Download The iE33 intelligent echocardiography system

The iE33 intelligent echocardiography
system
R.B. Peterson,
J. Hutchins
Philips Ultrasound, Philips Medical Systems, Bothell WA, USA.
features including voice-activated control and
automated image optimization technologies.
The iE33 system delivers powerful performance
The growing number of older patients with
chronic heart failure and valve disease has led to
a demand for cardiac imaging services which is
expected to increase dramatically over the next
decade. Cardiologists are seeking faster and more
cost-effective methods for accurately measuring
cardiac anatomy and function, in order to
improve diagnostic confidence and enhance the
quality of care, while hospitals and imaging
centers are facing a sharp rise in the demand for
echocardiography exams. At the same time, many
organizations are faced with reduced budgets and
fewer personnel. Last but not least, some 80% of
sonographers have experienced work-related pain,
and one in five sustains a career-ending injury due
to repetitive motion and misaligned scanning
positions.
The iE33 intelligent echocardiography system
(Figure 1) has been designed to address these
challenges. It combines extremely high 2D image
quality with next-generation Live 3D imaging,
powerful on-cart 2D and 3D quantification of
cardiac anatomy and function, and user-centered
ergonomics (Figure 2). The iE33 system also
offers a wide range of performance-enhancing
with the latest developments in 2D and Live
3D Echo imaging. The system's new line of
transducers includes the S5-1 with PureWave
crystal technology. PureWave is an entirely new
class of piezoelectric material that transmits and
receives ultrasound with greater efficiency than
conventional transducers. The resulting 2D and
color flow images display astonishingly crisp
and clear anatomic and physiological details,
helping to enhance diagnostic confidence, even
on the most technically challenging patients.
The iE33 is also the first premium echocardiography system to have fully integrated 3D
cardiac quantification software for measurements
such as left ventricle (LV) volume and ejection
fraction. The on-cart QLAB quantification
software allows physicians to measure cardiac
function and anatomy in minimal time and without
the need for expensive off-cart quantification
software. QLAB uses three-dimensional border
detection to provide rapid access to global
ventricular volumes and waveforms, and perform
regional analysis of the function of 17 different
segments of the heart at one time.
Figure 1.The iE33 intelligent
echocardiography system.
Figure 2.The iE33 system adapts to
virtually any scanning condition for
maximum user comfort and
convenience.
The iE33 combines
high quality 2D imaging
with live 3D imaging,
on-cart quantification
and user-centered
ergonomics.
MEDICAMUNDI 48/3 2004/11 45
The X3-1 transducer
provides true, real-time 3D
images of the beating heart.
Philip's next generation xMATRIX transducer
technology, the core of Live 3D Echo, is utilized
in the new X3-1 transducer. Tuned for the
majority of the adult population, this fully
sampled matrix array transducer provides the
ability to deliver true, real-time 3D volumes,
allowing physicians to examine the beating heart
almost as if they were holding it in their hands.
It also allows Live xPlane Imaging, which displays
two simultaneous views of the heart from the
same instant in the heartbeat. One view is a 2D
baseline reference, while the other can be any of
180 different views within the 3D data set.
Intelligent design and intelligent control combine
to produce revolutionary clinical performance
and increased workflow, providing clinicians and
administrators with more diagnostic capability,
broader clinical application, faster patient
throughput, and simplified system control.
First clinical experience
The first clinical experience with the iE33
intelligent ultrasound system (Figures 3-6)
indicates that the system has the potential to
allow earlier identification of the nature and
extent of heart disease, and enhance the
physician's diagnostic capability, thus reducing
or eliminating the need for more expensive or
invasive tests and procedures. It also provides
clearer ultrasound images of difficult-to-image
(larger) patients, and helps patients better
visualize and understand their condition.
Advanced architecture
A pure, uniform
piezocrystal structure
improves image quality
and penetration.
The iE33 system's xSTREAM architecture
processes multiple data streams simultaneously,
and incorporates a distributed multiprocessor
environment with a capability of up to
250 billion operations per second. Fully flexible
and configurable, xSTREAM architecture is
designed for the most demanding clinical
imaging applications, and advanced
quantification tools. It provides real-time
generation of volume data for instantaneous
display of Live 3D Echo and Live xPlane images,
together with SonoCT and Xres image
processing capabilities.
Live 3D Echo
Philips’ fourth-generation fully sampled matrix
array provides real-time 3D volume-rendered
imaging. The powerful xSTREAM architecture
enables easy acquisition, manipulation and
quantification of volume data.
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Live xPlane imaging
Enabled by the xSTREAM architecture's
multidirectional beam steering capabilities, Live
xPlane imaging acquires two planes
simultaneously from the same heartbeat and
from one acoustic window. Live xPlane speeds
exams and enhanced productivity by providing
twice as much information in the same amount
of time.
SonoCT real-time compound imaging
SonoCT acquires and processes up to nine lines
of sight to display exceptionally clear vascular
images, free of clutter and artifact. Compounding
precision and WideScan capabilities expand the
field of view for improved anatomical
documentation and measurement.
XRES image processing
XRES adaptive image processing, brought from
Philips MR research, is an algorithm that
performs real-time analysis of patterns, and refines
images throughout the entire field of view. Xres
processing virtually eliminates speckle noise
artifact and dynamically enhances tissue margins.
It is available on every transducer and for 2D,
Live 3D and Live xPlane imaging.
Transducers
The new Explora family of high-performance
transducers has been specially designed for
maximum acoustic efficiency, with a new lowloss lens design allowing greater penetration and
resolution with minimal artifacts. Ergonomic
design with very light and flexible cables reduces
operator strain and fatigue.
PureWave crystal technology
PureWave crystal technology is probably the most
significant advance in transducer material for
four decades. Its pure, uniform piezocrystal
structure exhibits significantly better acoustic
properties than traditional PZT ceramics, resulting
in exceptional performance and a marked increase
in 2D image quality and color flow sensitivity,
as well as improved penetration in difficult-toimage patients, and precise tracking of blood/
tissue interfaces. There is a significant reduction
in clutter, for excellent detail rendition in the
endocardium and fine structures, and greater
sensitivity in harmonic imaging.
The S5-1 transducer
The S5-1 transducer incorporates the bandwidth
of two conventional high-performance
transducers, eliminating the need for multiple
transducer selection. PureWave crystal technology
provides striking 2D clarity and color sensitivity.
xMATRIX transducer technology
xMATRIX transducer technology incorporates
exclusive micro-beamforming circuitry designed
to support up to 3,000 individual active elements.
The X3-1 transducer
The X3-1 transducer has fully sampled xMATRIX
array technology, providing sufficient on-board
processing power for Live 3D and Live xPlane
imaging. Its small size and aperture fits better
between adult ribs and improves the imaging of
technically difficult patients, allowing
sonographers to image an even greater proportion
of the adult patient population.
All Explora transducers feature superflex flexible
and lightweight cable technology, reducing user
fatigue.
Figure 3. 2D 4-chamber view with Xres
Figure 4. 3DQ slice volume measurement.
Figure 5. Live 3D apical 4-chamber view.
Figure 6. 3DQ advanced segmental analysis.
OmniPlane TEE technology
The S7-2 omni transesophageal transducer
incorporates tried and tested OmniPlane
technology. The 2 to 7 MHz frequency range
provides the necessary bandwidth for harmonic
imaging and contrast research applications,
while true electrocautery suppression virtually
eliminates noise artifacts during surgery.
Fourth generation Live 3D Echo Imaging
Fast image acquisition and image processing
allow true, instantaneous, real-time 3D imaging.
The proven versatility of Live 3D Echo imaging,
made possible by the xMATRIX technology,
enables quick acquisition, manipulation and
quantification of full-volume data sets. The very
large processing capability enables clinicians to
explore new applications for quicker and more
confident diagnosis.
On-cart cardiac quantification
Measurement of cardiac function and anatomy,
especially in 3D, can be a time-consuming and
costly task, often relegated to the research
environment and expensive off-line systems.
The iE33 system has integrated QLAB 3DQ
(3D Quantification), allowing the physician to
measure the true full volume of the left ventricle
(LV) in less than a minute, with little operator
intervention. The ejection fraction can also be
measured quickly and easily without the need
for expensive post- processing systems or traditional,
invasive scanning methods.
Other quantification capabilities available on
the system include: 2D and 3D distance, area,
length, LV mass, strain, intima-media thickness
(IMT), and the ability to define a region of
interest (ROI). In addition, the physician can
now evaluate global LV volume and the regional
volume of 17 segments of the heart. These new
quantification capabilities offer a faster working
procedure and potentially quicker diagnosis by
reducing the need for further exams. QLAB is
automated to facilitate exam throughput and
can be taken off-line to a standard PC or PACS
to maximize system productivity.
Clear, bright display
The unique LCD flat screen technology, designed
specifically for medical applications, provides a
new level of high-resolution, no-distortion image
display. Ultra-bright, flicker-free technology
reduces eyestrain, and the monitor can be easily
adjusted to almost any viewing position to
satisfy any scanning challenge and allow shared
patient viewing.
Voice recognition
Exclusive Philips iCOMMAND voice recognition,
based on Philips Speech Magic technology,
recognizes more than 2300 commands, eliminating
awkward scanning positions, providing more
imaging flexibility in tight locations, and leaving
both hands free for scanning and patient
manipulation. Unlike many other speech
recognition technologies, iCOMMAND can
provide an accuracy of 95% at start-up for most
native speakers, and can be optimized for more
challenging speech patterns with only a few
minutes of training. Speech recognition on the
iE33 system is currently available in five languages:
English, French, German, Italian and Spanish.
Intelligent automation
The iE33 can dynamically adjust as many as 40
different controls, in a variety of functions, at the
touch of a button. This intelligent automation is
designed to improve workflow and create more
consistent results across operators with varying
skill levels.
iCOMMAND wireless
voice recognition
technology allows
hands-free control.
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Philips iSCAN technology optimizes the
adaptive gain compensation (AGC) and Time
Gain Control (TGC) to reduce the effects of
commonly encountered artifacts.
Using iFOCUS, the user can select an area of
interest for vascular imaging, and the system then
calculates the ideal beam focal characteristics to
give the best detail resolution and tissue
uniformity.
The iE33 provides an
ergonomically optimized
scanning environment.
Flat panel monitor
A premium grade LCD monitor offers ultrabright, flicker-free technology for reduced
eyestrain
With iOPTIMIZE technology the user can select
any of four different functions, including specific
tissue type, patient size, blood flow and resolution
versus frame rate speed to optimize the image
dataset during acquisition. This dramatically
reduces the time necessary to make fine
adjustments and requires no knowledge of the
intricacies of acoustic science.
Control panel
Height, swivel and side-to-side extension
adjustments allow optimum positioning for
each user.
Ergonomics
Transducer connectors
3 universal ports placed for easy access and
minimal reach.
An additional challenge to the clinician is the fact
that some 80% of sonographers have experienced
work-related pain, resulting in reduced patient
throughput and increased employee health claims.
Intelligent automation
improves workflow and
provides consistent results.
Every detail on the iE33 system has been
designed for improved ergonomics. The result is
a unique, human-centered design that helps
reduce user fatigue and improves workflow and
department productivity.
The iE33 system provides the foundation for an
ergonomically optimized scanning environment
that adapts to virtually any scanning condition
for maximum user comfort and convenience. Its
articulating flat panel display and control panel
are coupled with a lightweight, slim chassis for
mobility, scanning flexibility and user comfort.
The unique ergonomic design adjusts to the user,
while hands-free voice command, one-button
automated optimization controls and a simple,
easy-to-use interface ensure quick and consistent
image acquisition by users of varying skill levels.
Touch screens
Dual graphical color screens allow full control
with minimal keystrokes and reach
Integrated DVD-RW/CD-RW drive
For easy-to-reach streamlined archiving.
Peripheral bay/storage shelf
VCR and printers can be mounted for either
left- or right-hand access.
Brake and swivel lock footswitch
Easy control of all options by foot.
Built-in storage
A built-in storage tray provides a safe and easy way
to transport TEEs and other items, while other
supplies are stored in convenient storage bins.
Sense and simplicity
A recent study [1] showed that the Philips system
design to be the only design that meets the US
SDMS (Society of Diagnostic Medical
Sonography) Industry Standards for independent
height adjustment of the monitor and control
panel, and for the full range of viewing distances.
The iE33 demonstrates the Philips
commitment to producing products designed
around the customer that are technically
advanced, yet easy to use. Now, more than ever,
users can focus on clinical diagnoses and less on
system controls and optimization References
[1] Albin JH. A Comparison of Six Ultrasound Systems with Regard to Conformance to the Industry Standards for the Prevention of Work-Related
Musculoskeletal Disorders in Sonography. Ultrasound Benchmark Study, July 2004.
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