(left) Rorke Data ASACA TeraCart DVD-RAM library; (right) Philips Digital Spot Imaging (DSI) system

Fujifilm Medical Systems USA Inc. (Stamford, Conn.) debuted V2, the latest version of its Synapse PACS. Synapse V2 is designed to perform sophisticated enterprisewide PACS functions and access information on-demand over slow networks, including the Internet.

“It represents the end of the base development of Synapse and the beginning of offering features to PACS that never have been available before,” said Clay Larsen, Fujifilm’s vice president of marketing and network development.

Synapse V2 includes features, such as Enterprise Multi-View, which integrates a healthcare enterprise’s remote locations with secure logins to control a user’s ability to view information from different facilities with one click.

Synapse AON (access over networks) — which was introduced a year ago as a works-in-progress — allows for faster access to information over the slowest of networks. Synapse AON includes AON Subscription, AON Engine and AON Factor.

AON Subscription allows users to subscribe to selected sets of information through a secure Intranet or Internet connection for faster access to specific images. AON Engine is an advanced compression and decompression technology that compresses images at the time of acquisition and preserves the depth and pixel size of the original image. AON Factor allows for the storage of multiple versions of the same image at different compression levels, Fujifilm initially will offer versions of AON Factor for mid-compression, or clinical level, images and a high-compression level, or reference images.

Fujifilm anticipates a first-quarter 2001 release and delivery for Synapse V2.

Fledgling Image Technology Laboratories Inc. (ITL of Kingston, N.Y.) is hoping radiologists take notice of its new PACS product and unconventional design. The works-in-progress ITL PACS transfers the controls of the viewing surface to a separate touch-screen control display.

“We wanted to design an interface around a radiologist’s workflow, what a radiologist does,” said ITL CFO, co-founder and radiologist Tad Phelps, M.D. “A touch screen gives multiple interfaces using the same surface area.”

Nothing is on the data screen except images. Thumbnail images on one screen correspond to the larger images on a second monitor. By removing control icons from the screen, Phelps said the ITL PACS eliminates distractions. ITL PACS also offers automatic saving of files when an interruption occurs in the workflow and automatic side-to-side comparisons with past reports. It also fully supports the ASP model, DICOM, HL7 and the IHE initiative.

The ITL PACS has been in development for four years. The company has yet to submit its product for FDA clearance. ITL hopes to operate the system in its testing and imaging center — built by CEO, co-founder and radiologist Dave Ryan, M.D. — in the first quarter of 2001. Phelps said the next step would be to install an ITL PACS in a satellite site, pending FDA clearance, and begin sales hopefully by the third quarter of 2001.

Algotec (Raanana, Israel) unveiled two new web-based products geared to referring physicians. Med-e-Mail automatically combines radiology reports with thumbnails of key images and sends them by e-mail to referring physicians. Physicians needing more detail can use a software link imbedded in Med-e-Mail to pull up a complete study via the Internet using Java viewing and processing tools.

For referring physicians who have yet to go online, Algotec offers CD-Surf, a CD-ROM containing reports and key images by providing information to healthcare professionals who may not yet have access to the Internet. The CD-ROM can store up to 650 megabytes of data, enough for a complete imaging study.

Both products have been installed in Europe and are available in the United States.

Konica Medical Imaging Inc. (Wayne, N.J.) featured enhancements to its product line. The improvements are FDA-cleared and set for shipping in mid- to late 2001.

A new high-speed sorter has been added to the DryPro 722 dry laser imager to speed access to completed films. With the imager capable of processing 150 films per hour, the sorter can send output films to any one of five bins.

The Regius 150 Direct digitizer has been improved with the addition of a quality control station to enhance the flow of patient and image data by connecting with several Regius CR systems.

The quality control station automatically self-corrects images for the proper exposure. The increased consistency from one patient to another improves diagnostic accuracy.

Philips Medical Systems showcased its new generation Digital Spot Imaging (DSI) system, which is available in three versions — DSI, DSI Pro and DSI ProVascular.

DSI is designed to streamline workflow by providing DICOM/RIS worklist management capability for scheduling and less duplication of work. DSI Pro features the ability to start one exam before the previous one is finished, to preview previous exams and print the results more quickly.

DSI ProVascular allows clinicians to perform advanced vascular exams, including precise vessel measurements.

In its first appearance in a major medical show as BarcoView (Duluth, Ga.), this division of Barco Inc. Display Systems rolled out three new products at RSNA 2000.

The Imagedesk radiology display system integrates state-of-the-art PC technology with Barco’s greyscale display units into an ergonomic radiology display desk. The combination of all electronic cables hidden within the console, coupled with a cordless mouse, is designed to eliminate clutter. The display system is equipped with a motorized lifting system to enable the desk to be raised or lowered for user preference.

Barco Imagedesk includes Medical Pro quality assurance software, which automatically checks and corrects monitor display performance, if it deviates from reference values.

Medical Administrator is a hospitalwide client/server quality management system that tracks the performance of every individual display. With web-based technology, the software package sends automatic alerts to the appropriate person if a display system does not meet the quality standards set.

Medis Tile 3MP medical flat-panel display system was the final new product featured at the Barco booth. This display system features a swivel base to enable either landscape or portrait positioning, and can be mounted on the wall or ceiling. DICOM Optimizer software insures a consistent image representation, and corrects greyscale tracking.

Vital Images Inc. (Plymouth, Minn.) announced 510(k) clearance from the FDA for its latest version of the Vitrea 2 software product. Vitrea is designed to facilitate surgical planning and non-invasive diagnostic evaluation of CT and MR image data. Vitrea features real-time navigation of 3D volume data, with image manipulation. In addition, Vitrea uses an intuitive clinical workflow through customized clinical protocols that were developed at major academic medical centers. Goals include simplicity of use and speed in workflow management.

Vital Images showcased Vitrea 2 version 2.2 specifically to aid in the diagnosis and analysis of heart disease and brain tumors. The software features new analytic tools that measure vascular function by automating the process of gathering selected vessel measurements for heart disease treatment plans. Vitrea 1 version 2.2 includes enhancements for CT colonoscopy, including integration of 2D and 3D visualization at a rapid speed.

Introduced as a works-in-progress with 510(k) clearance pending, VScore with AutoGate provides a non-invasive measurement of arterial calcification by automatically selecting images with the least amount of motion without the need for EKG signals. In the other version, Vscore with EKG Gate matches cardiac CT images with the corresponding EKG signal, which allows a physician to select images that are generated when the heart is closest to still.

Swearingen Software (Houston) launched an upgrade to its existing RIS product. RMS for Windows combines features from its original DOS-based software package with additional enhancements designed to meet the needs of its customers. Using the Btrieve Database Manager from Pervasive Software (Austin, Texas), RMS for Windows does not require database conversion for existing customers with the DOS product.

The new product retains keyboard shortcuts from its original DOS offering, while adding icon graphics to facilitate navigation through workflow steps. RMS for Windows uses a word processing system that saves all text in HTML to enable web access via a browser. The software modules include functions for patient management, film tracking, scheduling, transcription, inventory, quality control and equipment management. There are additional optional modules for mammography.

A.L.I. Technologies Inc. (Vancouver, B.C.) featured its ALI NewPort version 2.1 DICOM capture unit. Available in March, it serves as the backbone for a digital network system to provide full-motion video streaming of ultrasound cine capture. Either single or multi-frame images are archived in DICOM JPEG compressions (10:1 for static images, 30:21 for cine clips).

Equipped with a compact digital video camera, the system permits an off-site reviewing physician to access images, as well as a view of an exam room. The video streaming system enhancement is scheduled to ship in the third quarter of 2001.

ALI also has replaced an archive-centric approach with a RAID-centric PACS model. With its RAID (redundant arrays of inexpensive disks) system, years’ worth of current and previous studies are available on-line within seconds.

ALI’s new UltraWeb product uses wavelet compression to produce diagnostic quality images for CT and MRI images that are an improvement over JPEG compressions. UltraWeb can review both reports and images, and incorporate reports from an HIS/RIS. Bandwidth capability becomes an important issue for sending images and reports to remote locations due to the size of image files.

Artesian Medical L.L.C. (Dallas), a subsidiary of Cassling Diagnostic Imaging Inc. (Omaha, Neb.), was formed in November to provide system integration networks to function as PACS using an ASP model.

Artesian provides an ASP model of system integration that allows a radiology department to link its legacy equipment to perform PACS/RIS functions of archiving, storage and retrieval of images and data management.

Image copies may be stored in as many as five different places as part of the redundant off-site archiving feature. As part of Artesian’s contract with a facility, the company locks in a fee-per-use for five years. Currently working in 50 sites as a result of its partnership with PACS firm Inphact Inc. (Nashville), Artesian recently closed four contracts at large institutions and anticipates major growth in the coming year.

IDX Systems Inc. (Burlington, Vt.) and Stentor Inc. (South San Francisco) will collaborate to develop a fully integrated medical image and information management system. The product would include a diagnostic workstation, archive, as well as enterprisewide and referring physician distribution capabilities. iVault and iDiag have an anticipated release date of July 2001.

The IDX Imaging Suite and Connect products will be embedded with Stentor’s iSite system. The new medical image and information management product will be offered as an ASP model. The web-based architecture enables a variety of information/image management tasks from registration and scheduling through the patient scanning process to diagnostic interpretation and reporting, onto archive storage and image/report distribution to referring physicians.

Stentor also rolled out a suite of iSite medical image and information products. The suite will feature embedded integration with Imaging Suite, an RIS worklist and workflow image management system. Stentor will offer these new products as an ASP.

The iSite Version 2.0 introduces the first Stentor products featuring Imaging Suite, in which the company is leveraging its core iSyntax technology and expanding its enterprise footprint beyond Web-based clinical image distribution to enterprise-wide image and information management.

Stentor also debuted a specialized workstation for radiologists with a touch-screen control console which allows diagnostic monitor space to be reserved for image display rather than the user interface. Lastly, the new iVault product offering brings a long-term image storage appliance designed for multi-year storage of exams to meet the industry’s legal requirements for long-term image storage.

ScImage Inc. (Los Altos, Calif.) provides image and data management as an ASP provider through its web portal, PICOMOnline, released in 2000. With more than 400 sites using the system worldwide to date, primarily for fast CT, angiography and ultrasound studies, ScImage rolled out three new applications to enhance its web-based data/image management capability.

The echocardiology module was installed for the first time in December in Kansas City. The first MRI module will be installed in Las Vegas in January 2001. The lung nodule scanning module is a works-in-progress.

The NetraMD imaging system workstation is fully DICOM-compliant and 510(k)-approved as a medical device, and uses Microsoft Windows NT operating system. ScImage’s Multiview enhancement permits side-by-side comparative views of imaging studies from all modalities.

Siemens Medical Systems Inc. showcased its new common user graphical interface for cross-modality use that manages radiology department workflow from patient registration to diagnosis to data storage, including all diagnostic images at

a single workstation as it links DICOM-compatible modalities.

Siemens’ Shared Medical Systems (SMS) unit and Siemens Medical Engineering has produced a RIS/PACS combination that was developed from the SMS Radiology Information System (RIS) and the Siemens’ PACS. Completely integrated, this product is described as a RIS-centric PACS by Jon Zimmerman, general manager of SMS e.Solutions.

Fuzzy logic, a prototype program that enhances speed and memory, is one of several product developments from Cedara Software Corp. (Mississauga, Ontario, Canada).

Fuzzy logic enables a new generation of interactive imaging tools for applications based on Cedara’s Imaging Application Platform (IAP) to perform intelligent extractions of information; in other words, to reduce the time required to get to needed information.

For example, a radiologist looking to extract blood vessels from a 3D volume of patient data acquired using MR would click and point using the fuzzy logic application, instead of spending time drawing contours and sifting through individual images.

“It reduces the time to find what part of the anatomy you are looking for,” said Vittorro Accomazzi, architect VIP of Cedara’s Imaging and Information Solutions segment. “Fuzzy logic handles uncertainty. Generally, things are true or false. With fuzzy logic, it is not true, not false, but something in between.”

The flexible, extendable IAP platform allows clinical users to manage large 3D volumes of patient data and automatically extract relevant 3D information on structures or vessels with contextual value intact. It supports a variety of functions, including database, hard copy, DICOM services, image processing and 3D reconstruction from 2D imaging.

Cedera also announced that its subsidiary, Dicomit Dicom Information Technologies (Markham, Ontario), had entered into an agreement with Thomas Jefferson University Hospital (Philadelphia, Pa.) for the company’s 3D ultrasound scanning technology.

Cedara will equip the hospital’s primary reading room and 28 ultrasound scanners with 3D ultrasound scanning technology and DICOM connectivity solutions for local area networks (LAN), wide-area networks (WAN) and remote ultrasound viewing for Cedara’s Dicomit Dicom Information Technologies subsidiary.

Cedara also showed its new DVD technology for ultrasound as a works-in-progress. The 9.4-gigabyte drive can store one year of patient studies. Cedara expects the DVD to be available for sale by the end of second quarter in 2001.

Rorke Data Inc. (Eden Prairie, Minn.) had several new products on the RSNA floor. Plasmon, a 638-slot magnetic optical (MO) library came to light at RSNA.

Aaron Blotsky, regional sales manager of the medical division, said customers can get more storage out of the Plasmon by connecting multiple units using pass-through technology. Options available include web browser, bar code reader and utility management.

Other products from Rorke included:
• The ASACA TeraCart DVD-RAM library, the largest of which features a double-sided 4.7 gigabyte drive for a total of 9.4 gigabytes per slot with 1,450 slots. Libraries can be connected using pass-through technology.
• The 600-slot, 30 terabyte native AIT library, nearly double the capacity of the current 360-slot library.
• The Pioneer DRM-7000 FlexLibrary, which uses Pioneer 4.7 gigabytes of WORM DVDF-R media, and is available up to 720 slots and 16 drives.

At IMCO Technologies Inc.’s (Pewaukee, Wis.), new product capabilities include its System Integration Center. Newly built near the company’s headquarters, the System Integration Center will allow IMCO to increase production capacity as sales increase, while maintaining delivery schedules.

At its Network Monitoring Center, IMCO can monitor networks, file servers or other computers on the network for unusual activity. Once a problem has been detected, IMCO “cures” it with a software solution designed to return the system to its original state.

IMCO’s Secure Storage Center is pressed into service during a catastrophic failure so customers can retrieve its information quickly and securely from off-site storage.

Another IMCO highlight was the IMCO-RAD Capture, a module that captures video images from legacy modalities that do not support the DICOM standard. IMCO-RAD Capture converts non-DICOM images into the DICOM format and transfers the images to the desired destination for review. It is capable of handling up to four modalities.

Hailing the Internet as the “most promising environment — efficient for creating applications and efficient for integration,” Hamid Tabatabaie, CEO of Amicas (Newton, Mass.) introduced amicas.net at RSNA 2000.

amicas.net is a software suite of e-services that allows a healthcare enterprise to broker images and information throughout the institution and to referring physicians. amicas.net features an open architecture, which allows the system to adopt to the needs of healthcare professionals, rather than a propriety approach, which required that healthcare providers adopt to the demands of the system.

Voxar Inc. (Edinburgh, Scotland) launched a new release of its Plug n View 3D software. This PC-based software application, designed to bring workstation features to the desktop for imaging techniques such as CT and MR angiography, is marketed as affordable to smaller health care institutions.

“This is at a price point where for one of our competitors Unix workstations, you can have five or more PCs with Plug n View,” said Andrew Bissell, founder and president.

3D images offer a clinical advantage to communication activities, both from physicians to its patients and between healthcare professionals.

Voxar has entered into several strategic partnerships with a number of OEMs. DeJarnette Research Systems Inc. (Towson, Md.) and Voxar have expanded their collaboration with the integration of Plug n View software into the DeJarnette VisiShare display workstations. Fujifilm Medical Systems will offer the Voxar volume-based 3D functions of Plug n View into its Synapse PACS products.

Real Time Visualization (Con-cord, Mass.) introduced its new VolumePro Net that enables any desktop computer on a network to function as an interactive 3D workstation.

Physicians who are located in different locations may need real-time consultation using 3D images. VolumePro Net is designed to deliver diagnostic quality images to any desktop or laptop PC on the intranet or beyond. This system also allows two physicians to review images on the screen simultaneously, annotate or manipulate them interactively without being in the same place physically.

Agfa Medical Imaging (Ridgfield Park, N.J.) annnounced two new RIS offerings. Embedded RIS is an option that provides full scheduling within radiology, including tracking patients and materials management with a billing component. This product is targeted to imaging centers and smaller hospitals and will be available in the second quarter of 2001. A stand-alone RIS product was developed following Agfa’s acquisition of European RIS manufacturer Quadrad, will also be available in Q2 of next year. Both products offer some portions as an ASP model.

Agfa introduced two works-in-progress: the Impax for Cardiology image management system that provides hospital-wide access to a variety of image modalities such as CT, MRI scans, cardiac and peripheral angiography, intravascular ultrasound and echocardiography.

The other is the works-in-progress Impax for Orthopedics. This system allows an orthopedist to apply templates of prosthetic devices to diagnostic images as part of the surgical planning process.

Eastman Kodak Co.’s (Rochester, N.Y.) Health Imaging division announced that its new DryView 8200 laser imager will be available to customers in early 2001. The dual-drawer unit features multiple on-line film sizes, holding two 125-sheet instant daylight-load cartrides of 14-inch by 17-inch, 14-inch by 14-inch or 11-inch by 14-inch films in any combination. The unit is designed for general radiology and mid-volume CR and DR applications.

Kodak also inked two marketing agreements for its Distributed Medical Imager DMI line. Portable ultrasound developer Terason Corp. (Burlington, Mass.) will market the Kodak DMI

with the Terason 2000 hand-held ultrasound system. Elekta Oncology Systems Ltd. (West Sussex, United Kingdom) will market the Kodak 3600 DMI with Elekta’s PrecisePlan oncology treament planning system and its works-in-progress iViewGT protal imaging system.

In information services, Marconi Medical Systems showed its core of PACS products, including diagnostic and clinical workstations, archives, Web-based results distribution, high-speed networks and workflow managers. Marconi Medical has the additional help of fellow affiliate Marconi Communications to advance its information technology.

Marconi’s IntelliStore archive has a scalable design with built-in redundancy and fail-safe features. It stores and manages data in native DICOM format. Marconi also offers ASP services, as well as off-site, long-term archiving and disaster recovery services.

One works-in-progress is a secure 12-bit web-based distribution product, which will merge medical images with reports.

“The technology can find the key images in the study itself by reading the report through a technology we call automarking image,” said C. Richard Hullihen, Marconi’s vice president and general manager of RIS.

The product is set for release in the third quarter.

RSNA rookie, 3dMD (Atlanta), debuted medical surface imaging software products capable of acquiring a 3D image of the human face or human torso. The DSP 400 and DSP 800, which capture volume measurements and assessing volumetric change, are aimed primarily at cosmetic surgeons. The software helps capture the shapes of objects instanteously, as well as photo-realistic texture and skin tone, making it applicable for facial and breast surgery.

3D software and workstation developer AccuImage Diagnostics Corp.’s (So. San Francisco) newest products will use 3D imaging to perform non-invasive virtual endoscopy, virtual colonoscopy and cardiac calcium scoring, as well as tumor screening/analysis within the heart, lung, breast, colon and brain.

Toshiba demonstrated new software for its simPACS mini-PACS. Version 4.5 software contains new applications, including 3D imaging capabilities. The package is shipping.

simPACS employs a Windows NT-based technology platform for its review station and its archive and uses existing Internet technology and standard phone lines to distribute images electronically to referring physicians.

Toshiba also offers an enterprise-wide PACS as the result of its partnership with Agfa. That system has a Unix-based archive and a Windows NT-based review station.

EMC Corp. (Hopkinton, Mass.) made its RSNA debut to promote its information storage technology and infrastructure products to healthcare providers.

EMC’s offerings include EMC Symmertix and EMC Clariion storage systems. EMC Clariion probably sounds familiar. EMC integrated the mid-range storage system into its product when it acquired Data General Corp. (Westborough, Mass.) in 1999. EMC created a division appropriately called Data General to develop, manufacture and market high-end Aviion servers based on Data General’s NUMA (non-uniform memory access) architecture. NUMA is designed to provide high performance, scalability, flexibility and cost-effective performance for consolidated Windows NT and Windows 2000 environments.

Also available is EMC’s Rich Media Integration Platform for secure distribution and management of rich media asets.