With Ultrasound into the Future

By Mélisande Rouger

MyLab X90, Esaote’s newest release to date, is one of the first ultrasound systems powered by Artificial Intelligence (AI) or Augmented Insight, as the Italian company puts it. We spoke with Franco Fontana, Esaote’s CEO, to know how the new system, which was launched at ECR 2023, can help improve healthcare. We also discussed the value of low field MRI and current needs in medical IT solutions.

AI is available on almost every modality but ultrasound was the last frontier. How does AI expand ultrasound imaging on your new system?

There is a lot of ongoing work at the scientific and industry level, but the foundation for AI started many years ago. What has changed now is that we are able to process very large data and build up knowledge based on the data that has been collected, to train algorithms to do what we want to do. That is a big step ahead. Our focus at Esaote has been to develop solutions to streamline and facilitate workflow. It is all about letting the physicians focus on what really matters – clinical outcomes –, by sparing them tedious or repetitive tasks.

We have spent a lot of time with our R & D team putting up together all this data and knowledge, and discussing with experts. There is not one algorithm that works for everything. You have to work on every single anatomy, every single clinical application to build up your knowledge. Ultrasound examinations are complex. When you put a probe to scan, there are things and adjustments to take care of, because patients and applications may differ widely. MyLab X90 provides automatic AI-powered setting to recognize how the probes react and improve image quality. AI also enables to reduce scan time, by extrapolating measurements’ findings.

The system is useful in every application, from cardiac imaging, to extract all measurements from the cardiac cycle, to musculoskeletal, liver and women’s imaging, to name a few. You can automatically take 100 measurements in just a few seconds, and do fusion imaging for your interventional procedures with the equipment.

Franco Fontana, PhD, has been Chief Executive Officer of the Esaote Group since 2019. He has more than 25 years of experience in medical imaging and healthcare IT. He co-founded the PACS vendor AETmed, which was later incorporated into Esaote, giving origin to Ebit. He served as CEO of Ebit until 2020. Under his leadership, the PACS business has grown exponentially, with Ebit becoming a market leader in Italy and consolidating its international presence around the world. F. Fontana received his PhD in Telecommunications from the University of Genoa, and his executive MBA from Bocconi Business School in Milan, Italy.

Inter operator variability is still an issue in ultrasound imaging. How does AI help tackle the problem?

Our task is to design something that is fully reproducible and offers the same performance independently of external conditions. Measurements have to be repeatable.

With AI, systems will be more accessible to non-expert operators. MyLab X90 offers the possibility of automatically selecting the best scan plan to guide users throughout the examination. It automatically indicates if you have fully covered an organ in your examination or if you have missed something.

AI can make a big difference in interventional radiology, especially for beginners. You can match different modalities and do fusion imaging. It is one of the strong points of our system. It allows combining different data in real time on screen, to make sure you are doing the right thing.

MyLab X90, the new premium ultrasound system with Augmented Insight

Liver subcostal scanning with Wide view technology

Suprahepatic vein visualization with BrightFlow technology

Thyroid nodule with microV technology

Thyroid nodule with microV technology

Which other technological advances does the system feature?

MyLab X90 offers premium-level components like XCrystal probes and exclusive dual-layer eLed. We have done a great work on our probes, thanks to our factories in Italy and the Netherlands, and all the feedback and discussions we had with experts. There is a direct connection between the probe and image quality to improve diagnostic accuracy.

We also put a lot of effort into user experience and interaction with the system. Design is important. It is not just about how aesthetic your solution is, but also how easy to use it is. So we spent a lot of time with our Italian designers to build something that is both beautiful and useful.

You launched MyLab X90 a few weeks ago. What has been the response so far?

The reaction has been very positive. There is a lot of interest, we can see that in the road show we organized in our key geographical areas. Being a premium system, MyLab X90 is targeted at tertiary or reference hospitals and centres that do advanced research in interventional radiology, for instance, or follow complex patients. These institutions are very receptive to new technology and we already installed the system at different sites across Europe.

Esaote is also famous for its MRI systems. How has the Magnifico Open been doing since it was released two years ago?

The Magnifico Open, our first total body MR system, was launched in Europe in 2021 and received FDA approval in 2022. Our key markets reacted really well to the introduction of the system, which has pushed our MRI sales by 50 % last year. 2022 was actually the best year in our history, with a significant growth of our ultrasound line and a +10 % forecast turnover for the group.

The Magnifico Open is great not just for diagnostic imaging centers, but also orthopedics and surgery clinics. It is an ideal tool for musculoskeletal examinations, which we helped pioneer with the first MRI system dedicated to the limbs in 1992. MSK examinations are still the most commonly performed MRI scans today.

Another advantage is ease of installation. You do not need a very complex settlement to build or arrange where the system is going to be installed. Open technology also means low energy consumption, which fits our concern for delivering sustainable solutions.

The Magnifico Open is a low field MR system, which offers so many benefits, starting with wider patient acceptance. It is an open technology, which means that examinations no longer have to be performed in a closed tube. So claustrophobia is not an issue anymore. In addition, the system comes with great software that helps reduce scan time and improves image reconstruction.

Magnifico Open, Esaote’s total body MRI system

Hospitals increasingly demand complete solutions, not just medical equipment. What do you offer in terms of IT?

IT is a growing market and we also deliver cutting edge software. We have two lines in our IT solutions. The first is called enterprise imaging, where we offer a complete inhouse solution package that we pioneered at the end of 1990s, pushing the transition from film to digital. Digitalization saves costs and time. Everyone realizes the huge benefit of working with single electronic patient records and combining the data to improve workflows and patient outcomes. That work is done by Ebit, our IT subsidiary in Italy.

Our other IT line is in charge of everything connected with AI. That work is done by our subsidiary in the Netherlands, PIE Medical Imaging.

What does the future look like for Esaote?

There is still a lot to do in terms of image accuracy to better serve our customers’ needs. This is driving us. Ultrasound is widely recognized to be the stethoscope of the future and so we may also go back to where we started and take our probes to space again. Esaote provided the ultrasound system for cardiovascular examinations in astronauts into orbit on the NASA’s Space Shuttle back in the early 1990s.

With the development of private manned space flights, we may soon be able to help in this setting as well.

https://www.esaote.com