In the CT market, as with other imaging modalities, manufacturers continue focus on improving workflow, increasing image quality and lowering radiation dose.

Photon-counting CT is also seeing inroads. The technology uses detectors to capture and measure each individual X-ray that passes through a patient’s body, instead of measuring thousands of X-ray photons as a whole as in a conventional CT scanner. This eliminates the electronic noise from the detector systems, leading to better image quality without additional radiation dose.

Here is what’s new in CT scanners and software from several companies.

Canon Medical
In June, Canon Medical received FDA 510(k) clearance for the Precise IQ-Engine (PIQE), which provides deep learning reconstruction to produce high-resolution imaging on the Aquilion ONE / PRISM Edition CT scanner. The solution uses AI to improve resolution of cardiac studies, offering benefits that include improved visualization of plaque to aid in plaque evaluation, reduction in blooming artifact to aid in assessment of in-stent restenosis and reduction in blooming artifact of calcium to improve visualization of lumen.

The solution expands Canon’s suite of deep learning reconstruction features on the Aquilion ONE / PRISM Edition, which also offers Canon's Advanced intelligent Clear-IQ Engine (AiCE) DLR.

The company also recently received clearance for SilverBeam, a beam-shaping energy filter that optimizes the X-ray beam and lowers the radiation dose in CT scans. When combined with AiCE DLR, SilverBeam enables lung cancer screening CTs with doses closer to a chest X-ray, according to Dhruv Mehta, managing director of the CT business unit for Canon Medical Systems USA.

CurveBeam AI
CurveBeam recently announced that it has merged with StraxCorp to form CurveBeam AI.

“StraxCorp’s broad IP-portfolio for AI and deep learning AI bone separation, segmentation and analysis in the bone health space perfectly complements CurveBeam’s market leading bilateral weight bearing point-of-care diagnostic cone beam CT imaging solutions,” said Vinti Singh, director of marketing for CurveBeam AI.

Since last year, CurveBeam AI has adapted its InReach cone beam CT imaging system for the distal extremities to be able to assess bone microstructure in a point-of-care setting. The InReach high resolution peripheral quantitative CT (HR-pQCT) offers a resolution of 80 micron to visualize cortical porosity and trabecular density. This can be used for bone health assessment prior to orthopedic joint replacement surgery to prevent adverse outcomes due to bone fragility.

Up until recently, HR-pQCT imaging was only available at major research institutions and a few clinical radiology departments. It required a large footprint and qualified users, making it cost-prohibitive for routine clinical evaluation, Singh said. The FDA-cleared InReach HR-pQCT will be offered at a significantly lower price point than other systems, will not require advanced imaging technologists and will have a small footprint, making it more practical for widespread use.

“It takes HR-pQCT out of the research setting and delivers a commercial point-of-care solution to improve bone fragility assessment,” Singh said.

Austin Hospital, located in Melbourne, Australia, has been conducting InReach HR-pQCT research studies with the modality.

CurveBeam plans to launch the InReach HR-pQCT in late 2022.

CurveBeam AI is also exploring building HR-pQCT imaging into its HiRise system, a weight bearing cone beam CT imaging system for the lower extremities, including the hips and pelvis.

“Clinicians would be able to obtain advanced bone health information all from a single scan from the core skeleton, in conjunction with 3D weight-bearing alignment data,” Singh said.

FUJIFILM Healthcare Americas Corporation
In April, FUJIFILM Healthcare Americas Corporation received FDA clearance for its SCENARIA View Focus Edition CT system. The premium scanner is designed for both routine and advanced clinical applications, including interventional CT, extended coverage shuttle scanning for perfusion exams, cardiac CTA and dual-energy examinations.

SCENARIA View Focus Edition can be equipped with Cardio StillShot, which brings a new approach to solving the constant challenge of imaging patients with rapid and irregular heart rates, said Mark Silverman, director of marketing for CT and radiology at FUJIFILM Healthcare Americas Corporation.

The new cardiac motion correction feature acquires two data sets within the target reconstruction stage.

“These data sets are compared against each other to detect and calculate motion,” Silverman said.

With the motion data, Cardio StillShot generates a 4D-motion vector field to deliver images that are free of artifacts, with over six times better temporal resolution than conventional image reconstruction methods, even when imaging patients with irregular and faster heart rates. This enables a higher rate of successful prospectively gated exams and thereby also lowers radiation dose, according to Silverman.

“Without adequate temporal resolution, increased motion can make CT motion unreliable for accurate diagnosis,” Silverman said. “Cardio StillShot is the solution.”

GE Healthcare
Last fall, GE Healthcare launched the Revolution Ascend CT system, which is designed to improve operational efficiencies.

The scanner comes with Effortless Workflow, AI-based software that automates patient positioning and exam settings, saving the technologist time over the course of the exam, said Sonia Sahney, chief marketing officer for molecular imaging and CT at GE Healthcare.

“As we talk about staff shortages and we talk about resource needs, I think this is going be a great step for that,” Sahney said.

The scanner has a 75-centimeter-wide gantry with a lower table position that increases space inside the bore to accommodate larger patients.

Also last fall, GE introduced its new modular Revolution Apex platform, which is scalable and upgradable to meet facilities’ needs.

“You can buy it at a 40-millimeter detector and upgrade it to an 80- or 160-millimeter system, as your clinical needs evolve,” Sahney said. “It gives huge flexibility to buy the technology you need today, but also have the promise of being able to expand that system over the life of the scanner from both hardware and software perspective. We were seeing sites that are keeping our systems much longer than they did 10 years ago.”

The new Revolution Apex platform also offers a gantry speed of 0.23 seconds per rotation, which Sahney says is the fastest in the industry, and 19.5 millisecond effective temporal resolution to freeze cardiac motion.

GE Healthcare is also entering the photon-counting CT arena, and a year after acquiring Prismatic Sensors AB, a Swedish startup specializing in silicon detectors for photon counting CT, it has a clinical evaluation unit in place at the Karolinska Institutet and MedTechLabs. The device has the company's patented Deep Silicon detectors, which has the potential to deliver high spatial resolution without compromising count rate or spectral resolution.

“We've been scanning there and getting some really great results with our deep silicon detector technology,” Sahney said.

iCRco
iCRco recently released a 31-inch, large-bore, 18-kilowatt, portable cone beam CT scanner. The scanner is being deployed, along with X-ray and fluoroscopy systems, in a 16-foot trailer, to create a fully mobile imaging clinic.

The CT scanner comes with an 85-micron voxel size and volume of interest selection to visualize extremely small features, and allows integration of the Anatomage 3D software suite, said Stephen Neushul, president and chief executive officer of iCRco. Advanced artifact rejection and geometric calibration provide clear bone detail and there is new lung nodule tracking capability and early COVID-19 assessment.

The scanner comes with a simplified workflow, Neushul said. There are options for a motorized table option as well as a new compact table for small exam rooms.

iCRco plans to add a solar-powered, battery-powered CT system in the second half of 2022.

NeuroLogica
In March, NeuroLogica, a subsidiary of Samsung, received FDA 510(k) clearance for the addition of photon-counting detector technology on its OmniTom Elite mobile system.

“We are the first company in the world to receive 510(k) clearance for a single source and a single detector photon-counting machine,” said Jason Koshnitsky, senior director of global sales and marketing for NeuroLogica. “We're able to upgrade the current OmniTom Elite platform and create the first ever mobile photon counting, point-of-care CT scanner.”

The company will also offer current customers the option to upgrade their OmniTom Elite scanners to the new technology without replacing the entire scanner.

Improved image quality, artifact reduction, dose reduction, material decomposition and density differentiation are among some of the potential applications of photon-counting technology.

“There are many more that need to be uncovered and we are looking forward to working with our clinical partners to really drive forward the value of this technology,” Koshnitsky said.

PACSHealth, LLC
PACSHealth, LLC recently released a product called VNAHealth, an analytics tool to compare multiple DICOM data sets rapidly at the exam, image and metadata level to identify potential patient data errors.

"Organizations can now easily locate incorrect study merges, incomplete migrations and translated data across the enterprise," said Mike Battin, chief operating officer of PACSHealth, LLC.

VNAHealth can target even the largest enterprise, and can be modality-specific or VNA-based.

Philips
At last year's RSNA, Philips introduced its new CT 5100 Incisive, with CT Smart Workflow, an AI-enabled solution to help speed up workflow, reduce dose and aid in diagnostic confidence.

“This system is all about workflow efficiency,” said Frans Venker, general manager of CT/AMI at Philips. “With the combination of CT 5100 Incisive and CT Smart Workflow, we have embedded AI into the tools radiology departments use every day. By automating many of the process-related obstacles, we clear the way for precision in dose, speed and image quality for smart, clinical decision-making.”

Incisive CT is designed to reduce downtime while improving efficiency and care with OnPlan patient-side gantry controls and remote services with proactive monitoring, as well as Philips Enterprise Performance Analytics — Performance Bridge — for continuous improvement solutions. These integrated, AI-driven solutions connect clinical intelligence and operational data to advance precision diagnosis and treatment, according to the company.

The system includes Philips’ Tube for Life Guarantee, which ensures the X-ray tube for the life of the system to help minimize lifetime operating costs and provide reliability to help ensure efficient operation.

Siemens Healthineers
Last fall, Siemens Healthineers received FDA clearance for its NAEOTOM Alpha photon-counting CT, one of the first major advances in the CT space in years.

“The technology has the capability of achieving a much higher spatial resolution than was possible before without substantial dose penalty,” said Matthew Fuld, photon-counting CT product manager for Siemens Healthineers.

The NAEOTOM Alpha is positioned at the high end of the Siemens Healthineers portfolio and the dual-source temporal resolution will be an advantage for cardiovascular applications, pulmonary applications and pediatric imaging, where motion is a factor.

“With children, you always want to scan fast,” Fuld said. “You always need higher resolution, and you need to be as gentle as possible in terms of radiation and contrast dose.”

Large academic centers have been the primary customers for the NAEOTOM Alpha, but Fuld believes it will eventually be adopted by smaller facilities.

“Even in our traditional dual-source market, a market that used to be predominantly that same group of high-end academic institutions, we are now seeing these tools expand out much further into regional hospitals,” Fuld said. “We really see this as one of the pivotal moments in CT.”

United Imaging
United Imaging recently launched the uCT 550 Advance program, which provides customers with a brand new CT scanner in two weeks or less from the date of an order.

“This program is for customers who have older CT equipment that may no longer be cost effective to fix, or who have an acute need for a CT replacement quickly to minimize downtime,” said Jeffrey Bundy, chief executive officer of United Imaging Healthcare Solutions. “It’s also for customers who want to upgrade their scanner to expand clinical capabilities, have more reliable equipment and cap their costs, but also need it quickly to stay up and running as much as possible.”

The uCT 550 Advance is delivered as a fully configured 80-slice CT, with routine maintenance and parts and the company’s Software Upgrades for Life program included.

“Yes, we really deliver it in two weeks,” Bundy said. “These kinds of commitments are possible because we are such a highly vertically integrated company and have maximized flexibility and control over our supply chain, to a degree that is not typical in this industry.”

Xoran Technologies
Last year, Xoran Technologies was notified of a grant award from the National Heart, Lung, and Blood Institute (NHLBI) to support the company’s research and development efforts for lung cone beam computed tomography (CBCT) imaging.

To accomplish the aims in the grant, Xoran has established collaborative partnerships with critical care pulmonology specialists and radiologists at the University of Michigan. The company has proposed an open-bore, mobile CT to assist in identification of lung disease.

“This grant allows Xoran to commercialize our future open-bore CT products quickly,” said Misha Rakic, Xoran’s chief executive officer. “This truly mobile device helps to support the diagnosis, triaging, and monitoring of the lungs of respiratory patients both in the intensive care unit, and in future respirator pandemic situations."

In August, Xoran received FDA 510(k) clearance for TRON, an open-bore fluoroscopy CT and X-ray device for full-body, low dose point-of-care imaging.

“With this TRON system, Xoran will have an open-bore CT application that can be used for full-body, low-dose imaging,” Rakic said. "In fact, the capability of a compact, lightweight CT that can be placed in a small van has the potential in the future to assist in democratizing access to CT imaging, whether it is for emergency stroke CT or lung screening CT.”