OCTOBER 4--The problem in Nuclear Medicine (NM) imaging is resolution vs. noise. As the resolution, or quality of the image, is increased, the noise increases. As filtering is applied to reduce the noise, some of the image information is lost, as well. An added complication is that while visible light travels in a single direction, the gamma waves that provide the illumination source in NM are emitted in all directions, and a special device called a collimator that orients the waves must be applied to correct for this phenomenon. At best there is a trade-off, and more often than not the image is dependent on the skill and experience of the gamma camera operator, of whom there are too few.
The Wide Beam Reconstruction (WBR) technology of UltraSPECT (Haifa, Israel) creates a stack of images that are transferred to a workstation where physicians can review a 3-D model. This means more-accurate diagnoses by the doctors, more-efficient treatment for the patient, and a major change in the quality of NM imaging in American hospitals.
The gamma cameras scan in two different modes: planar, where the patient lies absolutely still for the better part of 30 minutes as the camera slowly passes down the length of the body making transverse images, or 'salami slices', as Shuli Schwartz, UltraSPECT CEO and cofounder, calls them; or SPECT (Single Photon Emission Computerized Tomography), where the camera revolves 180° around a specific part of the body, snapping up to 128 pictures along the way. Prior to each scan a radiopharmaceutical is injected into the body; different compounds are used depending on the type of scan and procedure. Radiopharmaceuticals are expensive and, as they are radioactive, carry a certain risk so it is in the patients' interest to receive as low a dose as possible.
Xact.bone and Xpress.bone--both launched in June after receiving US Food and Drug Administration clearance--truncate the duration of the imaging process, which is a convenience for the patient and a cost-saving measure that improves the efficiency and turnover of the highly expensive imaging devices. Says Schwartz, "We can reduce acquisition time by half, and reconstruct as good an image or better. This leads to better patient care and comfort and better accuracy for physicians."
The potential for UltraSPECT to have a behind-the-scenes impact on the quality of NM and health care in the USA is immense. At an average cost of $600 per procedure, this is a $4.5 billion dollar annual market, not including the hundreds of millions of dollars spent on capital equipment acquisition.
Established in 1999, the company, which operates in the USA out of Brookfield, WI, recently announced 15 installations of its systems in top-tier US and Israeli hospitals. Duke University Medical Center and Vanderbilt University Medical Center were both beta sites for the UltraSPECT products. In addition, UltraSPECT technology is already working at 13 other sites including NY Presbyterian Hospital, the Mayo Clinic, and two Israeli hospitals, Jerusalem's Hadassah Ein Kerem and Haifa Carmel. The company is currently in preliminary talks regarding alliances with leading medical imaging companies such as GE Medical, Philips, and Siemens.