Smart automation continues to be a major trend in the radiography market, with several new systems equipped with cameras and sensors that assist technologists with patient positioning and radiation dose reduction, and improving exam workflow.

Detectors continue to get lighter and some are even glass-free.

Here's a look at the new systems, software and detectors.

Agfa US Corporation, Radiology Solutions
At RSNA 2020, Agfa Radiology Solutions launched SmartXR, a solution for the company’s DR 600 ceiling-mounted X-ray room and the DR 100s mobile X-ray that helps guide technologists through proper patient positioning and optimally aligns the detector, tube and images.

The solution combines integrated sensors and cameras with AI, which George Curley, director of marketing and communications for the North American Imaging Business Unit of Agfa, compared to newer cars.

“It’s really there to help the ‘driver’, not take over,” Curley said. “Technologists are still completely in control of the system.”

The company has plans to add SmartDose, which uses IR to measure the front of the patient and SID, and uses the information to tailor exposure parameters.

“It measures thickness of patient and recommends going up or down from the default technique” Curley said. “For portables, it’s going to be extremely helpful.”

Canon Medical Systems USA
In January 2021, Canon Medical Systems released the OMNERA 500A, a new ceiling-mounted, auto-positioning system that was FDA cleared in November 2020. The system features ergonomics and “intelligent automation” to address workflow challenges, said Jay Aboujaoude, managing director of the X-Ray business unit for Canon Medical Systems USA.

Ergonomic features include a motorized, tilting wall stand with automated alignment and tracking, and updated, multi-position wall stand handrail that makes it more comfortable for patients. The automation also means less repetitive arm, shoulder and hand movements for technologists, reducing the risk of fatigue and injury.

“The wall stand is fully automated and so it takes less effort to move system,” Aboujaoude said.

There is also ambient lighting that provides information on system readiness and an open pedestal table with a lower height capability that allows easier patient transfers from stretchers, wheelchairs and Hoyer lift units. A tube head with a special glass overlay display that is free of edges for easier cleaning and disinfection, and fanless motors allow for quiet operation.

Automatic stitching is available on the wall stand or table and the system’s high-speed stitching feature allows for a complete exam in less than 30 seconds from acquisition to full image view, Aboujaoude said.

Carestream
Carestream recently released two technologies to enhance its radiography systems. The first is Smart Noise Cancellation, a software feature that helps reduce noise and lower dose, using deep convolutional neural networks to keep anatomical clarity and fine detail.

“This is most important for neonatal and pediatric imaging,” said Ron Muscosky, worldwide product line manager for Carestream. “The feedback from physicians is that images are much clearer and easier to read when compared to our standard processing.”

The technology is available on the DRX-Evolution and DRX-Evolution Plus as part of Carestream’s ImageView software.

The company also introduced its AI-driven Advanced Smart Features that use cameras mounted on the tube head and wall to allow for automatic equipment positioning, technique selection and collimation. This allows the technologist to spend less time adjusting the equipment and more time with the patient. It also provides the technologist with patient pose and positioning feedback on a live view of the patient at the Control Room Console to further optimize workflow, reduce repeats and improve image consistency.

Advanced Smart Room Features were available for the DRX-Compass in April and the DRX-Evolution Plus in early September.

In February, the company released its Lux 35 Detector with a glass-free sensor and new carbon fiber housing, which makes it much lighter than its predecessor, the DRX Plus Detector.

It comes in a 35 -by-43-cm size and a CSi scintillator. The detector has a new, sleek, ergonomic design with beveled edges, rounded corners and integrated finger grips for easier handling and smoother positioning under patients, said Jill Hamman, worldwide product marketing manager for global X-Ray at Carestream.

Earlier this year, Carestream unveiled an upgrade of its DRX-Evolution Plus premium room. It updated the table and tube head with a more compact tube head and larger displays so it’s easier to maneuver. They also added functional lighting that gives feedback on the status of the equipment.

“We’ve listened to customers and added additional features,” said Steve Romocki, worldwide product line manager for radiology systems at Carestream.

FUJIFILM Healthcare Americas Corporation
Earlier this year, FUJIFILM released a new radiography and fluoroscopy system called the Persona RF PREMIUM. The new system, which has a 584-pound capacity, comes with a video camera in the collimator, to allow technologists to verify patient positioning without using fluoro, and its workstation automatically maps exam selections to automated table positions to help simplify and speed exam times, said Rob Fabrizio, director of strategic marketing, medical imaging, for FUJIFILM Healthcare Americas Corporation.

It incorporates a 17-by-17-inch DR detector, bringing DR dose efficiency, image quality, speed and a much larger field of view.

“It’s a great multipurpose solution for any hospital looking to upgrade their fluoro or R/F system,” Fabrizio said.

The company is also expanding the lineup of their D-EVO III detector, a glass-free, cesium detector that Fabrizio said is a pound or more lighter than conventional detectors.

The detector is available in 14-by-17-inch, 17-by-17-inch and 24-by-30-centimeter sizes, and has Fujifilm’s exclusive antibacterial coating called Hydro AG, which regenerates its germ-killing silver ions to the surface when wiped down.

The company also recently revamped its flagship automated positioning Visionary Suite x-ray room with new functionality and configuration choices. The room is now also available as a fully manual system with an overhead tube that Fabrizio said is ultra-lightweight to speed workflow, and dramatically lightens the load for X-ray technologists.

Advanced applications, such as digital tomosynthesis, dual-energy subtraction and auto-stitching on the table and upright can be added.

GE Healthcare
Over the past year, GE Healthcare introduced two new X-ray systems, which the company says are designed to address the challenges faced by technologists and overburdened radiology departments.

The AMX Navigate, is a new portable, digital X-ray system designed with a power-assisted Free Motion telescoping column that aims to reduce lift force by up to 70 percent to help decrease technologist injury during positioning and transport. It also includes Zero Click Exam, a new workflow solution designed to increase efficiency by automating workflow and reducing user interface interactions.

The AMX platform includes Critical Care Suite 2.0, an AI technology designed to help radiologists prioritize critical cases by identifying critical finings at the point of care.

Company representatives traveled to a spot in California’s Mojave Desert called Furnace Creek, known as the hottest place on earth, to test the AMX Navigate under extreme conditions.

GE also released the Definium Tempo — a fixed, overhead tube suspension (OTS) digital X-ray system that uses automation to improve workflow, acting as what the company calls a “personal assistant” to the technologist. The system comes with a tube-mounted console for patient selection, protocol selection, technique modification and positioning setup, so the technologist can set up the exam beside the patient.

Workflow features, such as Auto Positioning, Auto Centering and Auto Tracking, automate the positioning of system components to improve ergonomics for the technologist.

JPI Healthcare Solutions Inc.
The company recently planned a limited October beta launch of its ExamVue Duo acquisition software, which works with DR systems and is designed for high-end, high-volume markets, including mobile X-ray, hospital, and general urgent care.

The software is designed for a touchscreen user interface and an easy-to-follow workflow, with a picture to illustrate the technique for each exposure.

“Operators can see where they are in the workflow easily,” said Khoa Le, marketing manager for JPI Healthcare Solutions Inc.

With integrated generators, technique is set by the software for the technician instead of going to the X-ray generator, saving time and minimizing errors. The integration works with generators from JPI Healthcare Solutions as well as leading manufacturers, such as CPI, Poskom, CubeX and IMD.

The software also comes with tools designed to be customizable for private practices of many kinds.

KA Imaging
In the last year, the company received FDA and Health Canada clearance for its Reveal 35C dual-energy X-ray detector. The DR detector provides a retrofit that’s adaptable to any CR or DR system and can deliver three images — soft tissue only, bone only, and both — with a single acquisition.

“Because our detector is a single exposure, we reduce the radiation dose compared to other dual-energy systems and eliminate motion artifacts,” said Robert Moccia, vice president of international sales for the U.S. and Canada at KA Imaging.

The Reveal 35C is also a quarter of the cost of a full room, according to Moccia.

“We’ve removed some of the inherent impediments of other dual-energy technologies — motion artifacts, double exposure and high cost,” Moccia said.

The market for the detector includes cancer centers and higher-end academic institutions that are more focused on outcomes than cost,” Moccia said.

Konica Minolta Healthcare Americas
The company has continued to put its Dynamic Digital Radiography
technology to use since it was FDA-cleared at the end of 2019. The DDR technology uses algorithms to create a moving picture from a rapid acquisition of a series of radiographs.

Guillermo Sander, director of marketing and digital radiography for Konica Minolta Healthcare Americas, said orthopedic surgeons using the technology have reported that by showing them the moving images, the patients become more compliant with therapy.

Neurosurgeons have also used the DDR technology to make sure the cervical spine is stable prior to surgery.

“In a static image, it’s hard to see if you’re not stable,” Sander said.

“DDR is gaining a lot of interest as a true diagnostic, easy-to-use tool,” Sander said.

The company is also in the process of launching a new portable X-ray system, FDA-cleared in September

The system has longer battery life and a touchscreen user interface.

The company also recently released its AeroDR Carbon line of detectors. The panels are made with light material with an antibacterial substance mixed in.

Philips
Over the past year, Philips released a product in Europe called Philips Radiology Smart Assistant. The AI technology, which is 510(k) pending, works with Philips fixed radiography and fluoroscopy systems to deliver immediate feedback to the technologists on patient positioning and image quality.

Philips is also working on the Lunit INSIGHT CXR, a server available on the hospital network to help prioritize reading lists and areas of interest starting with mobile radiography images for radiologists.

“The Lunit server makes its analysis and sends it to the PACS, assisting radiologists reading scans in prioritization (both order and where to focus), improving diagnostic performance and streamlining workflows” said Daan van Manen, general manager for diagnostic X-ray at Philips.

Lunit INSIGHT CXR is certified with CE mark and currently in preparation for U.S. FDA approval.

Rayence USA
At this year's RSNA meeting, Rayence will be showcasing their retrofit-ready fluoroscopy detectors and software. The fluoroscopy detectors will feature Super IGZO technology and new neonatal, MBS and orthopedic applications.

The company will also be showing the new series of wireless detectors that will feature a new lightweight, rugged design with easy-to-grip handles, nonskid backing and long battery life. The detectors feature the company’s GreenON technology, which gives their general radiography detectors a better dose performance for patient safety.

Siemens Healthineers
In January, the FDA cleared Siemens Healthineers' MULTIX Impact C ceiling-mounted system and MULTIX Impact floor-mounted system, two radiography systems that build on the company's established floor-mounted system.

The company added full automation as an option for the MULTIX Impact, while the MULTIX Impact C is semi-automated.

Both systems have a 2D camera built into the tube head, and technologists can use the Smart Virtual Ortho feature to set the field of view and adjust exposure parameters on the touch screen using a live camera image of the patient and AI sensors, setting up long-leg and full-spine examinations more easily.

“This saves 20% on setup time,” said Martin Pesce, X-ray product manager at Siemens Healthineers North America. “For every five patients I can do one more.”

Technologists can also use the 2D camera separately for patient movement verification.

The software includes myExam Companion, which helps guide technologists through procedures based on patient information.

At RSNA 2020, Siemens Healthineers debuted the LUMINOS Lotus Max, a premium remote-controlled radiography/fluoroscopy system.

The system can be operated remotely from a control room or used at the table with an optional second remote control console.

Other optional features include a new wireless foot switch for better maneuverability and multicolored mood lighting. There is also the option of the Enhanced Care software package, which allows for Improved workflow and dose management, said Timothy Glebinski, fluoroscopy product manager for Siemens Healthineers North America.

Swissray Customer Care
In June, Swissray Customer Care launched its ddRAura OTC RT, a DR system the company says is designed specifically to improve patient care.

The ddRAura OTC RT has an automated positioning system and a tube-mounted touchscreen console designed for a streamlined workflow, along with advanced image quality processing algorithms and software applications for low-dose imaging.

“Swissray Customer Care continues to develop innovative digital radiography systems that improve patient care and increase workflow efficiencies," said Ed Pol, chief executive officer of Swissray Customer Care.