Improving image quality and lowering dose, along with simplifying workflow, continue to be the main priorities of CT manufacturers. The latest releases are achieving this with deep learning and companion technology to provide clear imaging while speeding up exams.

CT scanners are also scaling down and becoming more portable so that the technology can be used by even more facilities.

Here’s a look at what's new in CT from several manufacturers.

Canon Medical
Canon Medical has continued to expand its Advanced intelligent Clear-IQ Engine (AiCE), which uses deep learning reconstruction to reduce noise and boost signal in images, making them clearer and more accurate. The technology was made available and integrated into the workflow on the company’s Aquilion Lightning and Aquilion Exceed LB at the beginning of this year.

The reason for expanding the AiCE technology is to allow high-quality care to be offered to more patients, said Dhruv Mehta, leader of strategic development for Canon Medical.

“We’re the only vendors that not only have this capability, but have made it available across our entire diagnostic CT portfolio,” Mehta said.

Earlier this year, Canon Medical enhanced its Deep Learning Spectral offering on the Aquilion ONE PRISM to enable the industry’s first and only 1-Beat Spectral cardiac capability.

The Aquilion Exceed LB, which comes with a 90-centimeter bore opening and field of view, the largest in the industry, was FDA cleared in December last year.

The system, which comes with a simplified tablet-based user interface, is designed for simple and streamlined interventional CT. The 90-cm wide bore is particularly beneficial in trauma and bariatric imaging, where patient positioning can be challenging, as well as radiation oncology applications.

In radiation oncology planning, the goal is to position the patient during imaging the same way they're going to be when they’re treated.

“That’s one of the areas where you see the clear benefit of a 90-centimeter bore,” Mehta said.

Also this year, Canon Medical introduced a mobile CT system with its Aquilion Lightning and Aquilion Prime SP scanners. The company worked with West Virginia University to pilot a mobile lung cancer screening program, with the goal of providing access to screening in rural communities.

Earlier this year, Canon Medical announced partnership with Cleerly, which provides cloud-based software for auto-generated reporting of atherosclerosis analysis based on cardiac CT images. The software, designed to simplify and automate CT analysis, is available across Canon Medical’s Cardiac CT portfolio.

CurveBeam
In November of last year, CurveBeam received FDA clearance for its HiRise, a weight-bearing CT scanner that can scan the entire lower extremities, including the hips and pelvis, in a standing position.

There have been several installations of the HiRise around the country, said Vinti Singh, director of marketing for CurveBeam.

“We’re encouraged by how quickly it’s been adopted,” Singh said.

The company is looking to expand clearance beyond the hip and pelvis to enable weight-bearing scans of the lumbar spine and sacrum.

CurveBeam is also developing a table for the HiRise so clinicians can also scan the whole body with the exception of shoulders, depending on patient size, in the supine position, and compare weight-bearing and non-weight-bearing imaging.

Also over the last year, CurveBeam launched its CubeVue Autometrics at a couple of beta sites. The web-based platform uses AI to automatically segment foot and ankle data sets and take measurements.

“It can take a full day to manually segment a weight-bearing CT data set,” Singh said.

Earlier this year, the company announced the launch of CurveBeam Cloud, a storage and backup solution that it says will simplify DICOM dataset storage and transport.

“The long-term vision of CurveBeam Cloud is that it will integrate with the Autometrics platform or [platforms from] other vendors to store large files,” Singh said. “Often what’s sent to PACS is a scaled-down version. So with CurveBeam Cloud, wherever you are you can view a high-res image.”

FUJIFILM Healthcare Americas Corporation
FUJIFILM Medical Systems U.S.A., Inc. and FUJIFILM Healthcare Americas Corporation (formerly Hitachi Healthcare Americas) recently announced that the two companies have merged and are operating under the name FUJIFILM Healthcare Americas Corporation.

“The overall portfolio combination of the Scenaria View, Supria True 64, Supria and the Persona CT [presents] offerings from the premium to value customer which is such a great complement to what we already have,” said Rick Banner, senior director of marketing for FUJIFILM Healthcare Americas Corporation.

Referring to Fujifilm’s Persona CT system, Banner said, “You’re going to continue to see a lot of new product offerings to expand our robust platform.”

The company is focused on lowering radiation dose and on bariatric imaging capabilities.

For the Persona CT, the company is planning to add additional oncology features tied to 4D gating technology, along with integration with Varian’s Real-time Position Management (RPM) and Respiratory Gating for Scanners (RGSC). Varian uses an infrared camera on its linear accelerator to monitor and map the motion of breathing.

“It’s unique to Varian,” Banner said. “We're testing to validate on our system.”

The company also plans to release version 1.7 of its Persona CT software in the fourth quarter of this year.

GE Healthcare
In November 2020, GE Healthcare announced the acquisition of Prismatic Sensors AB, a Swedish startup specializing in photon counting detectors.

The company acquired the technology in its pre-commercialization form, with plans to bring photon counting computed tomography (PCCT) to its scanners, said Sonia Sahney, chief marketing officer for molecular imaging and CT for GE Healthcare. The technology has the potential to allow visualization of smaller structures, improve tissue characterization, more accurate material density measurement and lower radiation dose,

“It is absolutely the future of CT,” Sahney said.

Also over the last year, GE expanded its Thoracic VCAR application, which provides automated lung segmentation and quantitative measurements in chest and lung scans, to improve lung and airway segmentations. There are also new presets for parenchyma analysis, helping to characterize and quantify areas of low and high attenuation within the lungs and disease patterns such as ground glass opacity or vascular dilatation, which may be present in patients with thoracic disease like pneumonia or COVID-19.

And a new version of the company’s FastStroke application was FDA cleared at the end of 2020. FastStroke automatically loads and processes CT studies, and sends the processed images in an email format, speeding up CT stroke evaluations.

The new version of FastStroke offers deep learning brain ventricle segmentation to prevent ventricular matter inclusion in quantitative results and improve visual inspection of the maps. It also provides tissue classification map segmented from absolute or relative values, customizable thresholds, and user selectable input maps.

Last year, the company expanded its TrueFidelity deep learning image reconstruction technology to dual-energy CT.

iCRco inc.
In March 2020, iCRco inc. introduced the Claris XT, a new large-format, 31-inch bore CBCT system. The scanner comes with 18-kilowatt tube, and a two-axis robotic table.

This new system and its software allows for high-resolution reconstructions of a volume of interest, said Stephen Neushul, president, chief executive officer and head engineer of iCRco.

“We’re trying to expand the functionality of CBCT,” Neushul said. “Most of its use has been for dental and extremities, because the sensors have been small. Now we’ve developed a large-format CBCT. Because it has a full-field sensor, you can do high-resolution imaging. With the robotic table, you can do long-length imaging with stitching. We essentially can do an entire spine with one device.”

The lower-dose, high-resolution system is portable, with a low upfront cost and cost of ownership.

The system is designed for orthopedic practices and there have also been studies on using it for lung scans to detect COVID-19 and lung nodules, with results being presented at the upcoming RSNA annual meeting.

Philips
In March, at ECR 2021, Philips introduced its Precise Suite, its AI-enabled solution that facilitates a more streamlined workflow, better image quality and dose reduction.

The software, currently available on the company’s Incisive CT scanner, is designed to reduce the variability of imaging among users, help reduce dose and speed up exam times, said Frans Venker, senior vice president and global business leader for CT/AMI at Philips.

One of the elements of Precise Suite, Precise Cardiac, was introduced on the new Spectral CT 7500, which came out earlier this year. Precise Cardiac is an AI-enabled smart algorithm to improve image quality by reducing motion artifacts impacting the coronary arteries. Spectral CT 7500 provides the user with more information, through its spectral/dual energy capabilities, to make a confident diagnosis, Venker said.

“With this scanner, our customers have seen a reduction in follow-up scans and an increase in diagnostic confidence,” Venker said.

The spectral detector is designed for hospitals trying to improve their diagnostic confidence on a wide variety of examinations, as it provides the spectral information on all scans. The scanner also has advanced cardiac imaging capabilities.

“You can analyze what a lesion is with a 23% increase in diagnostic confidence, providing reliability with decreased cost of care,” Venker said.

Planmed
Over the past year, Planmed updated the field of view on its Verity scanner to allow for horizontal stitching. While the device utilizes stitching instead of being able to image the entire foot on one scan, the previous stitching was only vertical, said Johan Moed, Planmed’s national sales manager.

The company also entered into a joint venture with software company Disior to exclusively distribute their software that provides automated segmenting and analysis for weight-bearing CT for the foot and ankle, knee, hand and wrist, and head and neck.

Unlike competitor Curvebeam’s CubeView Autometrics, being developed using machine learning, Disior uses the finite element method.

“It does actual segmentation directly in the slice data,” Moed said.

Software using artificial intelligence, needs tens of thousands of scans to train the algorithm, which Moed said “takes years of development and patient consent forms.”

Siemens Healthineers
Siemens Healthineers has released a new premium single-source CT scanner. Called the SOMATOM X.ceed, the system is designed to speed up cardiac exams and emergency imaging with a rotation time of up to 0.25 seconds per rotation.

“In cardiac imaging, fast rotation is key,” said Sybille Feldmann, CT product manager at Siemens Healthineers. “You also need excellent temporal resolution. With the SOMATOM X.ceed, you can achieve high image quality at the lowest possible dose.”

The system features an intuitive workflow called myExam Companion, which guides users through diagnostic procedures, including patient breath holds and highlighting medical artifacts before they can impact an exam, Feldmann said. The feature was already offered on the company’s SOMATOM X.cite, and is available across the entire lines of X. and go. platform scanners.

In addition, the scanner adds a second companion feature, myNeedle Companion, which helps plan and guide percutaneous interventional procedures across modalities, including CT and angiography with a common user interface called SHUI, the Siemens Healthineers User Interface, and myNeedle Laser, which projects the needle entry point and insertion angle directly on a patient’s body, and is especially helpful for procedures with multiple needle paths.

“You have the confidence to precisely hit the target area,” Feldmann said.

A Skull Unfolding application is already FDA cleared.

“It unfolds and flattens the skull image for the physician to visualize brain and skull surfaces,” Feldmann said.

A Brain Hemorrhage application that displays alerts of detected bleeding to help distinguish between stroke types is 510(k) pending.

Another added feature is myExam Satellite, which provides a workstation that shares the data set with the scanner. All of these are designed to be helpful in emergency and trauma settings, since radiologists can read one case while the next patient is already being scanned to help with faster triage.

The scanner has an 82-centimeter bore and a 120 kW X-ray tube, to image larger patients with high image quality, and an iPad tablet user interface. It supports dual-energy spectral imaging.

United Imaging
The evolution of United Imaging's CT portfolio continued in 2020 and 2021 with new developments that the company says offer healthcare providers the opportunity to expand their practice.

The uCT ATLAS, which is specifically designed to maximize clinical flexibility, was cleared by the FDA in late summer 2021. Among other features, the ultra-wide 82-centimeter bore and 700-pound table weight capacity facilitates the comfortable scanning of large patients and is designed to excel in the trauma environment.

The uCT ATLAS features an integrated uAI Vision 3D camera that enables an AI-empowered workflow, offering operational efficiencies to simplify complex exams.

"The speed of a large area coverage system coupled with a 0.25 second gantry rotation makes it easy to image a wide variety of patients, including pediatric and trauma patients as well as patients with compromised breathing," said Jeffrey Bundy, chief executive officer of United Imaging Healthcare Solutions. "In addition, low dose technologies such as 60 kVp scanning capability, uAI AI-IR and KARL 3D reduce radiation dose while maintaining image quality."

United Imaging also upgraded its entire installed base of uCT 5 series scanners with a new calcium scoring package as part of its Software Upgrades for Life commitment to customers, which included software and hardware, at no additional cost to customers. Via the upgrade, it delivered a prospective electrocardiogram (ECG)-gated coronary artery calcium scoring scan mode software and an overall software package that provides three calculation parameters: Agatston score, volume score and equivalent mass.

Xoran Technologies
Xoran Technologies recently reintroduced a mobile CT scanner for intraoperative imaging. Called the xCAT XL, it is designed for craniomaxillofacial (CMF) surgery.

“iCT provides surgeons with an effective tool to update surgical navigation, potentially improving surgical outcomes in both CMF and cochlear implantation surgery,” said Laura Dennis, vice president of sales and marketing for Xoran Technologies.

The company also improved the image quality of its xCAT IQ, a mobile CBCT used for imaging in both the operating room and neuro ICU, providing better differentiation of brain anatomy.

“In our current COVID pandemic environment, avoiding risky and uncomfortable intrahospital transport has become increasingly important,” Dennis said. “xCAT IQ does just that — allows clinicians to quickly and easily CT image these critically ill patients directly at the point of care, the neuro ICU.”

Xoran has also released a mobile, open-bore system for the veterinary market, technology it is looking to eventually carry over into medical imaging, allowing it to be used for spine, lung and orthopedic applications, among others.