporting is made easy to create, sign and distribute from a single integrates system. Flexible options for traditional speech recognition and report templates that suits the standard Current Procedural Terminology (CPT) billing codes enhances the workflow of the physicians by reducing report turnaround times. 3M Natural Language Processing (NLP) and Computerassisted Coding (CAC) are other features of this system. The software reduces errors of omission and recoding time for hospitals and professional services.
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nd Anniversary Issue
Taming the Heart Dr G Vijayaraghavan, Vice Chancellor and Founder Director of Kerala Institute of Medical Sciences, Trivandrum outlines the milestones in his career and elaborates on the latest advancements in cardiac medicine, treatment modalities, research and cost factor
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Ria Lakshman V l cd news rom a boy grown up in countryside in Kerala, to becoming the Vice Chairman and Founder Director of Kerala Institute of Medical Sciences, Dr Govindan Vijayaraghavan’s life has been a tale of extraordinary passion, perseverance, determination and dedication to excel. He began his journey from Trivandrum Medical College in 1964 and completed MD in General Medicine in 1969. Later, he pursued his studies at Christian Medical College, Vellore, from where he acquired his Doctorate in Cardiology, as well as continued as an academician and research fellow. From 1976, Dr Govindan Vijayaraghavan, fondly called as Dr GVR, began his pioneering research works on heart muscle disease (Endomyocardial Fibrosis) peculiar to Kerala. He continued his expeditions to create path-breaking discoveries on Cerebra Odollam poisoning and saved many lives through the innovative treatment modalities he introduced. He worked at the University of California,
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Los Angeles for two years from 1983 and became a pioneer researcher in Doppler Echocardiography. The first book on this subject was also co-authored by him. Dr GVR further authored and co-authored many medical books, some of which are prominent text books for medical students. He is a member of the editorial board of the Indian Edition of the American Heart Association Journals - Circulation and Hypertension. His meticulous efforts in conducting Continuing Medical Education (CME) programs all over the country has led to the establishment of 2D echocardiography as a major tool for cardiology examinations. For his unparalleled career as a researcher, academician and physician, the country honored him with one of the high civilian awards of India, Padma Shri. He has also achieved several other awards and honors, including fellowships from international universities like Royal College of Physicians, Edinburgh (FRCP Edin); Royal College of Physicians, London (FRCP Lond); American College of Cardiology (FACC); and the Premier Golden Heart Fellowship from the American Heart Association (FAHA). In this interview, Dr Vijayaraghavan glances through the landmarks in his career that scribbled some of the best chapters in the medical history. With more
than 40 decades of experience in medical sector, he shares his insights on several topics including 2D echo-imaging, Doppler techniques, research areas in cardiology, Endomyocardial Fibrosis and more. As an initiator of 2D echo imaging in India, please share your experience in establishing India’s first 2-Dimensional echo laboratory in 1979? It was way back in 1979 that I established the first two-dimensional echo lab in India. I was basically a cathlab man. To visualize the right ventricles, atriua and valves, we have been using selective angiography with all its difficulties and trauma, and its complications and problems. And then, we found there is a phenomenally different technology, where we put a crystal on the chest of the patient and the image—myocardium, the valves, the atrium and the blood vessels; each one of the structures came on the video monitor. It was an interesting experience to see them interpret the images and report them, and the excitement that we had was unparalleled. We first started studying the rheumatic heart diseases and then we went on to image other heart diseases. At that time, the VCR technology was not available in the 2D echo machine and I managed to get the moving pictures recorded on the 16 mm
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nd Anniversary Issue
Moment of Pride: Dr GVR receiving Padma Shri from Pratibha Patil, former Indian president
film. I presented a series of patients with rheumatic heart disease, tetrology of fallot and other congenital heart diseases. I presented the paper at the Annual Meeting of Cardiological Society of India at Delhi in 1981, January and I got a standing ovation from the audience. It was the first time they were seeing real moving images of the cardiac structures on the large screen. The echo equipment was rugged, the picture quality was good but we were using a mechanical transducer. This produced a lot of vibration and noise. The transducer was very heavy and the patients had some chest discomfort during the procedure. With extensive experience in clinical echocardiography for more than three decades, how do you rate the evolution of different echocardiography techniques during the course of time? The next stage of development was Doppler. I was fortunately involved in the evolution of this technology too. Based on my echo experience, I moved over to the University of California, Los Angles. We were given two echo Doppler machines for research and development of continuous wave Doppler and the pulse wave Doppler. It was the first time the continuous wave Doppler and pulse wave Doppler were systematically used to study various heart disease patients. I could write a book
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on the techniques of Doppler echocardiography along with my professor Pravin M Shah and my friend K T Singham from Malayasia. Pathophysiology and blood flow pattern that can be interpreted in terms of Doppler into Echo techniques. I came back from USA by January 1984 and in 1984 April, I got a letter from a friend of mine, that Omotto, the famous cardiac surgeon from Japan has mesmerized the audience by showing the color Doppler. At that particular meeting, I could not be present. In April 1984, the color Doppler was born. Visualization of the regurgitant and stenotic jets was made possible by the
We need more cath labs to perform primary angioplasty. Primary angioplasty should be made available to the common man in the government hospitals in a very large scale color Doppler. That was the next phase of development. The color Doppler gave more precision to the Doppler techniques
because you can align the beam parallel to the flow. Concept of diastolic dysfunction and diastolic failure evolved through Doppler over the years. Today we have strain imaging, strain rate as well as speckle tracking which make the calculation a shortening fraction (strain) very easy. Strain probably replaces the myocardial wall motion abnormality in patients with coronary artery diseases as well as in dilated cardiomyopathy. The 3D echo came later. The incubation period for 3D echo was very long. I still remember Dr Natesa Pandia giving the plenary session lecture on 3D echo using the complicated steppomotor. It took almost five years for a transducer to be available which could do the trans-thoracic real-time 3D or 4D echocardiography. Today we could see the structures of valves and septal defects from either side of the septum or chambers. The atrium can be dissected on the left hand side and then on the right hand side, so that exact structural details of any anomaly could be understood. This helps device closure of defects with precision and safety. An avid contributor to the field of cardiology, which are the areas of cardiology that are less focused on or that are yet to be focused on? One of the main contributions of echocardiography in the last few years has been the study of diastolic dysfunction. The contributions of Doppler echocardiography and 2D echocardiography on diastolic dysfunction and diastolic heart failure has been unparalleled. 3D echocardiography needs further fine-tuning. Techniques for early diagnosis of cardiac failure are yet to be standardized. With ample experience in organizing and managing Intensive Cardiac Care Units, what are the major issues or challenges that are to be looked at so as to provide better cardiac assessment and treatment to the patients? We installed 2D echo in the ICU in our hospital way back in 1990. Over a period of time, we found that on admission echo
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Doppler study identifies patients with wall motion abnormality, left ventricular failure, or other mechanical problems early. Other cardiac emergencies could also be solved by a timely 2D echo on admission or even in the emergency room. The number of pericardial effusions and infective endocarditis diagnosed on admission stand testimony to this new investigation. A normal echo on admission rules out cardiac emergencies in the emergency room. Every modern emergency room and intensive care units should have an echo machine available and the staff has to be trained in echocardiography. Having practiced at home and abroad, how do you evaluate the cardiac treatments in India? We have three types of hospitals. We have state-of-the-art hospitals, we have mediocre hospital, and we have sub-standard hospitals. The state-of-the-art hospitals do have nearly all the facilities and the personnel which are comparable to any other part of the world. The mediocre hospitals, which form the majority, have equipments, but the trained personnel are scarce. And, the sub-standard hospitals have too many equipments, and the equipment are in the hands of the ill-trained personnel. We always feel so sad when we find a badly recorded echocardiogram and report. This is the tragedy of this country. Your study on Tropical Endomyocardial Fibrosis in India is an internationally acclaimed one. How is this disease a common health problem and how prevalent is this disease is India today? I used to diagnose 60 to 70 new patients every year in the 1970s and 80s. The disease has become so rare. We see hardly five to seven new patients every year. Most of my patients are the accumulated patients from the last many years. Patients whose valves are spared but the ventricular endocardium is involved live for a long time without deterioration. Patients whose valves are involved are dead and gone. I feel that parasitic infestation and consequent eosinophelia was causing the
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fibrosis of ventricular endocardium. The eosinophilic toxins must have caused the disease. Today the parasitic infections have become rare, the eosinophelia is uncommon and the endomyocardial fibrosis has vanished. What are the recent advancements in cardiac medicine? One of the major points to be highlighted is the prevention of heart diseases. Death rates due to heart attacks have come down purely by modifying lifestyle in many countries, . The American Heart Association is the leading organization which advocates preventive cardiology and have achieved remarkable success in this direction. We have to follow their guidelines and their advice in our country. We have to educate the public for regular exercise, making them eat low fat low cholesterol diet. We should eradicate the tobacco habit. We have to address alcoholism in our community. We should try to educate people to eat less. Obesity is to be prevented. We need more cath labs to perform primary angioplasty. Primary angioplasty should be made available to the common man in the government hospitals in a very large scale. We should assure that thrombolytic agents are made available at subsidized cost to the poor people of India. That is the only way we can salvage the patients with heart attacks. For patients with end stage heart diseases stem cell therapy may be useful and research is this direction is
required. What is the latest research that you feel is important to share when it comes to heart health, but may not be so well publicized? People have started using tissue culture experimentally. Tissue cultured heart muscle may pave the way to engineer organ culture by 3D printing of the heart. Instead of heart transplant, such hearts may probably be used in the near future. Tissue cultured arteries may be available soon. Cost becomes bigger question in treating heart disease. What is your take on this? Cost is the main stumbling block when it comes to treating heart diseases. That is why it is said that angioplasty should be available to the common man in district hospitals and MCHs at subsidized cost. Cost is the major problem today because more modern the treatment, more expensive it is going to be. Even the newer medicines are going to be expensive, which is unaffordable for common men. Any advice to the young doctors? Never forget to talk to the patients regarding prevention of heart diseases, not only to patients, but to their family members as well. We have to reduce the incidences of heart diseases such as hypertension, blood pressure and diabetes. The message of prevention by lifestyle modification should percolate to the lowest strata of society and to the younger generation.
COLOR DOPPLER | JANUARY, 2014
nd Anniversary Issue
[ view point ]
Expanding Horizons
T
hree decades of professional experience, with an unparalleled 20 years track record in healthcare industry has made this man so befitting into the aura of Telerad Tech Private Limited, the company that has established its own space of innovation and ingenuity in teleradiology market. The man here is A B Sivasankar, Vice President – Sales and Marketing, Telerad Tech Pvt. Ltd. Sivasankar began his career as a senior systems engineer in Steelage Industries Limited. He designed office automation systems and managed innumerable other projects during his nine years of career in the company. From Steelage, his voyage was into Indchem ATL as a branch manager who was responsible for the promotion of ATL ultrasound and Indchem critical care products in North India. After four years of service at Indchem, he chose HCL Picker as his destination. Moving on, Sivasankar worked at Trivitron Medical too, where he headed the imaging division and business unit for nine years. This extensive career graph demonstrates why Sivasankar is now into Telerad Tech Pvt Ltd. Being a company that successfully collaborated healthcare with the novel ways of technology, he is a perfect leader for Telerad Tech. RADSpa, the revolutionary workflow solution from Telerad Tech, broke the conventional systems of radiology information systems and PACS by coming up with an integrated image management system. Its features maximized the productivity of radiologists’ and enhanced the user experience on an overall note. Sivasankar is responsible to take RADSpa to the unheard boundaries and cater to the needs of the patients who are unfortunate to be yet treated by timely radiologists in their nearby hospitals. Teleradiology Solutions and Telerad
COLOR DOPPLER | JANUARY, 2014
A B Sivasankar, Vice President, Sale and Marketing, Telerad Tech private Limited, tells Team Color Doppler about the expanding horizons of teleradiology and the state-of-the-art product RADSpa Tech are two different wings. Can you elaborate your role in these wings? My primary responsibility is RADSpa sales. RADSpa platform is a combination of PACS, RIS and teleradiology module which fits into hospitals, diagnostic centre (standalone and chain). In addition to the requirement of PACS, some centres would also be in need of diagnostic reporting, since it may not have a dedicated radiologist throughout the day. In such cases, we target tele-reporting as a backup. When we know that there is a requirement, for example, in some centres the radiologist may not be available after 6 pm. Deepam Hospital in Chennai has a radiology department. They are located on the highway and have more number of emergency cases. They have two or three radiologists who may not be available in the night hours. Hence, we promoted the RADSpa router software that can assist the hospital with remote reporting during an emergency. Through this we created an opportunity for the user, where he needs not totally depend on in-house radiologist. We have clients from Jharkand, Chattisgarh and from other remote areas, where they don’t have radiologist. Here teleradiology plays a crucial role in diagnosis. Despite of the geographical location, are you providing RADSpa to every user in need? Some might already have a PACS. Here RADSpa may not go as a main platform. RADSpa can also be used as a router, to route the studies to the TRS or any teleradiolgy service provider’s server. There are clients, who do not use RADSpa, but they still happen to be the clients of TRS, and they use only the RADSpa router. In some
cases, they may already have a router. We just have to encourage them to use it. Sometimes, we find that they do not use the routers as they are not used to it. So we give them a free trial. They use it for a week or 10 days. Ultimately, they end up buying it. And that is how we promote it. What is the total number of installations in India? In India, there are about 50 installations of both the models, both Enterprise and Cloud, growing at the rate of 25 percent annually. You say the 50 clients are teleradiology clients and not RADSpa clients. Is there a differentiation between both? The commercial differentiation is there. For example, when somebody buys a RADSpa Enterprise, it is a product purchase and the value is different to that of a RADSpa router which is a sold as a purchase for service. For example, Kamineni hospital has RADSpa Enterprise while Deepam has a RADSpa Router. Once they buy the RADSpa, they can create their own teleradiology group. Is that what happens? Exactly. We are creating a competition to ourselves. But, then it is ok. The market is very big and at some point of time, I think these things will happen. That is the reason why we are promoting TRS as a backup for our own RADSpa clientele, who already has a radiologist. RADSpa can never replace a radiologist. You can use RADSpa when he is not available. That is, when he is not available, use it to push studies to the teleradiology service provider. In India, what is your major client specialisation? Is it emergency or radiology? Around 80 percent are from emergency segment. It is emergency, where the radiologists are not available. Here emergency has to be defined little more logically. In America, emergency is real emergency. There an accident is an emergency. In India, if there is a non-availability of radi-
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nd Anniversary Issue
[ view point ]
ologist for reporting, then a normal case is an emergency. How does the cloud work? Model is PAY PER USE. It is used only for the studies that get pushed. What about the back-end support? We offer round-the-clock support. How does the PAY PER USE work? It can be weekly, bi-monthly, etc. It can be for a fixed number of studies. For example, you push 1,000 studies and you pay Rs10,000. We also make space available on the Cloud, if you want to retain the studies. The router can be on rent. All this, in India, is still a long way. But, RADSpa is software which brings all the characters in the radiology environment together. For example, it could be a data entry operator, an administrator, a physician, a Radiologist or it could be a patient, all accessing the same portal. Only thing is the user ID and the password varies. But, in India, we are still getting used to this concept. I need a little more explanation on the cloud concept. If I use Enterprise edition, the Cloud server is provided by Telerad. If not, you will use a third party server. What is the difference? We offer both, Enterprise, Cloud. In fact, we also offer a third alternative, a hybrid of both Enterprise and Cloud to suit the client investment and infrastructure arrangement. A start-up teleradiology services provider can opt for a cloud model, wherein the investment in terms of infrastructure is minimum and can migrate to Enterprise one, if it is sustainable. An existing (already in operation for several years) diagnostic/hospital chain which has its own intra telereporting planning for expansion, or add on better value services can straightaway opt for enterprise.User can buy any server brand of choice.(HP/ DELL/IBM etc.). A hybrid edition is also an option. Which one do the Indian clients generally prefer? Concept of cloud is a recent entry to India. The barriers are lack of awareness, HIPPA compliance, regulations, disaster management, etc. In India, cloud will take some time to take its presence. Are you selling the same product in every place and is everything developed here, in India? Everything is developed here. It is purely
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Concept of cloud is new to Indian clients. The barriers are lack of awareness, HIPPA compliance, regulations, disaster management, etc. In India, Cloud will take some time to take its presence A B Sivasankar Vice President, Sales and Marketing, Telerad Tech Pvt. Ltd an Indian product marketed by a global healthcare company. How is the acceptability of an Indian product across the globe? RADSpa is used by teleradiology service providers in UAE, Africa, and in some parts of Europe for the past three years. Recent RSNA booth interactions confirmed the interest of American market on RADSpa. Globally, there are many major players. So, it will take time to establish ourselves in such markets. Companies like IBM are into this segment. How do you see this? If the companies like IBM or big players come in, then the market will expand. But, you will have your share. And, it is good that somebody will promote it. We are the early bird. In that way, we have taken the lead. We also have a credential that we are a radiology company, not an IT company. That will take us forward. If IBM comes in, then that means it is a big market. How do radiologists react to the ethical problems and other related apprehensions of teleradiology? Have they changed? Actually, there is a lack of regulations here. In India, the regulations are only for drugs and there are not any for medical devices and teleradiology. In Singapore,
Europe and America, the scenario is different. In India, I feel, we need regulations more than ethics to prevent misuse. Our software is HIPPA complaint. Inherently, it takes care of all aspects in regard to security, safety and privacy. We already have it in place. For example, the software does not leave a footprint on your system after the studies are accessed and closed. Your are into RadGuru. Does this education module actually help you to build your brand? Yes. I mean education and awareness can happen through this. Dr Arjun is organizing a weekly e-lecture using Cisco platform. You can integrate RADSpa into it. The software itself can be used as a teaching tool. That way it really creates good awareness and hands on experience. What are the advantages of RADSpa? The major advantage is the knowledge domain. RADSpa is developed by the radiologist for the radiologist. It speaks the language of the radiologist. It is vendor neutral. In a sense, one can integrate modalities of any brand, PACS, LIS/HIS, EMR of any developers. RADSpa is flexible, customisable, user friendly, value for money. What was the inspiration to develop RADSpa? Inspiration to develop RADSpa was indigenisation and the foresight to the need, and the expanding telereporting requirement across the globe. That is how it started. Also, there is another thing that you can always upgrade. That is a regular process. We are looking into different verticals. Leave alone general radiology, there is DentalSpa, CBCT centres for dental practice, ECHOSpa dedicated for echo ultrasound, Clinical Spa where the clinical images are evaluated. Telerad Tech as a company is constantly innovating. What is your target for the year ahead? It is very difficult to fix the numbers. What happens is, if everybody goes for PAY PER USE, the number of clients will go up and the revenue is perpetual .If everybody goes for Enterprise, the value differs and the client numbers may not be like PAY PER USE. Internally, we fix targets. Without target, one cannot work. Targets are determined depending on the market segment and the business models, that is PAY PER USE, Enterprise, etc.
COLOR DOPPLER | JANUARY, 2014
nd Anniversary Issue
[ 2013 vs 2014 ]
Reviewing the Past, Anticipating the Future On this august beginning of yet another year, Color Doppler brings to you the thoughts and reviews of renowned medical practitioners in the country
A Rewarding Year
Y
ear 2013 was full of events. It was a very busy and rewarding year for me. Being the dean of Indian College of Medical Ultrasound (ICMU), the academic wing of IFUMB, we successfully conducted and guided the ICMU-CME held in February, 2013 at Pune. Another milestone in my career happened on February 24, 2013. Being the President Elect of IRIA of Gujarat State, I organized one-day workshop on ‘Continuing Medical Education’ (CME) on Conventional Radiology at Saffrony Resort, Mehsana in Gujarat. Next mega event was a two-day live workshop on USG and color Doppler on June 8 and 9 at the same resort in Mehsana. Then came the 11th Annual National Conference of Indian Society of Pediatric Radiology (ISPR). It was on October 5-6, 2013 at Ahmedabad. As the Organising Secretary of the event, it was a big challenge for me to make it happen well and God helped me again like always. There came the most prestigious moment for us, USCON 2013, held in Pondicherry from October 25-27. Being the dean of ICMU, I successfully conducted and guided the entire scientific
COLOR DOPPLER | JANUARY, 2014
Dr Y T Patel Professor of Radiology, GMERS Medical College, Dharpur-Patan. Dean of Indian College of Medical Ultrasound (ICMU), President Elect, IRIA, Gujarat State Branch.
events and also released the most awaited Journal of IFUMB during the inaugural function of the conference. Month of November was hectic from the personal side. My son Dr Dhruv’s wedding with Dr Nirali Mehta fulfilled the duty of a father. It was followed by the wedding of my younger brother’s son. After all these joyful occasions, unpleasant moment arrived as death of my younger brother’s wife. My younger brother passed away in the year 1994 suffering from intestine cancer. In short, 2013 came and left with mixed emotions and good memories. Now, I am looking forward to start 2014,
which I am confident will be better than 2013. Being President of IRIA, Gujarat State for the year 2014, I am looking forward for one more CME workshop on “Conventional Radiology” in the month of May/June. I am also planning for one day CME proceeded by live workshops at Ahmednagar in Maharashtra. This programme will be organized by Dr Dilip Lakhkar, Prof and HOD of Radiology of Medical College of Ahmednagar. In June/ July, there is a plan to conduct midterm CME of ICMU in Bhubaneswar, Orissa. It will be organised by Dr Rajat Ray. Then the 12th Annual National Conference of ISPR to be held on September 12th and 13th at CMC Vellore, 2014 which will be organized by Dr Sridhar and Prof Shayam Kumar of CMC. Next is USCON in October at New Delhi under the Presidentship of Dr Rahul Sachdev. I will hand over the charge of Deanship of ICMU to Dr P K Shah. Before concluding the year, as the President of IRIA,Gujarat, I want to celebrate “ The International day of X-ray” in a big way and thereby, to pay tributes to Sir Wilhelm Conrad Roentgen, the Founder of X-ray.
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nd Anniversary Issue
[ 2013 vs 2014 ]
A Progressive Year for Ultrasound
Dr Chander Lulla Consultant Sonologist, Jaslok Hospital and Ria Clinic Mumbai, Former President of Indian Federation of Ultrasound in Medicine and Biology (IFUMB)
Y
ear 2013 has been a great and progressive year for ultrasound and for me as well on a personal front. I completed my year of presidency of IFUMB . We had a wonderful USCON XXII at Puducherry, where we revived the Journal of IFUMB and the website with the help of Color Doppler Media and I thank them for it. On the technology front, it is exciting to have new technologies (contrast, elastog-
raphy, better resolution, etc.) to add to our armamentarium. Internationally, Sydney ISUOG and focused updates at Berlin provided me the adrenaline rush to pursue the next year. I am looking forward to INSUOG 2014 which will be held in May, at the Taj Mahal Palace, Mumbai. I invite you to a feast of academic excellence with Rabih, Paladini, Jon Hyet, and Nick Fenning along with a wonderful Indian faculty. See you in 2014 and wish everybody a wonderful year.
On a Quest for Better Patient Care
T
he year 2013 has been a very exciting year on the professional front for the department of nuclear medicine, PET/CT and radionuclide therapy at Kovai Medical Center and Hospital, Coimbatore. It has been heartening to see us play a major role in the expansion of nuclear medicine diagnostics and therapeutics in just three years time since our inception and making inroads to the consciousness of the oncologists as well as the patients afflicted with cancer. Whole body FDG-PET/CT has had a significant impact in the staging and treatment assessment in cancer, thereby significantly altering the stage of disease, affecting management decisions as well as giving the patients a visual analyses. This is simple and easy to understand; thereby motivating them to undergo therapy. It is in the realm of targeted therapy that Nuclear Medicine has really stepped up in offering niche options in previously hopeless situations which had been deemed medically and surgically untreatable. We have introduced the Trans Arterial Radio Embolization (TARE) procedure for inoperable/advanced liver cancers and metastatic liver lesions from abdominal/lung and breast malignancies. Our department is currently the only one in the country offering this therapy with the help of an imported radio activity generator and a team of world renowned doctors, inter-
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Dr Ajit Shinto DRM; DNB; PGDHA; MNAMS, Chief of Nuclear Medicine and PET Services, Comprehensive Cancer Care Centre, Asst Prof of Nuclear Medicine, Kovai Medical Centre and Hospital, Coimbatore
ventional radiologists, chemists as well as technologists who came down from all parts of the world to help us set this facility. Going by the significant palliative benefit as well as the cost effectiveness of this regimen, WARMTH (World Association of Radio Nuclide and Molecular Therapy) has designated KMCH as the nodal training centre for the entire country as well as Asia-Pacific region. Another therapy programme running successfully is Peptide Receptor Radio Nuclide Therapy (PRRT), which handles inoperable, advanced or metastatic Neuroendocrine tumors, with near curative effect. There is significant symptom palliation for the patients concerned and they go on to live for years without
any disturbance from their disease. As a coordinated project from Bhabha Atomic Research Centre(BARC) Mumbai and European Neuroendocrine Tumor Society (ENETS), this highly successful and costeffective treatment is routinely available to all deserving patients, who often travel thousands of kilometers to avail of this facility. Radiation Synpovectomy for inflammatory joint disease is another therapy programme that has been very satisfactory to institute. Quite a few patients with rheumatoid, hemophiliac as well as early Osteoarthritis have been treated with intra-articular injections and have significant improvement in joint swelling, range of movement and pain. In 2014, we hope to step up our therapy programme to include targeted therapies with various new and potentially game-changing agents in the field of oncology. We would be starting a post-graduate training programme in clinical nuclear medicine for aspiring students in addition to the highly sought after BSc Nuclear Medicine Technologists course that we have been running successfully. With these giant strides, we are offering services in Coimbatore at par with the best centres in the world and hope to impart knowledge and training to students and young doctors embarking on the journey of medicine and quest for better patient care.
COLOR DOPPLER | JANUARY, 2014
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INDIAULTRASOUND S A L E S ‘ N ’ S E R V I C E w w w . u l t r a s o u n d i n d i a . c o m
nd Anniversary Issue
[ 2013 vs 2014 ]
Life Saving Mission: A Dream Project
T
he year 2013 was indeed a wonderful year for me as a person, emergency physician and a social activist. I formally graduated in Emergency medicine from GWU in International Masters degree (MEM) in 2013. I also cleared MCEM of UK system (Part A and C) and waiting for Part B. My team have given training for more than 1, 00,000 people in life support skills. My dream project ANGELS received two international and one national award this year —Asian EMS award and AAEMI — Life Line foundation Award under international segment and AIIMS entrepreneurship award under national category. Angels decided to spread to other states as well. Angels faced lot of
problem from ambulance Mafia of Calicut Medical College premises. They created threats against angels activities and damaged angels vehicle also made personal level threats. I personally received three important awards — Jeevan Raksha Puraskar for Rajeev Gandhi Foundation (received from Kerala Chief Minister Oommen Chandy), Special Appreciation Award from the Chairman of DM -Healthcare and Vocational Excellence Award for Rotary Club, Calicut city. I have successfully led EMCON 2013, a path-breaking conference, which was introduced many firsts into the Indian medical conference history. Next year my focus is to start a new project to care elderly, which will be innovative and will touch people. I will continue my activities in the field of
Dr Venugopalan P P M B, B S, D A, DNB, MNAMS, MEM (GWU-USA); State Executive Director ANGELS; Site Director & National Faculty- Masters Program in Emergency Medicine (GWU-USA), Senior Doctor and HOD in Emergency Medicine at MIMS, Calicut
emergency medicine and pre-hospital care. Life saving mission at Sabarimala is one of my dream project. I am planning to write a novel. I also plan to publish my articles in a book format.
Mission: Ensuring Better Emergency Care
O
n a personal note, 2013 was an year that saw an extension of the projects I had started in 2011 and 2012. My primary focus was on the MCEM Training Program and BSc paramedic program that we had started in 2011 at Sundaram Medical Foundation. Guiding these bright young minds as they shape their career in emergency medicine was and will remain a huge responsibility. We took in our 2nd and 3rd batches of PGs and paramedics in 2012 and 2013 and are now working with a full complement of 12 PGs and 15 paramedic students. With a lot of discussion and inputs from the PGs themselves, we have evolved a training program which is satisfactory to both the PGs and faculty as well. But needless to say, there is still a lot of scope for improvement and that is indeed one of my goals for 2014. 2013 also saw a lull in my teaching assignments outside my parent institution which was a dampener because teaching is my passion. That could also be due to a shift in the way EM is growing in India. Attention is rightfully being focused on
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Dr Tausif A Thangalvadi Junior Consultant, Emergency department, Sundaram medical Foundation, Anna Nagar, Chennai
training doctors to become good emergency physicians rather than building state-of-the-art EDs. The way we are going about this training leaves a lot to be desired. Numerous training programs of various durations are popping up with accreditations of institutions offering them being suspect. For the institutions, it is a question of monetary gain with little loss. However, the trainee emergency physician is left vulnerable. Our national conference, EMCON proves to be an inspiration for us. Both in 2012 and 2013, the
interest shown by international visitors proves that Indian emergency medicine is finally being noticed on the world stage. At EMCON 2013, there were as many as five British hospitals which set up stalls to recruit emergency physicians from India. Being invited as faculty at our national conference, EMCON 2013 and also at PACE 2013 has been a satisfying experience. Working with an organization called Hospital Guide which offers free service to people looking for ethical consultants, institutions or generally wanting more information on appropriate doctors for their ailments was a gratifying experience.
My goals for 2014
My primary goal is to extend our teaching programs beyond Sundaram Medical Foundation and work with other likeminded institutions who are interested in offering training programs for emergency physicians and paramedics. We are also looking to bring in telemedicine into EM by connecting with hospitals in semiurban and rural areas. I will also continue to work with institutions like EMRI and Hospital Guide. COLOR DOPPLER | JANUARY, 2014
COLOR DOPPLER | JANUARY, 2014
37
nd Anniversary Issue
[ rsna recap ]
Future Unveiled RSNA 2013 underscored how essential coordination can do wonders for radiology’s continued success
T
he undulating saga of Radiological Society of North America (RSNA) began in 1915 when the physicians who discovered the potential of X-rays felt the need to show the world how radiology could become a critical part of healthcare sector. Since then, the organization has been the ultimate destination for all the technological revolutions of radiology world. Through the annual meets, RSNA continue to unite the radiologists across the world and stay committed to the ever-evolving needs of the radiology community. The recent 99th Scientific Assembly and Annual Meeting of RSNA was held at Chicago from December 1st-6th, 2013. RSNA 2013 was a grand platform for all the physicians from around the world. From ‘France Presents’ to the country pavilions in the technical exhibition house companies from Germany, Korea, China, Japan, France and Canada (Ontario Province), international partnerships was the important essence of RSNA 2013. Reflecting the thought on the theme of this year’s meeting ‘Power of Partner-
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COLOR DOPPLER | JANUARY, 2014
[rsna recap ]
nd Anniversary Issue
ship’, Sarah S Donaldson, MD and the President of RSNA 2013 signify the importance of extending international partnership among the radiologists. Also, Ms Donaldson called for a patient-driven care among the radiologists. “Team-based practice promotes collaborative clinical and research programs, augments one’s expertise, and builds careers. Professional interdependence promotes innovation and adds value to our collective endeavors”, she said. The session began with an interpretation, ‘You raise me up’ by Damian E Dupuy, Director of Tumor Ablation, Rhode Island Hospital and Professor of Diagnostic Im-
aging at the Warren Alpert Medical School of Brown University. Presenting the Annual Oration in Diagnostic Radiology Session on Sunday, Dr Dupuy highlighted the importance of working together to treat patients and to work on the strengths and weaknesses to give a better treatment. Three radiologists Vijay M Rao, David C Levin, and Jonathan W Berlin further stressed on the future of radiology, possible challenges and threats and how to respond them. Dr Rao urged radiologists to become more visible within the hospital environment, primarily with the evolution and adoption of new payment models. Three honorary memberships were
awarded to Gabriel P Krestin, Anne W Lee and Malgorzata Szczerbo-Trojanowska for their significant achievements in the field of radiology. Being the largest annual radiology conference, RSNA had plenty of scientific sessions, symposiums, case study discussions, new machine launches and new technological debuts to showcase. The technological innovations exhibited at RSNA 2013 represented the sweeping transformation in the healthcare industry. Color Doppler chose a few of the major innovations that are sure to have a seamless clinical collaboration, thus enhancing workflow and reducing infrastructural management overheads.
Launch Pad RSNA 2013
Cerner SkyVue
images.
This customizable image viewer framework enables the unified view of DICOM and non-DICOM images within the enterprise and beyond. Whether in the radiology department or throughout the enterprise, Cerner SkyVue gives organizations the same view of a patient’s images and HER information.
Qi Image Sharing Platform and Universal Viewer
PaxeraUltima
This web-based clinical electronic exchange capability allows clinicians to share medical images and information within or outside the healthcare enterprise
XPOSCROLL Auto Scrolling System
This is designed to increase radiologists’ productivity by enabling simultaneous study streaming, combining multiple sites to a single work list with full control on users’ accessibility.
With the intension to increase review efficiency of larger image sets in PACS, common for CT and MR imaging exams, XOPSCROLL has introduced a revolutionary auto-scrolling system.
WhiteStone Workstation
Montage Search and Analytics
Proper adjustable lighting, controlled climate and enhanced acoustics all wrapped up into an ergonomically friendly height adjustable unit in this integrated workstation.
ZONARE L20-5 Ultrasound Transducer
This search driven analytics tool helps reveal the business performance and clinical quality understanding concealed in the radiologist’s unstructured narrative.
Medic Vision low-dose CT Lung Screening Service
Based on ZONE Sonography Technology (ZST), this has unsurpassed image resolution for a wide variety of clinical applications.
With this service, low-dose CT lung images are forwarded to a remote cloud-based SafeCT system for instant processing, attaining high diagnostic picture quality.
Dome S6c
Biodex Ultrasound, Echocardiography and Vascular Imaging Tables
This 30” widescreen 6 mega pixel color display features LED backlight technology that offers high image quality, and is suitable for both grayscale and color COLOR DOPPLER | JANUARY, 2014
The improved designs that focus on ergonomics to benefit both the sonographer
and patient, include several features such as fowler back functionality, retractable stirrups, arm board and more.
LumaGEM Molecular Breast Imaging (MBI) system This dual-head, solid-state digital imaging system utilizing cadmium zinc telluride (CZT) technology for high-precision molecular breast imaging.
Anatomage Table This touch interface virtual dissection table for interactive anatomical visualization can display full-body anatomy based on patient data.
ATAL 8cw This wireless flat-panel detector with complete coverage for easy detector placement features a standard cassette format with the largest image capture capability and auto exposure sensing.
Apollo EZ This fully-featured radiofrequency system from Del Medical comes with integrated fluoroscopy, radiography, tomography, and angiography capability, all in one unit.
Unity Scheduler This redesigned scheduler from DR Systems has leveraged the latest technologies, integrated domain expertise and employed user-centered design to give customers the best possible user experience.
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Organizing Chairman
40
COLOR DOPPLER | JANUARY, 2014
COLOR DOPPLER | JANUARY, 2014
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COLOR DOPPLER | JANUARY, 2014
Our Faculty Dr M I Sahadulla | Dr Rakesh Gupta
Theme: Echocardiography for the Practising Physicians
Most Renowned National Faculty like: Prof S K Parashar | Dr Rakesh Gupta Dr Sameer Shrivastava | Dr Satish Govind
Society for Continuing Medical Education and Research (SOCOMER), KIMS
KIMS Faculty Prof G Vijayaraghavan Dr V Ramakrishna Pillai | Prof K Suresh Dr Ramesh Natarajan | Dr N P Padmaja Dr Peter K Joseph | Dr V Meera Dr S V Parveen
in association with Indian Academy Of Echocardiography (IAE) & Indian Association Of Clinical Cardiologists (IACC)
CEDET-2014
On 11th & 12th (Saturday-Sunday) January 2014 At KIMS (Osler Hall, KIMS North), Trivandrum, Kerala
3rd National Conference on
Comprehensive Echo Doppler Evaluation Techniques
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nd Anniversary Issue
[ event preview ]
On a Life-saving Mission Highlighting the importance of ‘Golden Hour’ and spreading the message of saving every throbbing life, the International Summit on Emergency Medicine and Trauma (ISEMT) 2014 is all set to hog the limelight with the delegates and faculties from across the globe Registration Details: Online-offline registrations are available. For online registration in India please visit isemt2014.com/ registration/online-registrationindia and fill the requirements. Before filling the registration form, kindly read the formalities. Select your category, whether you are an Indian Delegate, PG Students/ Interns, Nursing/Paramedics or an Accompanying Person.
The conference is jointly sponsored by JIPMER (above), AAEMI, GAEM and JAANA
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ith the mission ‘Golden Hour for the Golden Jubilee’ the International Summit on Emergency Medicine and Trauma (ISEMT) 2014 is going to be held in Pondicherry from February 12w-16, 2014. The conference is a jointly sponsored by the Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), the American Academy for Emergency Medicine in India (AAEMI), the Global Academy of Emergency Medicine (GAEM) and the JIPMER Alumni Association of North America (JAANA). Dr T S Ravikumar, the Organizing hairman of the International Summit on Emergency Medicine and Trauma (ISEMT) delightfully announced the international meet of ISEMT in Pondicherry. The organizing secretaries of the event are Dr Arun Nandi, Dr Kumar Alagappan, Dr Pankaj Arora, Dr Anita Bhavnani, Dr Nanda Kishore and Dr Ramprakash. There will be 31 international speakers and 19 Indian speakers inthe conference. Pre-conference wrkshops are on February 12 and 13, 2014 followed by confer-
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ences and scientific sessions from February 14 to 16, 2014. Going beyond trauma, the summit will focus on emergencies of all specialties including Paediatrics, Cardiology, Neurology, Pulmonology, Toxicology, Gastroenterology, Ophthalmology, Oncology, bstetrics and Gynaecology. There will be different scientific sessions focused on education for both adult and paediatric trauma care and Emergency Medicine. Core Trauma Care, Early recognition of Critical Injury, suscitation of Life and Limb, Pre-Hospital and Emergency Medical Services, Emergency Nursing and many more topics will be featured during the conference. There will be a day workshop on ‘Disaster Preparedness’, ‘Ultrasound in EM’ and ‘Pre hospital Care (EMT)’. There are also two days workshops on ‘ACLS (AHA certified)’, ‘PALS (AHA certified)’ and ‘EM nursing’. Workshop on ‘ATLS’ will be for three days. ‘Difficult Airway’ and ‘Work Flow Process’ will be for 1/2 day. A perfect getaway from the blitz and buzzing life, ISEMT welcomes you to this quiet and peaceful town, Pondicherry.
Under the category of ‘Select Your Registration’ the candidate is asked to fill the respective amount for the particular workshop he/she is registered for. Conference registration is mandatory for workshop registration except for pre-hospital care (EMT) workshop. Candidates can choose only one workshop, in the view of overlapping schedule. International Registration is available on globalacademyem. org. Deadline for ‘Early Bird’ registration is on December 31, 2013. For offline registration, log on to isemt2014.com/registration and download the registration form. Fill the requirements and details and send the form to: ISEMT-2014 Conference secretariat Office of the Director JIPMER, Dhanvantri Nagar, Pondicherry -605006 Phone: +91 9442182067 Please Note: Conference registration is mandatory to participate in workshops. Workshop registration fee does not include the conference registration.
COLOR DOPPLER | JANUARY, 2014
[ event preview ]
nd Anniversary Issue
Revitalizing Radiology The 67th Annual Conference of Indian Radiological and Imaging Association, which is going to be held at Agra from January 23 to 26, is all set to review and revive the current radiological practices
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hat is the best gift to present India at the dawn of a muchanticipated year? ‘A healthy future’. Wrapped in wonderful memories of the yesteryears, the key to find this precious gift will be unveiled at the biggest radiological extravaganza of the year, IRIA 2014. With a whole lot of ideas and innovations for building a healthy India, the 67th Annual Conference of Indian Radiological & Imaging Association is all set to begin on January 23. The four-day event features scientific deliberations and is bringing in the best known luminaries in the various sub-specialties of Radiology, from India and different parts of the globe.
We have also reduced the number of conference halls so as to decrease the confusion among the delegates
Dr Bhupendra Ahuja Organizing chairman, IRIA 2014
globe. The theme of this year’s conference is ‘Protocols of Reporting Standards of Imaging’. This year’s conference aims to formulate reporting standards and this will definitely benefit the delegates to enhance their radiology practice. The scientific programs covered in the previous editions of IRIA centered on a system rather than a modality. In general, the radiology practice in India is based on modalities and hence, this move. We have also reduced the number of conference halls so as to decrease the confusion among the delegates. The event venue that we have chosen- Hotel Jaypee Palace & Convention Center, Agra, is one of the best of its kind with world-class facilities,” he concluded.
Event Details
Date: January 23-26, 2014 Venue: Hotel Jaypee Palace & Convention Center, Agra, Uttar Pradesh For more details: www.iria2014.com
Indian Delegates IRIA 2014 is going to be a feast for the delegates with focus on various subjects in radiology such as recent advancements in radiology, ultrasound imaging, radiology in day-to-day practice, abdominal ultrasound, pulmonary radiology, cardiovascular imaging, neuroimaging, pediatric radiology, social radiology, pelvic radiology, musculoskeletal imaging, abdominal imaging, breast imaging, gynaecological ultrasound, head and toe imaging, interventional radiology, imaging in trauma and computer assisted diagnosis. Apart from scientific sessions, the event will
COLOR DOPPLER | JANUARY, 2014
also include film reading sessions, various workshops, ICRI CME, orations, presentation of awards, fellowships and a quiz competition. Sharing his views on the biggest radiology conference in the country, Dr Bhupendra Ahuja, the organizing chairman of IRIA 2014 commented, “ The number of delegates who are going to make it to IRIA 2014 is very high when compared to the previous editions of IRIA. We have nearly 3000 registrations so far and the company representations are also high. We have managed to bring in the best faculty in the field of radiology from across the
Category
Fee
IRIA Member
Rs. 7,000
Non IRIA Member
Rs. 7,500
PG Student
Rs. 6,000
Accompanying Person
Rs. 6,500
Trade Delegate
Rs. 10,000
Foreign Delegates Category
Fee
SAARC Delegate
US$ 250
Overseas Delegate
US$350
Accompanying Person
US$300
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[ upcoming issue ]
nd Anniversary Issue
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Treating the Emperor of All Maladies: Know What’s New and Trending!
ancer is still a word that strikes fear into people’s mind. Unlike other killer diseases, cancer gives a slow death involving pain, suffering, mental agony and despair. When the surveys show that every year 7.6 million people worldwide lose their lives due to cancer, it is also a silent fact that many of these deaths were preventable. The technology has advanced to the point where the disease can be detected much earlier. On account of World Cancer Day on 4th February, the next issue of Color Doppler provides insight into this area of technology. A detailed analysis through different types of imaging in cancer, with exclusive articles on the treatments and side effects intend to educate the readers on the latest imaging technologies
February issue of Color Doppler provides insights into the advanced cancer imaging technologies, with special emphasis of detection, treatments and side effects Cancer detection techniques Imaging different types of cancer Treatments and side effects Feature: World Cancer Day Special Featured Events: IRIA 2014, ISEMT 2014 and CEDET 2014 Editorial contact:
info@colordopplermedia.com, +91-9447766392
associated with the disease. To add to it, the real-time reporting from the venue of IRIA, ISEMT and CEDET will provide the readers with the most up-to-date updates in the radiology sector.
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