(left to right) Edge Medical’s QuixDB; Canon CXDI-22 U-arm; Fuji SmartCR

Despite the prognostications that digital radiography (DR) would overtake computed radiography (CR), the two medical imaging modalities continue to co-exist quite nicely.

In the last year, several CR companies — such as Agfa Corp. (Ridgfield Park, N.J.) — have crossed the imaginary line of demarcation and inked alliances with DR vendors — Canon Medical Systems (Irvine, Calif.), in Agfa’s case — to broaden product portfolios and offer both technologies to customers.

And on the DR side, entrenched manufacturers and budding entrepreneurs both are looking to reduce the high cost of DR systems by redesigning and improving existing technologies.

Edge Medical Devices Inc. (Sackensack, N.J.) this year ventured to RSNA for the first time with a novel DR design.

Edge Medical President A. Robert Sohval touted the company’s new works-in-progress QuixDB digital bucky and Quix100 digital X-ray detector as “affordable DR, which will break through the cost barriers on DR, which have impeded widespread market penetration.”

Edge utilizes what it calls smart matrix array readout technology, or SMART, rather than an active matrix array. Edge’s line scanner sweeps across the detector surface in 1.8 seconds and captures electric charges and converts them into a digital image. The company uses selenium-based semiconductors and directly converts X-rays to electric charges in a single step.

Edge’s monolithic 17-by-17-inch is designed to handle chest, abdominal and extremity exams without requiring detector rotation. The flat-panel system is three inches wide.

Edge’s products and technology are pending FDA clearance, so the company cannot talk specific prices. However, Edge estimates that its upgrade will be approximately half the cost of other DR upgrades.

Sohval says Edge plans to apply for FDA clearance early next year. If all goes well, Edge could begin deliveries of its Quix DR line by the middle of 2001. There are two market targets — OEMs for integration into their DR products and as upgrades or retrofits to current DR end-users.

Fujifilm Medical Systems USA is looking to solidify its standing in computed radiography (CR) with new product introductions.

In CR, Fujifilm debuted its new FCR 5000MA with dual-side reading and 50-micron capability for digital mammography. FCR 5000MA is a single-plate image reader that will accept all common cassette sizes and includes dual-side reading and 50-micron capability in 18 cm by 24 cm and 24 cm by 30 cm sizes.

FDA clearance on the FCR 5000MA is pending. Fujifilm anticipates that it will be available in early 2001. The mammographic application will not be available in the U.S. initially.

Fujifilm also unveiled its new compact SmartCR unit. At three square feet, the SmartCR has the smallest footprint of any CR system. All components work as a complete unit and feature a flat-panel touch screen and information processing unit, making the SmartCR multifunctional as a reader, workstation and ID-terminal.

“Our advanced image plate technology is the key to SmartCR’s high speed, high quality image output, because the amount of energy needed to scan the image from the plate is much less than traditional systems, shortening the time it takes to read the image and improving workflow,” said Todd Minnigh, national marketing manager for digital X-ray.

The SmartCR has a list price of less than $96,000. Shipping began with RSNA 2000 with some 30 units delivered.

VersaRad D radiography system is featured for the first time at RSNA by Fischer Imaging. A fully integrated digital radiographic system has been installed at 20 sites worldwide.

VersaRad D is designed for multi-purpose general radiographic applications. Because it rotates around the patient, it can be used for trauma victims, as well as ambulatory, standing, sitting or recumbent patient positions. As a digital system, it provides all the advantages of filmless imaging, including rapid throughput, decreased number of re-takes, and storage and retrieval capabilities enabled by a PACS.

The theme for general radiographic for Siemens is enhanced workflow management, said Tim Ketchmark, manager for AX division.

The Vertix FD is a ceiling-mounted X-ray source with a wall bucky that can tilt 90 degrees to perform arm and skeletal work, or 20 degrees for other images. The system includes a 17-in. by 17-in. amorphous-silicon detector with a 3K-by-3K matrix that yields 143 micron pixel size to produce good image resolution.

The Iconos R200 overtable R/F system was introduced last year. This year, Siemens has added several configurations to reach a greater number of price points. For example, instead of using the Florospot Top, there is the Florospot Compact as the digital imaging system to make the system affordable for smaller institutions.

GE Medical Systems highlighted its GE Revolution XR/d, a fully digital radiology room. Now FDA-cleared and commercially available, this system has been installed in 100 sites worldwide. The system features an enhanced DICOM networking capability.

Introduced as a works-in -progress, Dual Energy Radiography is enabled by the rapid readout capability of the GE Revolution detector. The flat-panel detector is capable of fluoroscopic procedures with a 7.5 frames per second readout time. A clinical application for this technology involves lung cancer detection.

“In most cases when lung nodules were missed in a chest X-ray, 85 percent of the time it is because they were obscured by bone,” says Scott Shubert, manager of global X-ray research marketing. “This system allows you to create an image where the bones have been ‘removed’ from the image.” The system has not been cleared by the FDA at this time.

Philips Medical Systems launched its Integris Allura, a dedicated interventional system designed to maximize 3D reconstructions. The system also can be customized for vascular, cardiovascular, neurovascular and nonvascular interventional and diagnostic procedures.

With its compact, ceiling-mounted C-arm, the Integris Allura is designed for greater patient access and its fully digital CCD imaging chain allows for better visualization for small vessels, stents and coils

In CR, Philips is replacing its AC 500 single-plate CR reader with its new Compano. The Compano will have the same features as Philips’ AC 5000 CR reader, which the company will continue to market. Compano has a smaller footprint than the AC 5000 and is within the same price range. Philips plans to ship the FDA-cleared product in the middle of 2001.

(left to right) Alara MetriScan; Canon CXDI-22 digital radiography bucky sensor unit system; Philips Integris Allura

Canon Medical Systems came to RSNA with a new version of its DR system.

The CXDI-22 digital radiography bucky sensor unit system offers a more functional user interface, storage for up to 750 images and the availability of a rotating U-arm and a tilting vertical wall-stand for easier and more versatile system operation.

The CXDI-22, which employs Canon’s patented amorphous-silicon sensor technology, has a flat plate thickness of 2.9 inches and can be retrofitted for customers who have bucky systems. The thin sensor allows customers to replace film cassette holders, while continuing to use existing X-ray generators in bucky table systems and bucky wall-stand systems. The new rotating U-arm allows the system to be maneuvered more easily, especially in emergency situations where patient mobility may be limited.

System prices range from $225,000 for a retrofit to $340,000, which includes a U-arm.

If RSNA is any indicaton, 2001 could be a “breakout” year for Cares Built Inc. (Keyport, N.J.).

Topping the list of products set to debut in 2001 is Cares Built’s Calrity 7000 direct digital imaging system for full-body imaging. The company has finalized the information for its FDA 510(k) clearance and, if all goes well, could have clearance in the first quarter.

Cares Built debuted Theseon, a multi-positional analog X-ray system, which can upgrade to a Clarity 7000. With a price range of $45,000, Theseon targets the hospital that is trying to optimize space and needs X-ray equipment that they handle many positions for a modest price.

The company also launched its Athena remote R/F system with table-side console at RSNA 2000. The company has added a video conferencing feature to Athena whereby a patient can see and communicate with the attending physician and vice versa through a nearby monitor.

Ken Alderfer, vice president of sales, says the Athena is ready to ship.

Also on display at RSNA 2000 were Cares Built’s mobile X-ray system, the Hercules 7000. The system, which was introduced to dealers in July,

is FDA 510(k)-cleared. Midway through the fourth quarter, Cares Built had installed eight Hercules 7000 units.

Cares Built also has a bone densitometer called Armadeus, which is pending FDA clearance. Aldefer says Armadeus is one of the few ultrasound bone densitometers for the foot that produces an image for diagnosis.

Plans are to ship early in 2001.

Also in the product catalog is Cares Built’s Atlas 4100,

a multi-purpose remote C-arm table for special procedures, interventional radiology, general R/F, general angiography and trauma. The company’s Apollo mobile C-arm features 130-degree orbital motion, rotating anode system for interventional surgical procedures and full fluoroscopic capabilities.

Swissray International Inc. (Elmsford, N.Y.) brought five new products to RSNA 2000, including OrthoVision, a software package intended to convert an orthopedic practice to digital imaging.

OrthoVision is designed for full-length spine imaging for scoliosis evaluation and facilitates leg-length studies by combining multiple, full-size radiographs into a single diagnostic image for orthopedic surgeons. The product began shipping in October.

Swissray also highlighted its new ddRModulaire, a complete, entry-level ddR system that the company said competes at the price for detector-only retrofits. Beginning at $250,000, the compact ddRModulaire incorporates Swissray’s patented overlapping quad-CCD detector in a new stand and features a counter-balanced, free-swinging isocentric arm to help with positioning.

Other offerings at the Swissray booth included:

• ddRFluoroscopy: The works-in-progress is designed to allow both DR and digital fluoroscopy with the same detector. Digital processing will output 2k-by-2k digital radiographs, while a separate but parallel imaging chain in the detector is expected to provide high-definition, high-resolution fluoroscopy.

• IGS2000: A pedestal table designed to provide positioning flexibility, the works-in-progress offers erect and supine positioning options, a free-floating top and a remote control option.

• IGS1000: Designed with a four-way floating top, the IGS1000 is available now on all Swissray ddR systems.

Toshiba unveiled its newest X-ray offering at RSNA — the all-digital, multipurpose Ultimax X-ray system. Ultimax offers a full range of diagnostic capabilities, including R/F, nonvascular intervention and angiographic procedures. It features two tantalum (Ta) filters, which help reduce radiation dose to the patient by eliminating low-energy X-rays, while cutting high-energy X-rays to suppress scattered radiation.

Ultimax is available in six variations, all with a standard, Windows NT-based digital platform, but each with different image intensifier sizes and choice or either dual or triple X-ray tube. The product currently is available, with more than 50 installed worldwide.

Also at RSNA 2000 was second-generation software for Toshiba’s 3D angio workstation. The Windows NT-based workstation, used to review MR, CT and vascular studies, is designed to render fine vessel detail in more clarity and reducing reconstruction time to 2.5 minutes. The product is available.

Advanced Instrument Development (AID of Melrose Park, Ill.) rolled out its new IMIX 2000 DR suite. This full digital radiographic room features a two detector system: one detector mounted on a wall bucky and one DR detector mounted in an elevated float top table. The 40cm x 40cm image size CCD panels permit display of the image in 10 seconds following exposure. The DICOM 3.0 compliance enables integration of the IMIX system with other DICOM applications such as PACS, reading workstations or laser imagers.

Imaging Dynamics Corp. (Calgary, Alberta, Canada) has developed and holds patents for a CCD (charge coupled device) based digital X-ray system that converts visual images (light data) into digitized data. At this year’s RSNA, IDC launched Xplorer 1700 system with several unique features.

The 17-in. by 17-in. image area may be used to retrofit older radiography equipment. As a self-triggering system, it does not require a connection to an X-ray source. Because the sensor refreshes every 20 seconds, throughput is increased. At a price point between $100,00 and $150,000 (U.S.), this system is competitive with others on the market.

Control-X Medical Inc. (Columbus, Ohio) launched its enhanced radiographic system that includes a new high-low table called the Phoenix, with upgrades to the TS 99 Tubestand and the PCX HF Series high frequency X-ray generator control box.

The Phoenix table’s vertical height adjustment design permits easy patient re-positioning for a variety of X-ray exams. When placed in the lowest position, even patients in wheelchairs can be positioned easily for arm/hand exams. It offers standard high-speed Bucky operation.

The enhanced TS 99 Tubestand can be installed as a floor to ceiling unit in either a freestanding or wall-mounted configuration. Using a dual-rope counterbalancing system, the unit offers maximum security in addition to ease of operation. The column can be rotated for cross-table exposures.

Trixell S.A.S. (Moirans, France) brought its Pixium 4600 flat-panel detector to RSNA 2000, as production of the digital detectors began last April. Trixell now is ramping up its production capabilities in phases. When the company reaches its peak, it will be able to manufacture up to 5,000 digital detectors a year at its facility near Grenoble, France.

Trixell estimated that by the end of 2000, approximately 100 radiography systems with the Pixium 4600 were installed and in service worldwide. Systems fitted with the Pixium 4600 include Philips’ Digital Diagnost universal Rad system, as well as Siemens’ Multix FD rad system, Thorax FD and Vertix FD dedicated digital chest units.