By Rachel Bennet, clinical analyst; Cris Bennet, clinical analyst; Julie Johnson, associate analyst; Sabrina Newell, clinical analyst; and Tom Watson, clinical analyst, with MD Buyline

Thousands of imaging and radiology professionals from around the world flocked to Chicago’s McCormick Place to see exhibits from hundreds of vendors. Here are just a few highlights:

General radiography
Upgrading existing technology was a primary focus for general radiography at this year’s RSNA. A common theme among digital mobile systems was extended battery life for both the detector and the mobile unit. Systems such as Siemens Mobilett Mira Max feature in-cradle detector charging, while Shimadzu’s new MobileDaRt Evolution MX7 offers the Smart SeCURE power management system. Other common themes among mobile systems were larger displays, memory upgrades and scatter correction. The new Samsung GM85 mobile on display featured S-Vue advanced imaging engine and SimGrid, which produces high-quality images without the need for a grid.



Konica Minolta’s redesigned digital detector, the AeroDR HD, offered 100-micron pixel size for improved resolution. Konica Minolta also introduced AeroRemote Active Monitoring service for its AeroDR systems. Canon featured the new DR Tablet Solution from Virtual Imaging that includes a tablet and CXDI wireless detector. Carestream showcased its digital detector offerings including the DRX Plus and new DRX Core detectors.

With sustained growth of outpatient and freestanding imaging centers, value-based systems continue to be an essential staple among most radiology vendors’ portfolios. Vendors are producing better quality, value-based systems that include features such as higher table weights and improved imaging capabilities with lower-cost detectors. Siemens introduced the mid-level Multix Fusion Max, an economical solution with high-quality imaging; the Max detector can be shared with the entire Siemens Max family lineup. U-arms appear to making a resurgence, with more interest in these smaller, economical systems that fit into virtually any room. Konica Minolta introduced a Digital U-arm featuring its Ultra Software and dual console providing for faster exam times.

Several vendors featured new multipurpose x-ray systems. Carestream showcased its DRX-Excel Plus, which offers a more compact design intended for large and mid-size facilities. Agfa introduced the DR 800 multipurpose x-ray system, which features its Dynamic MUSICA imaging processing software (pending FDA submission), while Philips’ new offering is the remote CombiDiagnost R90, which is still pending FDA approval.

Women’s Health
While the mammography vendors each had a different focal point this year, one commonality is that they all centered on advancements in digital breast tomosynthesis (DBT).

• Fujifilm presented its Aspire Cristalle system. Having submitted its last module to the FDA for PMA approval of 3-D imaging last July, Fujifilm has already gained approval for 2-D use of the Aspire Cristalle.

• GE Healthcare showcased a new platform, the Senographe Pristina™. This system features a redesigned gantry that is currently FDA approved for 2-D mammography; 3-D use is pending FDA clearance.

• In addition to its Selenia Dimensions™ system, Hologic displayed the Affirm™ Prone 3-D biopsy system. The Affirm Prone creates images consistent with those on the Selenia Dimensions, allowing for greater ease in locating suspicious areas seen on the original mammography images.

• Adding to its Mammomat Inspiration, Siemens now includes PRIME dose-reduction technology as a standard feature on all of its mammography platforms.

This year’s RSNA focused heavily on customer education. All of the mammography vendors hosted some form of training session to provide physicians and technologists with further insight into their product offerings.

Ultrasound
A majority of the ultrasound vendors showcased their premium-level systems with advanced applications, as well as economically-priced systems and point-of-care systems. The diagnostic ultrasound market continues to provide customers with premium-level systems that include new software enhancements, advanced imaging applications and intuitive quantification software aimed at increasing the efficiency and reproducibility of the ultrasound examination.

Economically priced systems continue to be exhibited in a majority of the vendor booths. These systems are typically configured with standard features and software and provide a cost-effective solution for many customers who need a high-volume, shared-service system with good image quality. Many of these systems can be configured with additional premium software upgrades and multiple transducers.

The point of care ultrasound systems (laptop, tablet and handheld) have grown in popularity. Many of these systems are dedicated to specialized applications, such as musculoskeletal, emergency medicine, anesthesiology and vascular access, to name a few. Many of these systems feature easy-to-use controls and intuitive applications, and are often used by medical professionals other than trained sonographers.

The major vendors also highlighted various software enhancements and applications solutions at this year’s RSNA.

Fusion imaging for needle-guided biopsies has been a feature available for many years, but earlier versions could be difficult and time-consuming to utilize, and prone to errors during the alignment process. The newer technology exhibited allows for the real-time fusion of images and instrument navigation capabilities to provide guidance during tissue biopsies and ablation procedures.

Another software enhancement that was highlighted was shear wave elastography. Shear wave elastography is a noninvasive and inexpensive procedure used to assess liver and breast lesions without an invasive biopsy. Ultrasound elastography technology has also been used for a number of years to obtain information concerning the elasticity of soft tissue; however shear wave elastography (transient elastography) provides more accurate, quantitative information concerning the stiffness of the tissue.

CT/MRI
The new Signa Architect 3T, Signa Voyager 1.5T, and Signa Artist 1.5t were a part of the new offerings from GE. Also on the MRI side of the booth was the Signa Premier, a work-in-progress collaboration with the National Football League.

In the CT portion of the booth GE highlighted its Revolution line of CT scanners with a new GSI detector that allows the user to perform spectral imaging. Toshiba showcased its new Galan 3T MRI and the new Aquilion Genesis 320 detector Premium CT system. Siemens launched the Magnetom Sempra 1.5T MRI system, and had three new offerings in the CT market as well. The new models include the Somatom Drive premium dual source system and the Somatom Go.Now 16- and 32-slice systems.

SwissRay has entered the MRI field with the SR Pulse 710. Hitachi and Philips debuted their current systems offerings. One of the big trends seen this year is the adaptation of all vendors offering five-minute MRI brain scans and faster scanning in other body parts. Many vendors are also offering software that can reformat a single MRI acquisition reconstructed into five sequences.

Interventional X-ray (IXR)
Several new systems were introduced, including Siemens’ Artis zeego Pheno, an updated version of its already unique Artis zeego robotic c-arm, as well as Toshiba’s Infinix-i Sky with a new concept of a double-slide c-arm design. Philips continued to tout its AlluraClarity line of imaging solutions as did GE with its unique laser-guided in-room mobile Discovery IGS 700 series. Shimadzu Trinias’ series of floor- and ceiling-mounted solutions rounded out the hardware that was being shown and highlighted.

The largest trend within this technology area is the growing focus on using IXR in more complex vascular and oncology-based imaging. Many of the new solutions, software and workstation packages were focused squarely on providing enhanced 3D imaging and software to facilitate image-guided biopsy and therapeutic oncology procedures.

A second clear trend in this area relates to simplifying and increasing the efficiencies in the workflow with improved operator interface and software that allows a more intuitive flow to the procedure. Reduced learning curves and more flexibility to address in-procedure variations were highlighted.

Discussion continues on the still emerging area of combined CT/Angio solutions, which are particular product lines from Siemens and Toshiba.

There was a renewed interest in dedicated, non-cardiac and non-peripheral vascular technology. These studies have largely been in the realm of services offered by interventional cardiologists over the past five to ten years. Cardiologists have expanded their practices to provide more than just primary cardiac care.

Rather than refer the patient to a dedicated interventional radiologist, many cardiologists have expanded beyond the heart and began to diagnose and treat vascular disease, primarily peripherally. By doing so the cardiologist can retain both the patient management and the revenue from the non-cardiac procedures.

The 2016 RSNA revealed an increased rejuvenation of specialized interventional radiology and oncology applications that are outside of the typical cardiologist’s expertise, with system configuration and features that are non-cardiac in nature. This appears to be a significant growth area in the next few years for interventional x-ray.

MD Buyline provides market research, planning and budget management tools, and consulting services to help hospitals, clinics, and health systems improve supply chain purchasing decisions for capital equipment, health care consumables, and Purchased Services.