Pocket-sized scanner set to revolutionise ultrasound

GE Healthcare has introduced an amazing little a pocketsized, portable ultrasound device that looks set to revolutionise the way, or more correctly ‘where’, ultrasound is used. This little scanner will open up access to ultrasound for many people – particularly those in remote areas, who until now have been too distant from medical facilities sufficiently sophisticated to have ultrasound equipment.

The device, which GE is calling the Vscan, is not much bigger than the ubiquitous iPod can be slipped into any GP’s coat pocket and taken out in the field to provide quick ultrasound diagnosis to patients in remote areas, to victims of traffic accidents, to wounded soldiers in the battlefield ... its potential scope of application is huge. “This is GE’s Healthymagination at work,” says Hisham Youssef, general manager ultrasound, Middle East, Africa, Turkey and Central Asia, GE Healthcare. “Following this initiative, GE is developing products that facilitate greater access to healthcare and that are more economical to use.”

The Vscan can be flipped open like a ‘clam shell’ to reveal a LCD screen on the upper half and a control panel on the lower half into which a transducer can be plugged.

Youssef says the device will enable doctors to a perform an ultrasound exam of a patient in the field in “just 2 minutes”.

He was speaking to Middle East Health at the Arab Health expo in Dubai in January where GE showcased the device to the public for the first time worldwide. GE did have it on show in a “closed pavilion” for people interested in new technologies at RSNA in Chicago late last year. The Vscan is light weight with a mass of only 390 grammes.

Youssef explained that currently it uses one transducer which is best suited to examine the internal organs as well as for use in cardiology and obstetrics and gynaecology.

Vscan has two standard imaging modes, including black and white for anatomy and colour-coded blood flow.

“With this device you can do abdominal examination of, for example, the liver or kidneys to see if there is internal bleeding or, if there is severe pain, to check if there are kidney stones. “It can also be used in obstetrics and gynaecology where you can examine the foetal heart, for example. If there is a complaint the baby is not moving you can check quickly to see if it is still alive

“It is opening a completely new area for us. We believe that this device will improve the speed of service, the cost of service and will save lives. We are currently doing to trials to show this,” he said.

Docking station

Like an iPod, this system can be attached to a docking station where it will be charged (about 2 hours for a full charge), while the images are downloaded in PDF format to a PC where they can be stored or emailed to a consultant if needs be. The Vscan software can also be updated through connection to a web-enabled PC.

The device has a storage capacity of 4GB (a 16GB version is also expected to be available in the market), which can hold 3,000 images.

Anzelle Trigaardt, ultrasound application specialist, GE Healthcare, Middle East, Africa, Turkey and Central Asia, pointed out that for its size the video image quality is very good and the device will serve as an excellent evaluation tool for a quick assessment.

The device switches on automatically when you flip open the device and it switches off automatically when you close it.

The Vscan also has a voice recording facility so the doctor can record the patient name and diagnosis.

The device has been designed to be simple to use. General practitioners who have not used ultrasound before should be able to pick it up and find it quite intuitive. Putting it in the hands of GPs will enable it to be used in remote areas.

GE will set up web-based online training in the use of the Vscan, according to Youssef and one would expect an online community to establish itself around this website where information and knowledge can be shared.

“As it is a new trend in the market we do expect there to be quite a few developments related to it in the future,” said Youssef, adding that it is GE’s philosophy not to make hardware obsolete through the upgrading of software and one could expect this philosophy to apply to the Vscan. “GE cares about protecting the clients assets, so when we upgrade the system, we upgrade the software so that the hardware can remain in use,” he told Middle East Health.

He said GE was planning to sell the device under a completely new concept whereby the product would be replaced instead of repaired during the service contract period. “We will look at this on a country-by-country basis,” he added.


Philips introduces elastography
for breast imaging

Philips has introduced the Vision 2010 upgrade to the iU22 ultrasound system. The upgrade adds the company’s new elastography solution to improve breast imaging. Middle East Health spoke to Patricia Venters, Philips Healthcare’s Vice President of Women's Health and Oncology Care Cycle, about elastography.

Middle East Health: What exactly is elastography?

Patricia Venters:
Elastography is a new technology on the Philips iU22 ultrasound used to image the relative stiffness of tissue, based on strain or elasticity imaging. It is used clinically as an adjunct technique in a breast imaging practice to determine if an area of tissue is hard or soft as compared with its surroundings. Clinical evaluators have indicated that this is useful in a breast imaging context since abnormal tissue tends to be stiffer and deforms less (less elastic) than normal tissue.

All breast tissue types can be imaged with elastography. The key objective is to find areas of increased stiffness relative to other tissue areas and correlate with other imaging technologies.

Elastography is part of a software to Philips iU22 ultrasound systems and adds to Philips’ current complement of advanced breast imaging solutions. It has been available on the iU22 with the L12-5 transducer since September 2009. All existing iU22 ultrasound systems may be upgraded to incorporate the elastography capability.

MEH: How does it improve breast imaging?

Together with other clinically proven breast imaging technologies on the Philips iU22 ultrasound, like tissue aberration correction, elastography offers additional information to assist in diagnostic decision making and hopefully lead to a more confident diagnosis.

MEH: What tests have been done to show its capabilities?

The breast imaging community as a whole is evaluating the clinical value and diagnostic relevance of elastography. One of the key areas of interest to the medical community is the possibility of decreasing the number of biopsies required due to the inclusion of elastography into the breast imaging practice.

MEH: Can this replace the traditional mammography scan, or should it be used as a complementary scan?

Ideally it should be used as an adjunct screening technique. Physicians can look at the ACRIN 6666 <www.ACRIN.org> study which recommends a combination of ultrasound and mammography for breast screening.

MEH: What other benefits does elastography offer?

Philips’ breast strain elastography incorporates nanometer tissue strain tracking technology. This is a highly sensitive method of tracking tissue deformation requiring virtually no external compression for reproducible strain imaging results. Inherent patient physiological movements provide the compression to generate the elastography image.

Another feature of Philips elastography is that it incorporates single key stroke entry and exit for simplified workflow and ease of use.

The iU22

Philips’ premium iU22 system brings together advanced volume imaging, SonoCT, iSlice, XRES and other advanced technologies to produce highdefinition 2D, 3D, and 4D images for obsgyn applications. The iU22 also has a comprehensive suite of Obs-Gyn analysis and reporting capabilities.

Key features of the system include:
● Advanced XRES – Adaptive image processing reduces speckle noise artifacts, improves image clarity and margin definition
● C5-1 transducer with PureWave technology – designed to image challenging patients
● Contrast imaging – Enhanced visualisation of micro-vascular structures within tumours for improved characterisation and therapy monitoring
● Elastography – Compression based technology provides additional clinical information to help characterise breast tissue
● Ergonomics – For a more productive scanning environment
● High Q automatic Doppler analysis – Automated Doppler analysis saves time and improves consistency
● iSCAN – One-touch 2D and Doppler optimisation
● Panoramic imaging – Extended fieldof- view display
● QLAB advanced quantification software
● SmartExam – Customizable, system guided protocols save time, reduce repeated moves, and increase efficiency and consistency of exams
● SonoCT – Real-time multiple line of sight imaging increases tissue information
● Tissue aberration correction – Sharpens edges and improves tissue uniformity throughout the depth of view on obese patients and breast imaging
● Volumetric imaging solutions
● 3D/4D imaging – Live volume Imaging
● Dynamic volume coloration
● iSLICE – Precision tomographic slicing
● Fetal STIC – Spatio-Temporal Image Correlation
● Live volume imaging – Twice as much clinical data in the same amount of time
● Live xPlane imaging – Acquire and display two live full resolution imaging planes simultaneously


Doppler ultrasound in pregnancy may reduce caesareans in high-risk groups

Current evidence suggests that using Doppler ultrasound in high-risk pregnancies to monitor a foetus’ health may reduce caesarean sections and the number of babies who die, according to a recent Cochrane Systematic Review.

Doppler ultrasound is a well established technique used to diagnose problems during pregnancy. In the same way that speed radar measures how fast cars are travelling, Doppler ultrasound can monitor how fast blood is moving in the umbilical blood flow. Physicians can then look to see whether the blood flow is normal, indicating that the foetus is healthy, or abnormal, indicating that the foetus is under stress – enabling them to decide which high-risk pregnancies need assistance in delivering the baby, and which women can be left to deliver without assistance.

Early intervention

The aim of using Doppler is to reduce risk to the baby. However, some experts argue that it may prompt some unnecessary early interventions.

The review included 18 studies which together included 10,000 women in “high risk” groups. High risk women included those who had previously lost babies during pregnancy, those carrying growth restricted babies and women with hypertension or diabetes. Women who were examined with Doppler ultrasound were compared with those who had no Doppler or with those who had cardiotocography (CTG), which monitors the baby’s heartbeat. According to the results, Doppler reduced infant deaths, possibly through better timing of caesarean sections, as well as reducing the number of caesarean sections themselves, and inductions of labour. However, the researchers say the studies included were of questionable quality.

“A case could certainly be made for a higher quality, multi-centre trial of Doppler ultrasound than we have so far seen,” said lead researcher Zarko Alfirevic, who is based at the Division of Perinatal and Reproductive Medicine at the University of Liverpool in the UK. “It is quite possible that for some so-called high risk groups foetal Doppler offers little or no benefit. Women with diabetes are one such group where foetal Doppler may, in fact, give false reassurance.

“It is important to point out, of course, that it is the clinical decision that follows a Doppler ultrasound examination that changes the outcome for the baby, and currently there is little agreement on what intervention should follow an abnormal Doppler finding.”

● Citation: Alfirevic Z, et al. Fetal and umbilical Doppler ultrasound in highrisk pregnancies. Cochrane Database of Systematic Reviews. 2010, Issue 1. Art. No.: CD007529. DOI: 10.1002/14651858. CD007529.pub2.

The Cochrane Library

The Cochrane Library contains high quality health care information, including the Cochrane Database of Systematic Reviews, from the Cochrane Collaboration. Cochrane Systematic Reviews bring together research on the effects of health care and are considered the gold standard for determining the relative effectiveness of different interventions. The Cochrane Collaboration <www.cochrane.org> is a UK registered international charity and the world’s leading producer of systematic Reviews.


The Cochrane Library Issue 1, 2010 Podcasts: a collection of podcasts on a selection of Cochrane Reviews by the authors is available at: <www.cochrane.org/podcasts



Siemens introduces stand-alone
breast volume scanner

At Arab Health in Dubai in January Siemens showcased their premium Acuson S2000 with several significant enhancements including advances to its Acoustic Radiation Force Imaging (ARFI), contrast-enhanced imaging, and automated breast volume scanning (ABVS).

Siemens says release 2.0 of the Acuson S2000 further optimises ARFI, Virtual Touch Tissue Imaging and Virtual Touch Tissue Quantification.

The company says that these technologies are redefining the use of ultrasound in the diagnosis and treatment of diseases affecting areas of the body that cannot be examined through physical palpation, such as the liver.

Breast volume scanning

Along with the Acuson S2000 system Siemens have introduced a stand-alone automated breast volume scanner (ABVS).

Stephan Kreuzer, segment manager for Europe, Middle East, CIS and Africa, speaking to Middle East Health at Arab Health 2010, explained: “It is a special standalone device that is plugged into the S2000 high end system. This is brand new and unique to the market.

“Originally it was a complete all-in-one system, but now we have developed a standalone device so that the S2000 system can also be also be used for obstetrics, cardiology and other applications.”

“The ABVS has a special 40MHz transducer and this produces something similar to a Mammomat mammography scanner. With this transducer the clinician is able to produce complete high resolution breast volume sets in just 10 minutes. From this 3D data you can produce slices as well as intuitive, anatomical coronal plane views of the breast (from the nipple to the breast wall), which is not available with conventional ultrasound imaging.

“This significantly increases diagnostic confidence,” he said. Kreuzer added that this system does not require the pressure usually required in mammography to obtain an image, making it more comfortable for the patient. In addition, the system’s automatic image acquisition significantly improves the workflow and speed of a breast ultrasound examination.

Complementary device

He said the system is ideally used as a complementary breast scanning device along with traditional mammography.

“You will never get rid of mammography, but there are certain points with mammography that you cannot see, which will show up with this system. It is especially good for imaging dense breasts, being able to distinguish between fatty and dense tissue.

He said they exhibited the ABVS for the first time at RSNA in Chicago late last year and now at Arab Health in Dubai this year.

“This is the first time we have shown this device in the Middle East,” he pointed out.

“We have had a lot of interest in the device, because of the high prevalence of breast cancer and the growing demand for accurate screening.”

Declining to talk figures he said relative to other modalities it is not expensive. “If you see around 40 patients a week you will pay for it in the first year,” he said.

Siemens notes that to further optimise high-volume patient care, the system also supports other Siemens breast imaging applications, such as Fatty Tissue and eSie Touch elasticity imaging. These applications also help increase diagnostic confidence and reduce examination time.

Virtual touch

Siemens has developed and launched Virtual Touch software which enables ultrasound scanning without having to apply pressure with the transducer.

The software checks and measures the mechanical strain properties or stiffness of tissue, which may be correlated with pathology. Siemens points out that Virtual Touch Tissue Quantification is the only ARFI application in the industry to provide a numerical value related to tissue stiffness at a precise anatomical location, which is highly promising in identifying early stages of liver diseases causing cirrhosis.

Contrast imaging

Siemens says they have improved their Cadence contrast pulse sequencing technology to provide highly sensitive agent detection with outstanding enhancement uniformity at high frame rate contrast agent imaging at frequencies from 1.5 to 18 MHz.

 Date of upload: 20th April 2010

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