Nuclear Medicine & Molecular Imaging

Vendors are focusing on fusion imaging with variations in design, logistics and more targeted, tailored imaging. As medicine moves toward achieving earlier and better disease detection, vendors are fine tuning their offerings to allow for better sensitivity and spatial resolution. Several vendors highlighted their products' flexibility when it comes to customizing for workflow and other specific user needs. Overall, molecular imaging vendors showed off their new priority with prominent booth position, through a few alliances with pharmaceutical companies developing biomarkers and a look into clinical and preclinical applications. This market is just dawning - but there's true excitement in the air.


Gamma Medica-Ideas
introduced an upgrade suite for its X-SPECT Pre-Clinical Imaging System, which includes three major enhancements for pre-clinical SPECT imaging. SuperSPECT is a reconstruction module that goes beyond traditional reconstruction methods in which spatial resolution can be no finer than the size of a gamma camera's pinhole aperture. In traditional pinhole imaging, to achieve a two-fold improvement in resolution, one has to accept a four-fold loss in sensitivity. Gamma Medica has eliminated this tradeoff by achieving a two-fold improvement in resolution with no resulting loss in sensitivity at all, the company says. SpiralSPECT is an image scanning feature that allows X-SPECT users to obtain high-resolution images of large subjects in a single procedure. Currently, when performing SPECT imaging, researchers place pinhole collimators on gamma cameras to obtain high-resolution images, but the tradeoff for this high resolution is a smaller field of view. SpiralSPECT allows users to obtain high-resolution images of larger subject areas. Multi-Pinhole Imaging is a SPECT imaging hardware and software upgrade that allows X-SPECT users to improve the sensitivity of their MicroSPECT images. Gamma Medica's Multi-Pinhole Imaging package, by collecting multiple parallel images of the same subject and adding them together, allows users to take full advantage of high-resolution gamma cameras in a way that achieves a high-sensitivity breakthrough while preserving the high-spatial resolution benefits of small-pinhole imaging.


GE Healthcare
showcased at RSNA its new molecular imaging system designed to help physicians detect, diagnose and monitor treatment of cancer and other diseases more accurately and earlier in the disease process. The Discovery STE is a fusion of the high-speed, high-resolution capabilities of GE's CT scanner and the metabolic and physiologic capabilities of its industry leading PET scanner. The new Discovery Dimension Console is fully integrated to optimize PET/CT workflow and provides a wider range of choices to meet patient's clinical needs, enabling physicians to simultaneously complete a static image and 4D motion study in one acquisition; perform advanced image reconstruction techniques of 2D and 3D; and tailor the CT x-ray dose to each patient, a capability that can reduce dose by up to 40 percent, GE says.

Driven by the desire to better understand the molecular make-up of disease, GE recently initiated deployment of PET/CT research units to premiere clinical partner sites. These units are expected to generate data that will broaden PET/CT technology applications beyond cancer care.

GE Healthcare's next-generation SPECT/CT hybrid system, the Infinia Hawkeye 4, combines GE's industry-leading Infinia gamma camera with an optimized 4-slice CT, offering speed and quality enhancements. The Infinia Hawkeye 4 SPECT/CT system provides 5 millimeter slices for approximately half the scan time. Infinia Hawkeye systems are integrated with the Xeleris workstations to enhance productivity using Ignite technology, a unique feature that enables the operator to complete a scan-and-review cycle in a single click. The Xeleris workstation delivers state-of-the-art processing speed, innovative productivity tools, and built-in connectivity to various imaging systems, as well as PACS.

GE Healthcare also introduced the PETtrace External Beam Line technology that offers GE PETtrace cyclotron users the ability to increase their research and development capacity. This new product was developed as part of a collaboration with Hevesy Laboratory, a major contributor in the Nordic region of PET imaging applications development. GE's PETtrace External Beam Line technology is the enabler of flexible utilization of cyclotrons, providing the customer with an easier way to develop new PET radiotracers, and simplifies access to accelerated particles (protons and deuterons) produced by a cyclotron by redirecting these particles to a location where they can be readily utilized to generate isotopes used for radiotracer synthesis. 

For the PET radiopharmacy, GE Healthcare introduced a significant expansion to its line of PET radiopharmacy equipment used by hospitals, research institutions and distribution pharmacies worldwide to produce radiotracers used in PET imaging. GE's new PETtrace10 will now offer PET radiopharmaceutical users the highest capacity and reliability for producing PET radioisotopes.
PETtrace10 is a dual-particle, dual-extraction cyclotron that can deliver 10Ci of 18F in two hours. Its higher capacity and ability to produce most research isotopes is expected to broaden the use of PET and hybrid PET/CT technologies worldwide. PET and PET/CT procedures utilize fluorodeoxyglucose (FDG) which when injected into a patient provides useful functional and anatomic information for oncological, neurological and cardiac evaluations. 

GE Healthcare also showcased its Evolution for Bone, a new suite of reconstruction tools for GE's Infinia with Xeleris functional imaging workstation. It's used for resolution recovery in SPECT/CT bone imaging. Available for images acquired on GE's Infinia nuclear imaging system, GE's Evolution for Bone improves image quality, diagnostic confidence, productivity and patient comfort. In addition, GE says Evolution for Bone provides clinicians with a reduction in imaging time of up to 50 percent.

The company also launched its new Discovery VCT, the world's first true 64-slice combination PET/CT system for cardiac imaging applications. The Discovery VCT combines the high-speed, high-resolution capabilities of GE's volumetric CT with the metabolic and physiologic capabilities of its industry leading PET system. By combining these scanning technologies, the Discovery VCT provides the tools to enable physicians to more accurately diagnose and identify heart disease and other conditions, including cancer and neurological disorders. GE originally designed the LightSpeed VCT, the world's first volume CT system introduced in 2004, to easily integrate with its PET technology. The company recently announced the 500th installation of the LightSpeed VCT, making it the fastest selling product in the company's history. The LightSpeed VCT noninvasively captures images of the heart and coronary arteries in fewer than five heartbeats. In a single rotation, the system creates 64 credit-card-thin images, totaling 40 millimeters of anatomical coverage. These images are combined to form a three-dimensional view of the patient's anatomy for the physician to analyze.

Further, GE Healthcare announced that London Health Sciences Centre of London, Ontario Canada, will host the world's first SPECT/CT Master Series Educational Program titled, Introduction to Hybrid Imaging: Focus on SPECT/CT. To commence in March 2006, the program will address numerous technical and clinical aspects, and provide hands-on training of this novel hybrid imaging technique.

One of several Master Series programs supported by GE Healthcare, the SPECT/CT Master Series will help new or experienced SPECT/CT users gain a thorough understanding of the technology in the areas of science, physics, clinical usefulness and interpretation. In addition to the hand-on workshops, other key topics include: practical fundamentals and quality control; patient preparation and imaging protocols; applications in cardiology and oncology; and present and future radiopharmaceutical applications. Physicians, physicists and technologists from London will teach the educational program under the guidance of Bill Pavlosky, MD, course director, SPECT/CT Master Series and a 20-year veteran at London.


Hitachi Medical Systems America Inc.
showcased the "power of three" available in its suite of differentiating capabilities that drive the Sceptre P3 PET/CT hybrid system. DAC technology, non-rigid fusion, and AVIA-PACS architecture combine for high throughput applications in oncology, cardiology, and neurology. The system features a comfortable table, open design, and Skyview gantry. The Sceptre dedicated PET system supplies true 3D acquisitions with patient-specific corrections through pico high-speed electronics. Sceptre capitalizes on the increasing benefits of cardiac PET over nuclear SPECT with its improved sensitivity in CAD, spatial resolution, and faster exam times. The Sceptre does this with one-touch protocols, dual-gantry controls, and laser positioning. The Sceptre Evolve program offers Sceptre users the opportunity to upgrade to a Sceptre P3 in the field.


MIMvista Corp.
displayed its MIM image display system which enables the operator to easily display and manually overlay tomographic images including PET, MR, SPECT, and CT. MIM maintains original scan volume accuracy while avoiding the time required for pre-calculation of resized image volumes and is faster than methods that require translation and rotation of the entire image volume. The operator aligns image volumes by translation and rotation of the image volumes. A simulated true color overlay displays the merged image volumes by the color summation of the two volumes. MIM runs on Windows 2000/XP computer systems.

MIM provides functionality as a multi-modality image review workstation which includes display of fusion images acquired on both separate and combination scanners. A thorough PET review and fusion package is offered, as well as cardiac and 2D support. It also offers both image manipulation and display variety, including tabbed screens for multi-patient presentation. Users can fuse any combination of PET, SPECT, CT, or MRI from virtually any manufacturer's system for enhanced visualization. MIM provides fast assisted alignment, a high speed automatic fusion process that accurately aligns two data sets in five to 10 seconds, without the need for corresponding point selection. Volume linking allows for the correlation of studies along multiple time points, including PET/CT and fused images. MIM includes automatic contour generation that allows for the creation of 3D PET/SPECT region of interest images (ROIs) for export to radiation therapy. Sub-segmentation of automatically created ROIs can also be displayed. The presentation of subtracted difference images provides means for quantitative analysis of pre and post studies for therapy validation and monitoring.


Naviscan PET Systems Inc.
announced that it has entered into an agreement with Mayo Foundation for Medical Education and Research (Mayo Clinic) to clinically validate and commercialize a dynamic patented molecular imaging agent for use with PET and other imaging modalities.

In accordance with the Bayh-Dole Act of 1980, Mayo Clinic has licensed the vitamin B-12 molecular imaging agent technology invented by Douglas A. Collins, MD, to Naviscan and will receive royalties from this license. Researchers at the Mayo Clinic have published studies that cancers have high uptake of radioactive B-12, notably breast tumors.
   
Naviscan is the first company to obtain FDA clearance for a high-resolution PET scanner designed to image small body parts. The device was developed to help physicians and researchers diagnose and locate cancer, guide interventions, and advance new clinical therapies. The PEM Flex Solo PET scanner has proven resolution of 1.5mm intrinsically, 2.0 mm in-plane. 


Philips Medical Systems
highlighted developments in hybrid imaging with its GEMINI line of PET-CT systems. The GEMINI GXL features rapid resolve PET technologies for superb image quality, 3D reconstruction algorithm for excellent image quality, and an open gantry design, the company says.

Also on display was the Extended Brilliance WorkSpace which features a flexible review display that can be optimized to suit user needs.  For instance, SPECT and MR datasets can be imported and fused for a supportive understanding of disease progression.

Philips' PET/CT Viewer was designed to meet the demands of multi-modality image review and analysis. Both PET/CT and diagnostic CT review and analysis are available in a single, integrated environment, allowing users to create a customized workflow. GuidedFlow productivity enhancements offer a user interface that takes the user step by step from review and analysis to reporting.

Philips also highlighted its Precedence SPECT-CT system which unites high-end, multislice CT with a flexible gamma camera for imaging that can aid diagnosis and treatment in cardiology and oncology. This merged system provides registered SPECT, planar and CT images in addition to individual SPECT, CT, or attenuation-corrected nuclear medicine images. Precedence is designed to perform currently reimbursable nuclear medicine and CT procedures and as a platform for future molecular imaging advances. The system can perform coronary CT angiography, calcium scoring and attenuation corrected myocardial perfusion in one imaging session.


Siemens Medical Solutions
introduced a three-tiered strategy to transform the detection and treatment of disease by taking healthcare to the molecular level, including clinical and preclinical molecular imaging solutions, and biomarker development. Following the company's acquisition of CTI Molecular Imaging, Inc. in April and the creation of the Siemens' Molecular Imaging Division, it says it is revolutionizing disease diagnosis at the molecular level to ultimately improve patient care.

Siemens' highlighted offerings included the biograph 64 PET-CT system that performs high-resolution CT angiography and myocardial perfusion, viability, and function in one accurately registered exam. Shipments are slated for Q1 of 2006. Another highlight was the Symbia TruePoint SPECT-CT. With a single scanning session, The Symbia TruePoint SPECT-CT captures comprehensive, accurate information on both the molecular and anatomical levels, enabling clinicians to detect changes in molecular activity even before structural changes become visible.

Siemens also showcased its syngo TrueD, an advanced visualization tool that enables physicians to compare patient scans from two different points in time, such as pre- and post-therapy. Scenium, a new computer-assisted tool to help clinicians in diagnosing dementia, advances neurological evaluation by enabling automatic correlation of the patient study with an average brain for assessment of abnormalities, according to the company. It will be offered to Siemens PET/CT installed base.

Siemens' microPET, microCAT, and microCAT+SPECT scanners offer early insight into in vivo pharmacokinetics and pharmacodynamics, providing the bridge between the laboratory and the clinic. This facilitates basic research as well as support for drug development processes.


Thinking Systems
introduced a range of enhancements to its multimodality, web-based ThinkingPACS specific to nuclear medicine use. The company introduced support for co-registration and fusion of independently acquired images in a full range of modalities, including PET and SPECT. In oncology, for example, clinicians often fuse a study with different modalities such as MR and PET, PET and PET, and CT and CT, and any other combination. In PET-CT, in particular, co-registration allows for quick comparison between studies. The system also offers maximum intensity projection 3D for a quick overview of a lesion's location. Also, the company now offers direct support for hybrid SPECT-CT scanners with dedicated image fusion software.

Thinking Systems also showcased its latest release of advanced PET-CT fusion software, which incorporates such features as the ability to select and fine-tune image display layouts based on multiple criteria.


Toshiba America Medical Systems
at RSNA showcased its t.cam signature camera, an easy-to-use system for whole body, cardiac, and general SPECT applications. Flash 3D algorithms deliver the highest SPECT image quality in the industry, the e.soft platform is the fastest in the industry, and the system allows users to acquire, process, and review images all on one workstation, the company says.

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