There are more than enough significant issues in the world today to easily distract any of us from ongoing scientific and medical developments. So, in the spirit of recognizing hard work and serious effort, I think it’s worth some time to see what may be coming soon to your hospital, imaging center or clinic.

SPIE — San Diego
The International Society of Optical Engineering (SPIE) held its annual Medical Imaging meeting in San Diego from February 15 to 20, 2003. With more than 1,000 attendees, this meeting retains its status as the pre-eminent gathering for the advancement of medical imaging related R&D topics. While the meeting includes top-level M.D.s, Ph.D.s, CEOs and R&D VPs, the real energy of this meeting is provided by the students, fellows, post-docs and researchers who are responsible for delivering on the technical developments promised by the theory. This is a none-too-subtle reference to the “10 percent inspiration, 90 percent perspiration” theory of scientific development, as much of this advanced work depends on the heavy lifting performed by these scientists. It is continually interesting to note that these scientists are located throughout the world, yet seem to collaborate across borders and time-zones on their common pursuits of improved imaging technology.

New and interesting
The keynote plenary presentation on optical coherence tomography imaging was delivered by James G. Fujimoto, Ph.D. and professor from MIT. Dr. Fujimoto’s work in the field of OCT covers many years, and his presentation to the standing-room-only audience led many to think that OCT will be the new kid on the imaging block for the next few years. Dr. Fujimoto encouraged the audience to consider OCT from the perspective of an optical biopsy tool. Today, cells are primarily extracted for analysis under the microscope, but tomorrow these same cells will be routinely analyzed in-vivo. OCT technology has moved rapidly to broad clinical application already in the ophthalmology field, led by Zeiss. Other applications expected to arrive soon were noted in the fields of osteoarthritis (in-vivo assessment of cartilage tissue), neoplastic (cancer) evaluations in the trachea, colon and esophagus and arterial plaque characterization (vulnerable plaque or evaluating effects of device interventions).

Dr. Fujimoto’s presentation was only one hour in a six-day meeting, however, so there was much more to note from this meeting as well.

PACS researchers generally have interesting developments to discuss, and the most note worthy presentation this year was offered by Chris Carr of RSNA on developments in IHE (Integrating the Healthcare Enterprise). IHE is not a new standard, but it is a group that develops interoperability protocols to enable hospital-based computing systems to work on an organized basis. The key standards in most every hospital system are either HL7 (patient information) or DICOM (imaging and procedure information), and IHE began several years ago to link the information from these standards in the radiology domain. IHE successfully bridged the HIMSS and RSNA meetings, and is now officially expanding into the cardiology field, which brings a clinical medical specialty into play that heavily depends on medical imaging for diagnosis and treatment strategies. Details are available at the IHE web site at www.rsna.org/ihe. IHE also is moving globally by either expanding or establishing country and continent specific groups (IHE Europe, IHE Japan, etc.) in order to leverage the benefits of the work initially done for the U.S. hospital market, and make these developments suitable for deployment in other parts of the world.

The performance and new developments in flat panel x-ray detectors were discussed late into the night by many SPIE attendees, as these devices have survived the first major round of commercial deployment. There was a great deal of confidence regarding improvements from the next generations of these devices as well, so the days of x-ray film may well be confined to a decreasing group of smaller sites. Can you spell Buggy-whip?

Image processing discussions, typically revolving around 3D workstations in the past, are now accelerating into specialized pre- and post-processing routines. A certain amount of image processing is performed routinely in CT and MRI exams, but the introduction of digital x-ray has stimulated even more development in this area. I’m expecting to see even more development work in this area over the next five years, in tandem with the work being performed in the CAD field, all focused on obtaining improved diagnoses by hard-working clinicians and radiologists.

With strong leadership from this group of scientists, engineers and clinicians, we can look forward to medical imaging procedures that result in timely and effective diagnoses and treatments for patients anywhere.

Doug Orr, president of J&M Group (Ridgefield, Conn.), consults with medical device companies in strategy and business development for emerging growth markets, notably radiology and cardiology. Comments and suggestions can be sent to dforr@aol.com.