PHOTO GALLERY: New technology and trends at RSNA 2022

This is an augmented reality (AR) procedure training system on display at RSNA 2022 by MediView. The headset allows the user to see inside the the training phantom to practice or perform procedures on a co-registered CT scan and the patient.

This is an augmented reality (AR) procedure training system on display at RSNA 2022 by MediView. The headset allows the user to see inside the the training phantom to practice or perform procedures on a co-registered CT scan and the patient.

The new breast imaging modality of opto-acoustic ultrasound (OA/US) is explained at the Seno Medical booth at RSNA 2022. The technology uses 6 separate images to show the functional and anatomic features of breast tissue and immediately display features that differentiate tumor neo-angiogenesis. This may prevent the need for additional testing or biopsy. The system just received U.S. FDA PMA clearance and the vendor celebrated with champaign being served in their booth.

The new breast imaging modality of opto-acoustic ultrasound (OA/US) from Seno Medical just received U.S. FDA PMA clearance and the vendor celebrated with champaign being served in their booth at RSNA. is explained at the Seno Medical booth at RSNA 2022. The technology uses 6 separate images to show the functional and anatomic features of breast tissue and immediately display features that differentiate tumor neoangiogenesis. This may prevent the need for additional testing or biopsy. 

The new breast imaging modality of opto-acoustic ultrasound (OA/US) is explained at the Seno Medical booth at RSNA 2022. The technology uses 6 separate images to show the functional and anatomic features of breast tissue and immediately display features that differentiate tumor neo-angiogenesis. This may prevent the need for additional testing or biopsy. The system just received U.S. FDA PMA clearance and the vendor celebrated with champaign being served in their booth.

This is a cold-cathode tube CT system to image head trauma and the brain shown my Micro-X. The vendor said it is already being deployed in Australia and can be installed in an ambulance for immediate stroke imaging. It uses carbon nanotube cold cathode X-ray technology, which eliminates the need for cooling systems, related structural supports and drive systems, which allows for very small, compact, lightweight and less expensive imaging systems.

Attendees getting photos with the iconic large RSNA logo at the 2022 meeting. The logos is one of the favorite photo spots at the annual conference.

Example of a 3D fetal ultrasound rendering from Alpinion, which also OEMs this technology for other vendors on the RSNA show floor.

The open MRI Velocity Oasis system on display at the Fujifilm booth at RSNA 2022. The 1.2T system can support patients up to 660 pounds and has a large 83 cm wide table. 

The open MRI Velocity Oasis system on display at the Fujifilm booth at RSNA 2022. The 1.2T system can support patients up to 660 pounds and has a large 83 cm wide table. 

Example of AI for automated breast cancer detection, where the AI highlights an area it believes has an abnormality or patters that match cancers. This example of the Lunit AI is being show in Intelerad's enterprise imaging system as a seamlessly integrated AI tool. 

Fujifilm employees watching the World Soccer Cup the last day of the RSNA expo when traffic is traditionally slow. Several vendors put the World Cup matches up on their large screens in their booths. When the U.S. played Iran, cheers could be heard across the floor when the U.S. team scored a goal. There is a sizable number of international attendees and and vendors, so there was wide interest in the cup across the event. 

The GE Senograph mammography system on display by GE at RSNA22.

The Fujifilm Aspire Cristalle mammography system on display at RSNA 2022. this is a 3D mammography system that enables digital breast tomosynthesis (DBT). Like a CT scan, it creates slices that can be flipped through to see the layers of tissue and better define if an area of suspected cancer is a series of layers of dense breast tissue or an actual lesion.

Example of a skeleton superimposed and fused with a patient so as they move, the bones can be seen moving with them. The MediMirror demonstrated this at RSNA 2022 this week to show how the technology can be used for patient education. They can also fuse CT segmented images such as various organs or a collection of anatomy to show the patient where issues are located and how they can be treated.

Automated breast ultrasound (ABUS) allows for reproducible breast imaging without variation based on which sonographer performs the exam. It also can help centers where they are short on qualified breast sonographers.  Breast ultrasound can help identify cancers, or benign cysts, even in women with very dense breast tissue. At the GE Healthcare booth at RSNA.

There has been renewed interest in nuclear imaging at RSNA over the past few years and many vendors showed new technologies. Part of this interest has been spurred because SPECT and PET technologies have advanced and hospitals are now looking to replace older systems from more than a decade ago. This is an example of one of the advanced SPECT-CT systems on the floor, the Spectrum Dynamics Veriton 400. Its digital detector is capable of imaging energies of 400 kev. It is primary aimed at the cardiology market. It has detector arms that come out from the bore to the patients chest to help enhance image quality.  

Example of cardiac myocardial perfusion imaging on SPECT-CT shown by Spectrum Dynamics. It was imaged on the Veriton 400. Its digital detector is capable of imaging energies of 400 kev. 

Example of cardiac myocardial perfusion imaging on SPECT-CT shown by Spectrum Dynamics. It was imaged on the Veriton 400. Its digital detector is capable of imaging energies of 400 kev.

Contrast-enhanced mammography can help confirm a cancer or dismiss a false positive diagnosis while the patient is still at a women’s imaging center. This case displayed by GE shows a clear spiculated cancer mass on the contrast-enhanced images, but dense breast tissue hides the actual extent of the the tumor on the mammogram. Find out more in the VIDEO: Why contrast enhance mammography might be the ideal supplemental imaging - interview with Connie Lehman, MD, at Mass General.

CT kidney analysis software demonstrated by Fujifilm at RSNA 2022. It offers detailed quantification and automation to help speed workflows. 

Automated CT liver analysis software demonstrated by Fujifilm at RSNA 2022. It offers detailed quantification and automation to help speed workflows.

Example of a 3D fetal ultrasound using GE's HDlive rendering software to create realistic images.

Demonstration of how remote sonographers or physicians can share fetal heart ultrasound exams with a remote digital expert for a consult, demonstrated by GE Healthcare.

Example of a fetal ultrasound spine image in 3D from the vendor Alpinion.

Fun badge ribbons being given out by the Advanced visualization vendor Fovia at RSNA 2022.

An RSNA 2022 attendee experiences portable brain MRI from the patient perspective. (Photo by Dave Fornell) 

Radiologist microphone used for dictating findings and interfaced with and AI voice recognition system from M-Modal.

Point-of-care ultrasound (POCUS) image enhancement software shown by ContextVision. The vendor said POCUS use has been limited because many physicians want to do more than just a quick look. This app allows for more diagnostic quality exams comparable to larger, more expensive imaging systems. ContextVision works as a software OEM for several of the big imaging systems vendors.

Pancreas on a CT automatically identified and countered from a CT scan by AI Metrics' cancer RECIST followup technology. The software can help[ call up prior serial exams and speed workflow when reviewing cancer treatment followup exams to see if treatments are affective. The AI can help reduce reproducibility issues between various radiologists. 

The Philips booth packed with attendees looking at new MRI technologies. All of the major vendors had packed solid booths the first three days of RSNA this year, a sign that RSNA is making a post-COVID attendance recovery.

The second commercially available photon-counting CT system on the RSNA expo floor — the Samsung Omnitom Elite PCD.  It gained FDA clearance for the photon-counting detector in early 2022. Several vendors are also working on photo-counting CT systems, and a couple made announcements about advances in their research programs at RSNA. PCDs are widely expected to to become a big technology leap for CT with its ability to improve image resolution, reduce dose and built in spectral imaging for all scans. Read more in 9 technology trends and takeaways from RSNA 2022.

Automated lung cancer detection and contouring by the AI Metrics cancer followup RECIST analysis artificial intelligence. The software is designed to speed serial cancer imaging exams to determine if treatment is working or not. The AI also helps increase consistency in the quantification of the tumor. 

A new control box with one-button press access to a variety of radiology PACS functions has been added to increase Intelerad's workflow efficiencies. At least one other vendor of the RSNA floor introduced a similar control box as workflow efficiency has become the key discussion point with PACS and enterprise imaging systems at both HIMSS and RSNA.

Cath lab hemodynamic system waveform and data displayed in the cardiology section of the Merge booth at RSNA 2022. Merge was purchased by IBM Watson with the goal of building a premier healthcare AI company. When that effort failed and IBM sold off its healthcare division recently to be reorganize into the new vendor Metative. However, the Merge name was revived and placed front and center at RSNA this year in banners around the conference because it was a strong company prior to its purchased by IBM. While AI, mainly through partnerships with AI vendors, is part of the new company, there has been a return to the core technologies Merge offers for PACS, enterprise imaging and CVIS.

PET nuclear imaging has seen some recent advances and increasing adoption in the past couple years, and that trend was evident on the RSNA 2022 expo floor with several new systems being displayed. GE Healthcare introduced the Omni Legend at RSNA 2022, an all-digital PET/CT platform. The new digital BGO (dBGO) detector material uses a small crystal size to deliver more than two times the sensitivity of prior digital scanners to enable faster scans and better small lesion detectability. 

The GE StarGuide SPECT-CT system uses 12 arms that extend to the patient to get the CZT detectors closer for better image quality. It can scan patients in 3D and is optimized for theranostics procedures, including Lutetium-177-based prostate cancer therapy.

The new MRI contrast agent gadopiclenol, sold under the trade names Elucirem and Vueway by Bracco and Guerbet, uses 50% less gadolinium than current MRI agents. Read more on this technology.

Example of new workflow functionality found on most PACS and enterprise imaging systems where turn around time deadlines are used to prioritize cases at the top of a DICOM worklist. These can be STAT reads or times set in service level agreements (SLAs). This example was shown by Merger. 

Cardiology patient cath lab worklist on Merge's cardiovascular information system (CVIS) at RSNA.

Example of AI sorting exams in a radiology DICOM worklist to read first based in the AI screening the studies and marking the ones that are not normal and likely to have critical findings at the top of the list for priority reads.  Example shown by Merge, but similar technology exists on most PACS vendors software with elements of workflow orchestration. 

The Artificial Intelligence Showcase at RSNA included a large number of vendors and covered a quarter of the South Hall's show floor. Read more about the AI advances seen on the show floor.

Example of AI pulling key images for thumbnails in a CT dataset for display to make it easier for radiologists to visually fine what they are looking for rather than reading a long list of text descriptions. Example shown by AI Metrics.

AI is still one of the key technologies on the floor that many radiologists want to learn more about. A product rep discussing breast automated detection AI in the crowded Lunit booth at RSNA 2022.

Strain cardiac echo imaging has become a hot topic in cardiac ultrasound and many cardiologists now see utility with the additional clinical information it can provide to inform care decisions. However, it can be time consuming and many centers have low usage of strain, even if they have strain packages on their systems. Dia showed an automated strain AI application at RSNA this year aimed at automating the process to increase strain usage.  

Automated bullseye plot of strain deficits in the myocardium detected by Dia's AI enabled, automated strain echocardiogram software. 

An example of the Delphinus whole breast ultrasound tomography technology. A ring transducer surrounding the breast creates an image of the whole breast, similar to MRI. It also uses reflection, sound speed and attenuation to characterize the tissue structure, as seen in the color-coded image, to help identify cancers.

Example of actionable results color coded in red based on automated AI assessment of a study so it if flagged for closer review by a radiologist. Example from the Merge PACS at RSNA 2022.

Example of how spectral CT can help detect a hard to see cancer in the skull. Example shown during a Philips Healthcare demo at RSNA 2022.

The new Shimadzu Trinias Opera F12 angiography system unveiled at RSNA 2022. It offers very clear imaging and several radiation dose reduction features. It also adds automated table and C-arm movements and positioning with one-button press.

The new Shimadzu Trinias Opera F12 angiography system offers several radiation dose reduction features. 

The new Shimadzu Trinias Opera F12 angiography system unveiled at RSNA 2022. It offers very clear imaging and several radiation dose reduction features. It also adds automated table and C-arm movements and positioning with one-button press.

DICOM worklist thumbnail images to help speed searching for a study rather than reading text descriptions. Example in the TeraRecon booth.

The Artificial Intelligence Showcase at RSNA included a large number of vendors and covered a quarter of the South Hall's show floor. Read more about the AI advances seen on the show floor.

A new radiation protection system to reduce radiation exposure to interventionalists and cath lab techs. The Radiaction Shield System uses an automated set of shields deployed at the touch of a button to block scatter radiation from angiography systems.

Live ultrasound imaging using a new portable system released by Philips at RSNA 2022.

Live images at RSNA using the portable Compact 5000 Series ultrasound system in the Philips booth.

Advances in nuclear imaging system technology and new tracers were a big topic this year at RSNA 2022. This is the Siemens PET-CT Biograph Vision Quadra system, which uses a new digital detector that is a fraction of the size of the old photo multiplier tubes. 

Advances in nuclear imaging system technology and new tracers were a big topic this year at RSNA 2022. This is a display in the Siemens booth showing the evolution of its PET-CT technology from photomultiplier tubes to the very small digital detectors on the Biograph Vision Quadra system.

Large crowds were seen packed into the booths of the major vendors the first three days of the show. This is the Siemens booth on day 2.

Example of AI automated detection and highlighting of critical lung findings on a chest X-ray for a possible lung cancer nodule and fibrosis. Example shown by AI vendor Lunit.

RSNA attendee tries out the new Philips 5300 MRI system video viewing system (projected on the wall behind the MRI and viewed using a mirror) to entertain patients during longer exams. It is a "helium free" system. It has a sealed cooling system so it only uses 7 liters of helium, as opposed to the usual 1,500 liters in conventional MRI systems.

The new "helium free" Philips 5300 MRI system on display at RSNA 2022. It has a sealed cooling system so it only uses 7 liters of helium, as opposed to the usual 1,500 liters in conventional MRI systems. The sealed system prevent boil off and does not require a vent stack.

Cath lab hemodynamic system displayed in the cardiology section of the Merge booth. Merge was purchased by IBM Watson with the goal of building a premier healthcare AI company. When that effort failed and IBM sold off its healthcare division recently to be reorganize into the new vendor Metative. However, the Merge name was revived and placed front and center at RSNA this year in banners around the conference because it was a strong company prior to its purchased by IBM. While AI, mainly through partnerships with AI vendors, is part of the new company, there has been a return to the core technologies Merge offers for PACS, enterprise imaging and CVIS.

Flexible MRI coils offered by Philips. MRI vendors are moving away from hard plastic, heavy coils and moving to light-weight, flexible coils that can wrap around the patient and are easier to use and store. Several MRI vendors showed similar flexible coil systems. 

Siemens' new MRI 3T Magnatom Cima X on display at RSNA 2022. This is Siemens new premium MRI system shown for the first time at RSNA 2022.

Several semi-truck trailer, mobile imaging systems were on display this year at RSNA 2022. This one is has a United Imaging PET-CT nuclear imaging system that can be moved to various hospitals in rural areas to provide access to advanced hybrid imaging, while keeping it cost effective for lower volume hospitals. 

Several semi-truck trailer, mobile imaging systems were on display this year at RSNA 2022. This one is has a United Imaging PET-CT nuclear imaging system that can be moved to various hospitals in rural areas to provide access to advanced hybrid imaging, while keeping it cost effective for lower volume hospitals. 

The hot lab section of a semi-truck trailer, mobile imaging PET-CT system. These are the radioactive isotope tracer containment vessels for the "pigs" that contain the radioactive PET agents injected into patients. 

The hot lab section of a semi-truck trailer, mobile imaging PET-CT system. These are the radioactive isotope tracer containment vessels for the "pigs" that contain the radioactive PET agents injected into patients. 

A PET-CT system from United Imaging on display at RSNA 2022.

Liver CT segmentation and analysis software in the Philips booth at RSNA 2022.

Example of the seamless integration to AI partners on the Sectra enterprise imaging system. The artificial intelligence algorithms radiologists choose from the Sectra partner list is fully integrated into the workflow on the system without requiring extra logins, different screens or workstations.

Syringeless contrast media injectors like the GE Ulrich CT Motion gained a lot of interest in 2022 because of the iodinated contrast shortage. These systems use rollers to squeeze precise amounts of contrast from a large bolus container for multiple patients, helping conserve a significant amount of contrast.

FDA-cleared, cold-cathode mobile DR X-ray system at RSNA 2022. The Micro-X Rover uses carbon nanotubes rather than the standard filaments used in X-ray tubes for the past century. The nano tubes produce an electron beam in the tube without producing heat, which is the majority of the energy released in standard tubes. This eliminates the need for cooling systems, the related structural metal supports and motorized drive system because of a massive weight reduction. Read more on this technology.

Workflow navigation tool the radiologist can open and click on the option they want using picture icons rather than clicking through several text submenus. Navigation enhancement was shown by Intelerad at RSNA 2022.

There has been a lot of consolidation and mergers of radiology vendors in the past several years, especially on the health IT side. This is an example from a booth presentation at Intelerad showing a list of the vendors the company has purchased to add additional functionality to its enterprise imaging platform, including large pieces for cardiology, remote viewing, workflow solutions and vendor neutral archive (VNA).

Attendees getting photos with the iconic large RSNA logo at the 2022 meeting. The logos is one of the favorite photo spots at the annual conference.

A key trend in PACS and enterprise imaging systems are features that can improve workflow to make it faster and more efficient. This was the common theme in messaging in all the vendor booths. This is the Sectra booth at RSNA 2022.

The new MRI contrast agent gadopiclenol, sold under the trade names Elucirem and Vueway by Bracco and Guerbet, uses 50% less gadolinium than current MRI agents. Read more on this technology.

The mKDR Express mobile DR X-ray system from Konica Minolta.

The mKDR Express mobile DR X-ray system from Konica Minolta.

Life-like hand CT Rembrant rendering on the ZioSoft advanced visualization software. 

The healthcare IT demo area in the Canon booth showing off advanced visualization and workflow software from Vitrea.

Fetal 3D ultrasound face shown by the vendor Alpinion. The company also OEMs its technology to some of the bigger vendors on the floor.  

Example of a digital pathology slide shown by Sectra, which offers digital pathology offerings has part of its enterprise imaging platform.

DICOM worklist on on the Intelerad enterprise imaging system. 

The Delphinus offers whole breast 3D ultrasound tomography system. To use the system, the patient lays in a prone position on a table with their breast inserted into a hole in the table. It is filled with water and a light suction device pulls the breast down to elongate without compression. It has a ring ultrasound transducer to create the tomography images and offers data on tissue composition to help assess cancers. Read more on this technology.

Konica-Minolta's DDR moving X-ray technology. This allows a fluoro video dynamic pulsed X-rays to be viewed for swallow and orthopedic assessments. The vendor said this technology is now available on its mobile DR systems.

CT reconstruction showing the carotid arteries in the neck on the Intelerad enterprise imaging system. It is a multi-modaility viewer system, so any modality and any types of reconstructed images can be shown in the same view without the need to go to another workstation.

A carotid artery assessment on a point-of-care-ultrasound system (POCUS) in the Konica-Minolta booth at RSNA.

Example of natural language processing converting the radiologist's dictation into text. This system from M-Model highlighted key words the artificial intelligence will use text in the report and for labeling the report file for later key word searches or data mining. 

As enterprise imaging systems see expanded use by other departments in the hospitals beyond cardiology and radiology, digital pathology is the third largest large data user in these systems. This is an example of photo of specimens from a patient and a X-ray of one of the specimens shown by Sectra.

Example of artificial intelligence lung X-ray analysis detecting four different findings and marking them as priority before the exam is seen by a radiologist, who can then confirm the findings. This type of technology can help move studies with suspected findings to the top of worklists. Example shown by Annalise.AI at RSNA 2022.

Many radiologists are still unsure about how much to trust artificial intelligence algorithms in reading exams. In response, some vendors have added confidence level indicators (bar graph under image) to show the level of certainty the AI has in its own finding based on the studies it was trained on. This is an AI lung assessment software from Annalise.AI at RSNA 2022.

Example of the number of AI algorithms available outside the U.S. for brain conditions by the vendor Annalise.AI. The U.S. FDA requires a higher bar for AI clearance, so the vendor is submitting only a fraction of these for review due to the time and costs it would take to clear them all one-by-one. Several vendors said this has been an obstacle to faster and wider AI approvals in the U.S. 

AI-automated detection of an intracranial hemorrhage on CT. The software can alert the care team before a radiologist even sees the exam. Example shown by TeraRecon at RSNA 2022.

Image of xenon gas MRI imaging showing areas where gas exchange in the longs is compromised due to long-COVID lung damage or continued inflammation. This was presented in sessions as a way to track long-COVID and to better evaluate damage in gas exchange membranes in the lungs that may be causing long-COVID symptoms.Find more COVID radiology imaging

Example of an AI finding highlighted by a brain algorithm shown by Annalise.AI at RSNA 2022. The colored areas can show where the AI believes there is an abnormality. The FDA does not like the color coding on AI apps and prefers the AI to just indicate there is an issue on and exam to alert the radiologist to then find the detected problem. Many of the color coded exams seen at RSNA are cleared for use outside the U.S.