It is a brisk morning, typical for November, and I am waiting for the bus to get me to the annual radiology circus: RSNA 2013 in McCormick Place conference center in Chicago. And a hustle and bustle it is indeed, especially around 10 am when the exhibition starts, and at 5 pm when it ends, and between scientific sessions when everyone is running to the next classroom to attend a presentation on the next latest and greatest technological innovation, or a lecture in order to get their CME credits.
|Need my caffeine fix, even if it takes|
I have split my observations into three parts, 1) what’s new, 2) what’s not so new (“new and old”) and 3) what’s old. So here are my first top 10 new ones:
|A typical dual energy CT image, |
showing the overlay with the 2nd image
- Multi-energy CT’s: Some of you might remember the very first generation of rotational CT’s, where a gantry containing the X-ray tube and detector were located in a rotating ring and images were taken slice by slice by rotating the gantry, and alternating clockwise and counterclockwise around the patient. Scan times could be 15-30 minutes with an additional 15 minutes or so doing the numbers crunching to create a set of maybe 50 images. Since then vendors introduced slip-ring technology to have a continuous rotation, multi-slice detectors to provide orthogonal voxels providing the source for excellent 3-D imaging, high-speed rotation of fractions of a second to allow for dynamic studies such as used for cardiac applications. Every time one might think the technology has matured, yet another innovation comes along to provide a complete new dimension and/or paradigm, such is the case with the CT multi-energy imaging capabilities. By processing two images that are acquired using a different energy spectrum, which can be done by using multiple X-ray tubes, switching voltage or, in the case Philips, multiple detectors, each with a different energy absorption characteristic, one can create different images that can provide more information than just the traditional attenuation information expressed in Hounsfield units. The images looked to me like fused PET/CT images however, the color images contain much different information using atomic numbers, which we will probably have to learn to interpret similar to when we saw the very first MR images. The CT images were created on a CT that is pending FDA approval so there is not a lot of experience available yet but who knows, this technology might become standard over the next few years, similar to the multi-slice capability of the recent CT’s.
- Micro-dose Mammo: There is also no disagreement that too
much X-ray radiation can increase
New mammo slit scanner technology
- Social media for radiology: The use of facebook® for posting images is regarded by many as a
- Radiology-patient partnerships: The theme of RSNA President Dr.
Sarah Donaldson’s address
View from the top on Sunday, which
was actually busier than usual
- NoSQL: Most people might not know what technology is behind managing those millions of Voila! the NoSQL, which stands for Not Only SQL, which indicates that they can still be accessed using SQL queries but also allow for other access methods. NoSQL databases were invented in the late 90’s and are very scalable and highly optimized for simple retrieval and updating operations such as used for medical applications. The nice thing about designing a product from scratch, which as an example, Karos did with their new VNA implementation, is that it allows you to use the latest technologies instead of porting or converting it from older technologies. NoSQL might become a good alternative to the commercial databases that are not as suitable and overkill for what a PACS or enterprise archive solutions are trying to accomplish.
- Analytics: Medicine is probably one of the disciplines that is
the least measured and analyzed
One of the many analytics companies
- Compact CR: CR systems are getting more and more compact.
The first generation CR I ever
Couldn't be more compact
- Wireless badges: When I used to work regularly with X-ray
systems and/or visit X-ray
Wireless X-ray badges
- Less floor space: What was different this year was the
reduction in exhibition floor space, which was somewhat of a mixed blessing. The
smaller exhibit space was very welcome to many of those who in the past had to
cross from the North-South location to the lakeside area exhibition halls.
There were only two exhibit halls this year as vendors brought in significantly
less “iron,” for example instead of a complete CT or MR gantry they would bring
Scale models instead of
the real thing
- More lines: It seemed to me as if sequestration or budget
cuts had an impact on the RSNA this year, as the waiting lines were much longer
than it appeared to me in the past. Waiting for half an hour during the TSA
check-in at the airport was to be expected for a holiday weekend, as well as 20
This is a typical 35 minutes wait
These were my observations about what’s new, and to be honest, there was not much earth shaking and or very innovative this year, as much technology has matured, which is why I will have a follow up on “what’s new and old” as well as “what old news,” in parts 2 and 3 of this report on RSNA 2013 (stay posted).