Ampronix, Irvine, Calif, has long been witness to, and often the frequent innovator of, the accelerating evolution in the medical imaging industry. CEO Nelson Fathollahi founded the company 27 years ago to provide service on CRT monitors for hospitals and OEMs. Later, the company transitioned to servicing a genuine laundry list of imaging wares, including printers, LCD monitors, and image-capturing products. By the late 1980s, strong demand from a growing customer base saw the company shift into equipment sales. Since then, Ampronix has focused its attentions on pioneering imaging solutions for some of the most challenging issues faced by biomeds. Fathollahi recently took some time out with 24×7 to discuss the imaging industry’s current state and how LCD innovations are ushering in a brilliant new age of diagnostics.
24×7: How is Ampronix working to improve the biomedical industry?
Fathollahi: Biomeds typically face challenges on a daily basis. What we try to do is to go over the whole issue. What challenges and difficulties are they having, and what are they trying to accomplish? Then we come up with a solution based on those issues. Our company, in addition to being a distributor and service center, also became an engineering firm to come up with these needed solutions.
24×7: Should hospitals be upgrading CRT monitors to LCDs?
Fathollahi: It’s not a choice; it’s a must. Hospitals have to transition from CRT to LCD because in the last few years manufacturers have shut down manufacturing CRTs. They slowly transitioned to end of life on these products. Those monitoring manufacturers then transitioned to LCDs. Refurbishing is not recommended because basically you’ll end up with another old CRT with the gun replaced. But when the gun is replaced, it’s not aligned properly because refurbishers are not really manufacturers. They may just cut the back of the tube and replace the gun, so the image would be focused in some area and not focused in others.
24×7: Do your innovations come mainly from your observations of the industry or from customer feedback?
Fathollahi: Mostly from what we observe. But from time to time biomeds contact us and say, “Can you guys come up with something like this?” Or, at trade shows they’ll tell us they’re having an issue and ask us if we can come up with a solution.
24×7: Can you provide a specific example of how feedback led to a new solution?
Fathollahi: Back in the year 2000, we came up with a solution for a Siemens CT full-color display. The CT kept failing because the components were getting quite hot and there was no cooling system embedded to retrofit that, so the image quality wasn’t great. We came up with a replacement for that same monitor so that people who were spending money on that unit could get pretty much the same thing, just as a working unit. We actually replaced it with a much better-quality unit. That’s the sort of thing people have to deal with all the time. There is always some oversight by the manufacturers that we need to come up with solutions for.
24×7: Why has the switch to LCDs been a challenge?
Fathollahi: In the medical industry there isn’t a standard for signals, and every manufacturer who designed a system came up with their own. There was no governing organization to standardize the signals that everyone followed. So throughout the whole industry there are all kinds of CRTs with different sizes, signals, and mechanical constructions. It’s become a major dilemma in the industry to come up with solutions easily because of the fact that the signals are not consistent. Whenever you try to use an LCD monitor, the signal has to be exactly compatible.
24×7: And what if it’s not?
Fathollahi: If it’s not, it will not work. What happens, a lot of times, is that hospitals try to replace the CRT monitors with LCDs. After a few tries a biomed will learn that it won’t work. That’s why you have to have an LCD that is what’s considered autosync, meaning it can sync with all different types of signals. These will accept all different types of inputs or connectivity, and at the same time it would have to accept all different types of signals for different programs. A universal solution for different modalities.
24×7: How did Ampronix respond to this issue?
Fathollahi: We knew that this would become a major issue worldwide and, being a service business, it would become a problem when people would try to replace their equipment with LCDs. So we started working on a universal solution. We ended up with Modalixx, a 20-inch display that is compatible with many different modalities and all different types of formats of legacy modalities. Mostly it’s dedicated for legacy modalities of the analog video signals, so that it would work as a universal display, compatible with all different types of signals. The monitor also optimizes the image. It takes any signal, it upscales it to a full 2 megapixel resolution, and even has a special feature that will actually take any low-resolution signal and upscale it to a full 2 megapixels. You just plug it in and the image comes up.
We just released the product about a year ago, and at this point we already have over 400 installations throughout Europe, South America, the Middle East, and quite a few in the US, for all different types of applications. There are even quite a few cath labs that use this display.
24×7: How do you address the worries hospitals may have about upgrading to LCDs because of the cost?
Fathollahi: The cost is minimal compared to what they have to go through with CRTs. Most of the systems usually function, but what fails much more rapidly are the actual CRT monitors—sometimes as often as every 6 months—because they’re constantly on and being used. Certain components—for example, the high voltage circuit and the horizontal circuit—are working at high temperatures, so they get quite hot and the components are working under stress.
If you look at the whole picture, if the CRT system is down but the rest of the system is functioning, the whole system is down. So it becomes important to have a solution readily available to replace them. We have some customers who, because of the image quality of the displays, consider replacing the whole system. They’re facing a major cost versus the cost of the LCD monitor they could replace it with. We recommend to our customers that before the CRT actually completely fails, when the picture is not that good anymore and image quality is gone, and the model may fail at any time, they should replace it.
24×7: What is the average shelf life of LCD monitors?
Fathollahi: LCDs typically do not fail for at least 3 years. The backlight may then get dim and then you would have to replace it, which is mostly predictable. LCDs function quite differently from CRTs. They have a totally different circuit, and while they do have a power supply, they don’t work as hard. They stay much cooler.
24×7: What are the actual advantages of LCD monitors over analog ones?
Fathollahi: Well, image quality is much better, and the focus is maintained throughout the whole screen, not just partial focus, making the images even throughout the screen. Every pixel is focused. There’s also a much more vivid image, and no radiation. Power consumption is about 1/3, and the weight of the LCDs is typically about 18 to 20 pounds. CRTs weigh about 45 pounds, on average.
The other major advantage is, of course, the downtime. With most LCDs it’s minimal. The way they’re designed, they fail less and that’s an important issue. Basically, heat is the enemy for electronic components, so if they’re designed to work at normal temperatures and they have a good heat dissipation system, they’ll be around for a long time, meaning you don’t have to worry about downtime as much.
24×7: What direction do you think the imaging industry as a whole is heading?
Fathollahi: I think the whole imaging industry is becoming a lot more sophisticated. People are a lot more educated in terms of what they should expect from a display, and even from other equipment, like media printers and film printers.
24×7: How are radiologists in particular adapting?
Fathollahi: Expectations are a lot higher, and it’s amazing how we see radiologists who are quite educated in the technology of displays. They know a lot more than people would expect. They understand how LCDs function, and they understand the differences of the different types of LCDs and have much higher expectations than just a few years ago because of what technology can deliver. We’re talking to radiologists about a lot more scientific topics in terms of display technology. Whenever you’re discussing the features of a display with a radiologist now, it’s not just how good it looks but why it looks that way, how it functions, and how this particular monitor processes images versus another.
24×7: What are some of the benefits of improved image quality?
Fathollahi: It’s really helping the whole industry and the results for patient care, especially diagnostics for cancer cells—for example, mammography. The displays are much more sophisticated, and there’s a lot better image quality than what used to exist. It’s really wonderful. It’s promising and so exciting. Image quality is really the key to having a good, careful diagnosis by a radiologist. Any time we see an old CRT, we wonder: Are they actually using that to diagnose patients?
24×7: Why should biomeds be paying close attention to image quality?
Fathollahi: I think recently The Joint Commission is getting involved and is more focused on displays and image quality in hospitals, so it’s becoming more and more important for hospitals to pay close attention to display image quality.
24×7: How is Ampronix committed to image quality?
Fathollahi: We feel that the end result is quite important. That’s what the doctors and radiologists look at. No matter how good the machine you have is, you still have to look through some sort of a display. If the display is not functioning properly, then you are really compromising the whole system. What’s the use of having an expensive million-dollar system when you don’t have the right product at the end to view it?
The industry expectation is for better products, better image quality, and the latest technology. We always try to deliver the most recent technology in terms of area that we are working on, such as displays and imaging technology, and we definitely avoid presenting things that we find to be not qualified for medical application.
There is no straight governing industry that can govern the industry as much as is needed, but we govern ourselves, and we make sure that products we sell and deliver to hospitals are really qualified to be used as medical devices.
Stephen Noonoo is the associate editor of 24×7. Contact him at .