From the March 2016 issue of HealthCare Business News magazine


Among the other OEMs, Philips has the EchoNavigator, which fuses live transesophageal echocardiogram (TEE) and live X-ray, and its HeartNavigator fuses TEE with a preprocedural CT. GE has multi-modality image fusion software called CardIQ Fusion and Toshiba has technology called Smart Fusion. Shimadzu has 3-D packages for vessel visibility and multiple detector CT features that allow for multiple dimension reconstruction and fluoro overlays to a previously acquired CT image.

More physicians need to be educated about the fusion modalities currently available, Maini says, and the technology does need further improvement, as now the current 3-D technology only shows a 22-degree field of view. But, Maini thinks the Siemens fusion technology is the “precursor to technology that will change and revolutionize how we take care of structural heart
disease.” “With further research, these tools are going to replace other imaging modalities, which in turn, if successful, would obviate then eed for general anesthesia for a lot of these procedures,” Maini says.
Single-plane vs. biplane
Another shift in the cath lab is from the use of single-plane to biplane angiography systems, which has two C-arms set at an angle to one another. Dr. Morton Kern, chief of medicine at the VA Long Beach Healthcare System in California, formerly chief of cardiology there, says he prefers biplane to single plane systems.

“The use of biplane imaging, with a vertical tube and a lateral tube, positioned in the oblique angles, with concordant cranial or caudal angulation, provides double imaging for half the cost — half the radiation cost and less contrast use,” Kern says. “We get to view the coronary arteries almost simultaneously in two projections and that reallyfacilitates wire movement, balloon placement, stent placement and post-procedural assessment.”

Kern says he’s worked in cath labs that still use single-plane systems and sees the limitations. “In labs that have biplane and don’t use it, they’re really, I think, sacrificing the advantage of having that much information at hand,” Kern says. There is a split in cardiology on the use of biplane versus a single-plane system, says Ronald Tabaksblat, the business leader for image guided therapy systems at Philips. “Typically, physicians who do pediatric procedures definitely prefer biplane,” Tabaksblat says. “For the rest, it’s a matter of what you are used to and how you’re trained.”

Toshiba markets what it calls the Infinix Select Dual Plane, which the company considers a separate category. The system has two separate C-arms, one with an 8-inch-by-8-inch detector for coronary imaging, and the other with a 12x16 detector for peripheral views, and one X-ray generator. “We call this our no compromise solution,” says Bill Newsom, marketing director for the X-ray/vascular business unit at Toshiba. “The doctor who wants to do peripherals in the room can have the perfect C-arm and the perfect panel for that, and the doctor who wants to do coronary can have the perfect C-arm and perfect panel.” Newsom says the Infinix Select Dual Plane is a little more expensive than a singleplane system, but less expensive than buying two rooms.

March 2016 Magazine

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