Ahead of November’s Radiological Society of North America annual meeting, here are some technologies generating buzz in radiology

By Chris Hayhurst

Earlier this year, on September 1, GE Healthcare received U.S. FDA clearance for a new mammography device that one medical director says heralds “a new age in breast imaging.” A few months before that, on June 21, Toshiba Medical announced it was introducing a new MRI system dubbed the Vantage Titan/Zen Edition 1.5T. Their product, the company reported, included “patient comfort tools,” “workflow enhancements,” and “new clinical applications,” among other advancements.

And then there was this from Siemens Healthineers on June 12: The FDA, the company said in a statement, had approved their Biograph Horizon Flow edition, a PET/CT system featuring their “revolutionary” FlowMotion continuous bed-motion-scanning technology. The new product allows users to “define up to four distinct scanning regions, each with a different bed speed,” it continued, and permits personalized PET exam protocols based on a patient’s unique anatomy.

Anyone who’s attended the annual meeting of the Radiological Society of North America (RSNA) is familiar with the jousting of device-makers vying for attention. Each year, hundreds of companies in the world of imaging technology use RSNA to showcase the products they’ve launched over the previous 12 months and to hint at the innovations coming in the future. (In 2015, the Chicago meeting’s tagline was “Innovation Is the Key to Our Future”; in 2016, it was “Beyond Imaging”, while this year the organizers chose “Explore. Invent. Transform.”)

“We’re always excited about RSNA,” says Michael Wendt, Siemens Healthineers North America’s senior vice president of diagnostic imaging. “It’s a very big event for us—a great chance to show everyone what we’re doing and where we’re headed.”

So what should RSNA attendees expect to see this year, and how might the latest innovations in imaging affect HTM professionals and their jobs?

Executives at GE, Siemens, and Toshiba aim to answer that question below, as do two individuals who are on the forefront of medical imaging: Iris Asllani, MSc, PhD, assistant professor of biomedical engineering and director of the Integrated NeuroImaging Lab at the Rochester Institute of Technology, and Matthew Dimino, a radiology engineer at Eskenazi Health and an instructor in the healthcare engineering technology management (HETM) program at Indiana University-Purdue University Indianapolis (IUPUI).

Advancements in Precision Medicine

At Siemens Healthineers, according to Wendt, they celebrated three other major launches in 2017 in addition to the Biograph Horizon Flow edition: the Symbia Intevo Bold SPECT/CT system, the MAGNETOM Vida 3 Tesla (3T) MRI scanner, and the SOMATOM go. CT platform, which is marketed as offering “simpler, user-guided workflows for more standardized results and reduction of variability.”

Siemens, Wendt says, is and will continue to be focused on precision medicine and helping its customers spend more time with their patients. “What’s happening in the industry right now is this shift toward value-based care, where hospitals are looking to demonstrate better outcomes” in order to maximize reimbursement.

Toward that end, he says, the technologies the company has introduced in recent months, as well as the technologies they’ll unveil at RSNA and in 2018, have been streamlined to minimize the need for in-the-field adjustments and tuned precisely to enable accurate and repeatable examinations.

“Almost everything is automated now,” Wendt says. “We want to make it easier for clinicians to do their work.” HTM professionals who are affiliated with Siemens’ customers will have access to service training provided by the company if their facility has agreed to such an arrangement, he adds.

Forging Customer Partnerships 

This time last year, you may remember, Satrajit Misra, vice president of marketing and strategic development at Toshiba America Medical Systems, predicted a “robust RSNA” for his company. That statement applies for 2017 as well, he says: “This year we’re continuing on the same trajectory and will have new launches across all of our modalities.”

The past year, Misra says, included two other significant product introductions in addition to their new MR system. In April, the company announced the release of the Aquilion Lightning 80 CT system, a 80-detector row solution meant for full-body imaging and routine volumetric scanning; and in September it introduced enhancements to its premium Aquilion ONE/GENESIS.

That latter system, Misra notes, now includes an advanced CT algorithm known as model-based iterative reconstruction (MBIR) that improves image quality while reducing radiation dosage. “We’re starting to push the envelope in high-definition imaging, and in ways we can bring value to clinicians,” he says.

HTM professionals will also see advantages in these new systems, as well as in those Toshiba will showcase at RSNA, Misra says. (Editor’s note: Toshiba became a Canon company last year and Toshiba Medical will soon be known as “Canon Medical Systems.”) “Our new devices offer access to a lot more data in a simple and integrated interface, and include tools that allow you to meaningfully use this data to manage your enterprise in an efficient manner.”

For example, he says, in a facility with multiple scanners, “you can look and see which ones are being utilized well, and which are not—where the bottlenecks are.” There are tools for monitoring scanner downtime and for tracking the tubes changed on each CT.

“And then on top of that, you can see clinical information like doses delivered and operator dose.”

What’s more, Misra says his company regularly works with its customers to provide training to their imaging engineers. “We see those professionals as an extended part of our organization,” he says. “They get almost the same levels of access to information about our technologies as our own internal service engineers.”

Designing with Service in Mind

When naming their “latest and greatest” imaging technologies, GE Healthcare officials singled out two products: the Senographe Pristina mammography system with Pristina Dueta, “a patient-assisted mammography device that literally puts women in control of their mammograms,” and the SIGNA Premier 3T MRI system—which, they say, will help clinicians “push the boundaries of what’s possible” with MRI.

The company is similarly on the forefront of innovation from a service standpoint, maintains Agnes Berzsenyi, president and CEO of GE Healthcare’s Women’s Health division. In fact, the picture she paints is of a company ready to partner with organizations to optimize efficiencies while improving clinical care.

Just look at the Senographe Pristina and SIGNA Premier systems, she says. Although GE handles the servicing of these devices , clinical customers also get in on the action.

Specifically, Berzsenyi says, the company “offers a range of customizable service levels for both products based on the customer’s needs, their desired outcomes, and their chosen service model,” and provides technical training and support to hospital biomeds to enable them to do this work themselves.

“Our objective is to be a strong partner to our clients at all stages of the service continuum from full-service support to very customized HTM support services and on-demand service options,” she says.

That said, Berzsenyi maintains, their products are designed for efficient implementation and maintenance in order to reduce service needs as much as possible. For the Senographe Pristina, for example, “more than 20 field service engineers from 11 countries were engaged to help co-develop the new system with the goal of making it more reliable, easier to install, and easier to maintain for the benefit of healthcare providers and their patients,” she says.

In fact, feedback from field-service engineers greatly influenced the hardware design—“resulting in a smaller product footprint in the customer room, fewer components for a leaner installation, and fewer parts to troubleshoot in case of failure,” Berzsenyi says. “Calibrations were designed so most can be performed on the production line versus during installation at the customer site.”

With the Senographe Pristina, Berzsenyi adds, installations are typically completed in just three days or less, “which is days faster than previous generations.”

The View from the Front Lines

An imaging device maker might be expected to try to drum up excitement about its latest offerings. But what do others in the industry think?

Iris Asllani, who is also an adjunct professor at the University of Rochester’s Center for Brain Imaging and a research collaborator at the Center for High Field MRI at Leiden University, says she’s been impressed with what she’s seen in MRI. “MRI, and functional MRI in particular, has transformed brain research,” she says. “It used to be, if we wanted to study the brain, we had to wait until somebody died. But now we can look inside the brain as it does its job.”

The next generation of MRI machines, Asllani predicts, will be so powerful “that hopefully they’ll give us images at the circuitry level, which will help us understand how memories are formed.”

This has implications for researchers like her who are studying Alzheimer’s and similar diseases, she adds. “Right now, we have a great map of the brain, and it’s a map with a resolution that is quite impressive. But once we know how diseases affect connections between neurons, and we can see how different parts of the brain connect as a whole—that’s where it’s going to get really exciting.”

Matthew Dimino, the radiology engineer and educator at Eskenazi Health, agrees with Asllani that imaging has come a long way, and has noticed the progress in his own work at Eskenazi Health. “It’s always a challenge keeping up with these technologies, and keeping up with the users of these technologies.”

As HTM professionals, Dimino says, “we can turn wrenches all day, but if we don’t understand what a clinician is saying” when they describe a problem, it can be exceedingly difficult to find a solution. “It used to be that when something went wrong, we could just turn a dial and that’s all it took—everything was pretty basic and easy to learn.” That’s no longer the case today, he says. “Now these systems are a lot more complicated and software-driven. Often, all we can do is review the logs.”

Still, Dimino says, biomeds should take it upon themselves to learn the ins and outs of the imaging devices in their facilities. “If a brand new MRI comes in the door, you want to be able to work on it when you can, and that requires some basic education.” Among other things, he recommends, be sure to understand any safety precautions, and get OEM or third-party training on the “physics and the mechanics” of the device and how it’s used in patient care.

Students in IUPUI’s HETM program, for instance, are offered an online class in imaging modalities that covers MRI, ultrasound, CT, among other systems, and delves into the various safety considerations for each.

“It’s not designed to teach you to walk in and service a device,” Dimino notes. “It’s designed to teach you what each device does, and how you should encounter the device when you get a call.”

His advice? If you’re new to imaging, sign up for something similar, and if you’re a seasoned biomed, look for ongoing educational opportunities through equipment distributors or your employer. “When the user comes to you and says there are artifacts on their fat-sats, that way you’re going to know what they mean,” Dimino says. “You may not be able to help them right there, but at least you’ll know what needs to happen next.”

Chris Hayhurst is a contributing writer for 24×7 Magazine. For more information, contact chief editor Keri Forsythe-Stephens at [email protected].