Dave Fornell, Editor DAIC
There were a few intriguing technology trends at the Radiological Society of North America (RSNA) 2014 meeting that shine a light on what the future of imaging holds. Among these are: touchscreen operation ultrasound systems; use of pocket ultrasound and app-based ultrasound technology that allows use of a smartphone or tablet as point-of-care imaging system; tracking systems to automatically record and report on radiation dose and contrast media used on each patient; and a movement away from traditional PACS and CVIS silos to a new concept of enterprise imaging.
Carestream introduced a high-end ultrasound system that uses only touchscreen interfaces, similar to the operation of a smartphone or tablet. The system also is the first to use a touchscreen control to replace the track ball. This use of sealed glass touchscreens makes cleaning and infection control much easier, especially as ultrasound increasingly is used for procedural guidance in both the OR and interventional lab. OEM vendor Grayhill also demonstrated new concepts in touchpad/touchscreen technology not only for ultrasound, but also for use on other imaging modalities to improve infection control.
Pocket-sized ultrasound systems were pioneered by GE Healthcare’s V-scan, which was upgraded at this RSNA with the introduction of a two-sided probe, combining a linear and sector probe for surface and deep imaging. Three other vendors introduced their versions of tiny point-of-care ultrasound systems, including Philips, which showed a work-in-progress app-based ultrasound system. It uses a new transducer that performs all the beam forming and computing to reconstruct the image in the probe, and uses a standard tablet or smartphone with a downloadable app to turn it into a basic ultrasound system.
Concern over cumulative patient and staff radiation dose from CT and angiography has prompted legislation for dose recording in a few states, which brought the issue to the forefront at RSNA. Numerous vendors showed dose recording software that automatically collects information of kV level, dose length product (DLP) and duration to estimate dosages, and sends the data to reporting systems and patient records. Concern over contrast-induced nephropathy has also prompted vendors to create contrast dose tracking systems to record the exact amounts injected into patients. These efforts are being led by both automated contrast media injector manufacturers and the primary CT vendors. New technology for real-time staff dose recording is also becoming a big area of interest in the cath lab.
Perhaps the biggest trend seen not only at RSNA, but in all radiology, cardiology and IT meetings this past year is the move away from traditional PACS and CVIS silos of data to enterprise imaging. Healthcare reform mandates interoperability between the traditional silos of imaging and patient reports that reside in each department, and that these elements be integrated into a central patient electronic medical record (EMR). This is not being made possible with the use of vendor neutral archives (VNA) as a central repository for all hospital departments. By “deconstructing” the PACS and CVIS to pull the department’s choices for the best viewers, DICOM worklists and reporting software from various vendors, they can build what they feel is a best of breed system in each department. The VNA then enables access to images and data throughout a hospital, healthcare system or regional health exchanges. The VNA also enables interfaces with the hospital EMR so images, waveforms and departmental reports can be attached to each patient’s files for a complete record located in one location. Some traditional PACS vendors are no longer using the term PACS and now refer to their systems only as “enterprise imaging systems.”
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Below are some of the new product releases from RSNA 2014.