At some point during the 90th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA of Oak Brook, Ill), it's a sure bet that Chicago's McCormick Place will erupt with a buzz in response to the unveiling of this blockbuster new product or that red-hot innovative technology. But until RSNA 2004 officially opens on November 28, no one can claim to know exactly which of those introductions (or reintroductions, for that matter) will capture the greatest attention. After all, close to 700 exhibitors will be at this year's event.

Even so, speculation is rife already as to what is likely to emerge as the most talked-about wares and wherefores by the time the Technical Exhibits close on December 3.

"It's always a challenge to figure out what the big buzz will be ahead of time," says Mike Fiske, director of marketing for healthcare information systems at Eastman Kodak Co's Health Imaging Group (Rochester, NY). "It's probably safe ground to expect that a lot of people will be excited about products that promise to [take] away the pain surrounding image interpretation and the pain of handling the image explosion."

Thomas McCausland, president of Siemens Medical Solutions USA Inc (Malvern, Pa), senses that considerable attention will focus around new products aimed at addressing other, equally urgent healthcare issues, such as patient safety and staffing shortages. His money is on "novel approaches to diagnostic imaging, with the investigation of new clinical applications across modalities, hybrid technologies, and molecular medicine solutions," he contends.

Julie Thomas, US communications manager for BarcoView LLC (Duluth, Ga), offers that today, imaging enterprises are "very concerned with long-term quality" (read: lifetime reliability) along with "cost of ownership, efficiency, and managing large CT data sets." For that reason, what she expects to find garnering a lot of notice at RSNA this year-as far as workstation monitors are concerned-will be LCD standardization, more color, and breakthroughs in 3-D imaging.

Tom Umbel, senior VP of business development for Hologic Inc (Bedford, Mass), thinks the talk of the show will be emerging technologies in breast imaging, especially advances in digital mammography.

On the other hand, expecting keener-than-ever interest in technologies to improve patient care and reduce costs is Mark M. Miller, VP of sales and marketing for ZONARE Medical Systems (Mountain View, Calif). "The actual buzz might be about the companies that try but fail to pull that off," he suggests. "[I also expect] some chatter about where the growth is. In ultrasound, it's in the compact arena, which has been growing at 25% to 30% a year, compared to 8% to 10% per year for ultrasound in all categories combined."

Miller hints, too, that attendees might hear some grumbling about the emerging use of ultrasound in nonclinical environments, such as shopping mall–based boutique businesses that have sprouted of late for the purpose of providing to pregnant women ultrasound "portraits" of their child in the womb.

"I think the physician community represented at RSNA will be heard voicing opposition to any use of ultrasound without there first being a medical indication for it," he says, adding that, when there is an indication, physicians likely will insist it be provided only in a clinical setting and by qualified personnel.

Michelle Pommells, director of business development and product communications for Cedara Software (Mississauga, Ontario), predicts that a variety of showstopper innovations will have everyone agog.

"People will be captivated by any Web-driven PACS technology that offers a full range of diagnostic tools directly at the workstation or over the Web at clinicians' offices, making postprocessing workstations redundant," she says.

Other buzz generators Pommells foresees include mobility solutions in the form of wireless PC tablets; more facile RIS/PACS integration solutions; automated 3-D, with automatic segmentation and analysis; superfast multi-slice CT scanners that reveal the subtlest of tumors by means of better, smarter visualization applications; mammography and computer-aided breast imaging that improve the ability to differentiate cancerous tumors from benign masses on breast scans; more highly evolved interventional radiology applications, such as image-guided therapy; PET-CT molecular imaging; and holographic imaging in interventional surgery.

How well the prognostications of Pommells and the others hold up will be evident soon enough. In the meantime, the exhibitors are queued up and ready to showcase their offerings. Have a look at what to expect during the 6-day run of RSNA 2004.

CR, DR, Film, and X-Ray

Canon USA Inc's Medical Systems Division (Irvine, Calif). A full line of DR products will be on display at the Canon booth, including the Canon CXDI-50G, a large-area, portable DR system. When integrated to a portable X-ray unit, the system can be used at multiple patient locations, such as the patient¹s bedside, ICU, or trauma. Also up for perusal will be the Canon CXDI-40G, a general DR system that will be featured in a universal stand, R&F table, remote table, and single-plate solution. And don¹t miss the DR Image Viewer, a viewing system designed for optimum use with Canon DR.

Cardinal Health's Triad TnT (top) offers multimodality calibration and QA testing. The MediCanvas (bottom) is the company's X-ray film illuminator.

Cardinal Health Inc (Cleveland). Multi-modality calibration and QA testing promises to go smoother and faster with Cardinal Health's new Triad TnT. In the hands of an X-ray field service engineer or physicist, it allows an array of highly sensitive measurements to be taken. Also on display will be Cardinal Health's Medicanvas X-ray film illuminators. These ultraslim TFD-LCD screens (just 1-inch thick) are designed to be placed in close proximity to PACS imaging monitors so that users can save time when recalling nondigitized patient films for comparisons. Cardinal offers two other X-ray illuminators as well: the premium Maxant Techline and the cost-efficient Maxant MVP.

CMT Medical Technologies (Haifa, Israel). Up for inspection is CMT's new line of DR systems. Featured products are the SmartRAD Elite (a single-detector upright system for chest applications), SmartRAD OmniX (a single-detector, multipurpose universal arm system for all types of radiographic exams), and SmartRAD GeminiX (a dual-detector system for all types of radiographic exams where high throughput is desired). CMT is positioning the SmartRAD line as a retrofit solution for radiography rooms and, alternatively, as an OEM partner opportunity. Features include a Pixium 4600 flat-panel detector with a DuraRAD-QSL enclosure, a 17- x 17-inch image area, and an exposure-to-image-display time of less than 4 seconds.

Eastman Kodak Co's Health Imaging Group. One of the many products to be highlighted at the Kodak booth is Hyper Speed G Medical Film. This new general purpose medical imaging film is designed to reduce radiation dosage for patients by up to 50% while still maintaining excellent quality. According to the company, Hyper Speed G is the first high-resolution radiographic film in 20 years to offer a significant radiation dose reduction. Also, the film's increased speed will reduce the impact of patient motion and retakes due to blurring caused by motion. Also, shown as one of a handful of works-in-progress, Kodak will be highlighting a new DR system that provides extra flexibility. With single- and dual-detector options, users can design a DR system that fits their exam room, applications, workflow, and budget. The new system features a wall stand (with detector) or a fixed four-way float table (with detector) that can be used alone or combined into a dual-detector configuration. An integrated operator console will control all imaging functions to expedite workflow, increase productivity, and support improved patient care.

Go wireless with FUJIFILM Medical Systems' Flex-UI for Handheld Devices (top, inset), featuring CR software and the ability to work remotely. The Xplorer 1600 (bottom) from Imaging Dynamics can perform chest and general radiography procedures.

FUJIFILM Medical Systems USA (FMSU of Stamford, Conn). High productivity in a DR system is found with FMSU's FCR Velocity-T, offering throughput of up to 240 images per hour and a fully processed image available in less than 9 seconds. The company describes the Velocity-T's cost of ownership as the lowest of any system in its class, providing maximum DR productivity at an affordable price. Another offering attendees will be able to examine is the Flex-UI for Handheld Devices. Here, FMSU has combined the customizable user interface of its Flex-UI CR software application with the convenience of remote workflow via wireless tablet PCs or PDAs. The result is that patient data and CR images can be accessed faster, right from the patient bedside, permitting caregivers to increase efficiency and reduce the potential for medical errors.

Imaging Dynamics Co (Calgary, Alberta). Great news for fans of CCD-based DR systems: Imaging Dynamics recently received FDA 510(k) clearance to begin marketing the Xplorer 1600, which will be on display at RSNA. It is being presented as a complete solution that includes a CCD Xplorer imaging detector paired with a Magellan II workstation. Also included is a U-arm positioning stand, attached X-ray tube and collimator, and an X-ray generator. As a result, the Xplorer 1600 can perform both chest and general radiography procedures-including cross-table exams-without the room needing to be equipped with an overhead structure.

InfiMed Inc (Liverpool, NY). Scheduled to appear at the InfiMed booth are a variety of the company's products, including the PlatinumOne Digital R/F Imaging System, the PlatinumOne Cardiac Portfolio, and the PlatinumOne Digital Subtraction Angiography System. They all have in common a reliance on the Innovision Digital CCD camera, which is optimized for each specific application. Also to be shown is the StingRay DR system, featuring a 17- x 17-inch Trixell flat-panel detector and full-resolution image acquisition in under 8 seconds.

Clockwise from left are Orex ZR, a mobile CR device from Orex Computed Radiography; the PaxScan 2020, a small panel designed for the diagnostic C-arm market from Varian Medical Systems; and the X-Sight, a digital processor from Stallion Technologies.

Orex Computed Radiography (Auburndale, Mass). Adding to a line of compact, cost-effective CR scanners, the company will introduce two new products. First, Orex ZR is a cart-based cordless and wireless scanner. This mobile CR device can move freely within a facility without external power or network limitations. It features a 4.5-hour battery life and Wi-Fi networking capabilities. Second, Or-PACS is a robust DICOM 3.0 image analysis, communication, and archiving solution. With versions fine-tuned for radiology, orthopedics, and radiation therapy, the software provides a scalable, user-friendly application that fully integrates both acquisition and PACS functions, while providing fast remote image archiving and communications. Or-PACS also offers such advanced functions as viewing stations, dual high-resolution monitor support, CD burning, and both short- and long-term storage.

Precise Optics (Bay Shore, NY). It's hard to tell from the outside, but under the hood of the PS 3000 Digital Photospot are state-of-the-art components arrayed to deliver quality and performance in the arenas of high-resolution digital fluoroscopy, DR, and interventional radiology. The PS 3000 consists of a 1024- x 1024-dpi x 12-bit sequential scan, large-area CCD camera head, a Pentium-class image processor running Windows 2000 Professional, an 18.1-inch flat-panel LCD monitor, and DICOM connectivity.

Stallion Technologies Inc (Liverpool, NY). On display from Stallion will be the X-Sight product line. Developed for any type of fluoroscopic imaging, X-Sight's digital processors deliver high-level performance and versatility in such applications as urology, EP, mobile C-arm, R&F, angiography, and cardiac cath. The X-Sight line offers a rich set of features for acquiring, processing, and displaying 12-bit images at resolutions up to 4K x 4K and at rates of up to 120 frames per second. The products have recently been upgraded with numerous enhancements, including integration of flat-panel technologies, time-saving automatic network functions, faster acquisition rates, a proprietary digital composite filtering technique, more DICOM options, and greater support for third-party cameras and detectors. The X-Sight line is practical for both upgrade and integration with new equipment.

Toshiba America Medical Systems (TAMS of Tustin, Calif). TAMS plans to display an assortment of X-ray systems, namely the Infinix VC-I for interventional and diagnostic vascular exams. The Infinix series platform is a new architecture based on both Windows and TAMS' proprietary processing capabilities.

Varian Medical Systems (Palo Alto, Calif). From Varian, two new X-ray products are set to make their debuts at the show: PaxScan 2020 and PaxScan 4030CB. The PaxScan 2020, a small panel designed for the diagnostic C-arm market, is geared for applications using 9-inch image-intensifier tubes. The fast-command processor is optimized with extended memory for operating in different acquisition modes, from 1 to 60 frames per second. The active imaging area is close to the panel's edge, for unrestricted access to the patient. An optimized pixel structure ensures low image lag and an improved signal-to-noise ratio. On the other hand, PaxScan 4030CB meets the needs of the emerging cone-beam X-ray imaging market. This panel is suited for medical diagnostic X-ray equipment requiring a 20-inch diagonal imaging area. It features multiple programmable sensitivity ranges and an extended dynamic range capability.

CT (Computed Tomography)

Cardinal Health Inc. The company will be highlighting its multiuse CT Dose Phantom set, featuring a new pediatric head phantom. The phantom kit consists of three parts: an adult body phantom, an adult head phantom that doubles as a pediatric body phantom, and the new pediatric head phantom. Each phantom can be purchased separately or combined in a kit according to need.

Cedara Software. The downside to owning an advanced multi-detector CT (MDCT) system is that it can leave you drowning in a flood of images. That's reason enough to drop by the Cedara booth for a demo of the company's new CT Works application. The solution uses automated presentation procedures to optimize the way users view and report MDCT studies, allowing users to view more patients in the span of a day and maximize overall reimbursement levels-without sacrificing quality of care. Features include a dynamic worklist triggered by matching user criteria, automatic presentation of wanted images, automatic selection of layouts and tools, and automatic loading of pending studies. Use CT Works in tandem with Cedara's new I-Report CT, an advanced CT-focused reporting workstation.

DeJarnette Research Systems Inc (Towson, Md). Demonstrations of the newest version of dyseCT are on tap at the DeJarnette booth. The software's patented technology automatically segments a CT scan into its various body parts and associates them with the correct billable orders, thereby eliminating a major disconnect between the way CT scans are performed and then presented to the radiologist and to the billing department. (Without dyseCT, a single scan covering multiple body parts can result in multiple procedure and billing codes.) Version 2.0 further enhances the functional capabilities of the dyseCT product with improvements in the segmentation algorithm, handling of neurological studies, and handling of CT auto-send for some makes and models of scanners; automatic destination fail-over; and storage commit proxy capability.

Dunlee's DA-200 series CT tubes are rated to 6.3 million heat units.

Dunlee (Aurora, Ill). When you need a quality replacement tube for your GE Healthcare-made CT system, you probably can't go wrong by installing the new DA-200 series tubes from Dunlee. Stop by the company's booth to see for yourself. DA-200 tubes are rated to 6.3 million heat units (MHU). Other features include a high-efficiency stator motor, which provides quick anode start-up. Dunlee tubes also feature a high-performance bearing assembly, which produces quiet operation and long tube life, especially in subsecond CT applications. All DA-200 tube housings incorporate a proprietary heat exchanger for quick cooling and maximum patient throughput. In addition to GE replacement tubes, Dunlee makes replacement products for systems by Picker/ Elscint, Siemens Medical Solutions, Shimadzu, Toshiba America Medical Systems, and Philips Medical Solutions.

From top to bottom are the X-O, a micro CT system from Gamma Medica, and the CT Sim robotic laser tracking system from Gammex RMI.

Gamma Medica Inc (Northridge, Calif). The company will display its new micro CT system, called the X-O-the latest addition to Gamma Medica's family of preclinical imaging products. It's described as capable of performing full-body scans on a range of test subjects in less than 1 minute. The X-O also features a field of view that's nearly 1,000 cm3.

Gammex RMI (Middleton, Wis). A pair of CT-related products worth exploring will be found at the Gammex RMI booth. Start with the company's CT Sim Robotic Laser Tracking System. This 3-D moveable laser system provides users with top-of-the-line precision positioning. Lasers can accept export coordinates from treatment planning systems, allowing easy and precise movement to the marking location. Then, take a gander at Gammex RMI's 467 Tissue Characterization Phantom, which simplifies establishing the relationship between the electron density of various tissues and their corresponding CT number (Hounsfield units). The phantom consists of a solid water disk that is about the size of an average pelvis. A matrix of 16 holes in the disk hold interchangeable rods made of various tissue- and water-simulating materials. Physical density and electron density relative to water is listed for each of the different tissue-mimicking rods. The phantom includes a pattern of small air holes with known spacing for verifying the CT scanner's distance measurement. An optional titanium rod insert is available.

GE Healthcare (Waukesha, Wis). A bevy of interesting reports is beginning to circulate about GE's earth-shaking volume CT system, known as LightSpeed VCT. At the company's booth, you'll learn about how one Milwaukee hospital is using the product to good effect. Basically, LightSpeed VCT is able to noninvasively capture any organ in 1 second, scan the whole body in less than 10, and capture images of the heart and coronaries in fewer than 5 heartbeats. In a single rotation, the system creates 64 credit-card-thin images, totaling 40 mm of anatomical coverage. These images are combined to form a 3-D view of the patient's anatomy for the physician to analyze.

Mindways Software Inc (San Francisco). Attendees are in for a pleasant surprise when they examine Mindways' QCT PRO 3D Spine & CTXA Hip bone-densitometry system for CT scanners. This product provides quantitative computed tomography (QCT) bone densitometry with, the company says, 1% precision in vivo, true volumetric bone mineral density (BMD), and separate cortical and trabecular BMD in the hip. Scanning is said to be fast and easy, with no repositioning of the patient, and exams can be done between normally scheduled cases.

S&S Technology (Houston). Say hello to SimpliCT, a laser system for CT-guided interventions. The product is made by NeoRad (Oslo, Norway), and S&S Technology is now the exclusive US and Canadian distributor. S&S Technology will highlight recent studies showing how the use of SimpliCT significantly reduces both time and radiation dose to the operator during CT-guided interventions. Those studies also indicate that the system facilitates the correct placement of RF ablation needles; thus, it might help standardize a procedure that is dependent on the skill level of the operator. S&S Technology will offer a free 2-week trial of the SimpliCT to radiology departments interested in this new technology.

TeraRecon (San Mateo, Calif). At RSNA 2004, the company will introduce a scalable cone-beam CT reconstruction cluster based on XTrillion processor technology. The system delivers reconstruction of a 2048 cube in less than 30 minutes.

Toshiba America Medical Systems. TAMS will be displaying an array of CT scanners, notably the newest of the crop: the Aquilion 16. This 16-slice model features a MegaCool 7.5 MHU tube, true isotropic imaging in large and small field of view, 1.8 m scan range couch, 40-row quantum detector, 32 mm total detector coverage per rotation, and optional 400 ms rotation speed.

Furniture

AFC Industries' telescopic cart (top) features an ergonomic work surface that is electronically height adjustable. The Carl's Table from Anthro Corp (bottom) is an integrated work environment for soft-copy reading.

AFC Industries Inc (College Point, NY). The company will present its ultracompact telescopic cart, an ergonomic work surface that is electronically height adjustable to enhance ease of use and user comfort. Designed to accommodate tight spaces and offer complete mobility (thanks to stable locking casters), the telescopic cart makes it simple to deploy as many as two flat-panel or CRT monitors wherever needed. Available in nine width and depth combinations, all sizes are customizable with table-mount or clamp-style monitor arms, ergonomic or standard work surfaces, multiple laminate finishes and colors, keyboard arms and trays, and larger casters for an additional 2 inches of height.

Anthro Corp (Portland, Ore). Available for the first time in the United States is Carl's Table (known in Europe as the AW-170 table), an integrated work environment ideal for soft-copy reading in all radiology environments. Anthro Corp is the authorized domestic seller of the Swedish-made Carl's Table, which was developed in conjunction with radiologists, ergonomic experts, and sight physiologists. Features include motorized height- and tilt-adjustment to facilitate all individual work positions, sitting or standing; tilting surface to support forearm and shoulders, thereby dramatically decreasing the risk of musculoskeletal disorders; and integrated automatic light correction to deliver glare-free viewing of the monitor screen.

Biodex Medical Systems Inc (Shirley, NY). Physicians who perform vascular, angiography, or cardiac interventional procedures will want to see this newly redesigned line of surgical C-arm tables-ranging from a low-cost, fixed-height table to a full-motion, free-float XY tabletop. All of Biodex's surgical C-arm tables offer a cantilevered, low-attenuation carbon-fiber tabletop with an extra-large radiolucent area, free of cross-members, allowing full fluoroscopic visualization and unobstructed C-arm positioning. Their functional design accommodates portable or ceiling-suspended C-arms, providing complete imaging access with reduced radiation exposure to clinicians. The line includes tables equipped for pain care, urology, and brachytherapy.

Clockwise from top right are a handful of ergonomically focused products to be displayed: the surgical C-arm table from Biodex Medical Systems; the new Cable Brace from Sound Ergonomics; and the StyleView point-of-care cart from Ergotron.

Ergotron Inc (St Paul, Minn). Get ready for StyleView, an ergonomically designed, point-of-care cart for mounting a flat-panel monitor. It's built to help increase accuracy and efficiency. Features include 20-inch height range for comfortable data entry whether the user is sitting or standing; patented lift technology for fluid, light-touch motion; an oversized work area for everyday tasks; a bar-code scanner holder to improve accuracy and patient safety; and an open architecture for future upgrades. The integrated power supply is UL 60601 listed and certified for safety, and the equipment locks for increased hardware security. The StyleView is available in flat panel, laptop, and tablet PC versions.

Hergo Inc (Long Island City, NY). Making their first official foray into industry view will be Hergo's Hydraulic Height Adjustable Medical workstations. They'll be joined by the company's Orbiter line of LCD flat-panel PACS workstation mounting arms. With Orbiter, workstations can be secured to desks, attached to walls, or suspended from ceilings. Hergo makes an assortment of technical furniture and racking systems, with ergonomic design a key ingredient.

Sound Ergonomics LLC (Kenmore, Wash). Learn how the Ergonomic Workstation reduces the risk of occupational injury in, among others, the sonography environment. The workstation includes an exam table, chair, and adaptive equipment for personal protection. The company also is offering ergonomic training sessions, during which instruction on proper use of the Ergonomic Workstation will be offered. Sound Ergonomics also offers a sonographer ergonomics training program as well as a clinical site evaluation service. Also on display will be Sound Ergonomics' new and improved Cable Brace, which features a D-ring, a wider tab for holding the cable, and an extended one-size-fits-all overall length.

Mammography and Breast Imaging

BarcoView LLC (Duluth, Ga). The newest addition to Barco's successful Coronis line is the 5MP Mammo, recently granted FDA 510(k) clearance. The display system introduces several innovations to further optimize accuracy and "provide the ultimate diagnostic confidence." For example, Barco's per-pixel uniformity (PPU) technology measures and adjusts the luminance output of each individual pixel, thereby eliminating distracting screen noise. Plus, defect-pixel compensation (DPC) ensures that no information is missing by detecting and identifying defect pixels in each display.

This digital mammogram was taken with Cedara Software's I-ReadMammo.

Cedara Software. Expect to hear much about the I-ReadMammo, a digital mammography screening and diagnostic workstation. Newly FDA cleared, it's loaded with features to optimize fetching and viewing of current and prior mammography images. I-ReadMammo also eliminates the need to switch between different workstations, since it supports mammography systems from multiple vendors. Likewise, it saves reading time by allowing radiologists to view images from multiple modalities.

DR Systems Inc (San Diego). Version 6 software of the Dominator Diagnostic Workstation has an important new capability: recently obtained FDA clearance for PACS-related digital mammography uses. In other words, users of DR Systems' products can eliminate their stand-alone mammography islands. The Dominator Diagnostic Workstation was designed for the primary reading of full-resolution diagnostic images, while providing highly efficient filtering, sorting, and worklist management capabilities for quick access to cases. Now, in addition to delivering greater efficiency to facilities' RIS/ PACS workflow, the digital-mammography capability enhances customers' patient image and information management, automated reporting, storage, archiving, and Web-based distribution.

The Health Imaging Group of Eastman Kodak Co offers the DirectView PACS 5 (top, inset), which now supports images from third-party digital mammography systems. Hologic will be showcasing its SecurView radiologist and technologist workstations (bottom).

Eastman Kodak Co's Health Imaging Group. Kodak will be announcing two new products for mammography. First is the extension of DirectView PACS System 5 that supports images from third-party digital mammography systems and includes a specialized mammography workstation. Second is a CAD system for the review of digital mammograms.

Fischer Imaging (Denver). See it in operation: the SenoScan Digital Mammography system, said by the company to be the first and only mammography system to offer 25 µm native diagnostic resolution. (That's about the highest image resolution available-25 µm being comparable to 14 line-pairs.) Fischer also will display an expanded family of soft copy review workstations, the SenoView and SenoView Plus, based on the integration of the Fischer SenoScan Digital Mammography system and the Cedara I-ReadMammo (see page 32). In addition, Fischer plans to showcase its MammoTest Select Breast Biopsy System, featuring a 1024 digital detector that sets the stage for delivery of high-quality images with excellent spatial and contrast resolution. The open design of MammoTest Select provides 360°-lesion access, and its lateral arm helps access superficial lesions and thinly compressed breast tissue.

Gamma Medica Inc. Attendees will be able to see the LumanGEM breast imaging system. Two recent research studies using the LumaGEM have demonstrated its capacity to detect breast cancers missed by standard mammography. Details of these studies will be available at the booth.

Hologic Inc. Last year at RSNA, Hologic unveiled its selenium-based, digital tomography technology for breast imaging. It was a work-in-progress then; it still is, but with advancements, as attendees will see this year. The biggest one is the use of a selenium detector enhanced to deliver an even larger field of view. Also set for display: the newly FDA-cleared digital mammography SecurView radiologist workstation and a new workstation for technologist use. Both feature advanced tools to handle multimodality viewing and to permit more efficient workflow. For example, digital notes and annotations can be exchanged between these two workstations, and certain limitations of PACS are overcome. The radiologist workstation includes a pair of 5 megapixel screens plus a third screen (2 megapixels) for multimodality work. Hologic also will unveil a step-change improvement in bone densitometry.

Livingston Products Inc (Wheeling, Ill). Because of breast size or sensitivity, some patients are difficult to position for mammograms. A possible solution is the Advantage Paddle. Livingston says it allows more room for proper positioning and automatic or controllable tilt for full anterior compression, with less pain for patients. Company statistics suggest that the Advantage Paddle enables administration of up to 5% less patient dosage. It can be locked in any tilt position to 13° or used as a normal flat-compression paddle.

Orex Computed Radiography. The company will be showcasing its lightweight ACLxy CR scanner for mammography, a versatile and cost-efficient system, as a work-in-progress. The scanner boasts an ultrafast processing speed of up to 150 plates per hour.

R2 Technology Inc (Sunnyvale, Calif). With some 1,500 ImageChecker CAD systems shipped to date and now providing interpretations of 8 million annual mammograms, R2 Technology is likely to attract plenty of attention from attendees who are curious to find out more about the systems. Good news: the entire family of ImageChecker CAD systems will be on display. These include the flagship ImageChecker DM (dual mode for film and digital) and the ImageChecker LX and DX CAD systems (the latter two offering a high-value solution to mammography sites with low to moderate mammogram volume). All of the systems are said by the company to increase early detection of breast cancer by as much as 23%.

Siemens Medical Solutions USA Inc. Attendees can feast their eyes on the Mammomat NovationDR full-field digital mammography (FFDM) system that recently garnered clearance from the FDA on a premarket approval application. The all-in-one system provides digital screening, diagnosis, and stereotactic biopsy.

VuCOMP's M-Vu mammography system is designed to detect early-stage breast cancers.

Suros Surgical Systems Inc (Indianapolis). Suros Surgical plans to raise the roof at McCormick Place with the introduction of the ATEC Pearl, its newest biopsy unit designed specifically for stereotactic and ultrasound-guided breast biopsy. The ATEC Pearl offers the same clinical advantages as the new ATEC Sapphire, which will be on display as well. The ATEC Sapphire is a breast biopsy and excision system that gives radiologists and surgeons the ability to perform breast biopsy with any of the three primary diagnostic imaging modalities-stereotactic, ultrasound, and MRI-using a single biopsy unit.

VuCOMP (Plano, Tex). For a sneak peek at a CAD product awaiting FDA clearance and CE marking, head to VuCOMP's booth, where the company will display its new M-Vu mammography technology. This system is designed to reliably detect early-stage breast cancers; however, it takes a fundamentally different approach to image understanding. Just how different, you'll have to see to appreciate.

Monitors and Displays

BarcoView LLC. Making its RSNA debut is Nio, BarcoView's next-generation industry-standard grayscale display system for high-quality, cost-effective soft-copy viewing. Said to feature impressive performance, reliability, and affordability characteristics, Nio benefits from a new, ultrafast display controller, more extended quality assurance functionality, and attractive design.

Monitors will abound at RSNA, including the RadiForce G22 from Eizo Nanao Technologies (left) and a range of Totoku-brand LCDs from US Electronics (right).

Eizo Nanao Technologies Inc (Cypress, Calif). Sharp, brilliant colors. That's the best way to describe the output of Eizo Nanao's new 1 MP color LCD monitor, the RadiForce R12. Offering 1280 x 1024 native resolution across a 19-inch screen, the R12 uses a super in-plane switching (IPS) panel with almost no noticeable color shift when viewing the screen from oblique angles. The R12 makes an ideal reference monitor for CT and MRI systems. The company also will showcase its RadiForce G22 monitor, a monochrome, 2 MP product. The G22, suitable for CT, MRI, and CR, features a super-IPS panel and a 19.6-inch screen, with 1200 x 1600 native resolution.

Image Systems Corp (Minnetonka, Minn). Expect a plethora of diagnostic and clinical high-resolution grayscale and color displays for all types of modalities to be highlighted by Image Systems. Included will be the company's dual-head 2 MP display solution with a calibration feedback system (CFS) software and a demonstration of remote diagnostics and hands-free DICOM calibration. Also highlighted will be a quad-head 3 MP grayscale diagnostic solution driven by a Matrox MED-DVI controller card; a dual-head 5 MP grayscale mammography display solution with a Matrox MED-DVI controller card; and a 24-inch color display solution.

Planar Systems Inc (Beaverton, Ore). It'll be a rollout in more ways than one as Planar introduces its wheeled Dome Surgery Review Cart, available in four different monitor resolutions and usable in operating rooms (ORs) for referral viewing of X-ray, CT, MRI, PET, SPECT, ultrasound, and other types of images. All configurations of the Dome Surgical Review Cart also include Planar's Dome CXtra software, which ensures that image quality on Planar displays conforms to DICOM standards. Dome CXtra software also reduces the total cost of ownership through its enterprise-management capabilities, enabling administrators and IT staff to easily monitor display performance and calibration from a central location using industry standard interfaces. The company expects its Dome Surgical Review Cart to help improve OR efficiency because access to referral images will be available on demand; previously, film images had to be prestocked in the OR prior to the procedure.

US Electronics Inc (USEI of Minneapolis). The company will introduce several new high-resolution, high-brightness flat-panel displays. First are the 3 MP color and 3 MP monochrome Totoku flat-panel displays with internal front luminance and environmental luminance sensors for DICOM calibration. Next is the 2 MP color and monochrome Totoku LCDs with front sensors. USEI's Totoku monitors also feature hardware and software that provides stable image display under a range of conditions to ensure consistent, reliable display characteristics.

MRI (Magnetic Resonance Imaging)

Choy Medical Technologies Inc (New York). At RSNA, the world gets its first glimpse of the Choy Axial Compression Frame, an advanced aid for MRI scans that permits diagnostic study of the spine under physiologic conditions, including simulation of the sitting position. Although the FDA hasn't yet signed off on it, the underlying principle of this technology has been clinically tested for more than 8 years now. The frame's advanced design induces pressure pneumatically and is equipped with a pressure meter that produces more accurate and reproducible conditions. Clinical testing reveals that use of the frame allows clinicians to better identify lumbar spine disorders, while ensuring a comfortable experience for patients with back pain. Thanks to this frame, clinicians can make immediate comparisons for more accurate, specific, and appropriate diagnoses and treatment.

ETS-Lindgren (Glendale Heights, Ill). Recently announced and available for attendees' inspection: a trio of MRI-shielding applications. First, with its pneumatically operated bladderless and gasketless design, the Auto-Seal II Door is a virtually maintenance-free RF sealing system. It comes in three configurations: RF shielded, acoustic, and fire-rated. Next, the Magnetic Active Compensation System is designed to shield sensitive MRI systems from environmental AC/DC magnetic interferences caused by moving vehicles, trains, elevators, electrical transformers, and other sources. It's said to be ideal for super–high-field magnetic applications-up to 3T or higher-and that includes permanent and resistive open MRI systems. (It's also effective in low-frequency applications.) Finally, the Ferromagnetic Detection System is an alarm system that helps detect and warn personnel before an object of significant ferrous metal is brought into the MRI room.

Machnet BV (Elde, The Netherlands). Useful hardly begins to describe the Bilateral 4-Channel Phased Array Carotid Coil for use in an MRI suite. It's designed for bilateral proton imaging of the carotids and allows for submillimeter resolution of the carotid lumen, the vessel walls, and atherosclerotic plaques. Due to its inherent contrast resolution, MRI has the potential to provide a surplus of information on the composition of the atherosclerotic plaque. The coil provides high-resolution images with good definition of both the lumen and the vessel walls, without disturbance from flow artifacts. The assembly of this flex coil is coated with soft polymer foam to minimize patient discomfort as it is positioned. The coil can be placed on both sides of the neck and is held in place with a soft collar.

New QBrain software from Medis medical imaging systems quantifies MRI scans to help monitor the progress of brain diseases.

Medis medical imaging systems BV (Leiden, The Netherlands). QBrain is a new software application that quickly and reliably quantifies MRI scans to provide more detailed information with which radiologists can diagnose and monitor the progress of diseases affecting the brain. The software, which will be one of the centerpiece products at Medis' booth, automatically segments and quantifies images to reveal morphological changes that would be difficult or impossible to determine with the naked eye-especially when evaluating multiple protocols or time points. The speed of the program enables faster diagnosis. Follow-up of patients is simplified, thanks to comparative historic analysis of images.

The Safescan Ferromagnetic MR Wand from Mednovus is a handheld device designed for safety in the MRI suite.

Mednovus Inc (Leucadia, Calif). A duo of highly sensitive ferromagnetic MRI prescreeners will be on display: Safescan Portal 3000 and Portal 9000. These require no construction modifications, and they operate conveniently at a safe distance from magnet Zone IV. Also displayed will be the Safescan Ferromagnetic MR Wand. This handheld device, which sounds the alarms on ferromagnetic-threat objects only, is considered ideal for safety screening at compact MR centers and mobile units.

ONI Medical Systems claims that its 1T MRI, the OrthOneXT, will hold its own against whole-body systems.

ONI Medical Systems Inc (Wilmington, Mass). Sure to be of keen interest to attendees eager to take extremity imaging to the next level is OrthOneXT, a dedicated high-field 1T MRI that more than holds its own against whole-body systems where image quality and throughput are concerned. As a result of its compact open-magnet design, the system is comfortable. According to OVI, OrthOneXT costs 65% less to acquire and operate than a whole-body system-and eats up about 75% less real estate.

Radcal's 9095 multipurpose analyzer is a portable diagnostic measurement system.

Radcal Corp (Monrovia, Calif). For its contribution to RSNA, Radcal is introducing the 9095 multipurpose analyzer, a portable, all-in-one diagnostic and mammography measurement system that simultaneously gauges dose, dose rate, kV, time, and mAs with a single exposure. It features full computer control and data capture; automatic pressure and temperature correction eliminates the need for user intervention.

Siemens Medical Solutions USA Inc. About the only thing you won't be able to see at the Siemens booth this year will be the kitchen sink. The company is girded for an ambitious exhibit that covers a range of innovations and returning favorites. At the top of the ticket, new technologies will be introduced in MRI and CT-but details won't be divulged until show time. Meanwhile, the company will disclose that it will parade the Magnetom Espree (an open-bore 1.5T MR) and Magnetom Avanto (another 1.5T MR, but one that incorporates Siemens' Total Imaging Matrix technology).

Toshiba America Medical Systems. There could be a Vantage high-field MRI in your facility's future following your viewing of TAMS' product-packed booth. Vantage is the company's latest MRI offering-an ultrashort, 1.5T with patented noise-reduction Pianissimo technology. Features include a 1.4-m magnet, 30 mT/m gradients, slew rate of 50 T/m/s or 130 T/m/s, and full 50 cm diameter spherical volume.

Nuclear Medicine, PET, and SPECT

Gamma Medica Inc. On display will be X-SPECT, a dual-modality preclinical imaging system used by medical researchers and drug companies employing in vivo imaging techniques and molecular markers to dramatically speed up studies of disease progression and therapy. The X-SPECT system combines the functional nuclear medicine technique of SPECT with anatomical imaging provided by CT.

Mallinckrodt Inc (St Louis). To be exhibited by Mallinckrodt, a Tyco Healthcare company, will be the newly FDA-approved NeutroSpec in vivo radiopharmaceutical labels white blood cells and myeloid precursors in scintigraphic imaging of patients 5 years and older with equivocal signs of appendicitis. Phase 3 clinical trial findings, available at the booth, reveal that NeutroSpec allowed positive diagnosis of appendicitis cases 98% of the time within 1 hour after injection.

Nuclear medicine products are just one of the highlights at RSNA this year, including the TruePoint SPECT/CT system from Siemens Medical Solutions (bottom left), the PEM Flex PET scanner from Naviscan PET Systems (above left), and the handheld mini-gamma camera from TeraRecon (right).

Naviscan PET Systems Inc (Rockville, Md). After you're finished kicking the proverbial tires on the compact Naviscan PEM Flex PET Scanner, pull up a chair at the plenary session where Mary Beth Lobrano, MD, will present the latest clinical results from a multicenter study in which the high-resolution, breast-focused PEM Flex played a starring role. In a nutshell, the trial demonstrated that the PEM Flex-ideal for scanning in a small room or mobile environment-provides spatial resolution of 1–2 mm, as compared to 5 mm for a whole-body PET scanner. Accuracy was high, and the PEM Flex images documented intraductal extension of breast cancer. Surgeons have employed the device to help make the appropriate decision between lumpectomy and mastectomy.

Siemens Medical Solutions USA Inc. The company will demonstrate its TruePoint SPECT/CT, which combines the functional sensitivity of SPECT with the rich, anatomical detail of multi-slice CT.

TeraRecon. Along with partner Acrorad, TeraRecon will unveil a handheld mini-gamma camera (MGC) for intraoperative imaging, especially of sentinel nodes. The MGC achieves imaging through the use of cadmium telluride semiconductor detectors.

Toshiba America Medical Systems. Nuclear medicine products will be well represented, primarily by the t.cam family of cameras, which provide optimal image quality for whole-body, nuclear cardiology, cardiac SPECT, and general SPECT studies.

PACS; RIS; Data Archiving, Storage, and Distribution

BarcoView LLC. A long-time favorite at the BarcoView booth is back again this year. The MediCal Administrator is described by the company as the world's most mature tool for managing the QA and bidirectional QC of an entire PACS installation, regardless of where the workstations might happen to be located-on site or dispersed across the Web. According to the company, cost savings are measured in, potentially, many thousands of man-hours with this product, all while ensuring best possible image quality.

Cedara Software's OrthoWorks is a complete PACS treatment and digital planning solution for orthopedic surgeons.

Cedara Software. Say you're a PACS user with growing mobility needs across the enterprise. One possible solution is Cedara's I-Reach, an advanced Web-PACS solution. It features a comprehensive set of specialist tools, such as progressive decompression technology to offer better image display performance. Or consider Cedara's OrthoWorks, a complete PACS treatment and digital planning solution for orthopedic surgeons. Specially designed to improve the efficiency of clinical workflow, the application includes acquisition capabilities for all orthopedic modalities, including CT, MRI, CR, DR, and digitized film. Also on display is Cedara's new I-Acquire/FD advanced film digitizer software provides facile, cost-efficient migration of massive film libraries to digital PACS.

Communication Synergy Technologies Inc (ComSynTech of Rochester, NY). RSNA provides the backdrop for the introduction of InFORM, a RIS featuring proprietary preservation and archiving technology. Patent-pending archiving software, called the CDV1000 Document Vault, was developed to provide a seamless workflow process to enable businesses to preserve and archive vital documents. The CDV1000 Document Vault is a scalable electronic filing device that captures, manages, and annotates any document, in any format, for digital preservation and retrieval. Aside from this archiving function, InFORM includes report dictation, transcription, and review. A benefit for customers is the system doesn't rely on a document's originating hardware or software to restore the document to a human-readable format. InFORM provides a complete radiology reporting solution for both the hospital and diagnostic imaging center markets, with modules specifically focused on increasing efficiency, reducing cost, and improving healthcare.

DeJarnette Research Systems. DeJarnette will demonstrate version 2.0 of its vendor-neutral, legacy PACS Migration Gateway tool kit. The Windows-based tool kit supports the migration of PACS data, both images and reports, from a legacy PACS to a new PACS. The tool kit supports multiple migration strategies, including study date–based migration, platter volume–based migration, priority RAID migration, prefetch-based migration, ad-hoc migration, and double-pitch operation. The tool kit allows for premigration worklists to be generated based on numerous criteria, postmigration incremental migration worklists, migration scheduling to minimize interference with daily clinical operations, multi-migration engine operation to speed migration, DICOM data cleanup (of the legacy data), and data verification. Another product from DeJarnette slated to make an appearance at RSNA 2004 is Ledger, a Web-based solution for radiology department management.

Dynamic Imaging (Allendale, NJ). New clinical applications, innovative fault-tolerant architecture, and management tools for today's large 3-D data sets highlight features of IntegradWeb PACS, which makes its debut at RSNA 2004. An advanced second-generation Web-based PACS, IntegradWeb offers a complete range of industry-leading features and provides full PACS functionality and accessibility from any networked computer. Also debuting at the show is the Fault Tolerant Grid Architecture, which enables each location in a multisite PACS deployment to independently continue to function in the event of network failure. Rounding out Dynamic Imaging's intros at the show will be OrthoPACS, an advanced orthopedic package featuring a comprehensive template library, from screws and palates to prosthetic devices. In conjunction with the IntegradWeb Image Viewer, this solution enables procedure planning and simulation for orthopedic surgeries, osteotomy, and trauma cases.

Eastman Kodak Co's Health Imaging Group. New software that expands the capabilities of Kodak's RIS/PACS products are among the never-before-seen-at-RSNA innovations the company will feature. The new software, Versatile Intelligent Patient Archive (VIParchive) works with the DirectView PACS System 5. VIParchive provides centralized, enterprise-wide management of images and information associated with radiology and other clinical systems as well as back-office systems, including purchasing, inventory, and other records systems. The software provides dynamic and transparent life-cycle management of information and is vendor neutral with regard to media, technology, and storage.

EMC Corp (Hopkinton, Mass). Intending to raise the bar for image archiving at RSNA 2004, EMC is introducing its enhanced content-addressed storage product. Offering flexible, long-term archiving of medical images, patient records, and other unchanging digital assets, the new Centera Universal Access version 2.1 now natively provides support for all four of the major industry-standard protocols: network file system (NFS), including IBM iSeries via Integrated File System using NFS; common Internet file system; FTP; and HTTP.

PACS solutions are everywhere this year, each with their own bells and whistles, including the eMed Matrix from eMed Technologies.

eMed Technologies (Burlington, Mass). On exhibit will be eMed Matrix, a next-generation PACS solution-the only one built with Microsoft's .NET smart-client architecture. (Smart-client technology combines the power of the PC with the reach of the Web for easier deployment and maintenance as well as improved local client performance). Also, eMed Matrix incorporates a new platform, a redesigned user interface, and dynamic peer-to-peer communication and collaboration tools, all to deliver a new level of efficiency and performance to radiologists and referring physicians. The solution allows users to work from any location without having to sacrifice performance, workflow, or feature functionality. In fact, the company says that radiologists can perform diagnostic reading remotely, from home or outlying facilities, for improved workload balance across distributed resources.

eSys Medical (Toronto). The company will showcase a new version of its Web-based RIS. Built with enhanced clustering and proprietary caching technologies, RadioLogic 5.0 is scalable to thousands of users and millions of exams, all while supporting multiple time zones and languages. With this release, the Canadian company is now able to offer a US billing module, which performs online insurance eligibility verification, electronic insurance submissions, and reconciliation. RadioLogic 5.0 also introduces significant new workflow features, including QuickSearch, which provides referring physicians with a simplified exam search screen; and Enterprise Snapshots Subscription Service, which sends email notifications of worklist changes to subscribed users. The latter also automatically alerts administrators when service levels, wait times, or staff work backlogs are outside of acceptable parameters.

Another PACS solutions is the Synapse from FUJIFILM Medical Systems.

FUJIFILM Medical Systems USA. FMSU continues to challenge the conventional definition of PACS with its Synapse software, and at RSNA, the company will demonstrate technologies that extend Synapse into new areas of the radiology practice. For example, FMSU intends to provide users with methods of achieving consistent, clinical outcomes and positive business metrics. Also, look for demonstrations of the company's patent-pending reading protocol technology, which is aimed at efficient navigation and interpretation of increasingly complicated exams.

Fujitsu Computer Products of America Inc (San Jose, Calif). Earlier this year, Fujitsu unveiled its high-performance optical disk DICOM image viewing solution, the DynaMO 1300 Pocket with DICOM Viewer. The company has bundled an ultraportable, high-performance 1.3 GB Magneto-Optical (MO) drive with DICOM image viewing software, a strategy similar to that employed in its 2.3 GB DynaMO 2300 U2, released earlier. The DynaMO 1300 Pocket drive weighs 15 oz and measures 23 mm thick. Power is supplied directly through its high-speed USB 2.0 interface, eliminating the need for an AC adapter. At RSNA, Fujitsu will demonstrate how ultrasound and healthcare professionals can easily transport DICOM images and data on 3.5-inch MO disks from medical imaging equipment to notebook PCs and workstations for offline review.

From top to bottom are four of the countless image-management products to be displayed at RSNA: the IMCO-view PACS solution from IMCO Technologies; the InDex disaster recovery plan from InSiteOne; the Fusion eFilm RIS/PACS solution from Merge eFilm; and the InteleViewer PACS from Intelerad.

IMCO Technologies (Pewaukee, Wis). IMCO will be introducing a comprehensive RIS, which includes an appointment scheduler, patient tracker, and facility management suite. Users are able to access RIS functionality without having to exit the IMCO system, the company reports. Also out on display will be IMCO-view, a PACS solution boasting more than 160 features, such as simplified user interfaces, customized hanging protocols, and a third monitor for dedicated viewing of worklists (to leave the other monitors available just for viewing images). Another product, IMCO-ortho, has been integrated with IMCO-view's software to produce a complete package option that features templates for the market's most widely used prostheses. Also available for the first time will be Quick Click with 16 programmable function keys. Meanwhile, IMCO-wireless has advanced to the next level with new technology for faster and more secure transmission of images in a wireless environment.

InSiteOne Inc (Wallingford, Conn). Disaster recovery is always an issue of concern. Accordingly, InSiteOne will be on hand to pull the wraps from InDex, an expanded disaster recovery and business-continuance service featuring data protection beyond DICOM images. The company indicates this new product achieves a higher level of versatility and security through compatibility with all medical data, including the databases that drive PACS and HIS/RIS systems, and by virtue of having customizable levels of service for a full range of storage needs, including storage length and frequency. InDex offers configurable settings for any environment, whether for a small network of servers or enterprise-wide SANs. It's HIPAA-compliant as well.

Intelerad Medical Systems Inc (Montreal). Enhancement to Intelerad's InteleViewer PACS will be showcased. The latest release of the InteleViewer will feature maximum intensity projection (MIP) and multi-planar reformatting (MPR) to address today's growing multi-slice CT and MRI data sets as well as to provide users with a range of display options to cater to individual preferences and advanced procedures. The solution now supports teaching files to enable academic users to combine clinical work with teaching duties. Also scheduled to be shown at RSNA is the latest version of Intelerad's Reporting Worklist software, which addresses IHE management issues. The company also will demonstrate its new IntelePACS monitor system with enhanced features and flexibility.

Intuitive Imaging Informatics LLC (I3 of Los Angeles). Recently released and destined for prominent booth exposure is I3's next-generation Web-based digital imaging suite: ImageQube and RISQube. These solutions permit the combining of fully featured PACS and RIS functionality into a single, platform-independent solution across the enterprise via either the Internet or an intranet. ImageQube is a standards- and Web-based PACS providing robust feature sets that include HIPAA-, IHE-, and DICOM-compliant functionality to the diagnostic imaging enterprise at a low total cost of ownership. Features include MPR, MIP, 3-D cursor, and all of the expected PACS diagnostic tools with multiple storage options. Meanwhile, RISQube is a fully featured RIS with multisite capability. Features include patient scheduling, order entry, patient registration, HL-7 messaging, DICOM modality worklist, report production, report distribution and tracking, and integration with HIS or existing third-party RIS/PACS. Seamless imaging workflow integration is provided with ImageQube PACS.

MedImage Inc (Ann Arbor, Mich). Just out is a volume-registration tool for MedImage's MedView product. It can be used to register studies of the same or different modalities, including PET, CT, and MRI. This powerful tool for comparing pre- and posttherapy images also provides a fast, efficient way of detecting tumor change.

Merge eFilm (Milwaukee). Automation, streamlining, and integration of RIS, PACS, dictation, document management, billing, and practice-analysis workflow into a single desktop solution is the story of Fusion RIS/PACS, to be demonstrated at the show. This product distributes images through a combination of image streaming and RIS/ PACS/DICOM-driven routing methods, which allows more flexibility in trafficking the images to the radiologist at the appropriate location in less time while optimizing network bandwidth. Merge eFilm also will demonstrate upcoming Fusion RIS/PACS product releases, which include a referring practice portal; Fusion eFilm hanging protocols; additional new Fusion eFilm diagnostic workstation features; a Fusion RIS billing collections module; and multi-tiered storage management. Topping it off, Merge eFilm also will demonstrate its next release of the eFilm Workstation.

These images were collected using the MIM 3.1 from MIMvista (top) and NovaPACS 6.0 from NovaRad (bottom).

MIMvista Corp (Cleveland). MIM image display and fusion software users will find increased user functionality and time-saving features with the release of MIM 3.1. This upgrade includes Assisted Alignment (which provides multimodality fusion from start to finish in about 10 seconds and offers accuracy of approximately 3 mm), Cardiac Orientation-ASNC, and utilities to support radiotherapy planning, including RT Struct for region-of-interest (ROI) contours. Additional utilities introduced in MIM 3.1 include FTP retrieve and routing; enhanced CD capabilities, such as DICOM media format; a JPG/HTML viewer for referring physicians; tools to embed ROIs in image data for DICOM transfer; creation and transfer of aligned PET data; and interleaved or composite fusion images to radiotherapy planning stations.

NovaRad Corp (American Fork, Utah). The spotlight will shine brightly at the NovaRad booth, where NovaPACS 6.0-a complete, turnkey RIS/PACS-makes its debut. Installation, hardware, maintenance, and training are included in one price, on one contract-and, the company reports, it's priced at one third of comparable PACS. Open and scalable, NovaPACS includes servers, viewers, and workstations, and it easily integrates with existing software and hardware systems.

ODS Medical (Minneapolis). The company is geared up to introduce two products that seek to help organizations of all sizes move progressively and economically toward a PACS environment. First, as described by the company, the PACScomm Image Recording System is an advanced, integrated-design CD/DVD image-recording system that provides a reliable and cost-saving alternative to film. PACScomm enables healthcare providers to record diagnostic image studies from multiple modalities or PACS to CD/DVD media and to distribute images to any workstation or other device with a DICOM interface, eliminating the need to make costly duplicate files for patients and referring physicians. Second, the PACSstor Image Archive Appliance is an economical yet high-performance RAID-based image archive offering a robust complement of image- and department-management features to support filmless imaging operations.

Radical Radiology (Birmingham, Ala). New to market is the RamSoft PACS and teleradiology system, up on display at RSNA. Geared toward imaging centers and small to medium-size hospital facilities, RamSoft is fully Web based and has unlimited user licenses. It's also fully integrated with Voxar 3-D and OrthoView orthopedic template software.

RamSoft Inc (Toronto). Behold PowerServer 3.2, PACS software offering unlimited users and workstations, document management, interactive unsharp mask enhancement, an MRI pathology finder, a satellite gateway that connects the modalities, and a new TeleServer that provides Web-based interpretation capabilities for facilities already using PACS. One enhancement to this latest version is the ability to select a scout thumbnail. Images and their scout thumbnails can be printed, recorded to CD, and then exchanged using the Web or email. Automatic scout thumbnails can be used when interpreting brain and spine studies, but manual selection is available for musculoskeletal examinations.

RealTimeImage (RTI of San Bruno, Calif). Big doings at the RTI booth, starting with the intro of iPACS Prism version 5.0, a robust Web-based PACS featuring lightning-fast image streaming that's complemented by advanced, easy-to-deploy digital image analysis, management, and archiving tools. Advanced radiology workstation features include hanging protocols for customization based on user preferences and modalities as well as patient-centric worklists, enhanced multi-monitor support, and zoom beyond 1:1. It also features such workflow tools as CD burning, a QC station, and DICOM save. In addition, RTI also will debut iPACS Cardio, an advanced cardiac cath lab solution, enabling fully digital cardiology image analysis and workflow.

ScImage (Los Altos, Calif). The company will demonstrate the new features and benefits of PICOM Enterprise version 2.0. This comprehensive, enterprise-level PACS is built to be deployed as a single server solution that can link one or more departments via a common database. Version 2.0 enables an order-driven workflow for radiology departments while simultaneously giving other departments within the enterprise a tool for acquisition, storage, and distribution of both images and reports. The new version also has a new interface engine that provides a seamless single point of entry through any third-party RIS, electronic medical record, or practice-management system. Hyper-streaming technology provides instant viewing of images over a broadband connection without using any proprietary image-formatting technologies. ScImage will also introduce PICOM ECG, a Web-enabled ECG management module.

Sectra Imtec AB (Linköping, Sweden). RSNA's theme this year is "Radiology's Global Forum." From halfway around the globe comes Sectra with a forum of its own on the floor of McCormick Place to demonstrate how its PACS solutions meet the challenges of radiologists as well as their enterprise-wide clinical colleagues. The company will highlight its workflow solutions, including image distribution and remote reading capabilities. Sectra PACS is optimized for Web-deployable performance to the point of care, whether inside the hospital or to referring physicians located outside the firewall. Sectra also will present an effective PACS management tool that helps to optimize radiology departments and to monitor system behavior.

Clockwise from the top are a host of image-management options on display at RSNA: Sectra PACS from Sectra Imtec; the DMC-2000 DICOM Media Creator from TDK Medical; and the Aquarius Workstation 3.4 from TeraRecon.

TDK Medical (Garden City, NY). Although this product launched in September, the potential remains 2 months later for it to emerge as an RSNA showstopper. It's the DMC-2000 DICOM Media Creator, a medical DVD and CD recording solution that incorporates an integrated PC. Connected to any DICOM network, the DMC-2000 network appliance enables on-demand recording of patient studies to DVD or CD. In support of the DMC-2000's launch, TDK also will debut BluPrint medical recording software. Preloaded on every DMC-2000, BluPrint features a Web-based interface that's accessible from any PC on the DICOM network; thus, almost any computer located anywhere in the institution can be used to push patient studies to the DMC-2000 and record them on demand to DVD or CD.

TeraRecon. Say hello to the AquariusNET Server 1.5, which TeraRecon has enhanced with an efficient database designed to emphasize HIPAA-friendly features, such as security management and enhanced logging. Other features include enhanced curved planar reformat; bone removal; perspective 3-D; and a "remote consult" mode, whereby one client user can take control of another client. The company also will exhibit enhanced Aquarius Workstation 3.4, boasting new segmentation, region growing, updated reporting, and on-the-fly stenosis analysis tools. The new version also features improvements to the image routing and compression tool, AquariusGATE.

Printers and Printing Supplies

Printers prevail at this year's RSNA, with options like aycan Medical Systems' aycan xray-print (top) and VIDAR Systems' DosimetryPRO (bottom).

aycan Medical Systems (Rochester, NY). The trend toward filmless imaging has, ironically, created growing demand for hard-copy images by referring physicians either not able to access soft copy via the Internet or who simply prefer working with what's most familiar. That's putting pressure on hospitals and clinics to find inexpensive ways of producing nondiagnostic prints of sufficient quality that physicians can use for treatment planning and consultation with colleagues and patients. Enter aycan Medical Systems with a cost-effective, near diagnostic image-quality paper-print solution that integrates with hospital databases using the DICOM 3.0 standard. Using aycan's xray-print software in tandem with a certified aycan high-resolution laser printer, images can be received from any modality and then turned into usable hard copies. The xray-print software includes presentation lookup tables that allow the setting of defaults and the adjustment of image quality output (brightness, gray scale, contract, and more) for each modality. The product fits seamlessly into both traditional and PACS workflows.

Codonics Inc (Middleburg Heights, Ohio). In today's customer-driven radiology department, the need for multi-format, multisize, multimedia film and color output can be answered with the Horizon Multi-media Dry Imager. The Horizon's unique ability to print gray scale and color in a single imager make it suited for advanced imaging applications requiring large-format film; color for CT perfusion; functional and 3-D rendering; and grayscale paper for diagnostic review, referral, and patient copies. The imager comes with a 5-year warranty, coupled with 24-hour replacement service.

VIDAR Systems Corp (Herndon, Va). That sea of shimmering film digitizers is no mirage; it's the VIDAR Systems booth. Featured there will be the DiagnosticPRO Advantage, DosimetryPRO Advantage, CAD PRO Advantage, and the SIERRA plus. The Advantage product platform features the latest version of VIDAR's HD-CCD technology and automatic digitizer calibration (ADS). Together, these technologies contribute to superior image quality, consistency, repeatability, and speed. All digitizers offer efficient, one-step film loading and minimal maintenance requirements. Typically, users can expect roughly 50,000 hours of operation from their Advantage system.

Services and Software

American Association for Women Radiologists (AAWR of Houston). Visit the AAWR booth to learn more about the effort to advance the professional and academic standing of women in the field of imaging. Founded in 1981, the AAWR provides a forum for issues unique to women radiologists, radiation oncologists, and others in related professions. The group also sponsors programs that promote opportunities for women radiologists and works hard at facilitating communication and visibility across the board on behalf of members. It operates the AAWR Research & Education Foundation, the mission supports members in research and career development.

American Society of Radiologic Technologists (ASRT of Albuquerque, NM). Continuing education is the name of the game at the ASRT booth this year, as the association exhibits a plethora of online courses. Usually, these courses are accessible only through the ASRT Online Learning Center, which offers more than 100 online CE products available 24/7. The organization also will demonstrate its soon-to-be-released ASRT Store, an e-commerce Web site chock-full of CDs, videos, and books to help professionals in the field advance their careers.

CBIZ Medical Management Professionals (CBIZ MMP of Chattanooga, Tenn). The company will highlight its list of available services, including billing and accounts receivable services, practice management services, compliance plans, and practice evaluations.

CIT Healthcare Finance (Livingston, NJ). Most companies are planning to spend big bucks to gain the technologic edge over their competition. That's the thrust of the findings presented in the first annual CIT Healthcare Industry Overview. Pick up a copy of it at the CIT Healthcare Finance booth. The Overview provides an in-depth look at the current state of the US specialty healthcare segment, having independently surveyed management personnel responsible for making key financial decisions within specialty healthcare organizations. More than 450 decision-makers from across the United States were surveyed by telephone; the study includes highlights from regions across the country.

CPU Medical Management Systems Inc (CPU of San Diego). CPU will be introducing MED/FM version 6.0, the company's medical financial management software. Version 6.0 is designed for HIPAA compliance and provides special areas for HIPAA privacy notes. Many enhancements also were added to its transcription module, such as passwords and access profiles. CPU's document attachment module is a key part of the new release; it allows users to attach an image to a patient's account. Also, an enhanced anesthesia module now handles concurrency and stop/start procedures. A new statement process allows users to view virtual statements and run reverse statement procedures across all entities.

Horizon Radiology Consultation PA (HRC of Leesburg, Fla). Good radiologists are becoming harder to recruit, but HRC stands ready to help ease the burden caused by being short-staffed. Swing by the outsourcing company's booth to find out how HRC can accurately and efficiently handle your overnight preliminary reads as well as daytime final reads, if necessary. The company is manned by American board-certified radiologists and uses state-of-the-art technology (as well as follows teleradiology protocols from the American College of Radiology) for image transfer and viewing.

LocumTenens.com (Alpharetta, Ga). Mad as a wet hen about your malpractice insurance premiums? Mad enough to wish you could leave private practice without actually leaving private practice? Then you might find it profitable to spend a few minutes with the folks at LocumTenens.com. This full-service physician recruiting agency specializes in the field of radiology, currently offering temporary and permanent opportunities nationwide. In addition to providing paid malpractice insurance for the folks it places, LocumTenens.com also holds forth the lure of excellent compensation coupled with the freedom and flexibility to decide when, where, and how often you want to work.

Mercury Computer Systems Inc (Chelmsford, Mass). The company will show its VisageRT series of embedded components that feature software and acceleration hardware modules for reconstruction and visualization of large image volumes. The ExamineRT series, also set for display, provides turnkey applications on accelerated, scalable platforms; solutions range from thin clients to full workstations. Mercury's comprehensive products are based on standard platforms and off-the-shelf components, enabling OEMs and PACS vendors to shorten time to market, reduce development costs, and protect investments.

Radiology Corp of America (RCOA of Boca Raton, Fla). Involved with PET, PET/CT, and other state-of-the-art modalities? RCOA is a one-stop resource. This organization can help provide those advanced imaging services and quickly put facilities on the forefront in treating cancer, Alzheimer's disease, heart disease, and many others. In addition to offering mobile and fixed-site services, RCOA's business models include fee-for-service, shared equity, and no-risk opportunities.

Radiology Business Management Association (RBMA of Irvine, Calif). Finding specialized information needed to manage a growing radiology enterprise can be a challenge. The RBMA is ready to help attendees lay their hands on that hitherto hard-to-find specialized information necessary to be successful. In existence since 1968, the RBMA is dedicated to keeping radiology professionals on the leading edge with educational programs and continuing education sources, direct networking with industry professionals, and access to invaluable products.

US Radiology On-Call (Santa Monica, Calif). Swamped with images? Studies pouring in faster than they can be read? Contact US Radiology On-Call. The company runs a 24/7 teleradiology service for all sizes of radiology groups, from Level I trauma centers to solo rural practices. The domestically staffed company is ready to show attendees how it can customize an affordable, HIPAA-compliant coverage solution for any practice.

Precision Software Inc (Atlanta). Scheduling has never been a bigger pain, so touch base with the crew at Precision Software who will be happy to highlight their high-tech scheduling solutions, as well as their technical support for physicians. Products include the Precision Scheduler+, WebSchedule, and TaskTrac, which together form a robust package for scheduling and distribution. Users can enter requests and trades via the Web from virtually anywhere. Authorized users can view, print, and download schedules to their PDAs, creating a seamless scheduling process.

Vision Imaging Partners Inc (Cherry Hill, NJ). Group purchasing power is pretty exciting-if, that is, you possess it. Talk to the team at the Vision Imaging Partners booth to obtain that power. Vision Imaging arrived on the scene in 1997 with the mission of preserving the independence and integrity of medical imaging service and supply companies through a nationwide network-which quickly became the foundation of the group purchasing organization it is today. Vision now consists of 58 independent medical imaging dealers nationwide. Its portfolio of quality products includes offerings from more than 40 participating manufacturers.

Ultrasound

Ardent Sound (Mesa, Ariz). Slated for introduction at RSNA is Voyager, a low-cost diagnostic ultrasound device for expanded point-of-care use. The company promises excellent image quality and clinical utility for new medical users who previously could not afford or use compact ultrasound handheld units or cart-based systems. Voyager owes all of these innovations to some rather novel mechanical and electronic designs. The pocket-size Voyager functions as a peripheral device (USB 2.0) to standard consumer or commercial laptop computers. It is DICOM compatible for image archiving across networks, has a simple user interface, and supports a broad range of clinical applications. If desired, software/ firmware options can be purchased to enable 3-D imaging and advanced image-processing capabilities.

CIVCO Medical Instruments (Kalona, Iowa). To go with the new Philips Medical Solutions iU22 real-time 4-D ultrasound system, CIVCO now offers several compatible needle-guidance systems and a full line of transducer covers. These accessories include the company's Ultra-Pro II, Multi-Pro 2000, and the new Infiniti disposable needle guides. The Ultra-Pro II and Multi-Pro 2000 needle-guidance systems affix to a nonsterile, reusable bracket. Once attached into locating features on the transducer, the guide provides secure and accurate placement of the needle in ultrasound-guided biopsy procedures. Additionally, the Ultra-Pro II features a locking mechanism that allows the guide to be released from the transducer quickly and easily while maintaining secure needle placement. The needle guides aid in performing fine-needle biopsy, fluid aspiration, and cath procedures safely and efficiently. Meanwhile, Infiniti delivers a multi-angled capability for shallow ultrasound-guided biopsy and instrument placement procedures. The needle guide safely and efficiently positions the instrument in the scan plane.

Fischer Imaging. The company will use RSNA 2004 to unfold its Roadmap for Fusion Imaging-a look at the company's vision for bringing together ultrasound and tomosynthesis technologies. Attendees also will be able to preview Fischer's advancements under development for slot-scanning imaging, technology that has already demonstrated improvements in image quality and the reduction of radiation exposure.

Clockwise from top left are a selection of ultrasound offerings to be shown at RSNA 2004: the SonoAce 8000 color system from Medison; the DP-6600 portable system from Mindray; a screen capture taken from the imorgan workstation from Sea Ridge Software; and the UP-D897 black-and-white ultrasound printer from Sony Medical Products.

Medison Co Ltd (Seoul, Korea). The Medison booth will be humming with activity as the company introduces the SonoAce 8000 LE, Medison's new mid-class color ultrasound system. Superceding the SonoAce 6000CMT and part of the Sono8000 series, the lower cost LE offers application capabilities ranging from obstetrics-gynecology to cardiology. Medison also will highlight 3-D eXtended Imaging that was recently added to its Accuvix XQ ultrasound system. 3D-XI features image enhancement technology that previously was available only in CT and MRI.

Mindray Co Ltd (Nanshan, China). Check out the recently launched DP-6600, a top-end digital portable ultrasound scanner that employs advanced digital beam–forming and tissue specialty imaging technologies. Offering crystal-clear image quality, the DP-6600's multifrequency transducers make it suitable for broad clinical applications, such as abdominal, urology, obstetrics/gynecology, cardiology, small parts, and neonatal. Mindray also will have on display its DP-8800 ultrasonic diagnostic imaging system that provides two active electronic transducer ports for easy switching between transducers. Finally, Mindray's DP-9900 diagnostic digital ultrasound scanner will be at the booth. This model comes with wideband, multifrequency, and high-sensitivity transducers, plus a 12-inch flicker-free monitor. It offers a large CINE-loop capacity of 128 frames, and distortion-free images can be archived on floppy disks. Software packages include prenatal screening.

Sea Ridge Software Inc (Menlo Park, Calif). Like seeing any rocket fire from Cape Canaveral, watching a new-product launch at RSNA is always a thrill. And so it will be when the imorgan ultrasound PACS platform blasts off on November 28. The low-cost, reduced complexity imorgan consists of a workstation and server. The workstation-your choice of single or dual monitor-is capable of displaying still and moving ultrasound images and is able to support images from all DICOM-compliant ultrasound systems. Each monitor can display one, four, or nine images and allows side-by-side study comparison, 2-D, and Doppler- and M-Mode measurements. Studies can be archived on the server with copies automatically forwarded to a full-blown PACS server for distribution to other clinical locations.

Sony Medical Products (Park Ridge, NJ). Get ready for the UP-D897, a very small but very fast black-and-white ultrasound video printer. The unit speeds printing with an ultrafast USB 2.0 digital interface that delivers images in seconds. The compact size-88 mm high and 240 mm deep-fits almost anywhere. The UP-D897 prints normal, small, and 2x zoom in both standard and side print orientations on a range of glossy, high-density, and standard paper. The UP-D897 replaces the Sony UP895MD.

TeraRecon. The company plans to join forces with Fukuda-Denshi to announce a new mid-range cart-based ultrasound system, the UF-850XTD. This multi-application digital scanner offers high image quality and an adjustable 15-inch LCD.

Toshiba America Medical Systems. Be sure to ask about the Aplio ultrasound platform with its support of all seven DICOM service classes, its differential tissue harmonics, and numerous other useful capabilities.

ZONARE Medical Systems is brand new to RSNA, displaying its new z.one Sonography system.

ZONARE Medical Systems. The company will introduce its new ultrasound technology, called z.one Sonography. Rather than scanning line by line from 128 separate channels and then plotting the received signals as conventional ultrasound does, the z.one Sonography approach is to send out signal in a form akin to flash photography. This returns an entire region of information, which allows fast processing of the image and, alternatively, permits use of various techniques for improving image quality. ZONARE's technology has enabled construction of a lower-cost device that's small and easily portable-a bridge of sorts between a large, full-size cart system and a compact device. The cart comes with a full-size flat-panel monitor, keyboard, and a full user interface. To go portable, pop the 5-lb electronics module out of its docking station.

Other Products

AADCO Medical is highlighting a wealth of safety products, including RayShield Clear Lead Acrylic shielding systems (top) and RayShield over-shield glasses (bottom).

AADCO Medical Inc (Randolph, Vt). An irradiated technologist is an unhappy technologist (and worse). Stop by AADCO Medical's booth for a look at the latest in radiation shielding systems, including RayShield's Clear Lead Acrylic-a high-strength, shatter-resistant, clear viewing panel that provides optimum durability, ease of installation, and safety. AADCO also will have on hand the easy-to-assemble, high-quality RayShield's Clear Lead Acrylic, Mobile, and Fixed Radiation Protection Barriers and Modular Control Booth Components. For combating back fatigue, there'll be AADCO's patented ErgoFit design apron, weighing 15%–20% less than a conventional vest or kilt (works even better when combined with AADCO's exclusive ErgoFit Back Support System, which transfers nearly 100% of the apron's weight to the wearer's hips. For eye protection, check out the collection of RayShield Over-Shield Glasses that fit over almost any conventional pair of glasses, thereby eliminating any need for expensive prescription X-ray glasses.

Ascension Technology will be showcasing its MicroBird 3-D localization and guidance device (top), and Endocare will be highlighting its PerCryo family of CryoProbes (bottom).

Ascension Technology Corp (Burlington, Vt). Attention researchers and manufacturers: After arriving at McCormick Place, make a beeline for the Ascension Technology booth to see MicroBird, a new 3-D localization and guidance device with advanced metal immunity. The device, which is available for beta testing, can track the real-time position and orientation of miniaturized sensors required for medical imaging applications, including computer-assisted procedures, cardiac interventions, and 3-D ultrasound.

EBone (Kenosha, Wis). Pay close attention to the neckties donned at RSNA 2004. Some will be emblazoned with design patterns that look suspiciously like sagittal MRI scans of the lower lumbar, if not a coronal knee MRI. Actually, that's precisely what they are. These novelty ties are available in a selection of anatomic structures as well as surgical instruments. They'll be on sale during the show at the EBone booth.

Looking for something a little different on the show floor? Don't miss EBone's line of neckties decorated with MRI scans.

Endocare Inc (Irvine, Calif). The PerCryo family of CryoProbes has been broadened with the addition of a 1.7-mm diameter CryoProbe (PERC-17), a longer-length shaft 2.4-mm CryoProbe (PERC-24L), and new spherical-shaped 2.4-mm ice-ball geometry (PERC-22)-all for use in percutaneous applications. The smaller diameter CryoProbes are designed to cause less trauma; the new, longer length CryoProbe is able to reach deeper lesions. The spherical shape allows for more precise matching of ice ball to target area. All PerCryo CryoProbes are designed to create ice ball formation, which can be easily planned and safely monitored.

Resonance Technology (Northridge, Calif). Among the many debuts taking place at RSNA will be Resonance Technology's easy-install, MRI-compatible virtual reality system with high-resolution 3-D for keeping claustrophobic or otherwise distressed patients calm. Called CinemaVision, it delivers impressive video while providing state-of-the-art, digital audio to immerse patients in a soothing virtual world. The company claims it works especially well for pediatric patients. Also new from Resonance Technology is an Internet-based monitor to remotely detect minor system problems and prevent large-scale malfunction.

The Sky Factory is looking to brighten MRI environments with line of Luminous SkyTiles and Luminous Virtual Windows (top). Swiss Medical Care is looking to speed contrast-media delivery with its CT Exprés (bottom), which holds two bottles at once.

The Sky Factory (Fairfield, Iowa). New from The Sky Factory this year are affordable ambient lighting systems for MRI environments. The systems are RF-free without shielding and offer a "daylight" LED light source lifetime of 100,000 hours. Also on display will be Luminous SkyTiles, which create back-lit sky ceilings in an energy-efficient manner; and Luminous Virtual Windows, which provide a single landscape and can be surface-mounted or recessed.

Swiss Medical Care SA (Lausanne, Switzerland). The applause you hear in the vicinity of the Swiss Medical Care booth is coming from attendees impressed by the company's new injector CT Exprés, a novel approach to contrast-media delivery. The device draws injection fluid directly from the contrast-media bottle, which spares the need to refill or replace syringes between patients as it reduces waste. CT Exprés holds two bottles at once, so it's possible to load the unit with either large, multi-dose bottles for daylong use or simultaneously with contrast media and saline. Up to three injection phases (or 300 mL per patient) can be programmed in advance, and as many as 100 injection protocols can be stored on a flash card.

Rick Romano is a contributing writer for Medical Imaging.