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JANUARY 2020, VOLUME 4 ISSUE 1 `200 INDIA MED TODAY

www.indiamedtoday.com

CHANGING DYNAMICS OF

RADIOLOGY BUSINESS Innovative business models will lead growth in the new decade

APPROACH UNDERSTANDING NEW USER

SPECIAL FEATURE INTERVIEW

JANUARY 2020

OPINION

WILL RADIOLOGY WED AI

LIVING LEGEND, HANS RINGERTZ

CT SCAN USE IN ORTHOPAEDICS


EDIT NOTE www.indiamedtoday.com

JANUARY 2020 EDITORIAL

BOARD OF ADVISORS

Editor Neelam Kachhap editorial@ indiamedtoday.com

Dr Alexander Thomas Dr Girdhar Gyani Dr Prem Kumar Nair Dr Bhabatosh Biswas Dr Alok Roy Ramesh Kannan

ART & PRODUCTION

CONSULTING EDITOR

5Th eLLemenT sTudio Prasshant

Dr Libert Anil Gomes Dr Salil Choudhary

ADVERTISING Gunjan Chauhan gunjanc@indiamedtoday.com The Media Ant help@themediaant.com DIGITAL MARKETING Vivek Nair

EDITORIAL ENQUIRIES editorial@indiamedtoday.com CUSTOMER SERVICE: Subscription support and other assistance for readers subscribe@indiamedtoday.com ADVERTISING ENQUIRIES sales@indiamedtoday.com OFFICE 301, Grazia, 1st main, 2nd Cross, Lingrajpuram, Bangalore 560084 www.indiamedtoday.com IndiaMedToday expressly disclaims liability for errors and omissions in this publication. While we try to keep the information timely and accurate, we make no guarantees. The views and opinions expressed in the magazine do not necessarily reflect the official policy or position of IndiaMedToday or the publication. Information on IndiaMedToday should not be used as a substitute for professional healthcare advice. Readers are advised to always seek specialist advice before acting on information contained in this publication. Never disregard professional medical advice or delay in seeking it because of something you have read on

Dawn of New Era in Healthcare AS INDIAMEDTODAY moves into its fourth year as a successful medium of communication in the healthcare industry, wewould like to wish a VERY HAPPY AND SUCCESSFUL 2020 to all our readers.The first issue of the New Year brings to you an abundance of information on trends, technology, views, opinions and more,apropos to the healthcare industry. Our Cover Story in this issue highlights the changing business models in radiology. As long as their clinical requirements are met, ownership of the equipment is of no value for care providers. With hospitals focusing on improving clinical standards and overall revenues, business models offering the product/solution as-a-service with guaranteed performance will gain traction, while traditional models focusing on selling products based on specification superiority or product USP are expected to slow down.

The first issue of the New Year brings to you an abundance of information on trends, technology, views, opinions and more,apropos to the healthcare industry The story also sheds a light on the fact that apart from equipment vendors, teleradiology and imaging information technology providers have also adopted the services model. While we discuss the effect of radiology as a service we also look at advancements in radiology modalities like CT. We also share perspective on Innovation in medical devices. One of the most celebrated radiologists of the world Prof. HansRingertz from LinkÜping University, Sweden and Stanford University, USA shares his journey through the many innovations and interventions developed in radiology. Dr Arjun Kalyanpur, shares his thoughts on making radiology practice more effective and Dr Deepak Patkar shares his views on the vision 2020. There are a number of informative features along with these stories. In addition, IndiaMedToday has a full lineup of stories for 2020 to help wade through different challenges in the forthcoming year. We will be your voice, and raise your concerns to the authorities. We will bring you inspiring stories and innovative tech as well as see you at the most acclaimed events. As always, if you have any comments or would like to submit an article, please don’t hesitate to contact me at mneelam.kachhap@indiamedtoday.com

IndiaMedToday. No part of this publication or any part of the contents thereof may be reproduced, stored in a retrieval system or transmitted in any form without the permission of the publishers in writing. Printed and published by M Neelam Kachhap, 301, Grazia, 1st main, 2nd Cross, Lingrajpuram, Bangalore 560084 on behalf of Neelam Publishing (OPC) Private Limited, Printed at Supriya Print Art 143, Pragati Industrial Estate, N M Joshi Marg, Lower Parel West, Mumbai - 400011. and published at 301, Grazia, 1st main, 2nd Cross, Lingrajpuram, Bangalore 560084.

Editor M Neelam Kachhap

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December2020 January 2019


JANUARY 2020

CONNECT WITH US Join the conversation with IndiaMedToday through our social media pages Twitter

CONTENTS

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OPINION

Facebook Linkedin

UPFRONT

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04 Editorial 06 Letters 07 News roundup 35 Products 42 Events listing

Will radiology wed AI

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SPECIAL FEATURE

COVER STORY

Changing Dynamics of Radiology Business

Innovative business models will lead growth in the new decade

INTERVIWE

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Living Legend In conversation with Hans Ringertz, world renowned radiology Scholar about traversing through an era of technology and innovations changing radiology for better

Leaders Speak Dr Deepak Patkar HoD Radiology, Nanavati Super Speciality Hospital

APPROACH

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Understanding New User New Era – Medical Consumer – Do we know him yet?

CT Scan Use in Orthopaedics

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PULSE

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Healthcare Innovations 2020 INSIGHT

In Conversation with Dr Arjun Kalyanpur on Making Radiology Practice More Effective

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LETTERS THE FUTURE OF HEALTHCARE AND DIGITAL TECHNOLOGIES

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he future of Healthcare will be primarily driven by digital technologies such as Artificial Intelligence, Robotics, 3D printing, augmented and virtual reality. Digitization will bring increased efficiency and accessibility to healthcare services. Today, AI is already becoming an intrinsic part of many Clinical decisions made by medical professionals. Data-based decisions help improve quality of care, clinician

productivity and address the challenges in scaling healthcare delivery to rural areas and make a huge impact for the masses. The progressive innovation in this industry coupled with the government’s support is sure to accelerate healthcare penetration and enhance the value for patients Geetha Manjunath, CEO & CTO, NIRAMAI

The year gone by has witnessed an extensive usage of online healthcare by urban, semi-urban and rural people alike.2019 saw an increase in acute disease manifestation from Dengue to Acute seasonal infections. Moreover, this year a lot of emphasis and awareness was seen for mental health issues like depression, anxiety and substance abuse. As per our data, more than 70 per cent of the people who took depression self-test on the platform are found to be at risk of moderate to severe depression. This year also had a lot of younger people struggling with chronic disease issues like obesity, diabetes and hypertension. Out of the total diabetes risk assessments taken on the platform, more than 65 per cent of individuals were found to be with medium to high risks. Overall, of the total queries/calls received, 71per cent were from the ones in the age group of 20-40 years. Satish Kannan, Co-founder & CEO, DocsApp

2019 was a very interesting year for the healthcare sector as a whole. There have been exciting things happening on policy level, providers’ side (hospitals and diagnostics companies), life sciences and one the insurance side. The Ministry of Health and Family Welfare, Government of India has come up with National Digital Health Blueprint which is an interesting step towards increasing the digital footprint in healthcare. We hope the government is going to build upon this blueprint and come up with simple and implantable policy in the coming year. Continuing the trend from 2018, Private Equity has shown keen interest in the hospital sector this year as well, there have been some key consolidation and M&A deals in the sector. We believe that this could bring in more efficiency in the ecosystem. This have impacted smaller neighbourhood hospitals as well, and across the ecosystem hospitals have become significantly more open to innovative solutions to improve patient experience and patient outcomes. We hope that in 2020, the adoption of innovative solutions by hospitals increases even further so that it can benefit both patients and the hospitals. Life Science and Pharma industry did pretty well this year. Change in the import policy by China is a promising welcome for India generic

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manufacturers. The industry has also made significant strides in the digital health innovation with new digital devices coming in from different pharmaceutical companies. For healthcare technology companies, 2019 has been a very good. There have been quite a few large value VC-PE deals this year which has given good impetus to the sector as a whole.We believe that this momentum is going to continue for a while now and this sector will grow significantly in the coming year replicating Indian Fintech sector growth. Gaurav Gupta, Co-founder, Navia Life Care

The technological advancements in healthcare has benefited the overall industry including the diagnostic market. In 2020, genetic testing will further shape the preventive healthcare segment. Recent findings in our genomic study and the significant decline in the costs of genetic testing will change the game completely. The industry will use these techniques to transform the way personalised healthcare is delivered in the country.As a result of Government backed research initiatives like IndiGen project, genetics sector is all set to go for a rapid change. Moreover, the Government has also given importance to the segment through its plan of setting up wellness centers across India resulting in the availability, accessibility and affordability of the preventive healthcare services to the masses. It will help to shift the focus to preventive from curative for the entire population and industry. Amol Naikawadi, Joint Managing Director, Indus Health Plus

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MOBILE CT ALLOWS HEAD delivery and improves the patient and staff experience. EXAMS AT PATIENT’S BEDSIDE WITH SOMATOM MEDICOVER HOSPITALS ON.SITE At the 105th Scientific Assembly and Annual INCREASES STAKE IN Meeting of the Radiological Society of North MAXCURE HOSPITALS America (RSNA), Siemens Healthineers debuts the SOMATOM On.site, a mobile head computed tomography (CT) scanner that changes the standard practice of transporting a critically ill patient from the intensive care unit (ICU) to the radiology department for a CT scan. With the SOMATOM On.site, the radiologic technologist can perform a CT head examination directly at the patient’s bedside, potentially eliminating costly patient transports with high staffing requirements and the potential risk to the patient. In this way, the SOMATOM On.site transforms care

Medicover AB (publ) has increased its ownership in Medicover Hospitals (MaxCure) in India from 49.2% to 53.1% via a mixture of primary shares and secondary shares acquired. Medicover holds also additional convertible loans that if converted would take ownership to approximately 57%. This investment brings the total carrying value of the ownership in Medicover Hospitals to EUR 57 million for its stake. Medicover is now the majority owner in Medicover Hospitals and the business will be consolidated as from 1 December 2019.

INDIA-SWEDEN HEALTHCARE INNOVATION CENTRE WITH AIIMS DELHI, JODHPUR The Swedish Trade Commissioner’s Office in collaboration with the All India Institute of Medical Sciences, New Delhi (AIIMS, New Delhi) and All India Institute of Medical Sciences, Jodhpur (AIIMS, Jodhpur) announced the launch of India-Sweden Healthcare Innovation Centre in India at India- Sweden Business Summit Inauguration held recently. The announcement was made in the presence of His Majesties King Carl XVI Gustaf of Sweden and in the presence of the Hon’ble Ministers Smt. NirmalaSitharaman, Finance, Government of India and Mr. Ibrahim Baylan, Ministry of Enterprise and Innovation,

Smt. Nirmala Sitharaman, Finance Minister along with Ylva Berg, Business Sweden CEO and other delegates, unveiling the centre

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NEWS ROUNDUP Government of Sweden. The Centre is envisioned to develop an ecosystem of open innovation that healthcare delivery stakeholders can use to collaborate and address current and future challenges in the healthcare sector in India. It will enable development and scale up of solutions through frugal innovation for affordable and accessible healthcare in line with the objectives of the Government of India, including technology, data, protocols and processes, skill development and business models.

APOLLO HOSPITALS SETS-UP ROBOTASSISTED CARDIAC SURGERY PROGRAM AT BENGALURU Apollo Hospitals Bengaluru announced the launch of a dedicated Robot-Assisted Cardiac Surgery Unit for minimally invasive cardiac surgery.The unit will be led by Dr. Sathyaki P Nambala, Sr. Consultant, Cardio-thoracic and Vascular Surgeon and HoD, Robotic Cardiac Surgery Unit and will be equipped with advanced fourth-generation ‘da Vinci Xi’ robotic surgical system.

ASEAN team

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ASEAN SERVICES TRADE FORUM DISCUSSION ON HEALTH AND SOCIAL SERVICES The ASEAN-Japan Centre (AJC) held the “ASEAN Services Trade Forum – Health and Social Services ” on 27 November 2019 in Tokyo, Japan. 107 participants from the Japanese private sector, government agencies, academia as well as representatives from nine ASEAN countries and ASEAN embassies in Tokyo joined the Forum.Human development depends on and determines economic and social development. The productivity of the labour force, which depends on its health status, plays a crucial role in determining the overall productivity. The importance of sustaining availability and providing easy access to quality healthcare infrastructure to the residents of ASEAN cannot be overemphasized. ASEAN governments have been aiming to achieve the Universal Health Coverage (UHC)1 by 2030, as part of the Sustainable Development Goals (SDGs).

FUJIFILM TO ACQUIRE HITACHI’S MEDICAL IMAGING BIZ FOR $1.56 BILLION

Corporation announced that it has entered into an agreement with Hitachi, Ltd. to acquire Hitachi’s Diagnostic Imaging-related Business to further expand its Healthcare business. The purchase price is expected to be approximately JPY179bn* ($1.56 billion). Prior to the acquisition, Hitachi will establish a new company and implement an absorption-type company split whereby the New Company will absorb the Business. Under the share purchase agreement between Fujifilm and Hitachi signed recently, Fujifilm will acquire all the outstanding shares of the New Company from Hitachi. The completion of this acquisition is subject to customary closing conditions and regulatory approvals.

HCG BANGALORE BECOMES THE FIRST HOSPITAL IN THE COUNTRY TO COMPLETELY DIGITIZE HISTOPATHOLOGY DIAGNOSIS Health Care Global Enterprise Ltd. (HCG) a global leader in Cancer Care becomes the first hospital in the country to completely digitize histopathology workflow for primary diagnosis at the HCG-Strand Laboratory at KR


Road, Bangalore. The hospital had introduced a US FDA approved digital pathology solution from Philips Intellisite Pathology Solutions and now the laboratory at HCG has successfully transformed to a 100% digital lab for Histopathology and Computational Pathology. The lab is also now accredited by College of American Pathologists (CAP) and National Accreditation Board for Testing and Calibration Laboratories (NABL), India, for its Digital Pathology facility in the fields of Histopathology, Cytopathology, Frozen section facility as well as the Artificial Intelligence based Breast Algorithm.

CO-DIAGNOSTICS JV RECEIVES INDIAN REGULATORY APPROVAL FOR FIVE DIAGNOSTIC ASSAYS Co-Diagnostics, Inc., Utah based molecular diagnostics company with a unique, patented platform for the development of molecular diagnostic tests, announced recently that CoSara Diagnostics Pvt Ltd, their Indian joint venture for manufacturing, has obtained regulatory clearance for five tests to be manufactured and sold as in vitro diagnostics from their facility in Ranoli, India.The Saragene™ tests for Mycobacterium tuberculosis, malaria, hepatitis B, hepatitis C and human papillomavirus (HPV) meet the requirements of the Central Drug Standard Control Organization (“CDSCO”) Medical Device Rules (MDR) 2017, to be manufactured and sold as IVDs the company said.

DR. AGARWAL’S GROUP OF EYE HOSPITALS RAISES RS. 215 CRORES FROM CDC GROUP

Dr. Agarwal’s Healthcare Ltd. (DAHCL) has raised Rs. 215 crores of debt from CDC Group to expand the geographical footprint of the eye care chain across India, Africa and South Asia along with significant investments in latest technology for super specialty eye-

care. The group has recently set up its first hospital in Mumbai in partnership with Advanced Eye Institute in Navi Mumbai. Dr. Agarwal’s Healthcare Ltd. (DAHCL) had raised Rs. 270 croreinvestment from Temasek, a global investment company headquartered in Singapore earlier this year.

NHA AND BHARTI FOUNDATION JOIN HANDS TO PROMOTE PM – JAY IN RURAL INDIA

Bharti Foundation the philanthropic arm of Bharti Enterprises recently announced the signing of Memorandum of Understanding (MoU) with the National Health Authority (NHA), an apex body responsible for implementing India’s flagship public health insurance scheme “Ayushman Bharat Pradhanmantri Jan ArogyaYojana”.As per the MoU, the NHA will leverage Bharti Foundation’s reach in villages across 16 states, through its education programs, to bolster PM-JAY’s objective of reaching the underprivileged and educating them on the benefits of the healthcare scheme to potential beneficiaries.

VILLGRO ANNOUNCES INVESTMENTS TO THE TUNE OF INR 4 CRORE THROUGH IPITCH

Villgro, India’s oldest and foremost social enterprise incubatorrecently announced its 2019 investees for iPitch. This time, iPitch has facilitated funding of over Rs 4 crore for innovative start-ups across the Agribusiness, Health, and Renewable Energy domains.Villgro India was the lead investor for start-ups in the health sector. It focused on tech-backed assistive technologies that can provide freedom to individuals with disabilities. BeAble Health, a manufacturer of rehabilitation and medical devices received INR 25,00,000. Flexmotiv Technologies, which creates anti-slip, all-terrain crutches, received INR 25,00,000 as well.

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NEWS ROUNDUP SYNGENE APPOINTS SIBAJI BISWAS AS CFO

V WITH $141 MILLION IN TOTAL CAPITAL

Syngene International Limited, a leading global contract research organization, announced the appointment of Mr.SibajiBiswas as Chief Financial Officer and member of the Executive Committee with effect from December 18, 2019. He will succeed Mr. M.B. Chinappa, current CFO, who will stay within the Biocon Group of Companies and join Biocon Biologics India Ltd. in a new role. SibajiBiswas brings more than twenty years of extensive experience in finance and related functions. His prior experience includes eleven years at Vodafone as well as roles in Fascel Telecommunications, Jhagadia Copper and the ABP Group. In his most recent role, he was CFO and Board Member for Vodafone Romania.

Kaiser Permanente Ventures (KPV) recently announced it has closed its fifth investment fund at $141 million, bringing the total assets under management to more than $500 million. This latest fund includes financial commitments from Kaiser Permanente and a diverse group of new and returning external strategic investors including Tufts Health Plan, Henry Ford Health System, and Highmark Ventures, a subsidiary of Highmark Health.KPV Fund V will continue KPV’s focus on supporting the growth of innovative companies that are addressing some of the most important unmet needs in the health care system.

SIDDHARTH MITTAL TAKES OVER AS CEO AND JOINT MANAGING DIRECTOR OF BIOCON LIMITED Biocon Ltd, an innovation-led global biopharmaceuticals company, announced that Siddharth Mittal has taken over as Chief Executive Officer & Joint Managing Director of the Company starting December 1, 2019.Mr. Mittal takes over from Dr. ArunChandavarkar who retired as Chief Executive Officer & Joint Managing Director of Biocon on November 30, 2019, after 29 years of outstanding contribution to the evolution and success of Biocon. Mr. Mittal has been serving as Biocon’s Chief Financial Officer (CFO) since August 2014.

VILLGRO SIGNS MOU WITH GENWORKS FOR WINNING GO-TO-MARKET STRATEGY

Villgro, India’s oldest and foremost social enterprise incubator has recently signed an MOU with GenWorks, medical device sales and service company to develop joint solution go-to-

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market that will have a far-reaching impact for Villgro incubated products.Talking exclusively to IndiaMedRecently about the MOU Paul Basil, Founder and CEO, Villgro, said,” One of the challenges social innovators face is access to markets and weak go-to-market strategies. A significant number of our incubatees are B2B and need help from established corporates. We believe that with Genworks’s high-quality network serving the healthcare provider requirements will help our incubatees build differentiated competitiveness and leadership in its target markets.”

MANKIND PHARMA, FIRST INDIAN COMPANY TO DEVELOP DYDROGESTERONE FOR INFERTILITY & PREGNANCY RELATED COMPLICATIONS Mankind Pharma, a Rs 5,600 crore pharmaceutical company, has launched a Dydrogesterone-containing drug, for treatment of pregnancy-related complications. Mankind Pharma becomes the first Indian and second global company to develop the drug and make it available at an affordable price. Progesterone is a natural hormone involved in the menstrual cycle, implantation, and in successful maintenance of pregnancy.It took nine years for a team of 400 scientists at Mankind Research Centre to develop this drug, which is the only retroprogesterone available commercially. The manufacturing process of Dydrogesterone is very complex as it involves the conversion of natural progesterone.

KAISER PERMANENTE VENTURES CLOSES FUND

BIOCON & EQUILLIUM EXPAND EXCLUSIVE LICENSING AGREEMENT FOR ITOLIZUMAB TO INCLUDE AUSTRALIA AND NEW ZEALAND Biocon Ltd (BSE code: 532523, NSE: BIOCON), an innovation-led global biopharmaceuticals company and Equillium Inc. (Nasdaq: EQ), a clinical-stage biotechnology company leveraging deep understanding of immunobiology to develop products to treat severe autoimmune and inflammatory disorders, recently announced that they have expanded their collaboration and license agreement for itolizumab to grant Equillium exclusive rights for developing and commercializing itolizumab in Australia and New Zealand.

ARVI LAUNCHES AT-HOME MEDICAL ALERT SYSTEM IN INDIA EXCLUSIVELY FOR SENIOR CITIZENS

Arvi (arvi.in), a healthcare solution for senior citizens, launched recently in India. To begin with, the startup is currently offering its services in Telangana and Andhra Pradesh.


The service aims to make healthcare easy, instant and accessible for senior citizens. Arvi provides a smart medical alert system that offers emergency and non- emergency medical assistance with doorstep convenience for senior citizens.

MEDGENOME LABS AWARDED CAP ACCREDITATION The accreditation committee of the ‘College of American Pathologist’-CAP awarded an accreditation to MedGenome Labs Private Limited yet again based on results of a recent on-site inspection as part of their accreditation program.MedGenome is a leading genetic testing laboratory that offers unique genomic solutions in rare diseases, neurology, oncology, infectious diseases, ophthalmology, cardiology and other rare diseases. Dr VL Ramprasad, Lab Director and COO at MedGenome Labs was congratulated for the excellence of the services being provided.

DR SKS MARYA RE-JOINS MAX HEALTHCARE Max Healthcare, a leading provider of comprehensive, seamless and integrated

world class healthcare services in India, announced the appointment of Dr. S.K.S. Marya, Chairman & Chief Surgeon, Max Institute of Musculoskeletal sciences and Orthopaedics. He will be operating out of the units at Max Smart Super Speciality Hospital, Saket and Max Hospital, Gurgaon.Dr Marya is a veteran in his field and has been bestowed with numerous awards and accolades for his work, including the prestigious Bharat Jyoti Award (Glory of India Award), DMA Distinguish Services Award, Haryana VigyanRatna and PramanPatra from Punjab Government to name a few. In over three decades of clinical practice, he has earned immense respect and admiration from his peers in India and abroad.

CIPLA ACQUIRES TRADEMARK RIGHTS OF VYSOV Cipla Ltd. has acquired the brand name and trademark rights for Vysov ® &Vysov M® (Vildagliptin + Metformin) of the anti-diabetic drug, Vildagliptin for the Indian market.The company has been co-marketing Vildagliptin in agreement with Novartis under brand names Vysov® &Vysov M® and has witnessed a strong uptake for the product in India for the last couple of years. It is currently available across the country.

32 YEAR OLD GETS A GIFT OF NEW LIFE THROUGH HEART TRANSPLANT FROM A 27YEAR OLD

Dr. S K S Marya

Christmas came early to 32 year old Mr. Shivakumar as he got a new lease of life recently after undergoing heart transplant at M.S. RamaiahNarayana Heart Centre. His saviour is a 27-year-old man. He was admitted to Apollo BGS Hospital Mysuru. Doctors had declared him brain dead and the family consented for organ donation.The heart was transported recently at 8 a.m. from Apollo BGS Hospital, Mysuru to M.S. RamaiahNarayana Heart Centre, Bengaluru with the help of a green corridor. A distance of 158 km was covered in a span of 120 minutes.

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NEWS ROUNDUP HCG OPENS CENTER IN MUMBAI Healthcare Global Enterprises Ltd. (HCG), India’s leading provider of cancer care, recently announced the launch of the first private comprehensive centre dedicated to Cancer care in Borivali, Mumbai. The 105 bedded centres with dedicated team of specialists in oncology will provide comprehensive diagnosis, radiation, medical and surgical oncology services under one roof. The centre was inaugurated by cancer winner and actor Ms. Manisha Koirala along with Dr. BS Ajaikumar, Chairman & CEO, HCG.

HETERO LAUNCHES TAFFIC, THE LATEST 3-IN1 SINGLE PILL FOR HIV TREATMENT.

Hetero, one of India’s leading generic pharmaceutical companies and the world’s largest producer of antiretroviral drugs, recently announces the launch of the latest 3-in-1 antiretroviral combination drug under the brand name ‘TAFFIC’ in India. The product

‘TAFFIC’ is the generic version of Gilead’s Biktarvy® and has been approved by the Drug Controller General of India (DCGI). The product will be marketed and distributed by Hetero Healthcare Ltd. in India.

KERALA CM PINARAYIVIJAYAN VISITS THE PRANEX CENTER, TERUMO, JAPAN

As part of his ongoing 11-day trip to Japan and South Korea, Kerala CM Mr. P Vijayan on the 29th of November visited Japanese health care giant Terumo’s Pranex and R&D Centre in NakaiMachi, Kanagawa, Japan. Terumo Pranex Centre is a state-of-the-art training facility that recreates the functions of actual hospitals and helps in the training of medical professionals. It trains medical professionals in specialized knowledge and skills while nurturing their situational judgment capabilities, leadership and communication skills, along with other non-technical skills. Mr. Vijayan said, “I am happy to learn about activities and facilities of Pranex, as training is an essential pillar for development and improvement of the skill set of medical practitioners”.

PRIMECARE HOSPITAL ANNOUNCES EMBRACE FERTILITY CENTER Primecare flags of Embrace Fertility Center Bengaluru, which is dedicated to excellence in Fertility care. Being childless is emotionally and physically unpleasant and it is very lonely journey of life. According to the Indian Society of Assisted Reproduction, 10-14% of married couples in India face infertility. Nearly 27.5 million couples who want to conceive suffer from infertility. It is surprising to know that only 45% of couples visit a doctor when they are trying to conceive; only 1% of infertile couples seek treatment. And to make matters worse, 55% of women are not even aware about ovulation tracking products like fertility gadget and 75% of men don’t.

AIMED APPLAUDS NITIAAYOG’S PROPOSED MEDICAL DEVICES BILL Rajiv Nath, Forum Coordinator of Association of Indian Medical Device Industry (AiMeD) on behalf of the Indian Medical Device Industry applauded NitiAayog for conducting a meeting with various stakeholders recently and presenting the proposed Medical Devices Bill, as a great visionary & well thought out Road Map with many innovative elements and which is in line with the requirements for the advancement & betterment of Indian Medical Device industry and stated Health Policy of the country.

TREATMENT STORY: KUMARAN HOSPITALS, PROF MOHAMED RELA

Pinarayi Vijayan visits the Pranex center, Terumo

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David Marshall, a 54-year-old gentleman suffered from serious Liver problems and came to Kumaran Hospitals, where he was diagnosed with Liver Failure and Liver Cancer. The problem was very serious and it was clearly evident that only a Liver Transplant could save his life.Though Tamilnadu is the pioneer in organ transplantation and the state tops the table of successful liver transplantations performed in India, the


numbers are still far away from adequate. Listing the recipient’s name in the State Organ Registry and waiting for it could take a very long time and many patients don’t survive this long and painful wait for a matching organ from an unknown brain-dead patient.

TIMELY INTERVENTION BY KARNATAKA STATE GOVERNMENT SAVES LIVES OF RARE DISEASE PATIENTS The battle for Rare disease patients in Karnataka has been going onsince 2015 (Refer to WRIT Petition #: 19061 / 2015 (GMRES)) and at recently’s hearing at the State HighCourt brought a respite to their plight. The State Government made a promising move by assigning 40per cent of the allocated funds for the treatment of patients suffering from Lysosomal Storage Disorder(LSDs). These funds will support existing and recently diagnosed rare disease patients withuninterrupted treatment. This order comes as a silver lining to the patients and families who have beenstruggling to receive treatment support for years.

The University of Hyderabad a premier institution of postgraduate teaching and research, established by an Act of Parliament, in 1974 as a Central University has entered into an agreement with Oasis Centre For Reproductive Medicine – which runs Oasis School For Human Embryology and Reproductive Medicine in Hyderabad and having 12 centers all across India for Advanced Certificate Course in Assisted Reproductive Technologies.

SANKARA EYE HOSPITAL WITH TITAN LAUNCHES WHO PREQUALIFIES FREE MOBILE RURAL FIRST BIOSIMILAR VISION SCREENING MEDICINE TRASTUZUMAB PROGRAM World Health Organization (WHO) prequalified its first biosimilar medicine – trastuzumab – in a move that could make this expensive, life-saving treatment more affordable and available to women globally.Breast cancer is the most common form of cancer in women. 2.1 million women contracted breast cancer in 2018. 630 000 of them died from the disease, many because of late diagnosis and lack of access to affordable treatment.

ADVANCED CERTIFICATE COURSE IN ASSISTED REPRODUCTIVE TECHNOLOGIES

Sankara Eye Hospital in collaboration with Titan has launched Mobile Rural Vision Screening Program to provide a comprehensive mobile eye care for the general public of rural and urban areas of Karnataka. The Mobile Rural Vision Screening bus was inaugurated by Dr. Kaushik, Sankara Eye Hospital and C.K Venkataraman, Managing Director, Titan. Covering rural and urban districts of Bangalore, Karnataka, this free check-up program by Sankara Eye Hospital has well equipped mobile bus that includes Vision examination, Direct and Indirect Ophthalmoscopes, optical dispensing, latest spectacles and frames along with patient counseling.

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NEWS ROUNDUP MANKIND PHARMA SIGNS UP WITH GLENMARK PHARMACEUTICALS FOR CO-MARKETING OF REMOGLIFLOZ IN ETABONATE

and helps identify reduced Left Ventricular Ejection Fraction (LVEF), a measure commonly used to diagnose patients with heart failure. FDA Breakthrough Device designation helps accelerate the algorithm’s regulatory review and is only awarded to novel innovations that demonstrate the potential to address unmet medical needs for life-threatening or irreversibly debilitating diseases.

Mankind Pharmaceuticals Ltd. and Glenmark Pharmaceuticals Ltd. recently inked a sublicensing agreement to co-market sodium glucose co-transporter-2 (SGLT2) inhibitor, RemogliflozinEtabonate (Remogliflozin) in India. Under the agreement, Mankind will market the drug under its own trademark while Glenmark will manufacture and supply Remogliflozin to Mankind.

JIVAGRAM SIGNS MOU WITH VIETNAM MINISTRY OF PUBLIC SECURITY Jivagram Centre for Wellbeing, one of the nation’s premier authentic Ayurveda and Panchakarma treatment signed a Memorandum of Understanding (MOU) with the Traditional Medicine Hospital – Ministry of Public Security of Vietnam, which lays the groundwork for the Vietnamese hospital to gain deeper understanding of treating and preventing diseases through Ayurvedic medicines, diet and lifestyle. The MOU was signed by Shri Rishipal Chauhan, MD, Jiva Group and Dr. Le Thi Hoai Anh, Deputy Director, Traditional Medicine Hospital, Vietnam. Dr Anh represented a delegation of 12 doctors who had arrived at Jivagram to sign the MOU.

RAVISH MITTAL IS THE NEW GROUP CHIEF FINANCIAL OFFICER TRIVITRON HEALTHCARE

Trivitron Healthcare Private Limited, a leading medical device company providing affordable healthcare solutions to the healthcare industry, has announced the appointment of Ravish Mittal as Group Chief Financial Officer effective 9th December 2019. Mr. Mittal, a qualified CA and Fellow member of the Institute

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MANIPAL HOSPITALS PERFORMS SUCCESSFUL ROBOTIC LIVER TRANSPLANT

Mr. Ravish Mittal, Group Chief Financial Officer (CFO), Trivitron Healthcare

of Directors (India & London) brings with him more than 25 years of varied experience across Strategic Direction, Business Partnering & Controlling, Mergers & Acquisitions, Joint Ventures, Treasury &Forex Management, Fund Raising, Project & Compliance Management in Multinational Corporations and promoter driven companies in India.

FDA GRANTS ‘BREAKTHROUGH’ DESIGNATION TO EKO’S ECG-BASED LOW EJECTION FRACTION SCREENING ALGORITHM Eko, a digital health company applying artificial intelligence (AI) in the fight against heart disease, recently announced the U.S. Food and Drug Administration (FDA) has granted the company breakthrough status for a novel ECG-based algorithm that could provide an easily accessible screening test for heart failure. The algorithm analyzes 15 seconds of ECG data collected from the Eko DUO digital stethoscope during a physical exam

Manipal Hospitals Bengaluru performed a unique robotic liver transplant on a 40-yearold patient and scripted Karnataka’s first unprecedented transplant wherein the donor had only a small scar in the bikini area but no scar in abdomen. Dr. RavichandSiddachari, HOD & Consultant HPB & Liver Transplantation Surgery at Manipal Hospitals Bangalore, conducted this milestone surgery.The recipient received a portion of the liver from a 32-year-old relative. A part of the donor’s liver was extracted using a robotic arm during the process known as liver Hepatectomy i.e. the surgical removal of part of donor’s liver.

LEVERAGING DIGITAL TECHNOLOGIES TO REVOLUTIONIZE HEALTHCARE

The Swedish healthcare technology company has come forward with a unique New Year’s resolution. Namely, in 2020, the company aims to revolutionize and democratize healthcare by incorporating artificial intelligence and robotics into it.BraineHealth is already working on a slew of digital health solutions, covering different medical areas from primary and elderly healthcare to mental health. The company’s primary goal is to connect expert systems, certified medical professionals and patients around the world and enable that in need to get a diagnosis, and medical advice within minutes, without having to leave their homes.


COVER STORY

CHANGING DYNAMICS OF

RADIOLOGY

BUSINESS

Innovative business models will lead growth in the new decade

Frost & Sullivan, Global Transformational Health team

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January 2020

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COVER STORY

T

he $250 billion global medical imaging industry is undergoing seismic changes, transitioning from its traditional productselling focus to providing solutions and services. This significant development is a direct result of the immense pressure on the healthcare sector, where investments are slowing down, patients are demanding better medical care, and governments are pushing for a reduction in overall healthcare costs. The need to provide advanced diagnostics at an affordable cost, without any adverse effect on their sustainability, is driving healthcare providers towards adopting service models in medical imaging. With the as-a-service model in place, THE NEED TO PROVIDE ADVANCED DIAGNOSTICS AT AN care providers aren’t required to purchase AFFORDABLE COST, WITHOUT ANY ADVERSE EFFECT imaging equipment outright. Instead, they ON THEIR SUSTAINABILITY, IS DRIVING HEALTHCARE can partner with vendors who provide the PROVIDERS TOWARDS ADOPTING SERVICE MODELS IN necessary equipment and related services, MEDICAL IMAGING with payments made on a pay-per-use or periodic basis. Under this arrangement, the upfront capital costs involved are drastically reduced, thereby easing the burden on the capital budgets of care providers. This is an excellent proposition for cashstrapped hospitals, whose balance sheets are already stretched thin.

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Traditional Model vs. as-a-Service Model As long as their clinical requirements are met, ownership of the equipment is of no value for care providers. With hospitals focusing on improving clinical standards and overall revenues, business models offering the product/solution as-a-service with guaranteed performance will gain traction, while traditional models focusing on selling products based on specification superiority or product USP are expected to slow down. In the traditional model, hospitals purchase imaging equipment utilising their capital budgets, leading to uneven, lumpy expenditures over time. Maintenance of the expensive equipment is carried HAVING IN-HOUSE RADIOLOGISTS FOR IMAGE READING out in-house by their biomedical staff or AND CONSULTATION MAY BE CONVENIENT, BUT IT HAS through paid maintenance service contracts MANY LIMITATIONS, SUCH AS AVAILABILITY DURING with OEMs. Under the new services model, EMERGENCIES, AT NIGHTS, AND DURING WEEKENDS payments are more predictable and evenly distributed over a longer period of time, providing substantial flexibility to care providers to upgrade equipment at regular intervals and manage performance while focusing on patient care. Also, equipment handling and maintenance is taken care of by the vendor and any downtime suffered would be their responsibility. Apart from equipment vendors, teleradiology and imaging information technology providers have also adopted the services model. Having in-house radiologists for image reading and consultation may be convenient, but it has many limitation, such as availability during emergencies, at nights, and during weekends. Teleradiology promises round-the-clock access to image reading services by radiologists of various specialties and expertise. Hospitals can subscribe to teleradiology services as per their requirements, which would prove

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COVER STORY

to be considerably less expensive than hiring a team of in-house radiologists serving them 24x7. With the advent of cloud-based imaging IT services, hospitals need not invest in developing and maintaining image distribution and archival systems on-site. Instead, they can employ cloud-based systems and pay for these services as they are consumed. These systems can be upgraded seamlessly, whenever required, which is otherwise an expensive and time-consuming proposition with on-site systems. Types of Partnerships between Providers and Vendors In the medical imaging space, there are a variety of as-a-service contracts that care providers and vendors enter into. Based on their requirement and budget, the two parties can enter into a transactional contract, performance contract, or risk-sharing contract. Transactional contracts refer to the episodic contracts granted to service providers to perform ad-hoc tasks. The contractors execute the tasks as per the standards and framework prescribed by the hospital. With performance contracts, THE CONTRACTORS EXECUTE THE TASKS AS PER THE hospitals engage service providers with STANDARDS AND FRAMEWORK PRESCRIBED BY THE defined output and performance metrics. HOSPITAL. WITH PERFORMANCE CONTRACTS, HOSPITALS The vendor is financially incentivised to ENGAGE SERVICE PROVIDERS WITH DEFINED OUTPUT strictly adhere to the performance and AND PERFORMANCE METRICS output metrics. In a risk-sharing contract, the vendor owns the imaging department, or at least a significant portion of it, and is responsible for its maintenance. The contract rewards the vendor upon reaching pre-determined clinical and economic outcomes. This is best suited for hospitals that intend to upgrade their radiology department.

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Advantages and Shortcomings The as-a-service model allows healthcare providers access to the latest in medical imaging technology with little investment. This enables them to provide the best possible diagnoses for patients at significantly lowered costs. Forging long-term partnerships promises business continuity for hospitals and recurring stable revenues for vendors. Equipment vendors will see net cash outflow in the near term, and rather than getting paid up front, it’ll take them years to recover equipment costs. However, the upside is that the service model guarantees them a client base and cash inflow for a set period while giving them the ability to cross-sell other products THE AS-A-SERVICE MODEL ALLOWS HEALTHCARE PROto existing clientele, creating a win-win VIDERS ACCESS TO THE LATEST IN MEDICAL IMAGING situation for both hospitals and imaging TECHNOLOGY WITH LITTLE INVESTMENT. THIS ENABLES vendors. THEM TO PROVIDE THE BEST POSSIBLE DIAGNOSES FOR

PATIENTS AT SIGNIFICANTLY LOWERED COSTS

Future Outlook As the entire medical imaging industry gradually shifts towards the as-a-service model, traditional product selling will cease to be an avenue for long-term growth for vendors. Total cost of ownership (TCO) and return on investment (ROI) will be the key factors based on which contracts will be offered.. The shift to service-based models in imaging will also help drive innovation in equipment parts and components, leading to lower maintenance costs and higher mean time between failures (MTBF). From a capital-intensive model, the industry will move towards a hybrid model before finally transforming into a truly operational expense model within the next 10 years.

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APPROACH

Understanding New User New Era – Medical Consumer – Do we know him yet?

Sudhaker Jadhav, Chief Operating Officer, Oasis Fertility

THE MEDICAL consumers have been changing the buying pattern rapidly and it is highly challenging for the healthcare marketers to track this behavior. The healthcare marketers are still committing the same old mistake of expecting a different result by doing the same things that they had been doing a decade ago. Today the medical consumer is in lot more control than he was before. He doesn’t take advice from the family physician anymore even if the suggestion is tossed, he would have his own ways of selecting the healthcare brand to consume. There is enough of content and data sets available which is facilitating the medical consumer to choose the brand coupled by the word of mouth advice by a fellow consumer. It is getting increasingly complex for healthcare enterprise to get the ROI from the money being spent. Where do you spend your marketing dollar? While it is important for a healthcare enterprise to invest in marketing dollar as healthcare marketing is a long haul and doesn’t give you a quick fix solution, it is important that you have a seamless connect of what you promise to the external world is being delivered with pleasant surprise by the operations team. Today, typically the cost of acquisition of each of customer through marketing channel ranges anywhere between INR 5000- 15000 rupees and if we are not able to create a robust patient engagement, the healthcare consumer is bound to look out for your competitor. Hence the principal of CRM has to be applied that it is worthwhile to retain a consumer and engage with him to create a life time value than simply adding new consumers without any customer engagement platform.

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Do You Hunt or do you Farm? A very aggressive term used in sales and operations. Yes, I think we should do both for sustaining any healthcare enterprise. While the BD team meet the fraternity and funnel the referrals the marketing and branding team generate leads by executing online and offline efforts. The core objective of both the team is to generate the footfalls and hence are termed as hunters. The operations team are called farmers as they try and build a long-term engagement plan with the patients for the repeat purchases of the services. Is your screen Green? How many of us ever looked at our screens which the customer care teams use with their spreads sheets open and following up with the patients for the appointments or rescheduling, the predominant color on the screen is yellow (read it as follow up required) as the patients are indecisive and not yet made up their mind, then there you find red strips in between (read it as moved out and not interested in your services) and then you will find some faint strips of green (read it as patient has been converted) Hence it is important to keep a track of this simple sheet and ensuring that the screen is green. Patient is looking for the best and not different Please remember that trying to be different is just a passé, todays medical consumer would like to settle with the best, hence it is mission critical in your position to be the best and communicate accordingly, it just not enough to communicate your best but demonstrate consistently that you are the best.


Moments of Truth Moments of truth are defined as the moment when a customer/user interacts with a brand, product or service to form or change an impression about that particular brand, product or service. In healthcare, the minute the medical consumer consumes the brand and the experiences it are defined as the moments of truth. Hence as mentioned above, it is important that we walk the talk. How many of us track the NPS A whopping 22 per cent of the patients just walk away to your competitors as you have not cared enough about them. Imagine the amount of top dollar you have spent in getting them to your facility. It is evitable that each of the healthcare enterprise has to focus on their NPS, there are

many tools available online to track the NPS score of your customers. The core objective is to focus on cultivating the promoters and not detractors. Do you have a story to tell? Last but not the least, do you have a story to tell? whatever you are communicating are you abiding and executing the same? Is the patient experiencing moments of truth? Consumers today don’t understand the complex data, the data has to be interpreted in the form of story and needs to be told. For a patient a 99.9 percent success rates in bypass surgery may not entice him but the if there are positive stories around this success percentage, higher the chances you retain the consumer.

Today the medical consumer is in lot more control than he was before. He doesn’t take advice from the family physician anymore even if the suggestion is tossed, he would have his own ways of selecting the healthcare brand to consume

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OPINION

Will radiology wed AI Author is a clinical radiologist based in Bengaluru with diverse interest and expertise in academics, research and healthcare technology

Madhav Hegde

CURRENTLY, MEDICAL imaging or radiology is the most promising field for AI application. This article provides views on AI in its functional form - automation and may be generalised to its various technical forms like machine learning/deep learning, neural networks, computer vision, and robotics and many conventional (not so intelligent) applications used in contemporary radiology. By nature, a radiologist is a technophile I would like to opine that the most critical ratelimiting factor would be the manner in which an AI project is implemented and executed. Collaboration is the key for all stakeholders. Being the end user and possible competitor of AI solutions, radiologists should be the primary collaborators. Action, spirit, and intent (at least short and midterm) of AI projects should be to assist radiologists. Radiologists are prepared to accept AI tools that would help them optimise imaging protocols, which would obviate the need of continuous monitoring for correctness and quality of the study. An application that would schedule studies and help radiologists in priority management would be useful. Why would radiologists not desire a virtual assistant that would help them browse through latest ‘WhatsApp’ posts in their ‘Healthtech’ group, while gathering information regarding abnormalities in MRI performed last night? Wouldn’t it be fun if on a typical day when I have 25 thorax studies to report I could rely on technology? I could run pulmonary embolism, pneumonia, pneumothorax, and hydrothorax detection AI tools on all 25 thorax studies and walk to grab a cup of filter coffee with indigenous Bengaluru aroma. By the time

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January 2020

I am done with the last sip of coffee, reporting templates of 25 studies with tentative findings would be ready. I would be required to make some correctionsonly or add some more intelligence - likely general intelligence - usinga Natural Language Processing (NLP)-driven speech-to-text-converting tool. Radiologists contribute to human care regardless of thembeing in the frontline or mid field, or at the back; hence, they are best placed to embrace AI among healthcare professionals. I do not find a major reason for conflict between the AI application and radiologists, yet ‘human’ apprehension of uncertainty exists. Radiologists came to existence with the discovery of X-rays and grew stronger with the growth of CT, USG, and MRI technologies. Radiologists understand the paradox that ‘technology is as clever as we are, and we are as relevant as the technology we use’. So, radiologists are mentally and skilfully apt tosustainthis ‘strong’ AI wave with an unlikely third AI winter. One behavioural aspect radiologists should work on is to lead collaborative efforts in the AI project, particularly from a functional perspective. This would also help in the negation of the perception or potential of a fight between technology and a technophile radiologist. As leaders in imaging, most of us have experienced the shortage of skilled vital support staff (front office personnel, technicians, transcription, and clinical assistance). We may deploy AI tools to address this inefficiency in the system.We may also use the AI solution to obtain a contextual gist from a large amount of patient data (paper-based/electronic). These data may be collected through physical examination, laboratory tests, or prior imaging studies. Radiologists may obtain a curated


contextual text, numerical and imaging data from AI tools; this would aid them in arriving at a ‘holistic’ diagnosis at ease. The AI solution helps radiologists collaborate effectively with general practitioners and internists,which in turn helpsthem to advise on the preferred therapeutic mode on the basis of appropriate diagnosis, stage of illness, and possible outcome. This would also help them to conclude with a possible therapeutic direction similar to the collaborative practice among cardiologists and cardiothoracic surgeons, thereby helping them to stay relevant. Radiologists can also use AI in the field of education, learning and research. If AI could offer a tool to help radiologists self-audit their performance and help them to continuously improve, they would love to be the champions of automation. Radiologists also expect developers of AI tools, organisations deploying them, and regulators share the major part of professional indemnity in case of deviation from expected performance of AI tools. Awareness of radiologists’ expectationswith AI would help health tech entrepreneurs and investors introduce ambitious disruptive tech solutions in a friendly manner without threatening notes. Allowing the end user

(radiologist)to be the champion would only accelerate the rapid adaptation of technology. This would also help the industry to avoid the ‘long winter’ that EHR/EMR adaptation has witnessed. At the corner of the mind,a question still haunts: Will we lose our jobs? There is nothing artificial about the question; it is a natural one. The answer is most likely ‘yes’. In long term (potentially foreseeable), we will lose our traditional role, only giving us opportunities to unlearn and upskill. People often ask me‘are you radiologists digging your own grave?’ I am left with no choice but to say, ‘trying to predict at this moment the way AI will unfold in years to come is near suicidal!’ Finally,a word of caution from a balanced perspective or rather more of general human intelligence. We need to have a rigid ethical regulation on intended tasks and outcomes of AI applications. I would suggest these to be on similar lines with those governing cloning.I would like to end with a debatable question: Whether introducing affect (human emotions) and highest cognitive tasks to radiology AI solution would fall under the realms of ethical practice in the broadest sense? Think about it.

Radiologists contribute to human care regardless of thembeing in the frontline or mid field, or at the back; hence, they are best placed to embrace AI among healthcare professionals

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INTERVIEW

Living Legend In conversation with Hans Ringertz, world renowned radiology Scholar about traversing through an era of technology and innovations changing radiology for better

“I STARTED in radiology research and clinical work in early 1964. At that time we did not have any ultrasound, CT, or MRI,” says Hans Ringertz MD, Adjunct Professor, Associate Chair, Radiology, Stanford University and Professor Emeritus, Karolinska institute, Stockholm, Sweden. “We had X-rays without and with contrast media. We had primitive nuclear medicine and the front-line was lymphography and angiography,” says the 81-yr-old radiology veteran. It was a time when the radiologist had to peer at a film and suggest if the surgery had to be done. “Most of the interpretive knowledge from those technologies is gone today but the radiological problems are solved with higher certainty and often at higher cost today,” he says. Dr Ringertz has grown with radiology for the past five and a half decades. He has seen primitive technologies being fine-tuned and batted for newer technologies like MRI.

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From a biophysicist to the champion of dose-reduction and safety in radiology, he has donned many hats. He has been honorary member of 16 radiological societies around the globe and President of some of these. Dr Ringertz has an impressive publication record with 230 scientific articles and six books. He continues to work and collaborate with young minds; actively pursuing the new age artificial intelligence and machine learning. In an e-mail interview Dr Ringertz spoke about some of the topics that are important to him. Talking about the current technology aided radiology eraDr Ringertz says that ultrasound is time-consuming and operator dependent but should probably be used more. CT and MRI is over-utilized “to be really sure”. From a health care point of view radiology is replacing old fashioned clinical examination and that is unfortunately expensive. Finally information technology has to be used as it evolves. “Citing my colleague at Stanford Curt Langlotz “Radiologists that does not use AI will be replaced by radiologists that do use AI”. The role of radiologists has had a drastic changed over the past few decades; at least from the time Ringertz started medicine. “From a now and then used ‘photographer’ to centrally positioned medical professional a radiologists role had a makeover; without whom the modern health care system would collapse,” he says. X-rays has been the backbone of radiology diagnostics for ages. Is it becoming obsolete now with so many new techniques coming in? Talking about this Dr Ringertz says that musculoskeletaland pulmonary X-rays will not be obsolete for a large number of patients with minor trauma, degenerative diseases,


pulmonary infections, minor cardiomegaly etc. A minority of these cases may need additional cross-sectional examinations; and that decision should be made by radiologists and not be made to maximize radiology income but for optimal healthcare. This can be difficult in certain healthcare systems, he observes. Advanced imaging is all the buzz today, with imaging modalities in the OT delivering clinical value. In this regard, many centers are using mobile C-Arms X-ray system for different surgical requirements. Dr Ringertz feels that a C-Arm for orthopedic surgery is a very good idea for a very limited number of cases and therapies. All of radiology has to defend interventional radiology. “Our imaging technologies are ideally suited to handle a large number of minimally invasive cases and our advantage is that we can in a cost-effective way handle all, independent of whether they are orthopedic, surgical or internal medicine patients. If orthopedic surgery handles it they will mainly handle their own patients and the use of expensive equipment will be suboptimally utilized,” he says.

And before we close Dr Ringertz gives us his mantras for success. My advice to young radiologists around the world today is:  Learn the job from the base up; do not immediately specialise in advanced crosssectional techniques.  Learn how to do ultrasound yourself before you let the technologists help you.  Sub-specialise in one modality and one anatomic area (pediatric is also one such area).  Get in contact with the patients when possible. Radiology needs a face, we are not photographers: go out in the waiting room or up to a ward even to confirm a simple finding if there is time.  Avoid turf battles, “if you cannot beat them, join them”, co-operate.  Join forces with the pathologists to form diagnostic teams.  Be involved in science, even if it is just as case reports or simple case series. Ignore the scale: molecular to whole body imaging.

Most of the interpretive knowledge from those technologies is gone today but the radiological problems are solved with higher certainty and often at higher cost today

Hans Ringertz

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INTERVIEW

Leaders Speak

26 January 2020

DR DEEPAK PATKAR is one of India’s leading consultant radiologist and Head of departments of Radiology of the Nanavati Super Speciality Hospital, at the Vile Parle in Mumbai, India. Over the course of a career spanning nearly 30 years in the UK and in Indias Dr Patkar has been at the forefront of radiological advancements. He has worked for the betterment of the speciality, attending and organizing a number of global meeting; delivering more than 1000 lectures and orations at national and international conferences, including ‘India meets at ESR’ at ECR 2008 Vienna. To his credit, he has over 150 national and 75 international publications predominantly on neuro and musculoskeletal MRI related topics, one of the best being ‘Central Nervous System Tuberculosis: Pathophysiology and imaging findings’ published in Clinical review articles of Neuroimaging Clinics of North America (NCNA). We spoke to him about the present state of medical imaging and recent trends in radiology in India.

So we can say that as a radiologist, we have the privilege of delivering utmost patient satisfaction and care.

Radiology in 2020 Radiology is the most sought-after specialty in medicine today. Radiologist plays a key and critical role in patient management as correct diagnosis is the basis of correct treatment. It is a branch which utilises a multidisciplinary and multimodality approach towards finding a diagnosis. We help and support clinicians to shape and plan course of patient care. In India, healthcare has seen a significant change in trends in the last few decades and so has radiology. Radiology has now moved from mere diagnostics to therapeutics. Endovascular and minimally invasive image-guided intervention radiology techniques provide efficient and effective treatment options in several pathologic conditions. With patient-friendly techniques like MRgFUS, even uterine fibroids may be treated without surgical intervention.

Significance of patient centric mammography Patient satisfaction has gained immeasurable attention recently. Our aim is to make the patient as comfortable as possible during the study. Compression is the most unpleasant part of mammography and making this aspect as tolerable as possible is a very important aspect. Patient comfort ensures that the investigation is done appropriately and adequately which in turn helps in proper diagnosis.

Importance of quality control in radiology Radiology being a diagnostic field demands strict quality assurance .The primary goal of any radiological investigation is to provide a prompt and accurate diagnosis with the least possible dose. All imaging departments are expected to establish and maintain effective quality, safety, and performance-improvement programs. Essential components of such programs include adherence to the basic principles of quality management and appropriate utilization of quality tools. Quality improvement requires a careful, dedicated, and continuously planned effort by a number of skilled and committed team members, with the goal being to do the right thing in a timely fashion in every case.

Advancements in digital X-Ray Digital radiography has supplanted screenfilm radiography in almost every radiology departments. Digital detectors allow implementation of a fully digital picture archiving and communication system, in which images are


stored digitally and are available anytime. Image distribution in hospitals can now be achieved electronically by means of webbased technology without any risk of losing images and information. Other advantages include increased dose efficiency and the greater dynamic range of digital detectors with possible reduction of radiation exposure to the patient. Therefore, as per all current guidelines digital radiography is recommended.

Most of the interpretive knowledge from those technologies is gone today but the radiological problems are solved with higher certainty and often at higher cost today

Significance of CT scan for orthopaedic surgeries CT is the modality of choice for assessment of osseous anatomy abnormalities. Orthopaedic surgeries are all about precision and this information is provided by CT. For surgical implants precise measurements are very important and CT provides clear demarcation of bony margins and accurate measurements which provides excellent guidance in surgeries. 3D reconstructions also help in better understanding of the anatomy and abnormalities. Challenges of soft tissue imaging and how advancements in MRI technology helps The primary aim in soft tissue tumor imaging is to reach a specific diagnosis or to narrow the differential diagnosis, and to help to decide whether biopsy, surgical intervention, or simple observation is required for further management. In addition to contributing toward diagnosis, imaging has an important role in the staging of soft tissue malignancies and potentially in response assessment. MRI is the imaging method with the best soft tissue contrast, multiplanar capability and lack of ionizing radiation. Thus it is the imaging modality of choice for evaluating soft tissue masses. Neurovascular structures can be better assessed even without the need of intravenous contrast agents. It serves to further characterize the tumor, to perform local staging reliably and reproducibly for therapy planning, and to help select appropriate biopsy regions. Also, it is the modality of choice for local surveillance after malignant soft tissue tumor resection. Thus MRI provides a complete assessment in evaluation of soft tissue lesions.

Dr Deepak Patkar HoD Radiology, Nanavati Super Speciality Hospital

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SPECIAL FEATURE

CT Scan Use in Orthopaedics Dr Santosh Hakkalamani, Consultant - Orthopaedic Surgeon at BGS Gleneagles Global Hospital, Bangalore

COMPUTED TOMOGRAPHY (CT scan) is an imaging tool developed by Sir Godfrey Hounsfield from London UK. It is a noninvasive diagnostic imaging tool that combines X-Rays and computer technology to produce horizontal, or axial, images of the body. CT scan machines have improved over years to present generation of CT scans like 4th generation CT with stationary detectors, 5th generation of Electron based CT, multi slice CT scans and dual source CT. The newer generation CT scans give better resolution of the organs, thereby helping even the minor changes in the organs. CT scans have added another dimension to the evaluation of musculoskeletal diseases. CT scan in fractures CT scan has revolutionized the way fractures are diagnosed and treated now. Fractures around complex areas like pelvis and spine, CT scans give the three dimensional directions of the fractures thereby helping surgeons to plan andexecute the treatment. When the radiographs miss fractures in some areas of the body because of the anatomical location of the bones CT scans help to pick up those fractures easily. Example, carpal bone fractures are easily not detected by radiographs because of the complexity of the arrangement and overlapping of bones, CT scans are more commonly used now to identify such fractures. Fractures around prosthesis and previous metal implants where the fractures are hidden behind the metal parts are difficult to visualize by conventional Radiographs, in such cases metal artifact reduction CT scans have helped to diagnose and treat such fractures. Fractures of the joints involving articular cartilage which are not seen by convention radiographs are now evaluated

28 January 2020

by CT scans. The CT scan helps in mapping the cartilage injury. They give the three dimensional details of the fractures. CT angiograms have helped to diagnose vascular injuries in complex fractures of the limbs and spinal fractures. They help in not only diagnosing the injury but also the site of injury/obstruction and extent of injury which help in planning the management. CT scans in musculoskeletal tumours CT scan is the mode of investigation to evaluate many bone tumours. CT scans of the bones can provide further detailed information about the bone tissue and bone structure than standard X-rays of the bone. Thus, the scan provides more information related to injuries and/or diseases of the bone. They help in mapping the tumour and help in diagnosis. CT guided biopsies of the tumours helps in getting representative of the tumour tissue thereby reducing the errors of sampling. PET CT scan helps in diagnosis of distant metastasis of the tumours. CT scan also hastherapeutic value in some tumours like Osteoid Osteoma where in radiofrequency probe is used to kill the tumour cells using CT scan to guide to the site of tumour. CT scan in joint replacement CT scans have been greatly used in mapping the joints, getting the information about sizes of the bones thereby helping to develop the artificial joints. CT scans are also used in developing the custom made cutting blocks which help surgeons during operation to get the correct alignment of the joint. These are called as personalized joint replacement. In extreme cases of deformities of the bones


like developmental dysplasia of the joints mainly of hip and knee joints, post fractures or metabolic disorders of the bone, CT scans are very useful in getting the three dimensional measurement of the joint and thereby custom make the prosthesis to fit the patient. Images are reconstructed from CT and MRI, and then later converted into a 3D CAD model with the help of different software, and this CAD model is easily printable by AM technologies using the layer by layer technique. Missing part of the bone is also created by this technique. This technology is also successfully applied for an exact replica of the orthopedic implant with great flexibility and accurate dimensioning which improved patient care. Recent advances in the use of CT scan have helped to custom made the prosthesis to fit the patients using 3D printing techniques instead of using the traditional implants.

CT scan machines have improved over years to present generation of CT scans like 4th generation CT with stationary detectors, 5thgeneration of Electron based CT, multi slice CT scans and dual source CT

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PULSE

Healthcare Innovations 2020 Impactful innovations to look out for in the next decade

Jatin Mahajan, Managing Director, J Mitra & Co. Pvt. Ltd.

30 January 2020

THE GLOBAL healthcare space is very dynamic and ever-evolving. Constant innovations based on extensive R&D drives the segment. The healthcare segment is as vast and as diverse as the human mind allows it to be. Medical innovations touch each and every life on this planet, identifying new ways and means of prevention, diagnosis and monitoring of health problems, as well as new drugs and devices for the optimal management and treatment of the diseases. While such innovations are many, here are some that we find very impactful: Artificial Intelligence (AI) and Machine Learning (ML) have pervaded the healthcare space. AI and ML have become the absolute game-changers in the healthcare industry and catalysing immense developments in diagnostics, detection, management and treatment of ailments. AI can analyse and interpret data in more complex and diverse combinations than a human mind, providing extremely potent data for effective and accurate diagnostics. Medical imaging has become the leading and most popular field for AI applications. Big Data is playing a key role. The humongous amount of data available globally can be merged, integrated and analysed based on parameters like biological, environmental, socioeconomical or geospatial. With this quantum of global information at their fingertips, researchers are being able to analyse information faster and more accurately leading to a significant decrease in the development of newer drugs and techniques AI and big data together have enormous potential of transforming the entire healthcare segment. Devices are an all-pervasive aspect of healthcare delivery – so much so that the Indian

government has decided to constitute a separate regulatory body for the devices segment. From injectable devices, to devices that may be swallowed to robotic arms, mechanical heart valves, 3D printing devices, or digital health technologies, the applications and potentials are huge and medical devices innovation is flourishing, making them a key element of healthcare innovation. Real-world medical data combined with 3D printing and imagery provides the foundation for developing newer and more efficient devices and optimising complex surgical procedures. 3D printing has specifically demonstrated great promise in areas like external prosthetics, cranial & orthopaedic implants, and customized airway stents for diseases narrowing the airway. mHealth or Mobile-based Healthcare Delivery is another key game-changer. The advent of smartphones and mobile applications has increased the potential impact and scope of mobile health (mHealth) dramatically. Downloads and usage of healthcare apps has increased substantially in the last two years, especially amongst the millennials. With over 3 billion downloads for mobile health apps globally, the potential and the challenges are huge for the digital health


industry that is globally pegged at thirty six thousand crore (INR 36,000,000 cr) by 2025. In a country like India where tele-penetration is around 79 per cent and a significant population resides in rural areas, mHealth has vast potential for ensuring access to healthcare services. This segment is making significant strides and making a huge difference in the way healthcare is delivered to the masses. RNA-based Therapies are another key focus area for scientists across the world. Modifying the genetic data at the RNA level allows scientists to identify a person’s genetic abnormality. RNA Therapy based on antisense nucleotides and RNA interference is being explored in cancer and neurological treatments, and promise to change the way these set of diseases are treated the world over. Virtual & Mixed Reality especially in areas like medical education has seriously caught the attention of healthcare professionals. VR / MR applications provide simulated training and augment traditional medical education. VR / MR based education catalyses and catapults the

understandings and learnings to an altogether different paradigm. Robotic Surgery is not new, but constant innovations and enhancements are ensuring that surgeries are more effective and precise while reducing the time involvement and being least invasive. Significant strides will continue to be made in this arena. Stroke Diagnostics Visor for haemorrhagic strokes is an efficient diagnostic based on advanced technology. Haemorrhagic stroke accounts for roughly 40 per cent of stroke deaths. Lack of immediate diagnosis leads to ineffective treatment and uncontrolled swelling damages the brain cells. The haemorrhage scanning visor can detect bleeding in the brain and thus helps to speed up the diagnosis and critically cuts down the time-to-treatment. Biological Therapy, also known as Cancer immunotherapy, uses the body’s own immune system to fight cancer. The global development towards a possible cure for cancer continues to define new and

Medical innovations touch each and every life on this planet, identifying new ways and means of prevention, diagnosis and monitoring of health problems, as well as new drugs and devices for the optimal management and treatment of the diseases

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PULSE unique immunotherapeutic targets. Scientists are discovering life-changing treatments based on the concepts of joint therapy and engineered T-cells. The latest discoveries of new targets and biomarkers are a hope towards possible existence of effective therapies for all tumour profiles. Genomics is gaining widespread popularity due to the various developments in big data and genetic sequencing technology. Genomics, the study of a person’s entire genome of organisms, and incorporates elements from genetics. Genomics uses a combination of recombinant DNA, DNA sequencing methods, and bioinformatics to sequence, assemble, and analyse the structure and function of genomes. Apart from determining one’s Ancestry, genomics will surely become a very powerful diagnostics tool and a key asset for precision medicine. The IVD (in-vitro diagnostics) segment is also witnessing major developments –

DECEMBER 2019, VOLUME 3 ISSUE 12 `200 INDIA MED TODAY

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TRENDS

2020

Subscribe to IndiaMedToday and get 20% discount + Extra FREE issues Indiamedtoday magazine reports on the issues and trends that are shaping the business of healthcare in India and abroad today. Each month, the print magazine discusses long-term strategies to meet the challenges posed by an evolving healthcare marketplace. In every issue, our readers discover the practical advice, analysis, and receive and insight on management trends, innovative 12 + 3 FREE issue. concepts, market strategies and real-world solutions they need to navigate the changing landscape of the business of healthcare.

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INTERVIWE

Chemiluminescence immunoassay (CLIA) technology is making extremely rapid strides in IVD diagnostics. Chemiluminescent blotting is starting to dominate in research laboratories, along with a wide variety of other chemiluminescent assay techniques. The scope of chemiluminescent assays will continue to expand. Lab automation tools are making the segment more and more effective while at the same time leading to massive reduction in cost and timelines. Point-of-care is moving closer and closer to the patients, and high-end diagnostics are soon going to be available even in remote and rural places. Many of the factors mentioned above are also interlinked and affect each other majorly. Singularly they are great innovations, and coupled with others in this group, they create a multiplier effect which tremendously impacts their potential. It is going to be a very interesting decade for the healthcare industry.

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32 January 2020


INSIGHT

In Conversation with Dr Arjun Kalyanpur on Making Radiology Practice More Effective Dr Arjun Kalyanpur

FASTER AND accurate, are the words that have defined and anchored innovations in radiology for the past decade. There has been a major movement for quicker scans and accurate diagnostics to save patient lives throughout 2000s. As a consequence, the number of cases radiologists go through have increased dramatically. This raised issues related to burnout and safety. To remain accurate with speed without getting burnout and provide safe diagnostics is the current challenge radiologists’ face. Efficiency and safety will be the definitive pillars of innovation for the coming decade. The focus now is not only on delivering faster diagnostics but better outcomes throughout care continuum. To find out more about making radiology practice more effective, we spoke to noted radiologist Dr Arjun Kalyanpur, Co-Founder, Teleradiology Solutions. He talks about the appropriateness of radiology testing and correct diagnosis having a positive impact on treatment decisions and ultimately making patients healthier. Looking at the current practice in India and South East Asia do you think we are focusing enough on effectiveness? I feel that the healthcare situation in India is currently overwhelmed by physician shortages (radiology is at the forefront of this crisis). With

the increasing corporatisation of healthcare comes the realisation that effectiveness needs to be made a focus but this is still nascent to some extent. Although technologies that greatly enhance the effectiveness of healthcare delivery such as telemedicine (with teleradiology being a subspecialty application thereof) have now been available for at least two decades, they are still significantly underutilised which to my mind is an indication that this focus is lacking. How do we make changes to bring more effectiveness into radiology practice? The primary change needed is a mindset change on the part of the stakeholders in the form of awareness of what effectiveness means in healthcare. Its key components include appropriate utilization, evidence based medicine and value based medical practice, with the fourth pillar being efficiency. Training of medical personnel beginning at the medical school level is necessary to understand what diagnostic study is appropriate in what clinical scenario. The development of diagnostic algorithms and pathways by specialist societies (for example by the Society of Emergency Radiology, of which I have the privilege of being a founder member), are key to ensuring appropriate diagnostic triage. The use of evidence based medicine is a key initiative in

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INSIGHT improving the quality of healthcare delivered and ensuring standards of practice are maintained in healthcare, and involves periodic review and incorporation of the latest scientific developments into medical practice, ie close collaboration between research institutions and healthcare institutions. The focus on value based medicine is irrevocably linked with that of efficiency. In teleradiology, for example, the use of creative scheduling solutions, workflow technologies and Artificial Intelligence/Deep Learning algorithms allows for optimal utilisation of radiologist time which is a highly precious resource today, and allows for the value thus created to be passed on to the healthcare system in the form of improved quality with more rapid and efficient service delivery. Can we measure this effectiveness? We can and certainly should. Tracking parameters and metrics need to be utilised to track effectiveness of healthcare practice

34

January 2020

that may be tailored to the specific service being delivered. In the teleradiology space the parameters that are tracked (by our organization for example) are report turnaround time (TAT) and Report Quality metrics. A good example is the peer review scoring system developed by the American College of Radiology. In similar manner, each specialty and service can develop or incorporate and utilise parameters that are relevant to them. What should we strive for in the future? A nation/world in which healthcare delivery is gauged not merely by the quality of an individual physician, or by the best outcome delivered and anecdotally communicated but on consistency of performance as determined by objective quantification and tracking of performance metrics and rigorously documented and shared in an atmosphere of transparency, with the quality patient care as its primary focus.

Faster and accurate, are the words that have defined and anchored innovations in radiology for the past decade. There has been a major movement for quicker scans and accurate diagnostics to save patient lives throughout 2000s


s

quanti­ ation to

ull body)

ation

• examination: 0.23 mm spatial resolution 0.35 seconds 0.35 s rotation •• Minimum slice thickness: 0.625 mm • 4 cm coverage

BEST BUY Computed Tomography ◼

COMPUTED TOMOGRAPHY Dual Source CT

Siemens Healthineers · Somatom Drive Siemens Healthineers Gantry · Somatom Force bore

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◼ TOMOGRAPHY 240 COMPUTED kW VOLUME CT Highlights Philips · iCT

• Bring image quality to the next level Slices per rotation 256 / 128 with Vectron X‐ray tube. (Replace Coverage 80mm / 40 mm with low dose early) Highlights Power 120 kW / 100 kW •• Tin Kidney‐friendly scanning with Filters – a new level of CARE, significantly reduced contrast media bring CT doses to those expected amounts required (low kV imaging) in a routine X­ray series Ultra lowMX dose andX­ray “free‐breathing” •• Straton Sigma tube with CT with outstanding native temporal High Power 70 & 80 enables lower resolution doses with consistent image quality • FAST Integrated Workflow with FAST FAST with FAST •3D Precise dosedrives neutral Energyinquanti­ •• 10 kVIntegrated Steps allowWorkflow for the most Camera precision patient 3D Camera get two fication to add tissue information to precise dosetovalues forsteps everyahead single in positioning patient positioning morphology • Dual Source Dual Energy patient Highlights • Dual Source Dual Energy • Temporal resolution: 66 ms (full body) • iPatient – Consistent image quality and improved scan workflow. • High patient Volume CT eligibility – • Low-dose brain perfusion Bariatric ·and Pediatric One Genesis Edition Canon Aquilion Block Imaging • With iDose4 Premium • Low energy imaging for a large Power Scan range Package – Gantry bore Power Scan range Gantry number iDose4 reconstructor including O-MAR 100 kW of patients 78 cmbore 150 / 200 cm 35 – 120 kWcoronary CTA for70a cm cm Model-based • Low dose large • Optional IMR 170 – Iterative number of patients Reconstruction

Philips · Ingenuity Elite Slices per rotation 128 Coverage 40 mm Power 80 kW (105 kW Effective) Highlights Highlights the most popular •Offering AiCE (Deep Learning Reconstruction) from all major in manufacturers •models Artificial intelligence scanning and • SUREPosition patient centring • We buy and sell used CT systems processing • Lateral table movement 4 – ViSION 320 Slice systems available •• PURE • 300 kg patient table Optics imaging chain •• Professional project managers handle every detail of system deinstallation • SEMAR (Metal Artefact Reduction) 0.275 s rotation installation • Wide range of Cardiac and Dual • and 16 cm coverage •• Systems available from GE, Toshiba, Philips, Hitachi, and more Energy applications 640 slices/rotation •• Recover value of your trade­in • Isophasic organ perfusion 0.22 mmtrue spatial resolution Highlights „Go Green“ and recycle ••New Nanopanel Elite your equipment

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Power PowerkW 100

103 kW

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Siemen GE Hea

Power Powerto 100 Up

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Highlights • Tin Filters – bringing CT doses to those expected in a routine X­ray series • FAST Integrated Workflow with FAST 3D Camera drives precision in patient positioning •Siemens High Power 70 & 80 and 10 ·kVSomatom Drive Healthineers • Best effective temporal resolution Highlights Steps helps to obtain high quality Power Scan speed Gantry bore enabled by 0.28­second rotation • images Gemstone Clarity Detector fordiversity 80 or despite large patient 200 kW 78 cm Up to 458intelligent mm/s speed combined with 160 mm detector coverage • Cardiac and 4D imaging at high • quality Uniqueand image with • TwinBeam motion correction for excellent cardiac lowchain dosehardware – outperform­ Dual Energy Volume HD reconstruction imaging at any heart ratems (full body) ing all other single source systems • Temporal resolution: 140 • ASiR­V – up to 82 percent lower dose • Aorta, heart and lung in just one second

Computed Tomography ◼

Philips · iCT Elite Siemens · Somatom go.Top Slices perHealthineers rotation 256 GE Healthcare · Revolution HD Coverage 80 mm Power Gantry bore

Highlig • Spectra daily ro Highlig • perform 0.28 s ro • entire Revolutc • 0.50 Excellen mm Gemsto resoluti Spectra •• Straton tempor and 70 images

20 to 64 S

Canon GE Hea

Scan speed Scan to range Up 175 mm / s

Power Gantry 75 kW 70 cmbore Power 120 kW Highlights 100 kW 70 cm 200 cm • Tin Filters – a new level of CARE, bring CT doses to those expected in a routine X­ray series • Straton MX Sigma X­ray tube with High Power 70 & 80 enables lower doses with consistent image quality • FAST Integrated Workflow with FAST Highlights • 10 kV Steps allow for the most 3D Camera drives precision in patient • The unique Mobile precise dose valuesWorkflow for everyallows single positioning operation • Dual Source Dual Energy patient of the scanner from a Highlights wireless tablet • New Nanopanel Detector HD canElite reach any part– of •Revolution The GO technologies automate Enables lowvirtually dose scanning the body of any patient and workflows with machine learning • iPatientboth – Consistent image perform generalized andquality specia­ landmark detection Canon · Aquilion One Genesis Edition • Gemstone andclinical improved scan time workflow IMR – Virtually noise free quality. detector – image applications, including: •lized Low‐kV imaging, 10 kV steps , Tin • High temporal resolution for excel­ Power Scan range Gantry Platform forSpectral delivering future CTbore 2.7 x improvement in low (0.23 contrast highest spatial resolution mm) • Filter Gemstone Imaging – reconstruction lent cardiac imaging and 100 kWand iterative 78 cm 150 / 200 cmTBDE to discoveries like IMR detectability index • Cardiac GSI quantitative dual­energy CT enable dose‐optimized scanning improve diagnostic quality Syncright – CT /–Injector integration iDose4 Premium Package SmartMAR – rawEnergy data based Neuro imaging HD •• The •• TwinBeam Dual (TBDE)metal Stellar detectorRevolution keeps electronic ensures coveragedose to perform System reduction footprint: 7.4 m² noise lowample and increases efficiency • artifact perfusion studies of the entire brain • ASiR­V – up to 82 percent lower dose

Philips · IQon Spectral CT scanner RADBOOK 2019

12

Highlights • AiCE (Deep Learning Reconstruction) • Artificial intelligence in scanning and processing • PUREViSION Optics imaging chain • 0.275 s rotation • 16 cm coverage • 640 slices/rotation Highlights 0.22world's mm spatial resolution ••The first and only spectral

• SUREPosition patient centring • Lateral table movement • 300 kg patient table • SEMAR (Metal Artefact Reduction) • Wide range of Cardiac and Dual Energy applications • Isophasic organ perfusion

Detector – Enables low dose scanning • iPatient – Consistent image quality • IMR – Virtually noise free image quality. and improved scan time workflow. Canon · Aquilion Precision Canon Genesis 350 Scan range Platform· forAquilion deliveringOne future CTbore Edition 2.7 x improvement in low contrast Power Gantry Power Scan range Gantry like IMR detectability index. 72discoveries kW 78 cmbore 170 / 200 cm 100 kW 78 cm 150Package / 200 cm– iDose4 • Syncright – Appropriate contrast • iDose4 Premium dose with CT / Injector integration Reconstructor including O-MAR

detector solution delivering comprehensive, valuable diagnostic and clinical insights. Canon · tissue Aquilion Precision • Improved characterization Power Gantry bore and visualization 72 kW 78 time, cm • Spectral results 100 % of the in one scan

• For the most challenging cases, routinely Scanwith range your current • Fully integrated 170 / 200 cm workflow, from scanner to PACS • And at low dose

Siemens Healthineers · SOMATOM Definition Edge

Siemens Healthineers · SOMATOM Definition AS

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Power Power kW 50.4

72 / 89 kW

Highlig • AIDR 3D reconst •Highlig Artificia • Widest process PURE • plicatio ViSIO • advanc 0.5 s rot • Confide 2 cm co • advanc Up to 3 and TAV


•• 220 kg32 patient table Up to slices/rotation •• SEMAR (Metal Artefact 220 kg patient table Reduction) • SEMAR (Metal Artefact Reduction)

•• SURESubtraction superb iodine Start iterativeforbolus tracking imaging SURE • Subtraction for superb iodine imaging

Hitachi · Supria 16 / 32 Power Hitachi

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Siemens Healthineers · Somatom go.All

Gantry bore · Supria 16 / 32

Power

Scan range

Power Gantry bore Hitachi Scenaria View Siemens· Healthineers · Somatom go.All

Scan range

Power Power

75 cm

180 cm

75 cm

180 cm

Gantry bore

51 kW

Highlights •Highlights 5 MHU X Ray tube •• Sub second 5 MHU X Rayscan tubetime for all • examinations Sub second scan time for all • 0.675 mm minimum slice thickness examinations •• 75 cmmm wideminimum gantry bore improved 0.675 sliceforthickness experience • patient 75 cm wide gantry bore for improved • The compact footrpint needs small patient experience space • installation The compact footrpint needs small • New Iterative reconstruction algo­ installation space for low dose examinations • rithm New Iterative reconstruction algo­

• Intuitive GUI design with 24­inch monitor • wide Intuitive GUI design with 24­inch • Slices per rotation: 16 / 32 wide monitor •• Field view: 500 mm Slicesofper rotation: 16 / 32

◼  Computed Tomography rithm for low dose examinations

• Advanced reconstruction to •• Slices perGUI rotation: 64 / 128color display easiness ofiterative installation Intuitive with 24­inch 2 allow low dose examinations • System Footprint: 13.5 • Advanced iterative reconstruction to • Slices per rotation: 64 /m 128 allow low dose examinations • System Footprint: 13.5 m2

• Field of view: 500 mm

75 kW

72 75kW kW(84 kW optional)

70 cm

Gantry Gantrybore bore

80 70cm cm

Highlights •Highlights The unique Mobile Workflow allows the scanner fromallows a • operation The uniqueofMobile Workflow wireless tablet Highlights operation of the scanner from a The GO technologies ••Open design concept automate with aperture wireless tablet workflows with machine learning diameter of 800 mm • The GO technologies automate landmark detection • New algorithms iterative workflows with for machine learning •reconstruction: Low‐kV imaging, 10 kV Intelli IPVsteps, Tin landmark detection Filter andimaging, iterative reconstruction ••X­ray tunbe: 7.5 MHU equivalent Low‐kV 10 kV steps, Tinto enable dose‐optimized 45 MHU with Intelli IPV scanning Filter and iterative reconstruction The Stellar detector electronic ••Minimum scan timekeeps for all types of enable dose‐optimized scanning noise low and increases dose efficiency examination: 0.35 seconds • The Stellar detector keeps electronic • Minimum sliceincreases thickness:dose 0.625 mm noise low and efficiency

Scan speed

Hitachi

Scan Scanrange speed

Power

Up to 100 mm / s

200 Up cm to 100 mm / s

High temporal and table ••Unique laterallyresolution moving patient workflow automation facilitate 200 mm) •(total: High temporal resolution and easy cardiac examinations • 475 mm wide patient table witheasy workflow automation facilitate •weight Rotation speed: 0.33 of 250 kgs cardiaclimit examinations System 7.4 •••Slices perfootprint: rotation0.33 64 /sm² 128 Rotation speed: ••Dual Energy Scan 7.4 m² System footprint:

51 kW

Highligh • 5 MHU • Sub sec examin • 0.675 m • 75 cm w patient • The com installat • New Ite rithm fo

20 to 64 Slices

Siemens· Healthineers Canon Aquilion Start· Somatom go.Up Power Gantry bore Power bore Siemens HealthineersGantry · Somatom go.Up

32kW kW 36 Power 32 kW

70cm cm 78 Gantry bore 70 cm

Siemens·Healthineers · Somatom go.Now Fujifilm FCT Speedia HD Scanrange speed Scan

Up to 42 cm mm / s 153 / 183 Scan speed Up to 42 mm / s

Highlights •Highlights The unique Mobile Workflow allows the scanner fromallows a Highlights • operation The uniqueofMobile Workflow wireless • AIDR 3D tablet operation of the scanner from a •Enhanced The GO technologies automate iterative reconstruction wireless tablet workflows with machine learning ••Artificial intelligence The GO technologies automate landmark detection in scanning and processing workflows with machine learning Tin Filter technology enables ultra‐ ••PURE ViSION low dose detector landmark detection low dose‐optimized scanning at the • First level cardiac assessment sup­ ••0.75 s rotation Tin Filter technology enables ultra‐ ported by cardiac calcium scoring evaluation levels of conventionalscanning X‐ray at the ••vHP, • 1.6 coverage helicalassessment parameters Firstvariable level sup­ lowcm dose‐optimized SURE • Wireless tablet and remote control The Stellar detector keeps electronic ••Up to 32 slices/rotation • Start iterative bolus tracking ported by calcium scoring evaluation levels of conventional X‐ray •SURE Slices per rotation: 64 withiodine IVR noise low and increases dose ••220 patient table Subtraction tabletfor andsuperb remote control Thekg Stellar detector keeps electronic •• Wireless • System footprint: 7.4 m² efficiency • SEMAR (Metal Artefact Reduction) imaging • Slices per rotation: 64 with IVR noise low and increases dose Oncology • System footprint: 7.4 m² efficiencyCT

Canon · Aquilion LB

Power Power 16 Hitachi 72 kW Power 16

Siemen

Power Power

Power

32/kW 72 108 kW 100 kW 32 kW

70cm cm 75 Gantry Gantrybore bore

Up to 21 cm mm / s 175 /speed 195 Scan Scanspeed

78 70cm cm

Highlights •Highlights The unique Mobile Workflow allows Highlights operation the scanner fromtoallows athose Highlights ••Tin –of bringing CT doses TheFilters unique Mobile Workflow tablet • expected 5wireless MHU tube X­rayfrom seriesa operationinofa routine the scanner The GO technologies •••Sub second scan time forautomate all applications FAST Integrated Workflow with FAST wireless tablet workflows with learning ••3D 0.675 mmtechnologies minimum slice thickness drivesmachine precision in patient TheCamera GO automate landmark • positioning Wide bore detection gantry for improved patient workflows with machine learning •• experience Tin Filter technology enables ultra‐ and operators’ practice High Powerdetection 70 & 80 and 10 kV landmark low dose‐optimized at the ••Steps Compact footprint toscanning maximize helps to obtain high quality Tin Filter technology enables ultra‐ levels of conventional X‐ray easiness of installation images despite large patient diversity low dose‐optimized scanning at the The Stellar detector keeps •••Advanced iterative reconstruction Cardiac 4D imaging atelectronic high to levels ofand conventional X‐ray noise dose efficiency low dose examinations quality andand lowincreases dosekeeps – outperform­ •allow The Stellar detector electronic

Up mm/s Uptoto230 21 mm /s

• Longer lasting Chronon tube downtime andtube maximizes • minimizes Longer lasting Chronon throughput • Intuitive GUI with 24­inch color display minimizes downtime and maximizes Slices perrotation: rotation:64 32/with ••Slices per 128 IVR throughput System footprint: 7.4 ••••TwinBeam System Footprint: 13.5 m2 IVR Dual Energy Slices per rotation: 32m² with

Computed Tomography ◼

ing all low other single source systems resolution:7.4140 System footprint: m²ms (full body) noise and increases dose efficiency ••Temporal

Up to 100

Highligh • 0.28 s ro • Revolut 0.50 mm resoluti • Straton and 70

GE Healthcare · Discovery RT

Gantry bore bore · Supria 16 / 32Gantry

51 kW

Power Scanrange speed Gantry bore Power bore Siemens ·· Somatom Edge PlusScan SiemensHealthineers HealthineersGantry Somatom go.Now

90 cm

Gantry bore

75 cm

Scan Scan range range

150 / 200 cm

Scan range

180 cm

Highlights Highlights cm FOV ••570 MHU X Ray tube • 85 extended FOV for all • Subcm second scan time •examinations Artificial intelligence in • 300 kg patient table scanning processing • 0.675 mm and minimum slice thickness • SEMAR (Metal Artefact Reduction) AIDR 3D iterative reconstruction ••75 cm wide gantry bore for improved PURE PURE SURE • SURE •patient ViSION low dose detector Start iterative bolus tracking experience • 0.5 s rotation • Respiratory • The compact footrpint needs small • Intuitive GUI gating design with 24­inch •installation 3.2 cm coverage •wide Iterative 3D Fluoro space monitor Up toIterative 32 slices/rotation Oncology table top16 / 32 ••New reconstruction algo­ ••Slices per rotation: rithm for low dose examinations • Field of view: 500 mm

36 January 2020 Siemens Healthineers · Somatom go.Up

Power Power bore Gantry bore Siemens Healthineers Gantry · Somatom go.All 55 / 100 kW 80 cm Power bore Siemens Healthineers Gantry · Somatom go.Top

75 kW 75 kW

Power

70 cm Gantry bore 70 cm

Highlights •Highlights The unique Mobile Workflow allows Highlights operation ofMobile the scanner from a ••The unique Workflow Wide bore geometry (80 cm)allows wireless tablet of thecompliant scanner from a •operation All tables TG66 • The GO technologies automate wireless (225 andtablet 295 kg max) workflows with machine learning ••The technologies automate Up GO to 40 % dose reduction across landmark detection workflows with machine the body with integratedlearning ASiR • landmark Low‐kV imaging, 10 kV steps, Tin detection reconstruction* andimaging, iterative10reconstruction ••Filter Low‐kV kV steps Tin 4D gating reconstruction on, the enable dose‐optimized scanning Filter and iterative operator console reconstruction • enable The Stellar detector keepsscanning electronic dose‐optimized low and increases dose efficiency • noise The Stellar detector keeps electronic noise low and increases dose efficiency

Scan Scan range range

170 cm

RADBOOK 2019

RADBOOK 2019 Scan speed Up to 100 mm / s Scan speed Up to 175 mm / s

• Complete and easy to use RT sim­ ulation planning solution with SIM MD on AW • SmartMAR – raw data based metal • High temporal resolution and atrefact reduction automation facilitate easy ••workflow High temporal for excel­ Deviceless 4D resolution – breath gating cardiac examinationsand TBDE to cardiac •lent 80 cm max imaging FOV • improve Rotation diagnostic speed: 0.33quality s •• TwinBeam System footprint: 7.4 m²(TBDE) Dual Energy • System footprint: 7.4 m²

Siemens Healthineers · Somatom go.Now

20 to 64 S

Canon Power

50.4 kW

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e– g O-MAR el-based

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image quality at high pitch • iMAR (iterative Metal Artifact Reduction) and fast iterative reconstruction

• FIRST (Model Based IR, option) • Adaptive Diagnostics

Philips ·· iCT Elite ONE Toshiba Aquilion

Toshiba · Aquilion PRIME

Slices perper rotation Coverage rotation Coverage Slices per rotation Power Slice thickness Rotation speed

Rotation speed Coverage Slices per rotation Slice thickness

256cm 16 80 mm 640 120mm kW 0.5 0.35 s

• UltraHelical • Dual Energy at 50 cm FOV (option)

40 80 / 160 0.5 mm 0.35 s

◼  Magnetic Resonance Imaging Open

Highlights Airis Vento O5 PURE ViSION· detector •Hitachi Gradient Slewrate •Highlights Upgradeable to 0.275 s / rotation 22 mT m 55 T /–m / s New Elite Detector ••78 cm/Nanopanel bore • 2Enables mm @ low 3 HUdose LCR scanning iPatient – Consistent image quality ••300 kg patient load table and improved scan time(option) workflow • Lateral table movement Platform for delivering future CT • AIDR 3D Enhanced iterative discoveries like IMR reconstruction Syncright – CT / Injector integration ••FIRST (Model Based IR, option)

Channels

2 • Adaptive Diagnostics • SEMAR (Metal Artifact Reduction) • Sub mSv Cardiac IMR – Virtually noise free image quality. ••Arrhythmia scanning 2.7 x improvement in low contrast • Isophasic organ perfusion detectability index • UltraHelical iDose4 Premium ••Dual Energy at 50Package cm FOV (option)

7 Tesla 20 TO 64 SLICES Siemens Healthineers · Magnetom Terra

MAGNETIC RESONANCE IMAGING

• World’s first 7T MRI scanner released for clinical use • Dual Mode – secure switch between Mindray Medical · MagSense 360 MRI System research and clinical operation Highlights •Gradient percent 7 Tonly magnet tech­ Channels Slewrate •50 The world'slighter first and spectral Highlights 25 mT / mfor 60into Tap/ mclinical / s environments2 easier detector solution delivering • nology Widest variety of integration patients and • Double SNRfrom for more precision comprehensive, valuable diagnostic imaging chain with technology plications, complex trauma to • XR 80/200 gradients; 8 channel parallel transmit in research •inherited For thefunctionality most cases, and clinical insights. fromchallenging Revolution CT mode advanced vascular and perfusion. •••Submillimeter BOLD fMRI precision for pre­surgical evaluation routinely Improved tissue characterization • ASiR-V – up to 82% lower dose* Confidence even when performing • Latest applications available syngo •MR E12integrated software •SmartMAR Fully with your current and visualization – rawdatabased metal advanced procedures such aswith cardiac ••Additional metabolic imaging andscanner 31P spectroscopy workflow, from to PACS Spectral results 100 %information of the time,with 23Na artifact reduction and TAVI planning And at low dose in one scan • High-resolution at low-dose: Clarity *• Compared to prior generation

Canon · Vantage Galan 3 T Gradient Channels Siemens2017 HealthineersSlewrate · SOMATOM Definition AS RADBOOK 33 / 45 mT / m 200 mT / m / s 128 Dual Energy Yes Slices per rotation 128 Highlights Gantry boreInScan Technology 78 cm • Innovative Power to 100 kW • Advanced Gradient systemUp Design • Ergonomic Design make you more comfortable • Multi­clinical Applications satisfied doctors requirement Highlights Multiple coils selection • •Patient friendly 71cm make all examination reality

wide bore with 50 × 50 × 45 cm cylindrical scan area Highlights Healthcare · Signa PET / MR 3.0 T •GE resolution in sdaily •High Rotation time ofimaging up to 0.3 Gradient Channels • M­power intuitive practice withSTRATON PURERF and Slewrate and 0 MHU tubeSaturn 44gradient mT /70 m kV 200 T / m / s graphical user32 / 128 interface technology with • Next generation scan techniques, ••EasyTech for automated Workflowsolutions optimization for more MultiBand SPEEDER, Fast3D mVox, scan­planning and increased reliable and reproducible scanNova+based & freeiterative breathing productivity •Olea Raw-data reconstrucning with FAST CARE technology and k­t/ s ••Silent scanning with Pianissimo Zen Automated kV setting with CARE kV examinations tion (SAFIRE) with with Quickstar up to 20 images •sequences TwinBeam Dual Energy and iMAR •SPEEDER. 3D-guided intervention, upgradeable to Stellar detector (iterative Metal Artifact Reduction)

MR-PET

GE Healthcare · Signa Pioneer 3.0 T Slewrate

Channels

1

• Adaptive Diagnostics • SEMAR (Metal Artifact Reduction) • Low dose Cardiac scanning (option) • Dual Energy at 50 cm FOV (option) • 14.8 m2 installation space

Magnetic Resonance Imaging ◼

3 Tesla

Highlights Gradient Channels Philips · IQon ·Spectral CT scanner Slewrate GE Healthcare Revolution EVO Comfort 80• mT / m1 class permanent200 T / m / s1 Up to 64 × 64 Slices 64 / 128 openper MRIrotation system, which keeps 1 Maximum gradient amplitude and slewrate can be applied simultaneously Power 72 / 400 kW • Environment friendly: extremely low enhanced capabilities meeting Spatial resolution power consumption and reduced sophisticated open design0.28 mm Rotation speed 0.35 sec installation requirements • Offers newly developed technolo­ • Low running costs allowing fast gies available at an excellent cost of return of investment ownership • Field strength: 0.3 T • High magnetic field homogeneity Highlights

Gradient

Highlights Airis Light PURE ViSION· detector •Hitachi Gradient Slewrate • 78 cm bore 22 55 T / m / s • 2 mT mm/ m @ 3 HU LCR • 300 kg patient load table • Lateral table movement (option) • AIDR 3D Enhanced iterative reconstruction • Iterative bolus tracking • Iterative 3D Fluoro (option)

Channels

RADBOOK 2017

Highlights Imaging 7Block Tesla

Airis Light – the economic,Slewrate · Optima CT660 Siemensand Healthineers · Magnetom Terra Channels wide open MR 33compact mT / m 120solution T/m /s 8 / 16 Gradient Channels of placing Slewrate Slices per rotation 64 / 128 giving the possibility • The open system architecture gives 1 1 80 mT /only m a feeling of security 200 T100 / malso / s the patient always Up to 64 Power 72 /but kW in × the64centre to not 1 Maximum gradient amplitude and slewrate can be applied simultaneously Spatial resolutionmerits when 0.31 mm has considerable taking achieve high image Rotation speed sec • Newly developed built­in technolo­ care of small children and0.35 elderly gies give you high performances in a patients small footprint system • The floating table allows to fit the • Field strength: 0.25 T system into small spaces while Gradient GE Healthcare

Highlights • World’s first 7T MRI scanner released for clinical use Siemens Healthineers · Magnetom RT Pro edition Highlights • Dual Mode – secure switch between •Gradient We buy and sell used MRI systems Channels Slewrate research and clinical operation – managers •–Open and closed bore from–0.2T to 3T • Professional project • 50 percent lighter 7 T magnet tech­ •Highlights Excellent prices on the most popular handle every detail of system dein­ nology for easier integration into clinical environments stallation and installation from all major manufacturers •• models Diagnostic andprecision workflow Double SNRpower for more •• Systems available all modalities, • Consider upgrading yourhigh-quality GE MRI Powered by Smartfrom Technologies efficiency, enabling fast, • XR 80/200 gradients; 8 channel parallel transmit functionality in research mode Highlights Siemens, GE, and Hitachi without moving a wall: 16ch 23X, at BOLD optimized • including: ASiR • acquisitions Submillimeter fMRI dose. precision for pre­surgical evaluation Support precision in • Tested, 23X, 16ch 16X,CT or radiotherapy 16chSnapShot 15X warrantied spare partsmetal available SmartMAR - rawdatabased •••8ch Intelligent cardaic with Latest applications available with syngo•MR E12 software with Magnetom Aera, Skyra, Sola, artifact reduction and SnapShot • Assist Additional metabolicFreeze information with 23Na imaging and 31P spectroscopy or Vida and trendsetting applica­ tions such as RESOLVE, StarVIBE or Sensing GRASP­VIBE GECompressed Healthcare · Signa Architect 3.0 T • Scan patients consistently in the Gradient Channels Slewrate 11 Canon · Vantage Galan 3T treatment 44 mT / m position with dedicated 200 T / m / s 96 / 128 Gradient Channels Slewrate RT positioning equipment (CIVCO, 33 /Orfit, 45 mT / m an MR compatible 200 mT /m/s 128 Qfix), laser bridge (LAP), and a large variety of flexible coils • Rely on intuitive and dedicated RT workflows with the RT Dot Engine and the RT Image Suite • Enable an MR­only RT planning workflow with the RT Dot Engine and RT Image Suite’s Synthetic CT feature Highlights • Patient friendly 71cm wide bore with 50 × 50 × 45 cm cylindrical Siemens Healthineers · Biograph mMR Highlights scan area •Gradient Premium 3.0T MRI with 70 cm wide bore, Channels • High resolution imaging inSlewrate daily 45detachable mT / m1 table and total 200 T/m / s1 Up to 102 × 32 digital imaging • M­power intuitive practice with PURERF and Saturn Maximum gradient amplitude slewrate canpatient be applied simultaneously • 1Dedicated toandhigh comfort and produc­ graphical user interface gradient technology tivity with the latest Signa Works platform and • Next generation scan techniques, • EasyTech solutions for automated new technologies like ViosWorks 7D Flow and MultiBand SPEEDER, Fast3D mVox, scan­planning and increased HyperSense/HyperBand acceleration technique Olea Nova+ & free breathing productivity • Revolutionary AIR Technology with ultralight coils for brilliant image quality examinations with Quickstar and k­t • Silent scanning with Pianissimo Zen SPEEDER. sequences Highlights • Largest customer base of installed systems·worldwide GEMR­PET Healthcare Signa Premier 3.0 T • State­of­the­art 3T MRI with

Gradient GE Healthcare

· SignaSlewrate Pioneer 3.0 T

www.indiamedtoday.com Channels

3 Tesla

Block Im Gradient

33 mT / m

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Siemens Healthineers · Magnetom Sola Cardiovascular Edition

Hitachi Gradient Gradient

33mT mT//mm1 120TT//mm//ss1 16 to 96 × 16 30 100 Up Gradient · ECHELON OVAL 34 mT / m Hitachi 1 Maximum gradient amplitude and slewrate can be applied simultaneously Slew rate 150 T / m / s Gradient 34 mT / m Channels 16 (32 ) Slew rate 150 T / m / s Channels 16 (32 ) Highlights • 10­min exams with best­practice­ based protocols • Up to 30 percent energy savings in standby mode with Eco­Power Highlights • •Increased throughput Reliable clinical resultsand as well as high consistency Spine and productivitywith andBrain, profitability Dot engines •Large High Joint productivity thanks to latest Signa • More comfort with ultra­light­ Workspatient platform with SilentScan and weight MAGiCTim 4G coils and Quiet Suite •Highlights offerings advanced trendsetting applications •Expand Efficientclinical workflow thankswith to automatic •• Latest applications available withasyngo MRcoil XA12 software such as Compressed presets, Slide Bar and integrated express Revolutionary design featuring Highlights Sensing, SMS,and andOVAL many moreflex coils • WIT RF Coil System technology 16­channel 74 cm spacious environment Revolutionary designand featuring a ••••Increased consistency workflow with DotGO Digital OpTix RF­technolgy Shaped around the human body acceleration • WIT Mobile Tableand GO technologies 74 cm spacious OVAL environment • WIT RF Coil System • Workflow Integrated Technology (WIT) • WIT Patient Information Monitor • Shaped around the human body • WIT Mobile Table • Workflow Integrated Technology (WIT) • WIT Patient Information Monitor

33mT T / /mm 120TT//mm//ss 32 40 150 16 Field strength Philips · Ingenia 1.5 T1.5 S T Gradient 57 mT / m or 33 mT / m Field strength 1.5 T Slewrate 208 T / m / s or 120 T / m / s Gradient 57 mT / m or 33 mT / m Slewrate 208 T / m / s or 120 T / m / s

33mT mT//mm 130TT//mm//ss 33 100 Field strength Philips · Multiva 1.5T 1.5 T Gradient 33 mT / m Field strength 1.5 T Slewrate 122 T / m / s Gradient 33 mT / m Slewrate 122 T / m / s

45 mT / m1

Channels

Slewrate

200 T / m / s1

204 × 64

Canon · Vantage Galan 3 T

GE Hea

1 Maximum gradient amplitude and slewrate can be applied simultaneously

Gradient

33 / 45 mT / m

Channels

Slewrate

200 mT / m / s

Gradient

44 mT / m

128

Highlights • A dedicated MRI scanner designed to meet the demands of cardiovas­ cular examinations •Highlights Free­breathing CMR exams with Compressed Sensing • Patient friendly 71cm Cardiac Cine for functional wide bore withimaging even for patients arrhythmias 50 × 50 ×with 45 cm cylindricalor those who scan cannot area hold their breath. •• Tissue characterization Myo­ High resolution imagingwith in daily Maps andwith HeartFreeze for differential diagnosis of myocardial • M­power intuitive injury practice PURERF and Saturn • Consistent results, fast with BioMatrix Sensors and the graphical userAI­powered interface Cardiac gradient technology Engine for fast patient setup and step­by­step guidance fortechniques, CMR exams in • Next generation scan • Dot EasyTech solutions for automated as little as 30 minutes* MultiBand SPEEDER, Fast3D mVox, scan­planning and increased

◼  Magnetic ResonanceOleaImaging * Data on file, results may vary Nova+ & free breathing productivity • Silent scanning with Pianissimo Zen sequences

examinations with Quickstar and k­t SPEEDER.

Highligh • Premium detacha • Dedicat tivity w new tec HyperS • Revolut

RADBOOK 2019 GE Healthcare · MRgFUS & Signa Architect 3.0 T Channels · SignaSlewrate Pioneer 3.0 T

Gradient GE Hea

Gradient

Gradient

Gradient GE Healthcare

Highlights • Short cavity magnet with zero helium consumption • Highlights Fully digitalized multi­channel •spectrometer Focused, non­invasive thermal ablation therapy, combining • Multi­channel PA RF receiving coil highly energeticidentification, focused ultra­ with intelligent Highlights soundreconstruction (ExAblate) MRI •• Image 1,500 fps Increase SNR by upwith tospeed 40 % imaging Highlights CE­certified for:%Uterine fibroids, •••Maximum field and slewbone metastases, facets, essential tremor, As much asgradient 30 improvement • Increase SNR by up to 40 % tremor dominant rate reached at theParkinson’s same time disease, neuropathic pain in throughput • As much as 30 % improvement MRI guidance for therapy planning, targeting and magnet thermal feedback, withtasks •••Parallel acquisition technology •• Compact design, minimum Plug-and-play expansion Significant reduction of routine in throughput immediate results space: 35broadband m² • platform Largest homogeneous FOV for • installation The first-ever digital • Plug-and-play expansion • Significant reduction of routine tasks MR system a 70 cm bore • Largest homogeneous FOV for • The first-ever digital broadband MR system a 70 cm bore Open

Hitachi · · Oasis Echelon Smart Plus Hitachi · Multiva 1.5TSlewrate Slewrate

Gradient

3 Tesla

GE Healthcare · MRgFUS SternMed · Marcom 1.5T & Signa Artist 1.5 T Philips · Ingenia 1.5 TSlewrate S Gradient Channels Slewrate Gradient Channels

Philips Gradient Gradient

• Conside withou 8ch 23X

44 mT / m

200 T / m / s

36 / 45 mT / m

150 / 200 T / m / s

Slewrate

32 / 128 Channels 65 / 97

GE Hea

44 mT / m

80 mT / m

Highlights • New 3 T wide bore MR with future Highlights oriented technologies in the areas of • image Focused, non­invasive thermal quality, productivity, profitability ablation therapy, combining highly energetic focused ultrasound and patient comfort Please with visit us at MRI imaging • (ExAblate) High productivity with the Signa Works • platform CE­certified for: Uterine fibroids, bone metastases, facets, essential tremor, dominant Parkinson’s disease, • tremor Latest technologies like ViosWorks 7D neuropathic pain • Flow, MRI guidance for therapy planning, targetingtechnique and thermal feedback, with HyperSense / HyperBand acceleration immediate • Total digital results imaging and ultra high efficient gradients (UHE) equivalent to 44/200

Highligh • Ultra­H ultra str dients, detacha digital i • Combin Highligh with inn Surgica •• Equipp post­op machin Include •• The suit a fully e requirem

• Revolutionary AIR Technology with ultralight coils for brilliant image quality

• Revolut

www.healthcare-in-europe.com

Hitachi · Aperto Lucent O5 Channels Channels

Gradient

Slewrate

Channels

RADBOOK 2019

816

25 mT / m RADBOOK 2019

55 T / m / s

2

Highlights • Wide, 320 degrees open permanent MRI system • Features top field strength amongst the permanent MRI systems presently • Fast processing chain allows increas­ on the market ing patient throughput • Newly developed built­in technolo­ gies keep Aperto Please visitLucent us atdelivering • Reduced running costs allowing fast image quality comparable with entry return of investment • Field strength: 0.4 T level HF MRI scanner

Highlights •Highlights World's most powerful open MRI ••Highlights Vertical field SmartExam superconductive FlexStream, and SmartAssist offer an easy-to-use system for fast Highlights •magnet Neweasy Signal Processing • Two­pillar asymmetric design for high SNRfor Platform and workflow increasedwith throughput • FlexStream, SmartExam and SmartAssist offer an easy-to-use system for fast Iterative Reconstruction reducing the coil • Soft Soundfor Technology •• 270° panoramic view, accommo­ Ultra-light weight coils. No additional handling total spine imaging and easy workflow for increased throughput routine scan time by 30paediatric, percent total. •with Multiple connectors withand Zenith claustrophobic, • dates High quality, 10-minute routineinexams high coil channel count coils • Ultra-light weight coils. No additional coil handling for total spine imaging •obese SynergyDrive theupworkflow element based, highly patients SENSE parallel optimizes imaging for to 16-timessolenoid acceleration • High quality, 10-minute routine exams with high channel count coils and withmotorized Hitachi’s “AI” technology (Auto­ •sensitive SoftSoundSuite reach more than receiverto coils •• Fully extra wide 82 cm Comprehensive range of clinical applications SENSE parallel imaging for up to 16-times acceleration Pose, AutoExam, AutoMIPclipping) 80 percent noise • Field strength: 1.2 reduction T table– (up 300 kg) costs • patient PowerSave lowto operation • Comprehensive range of clinical applications Not available in the USA. • PowerSave – low operation costs

www.healthcare-in-europe.com

Siemen Gradient

Up to 60 m 1 Maximum gradient

Highligh • The first technol Tuners, • An all­n Field­of • Up to 6 for up t • Acceler put and • Perform Sensing • Reliable • Up to 5 Multi­S

Not available in the USA.

RADBOOK 2019 38 January 2020

37 RADBOOK 2017

39 Siemens Healthineers · Magnetom Lumina with BioMatrix

Siemen


ology itor

• Touch Screen Panel PC directly on C-arm with live image • E-motion: all C-arm movements can be motorized

for Housing and Generator • Dual Power System: power reserve system • Wireless pedal as option

INTERVENTIONAL SYSTEMS Philips · BV Endura 2 Power II format

Multi Modality Suites

Canon · Alphenix 4D CT Detector

Shimadzu · Opescopea­SiActeno 100 kW / CsI Resolution II format Power

GE Healthcare · Innova IGS 620 Power

Pixel size

194 μm CCD-Sensor, 1,024 x 1,024 x 12 bit 23 or 15 cm 2 kW

Highlights This integrated system combines premium CT and ceiling­mounted Highlights technology. The perfect angiography • High quality diagnostic andimaging treatment set­up for •high­risk Easy operation through fully inter­ procedures in various balancedsegments C-arm such as: ventional Magnetic locksOncology and all-free buttons •• Interventional • Memory functions support an efficient workflow Detector

• Trauma / Neuro / Stroke • General Vascular • Additional or Backup CT • Detector size: 30 × 30 cm / 30 × 40 cm The system is available with two different CT configurations: Aquilion One Genesis and Aquilion Prime • Inside C-arm cabling • Flexible upgradeability Pixel size

Siemens · nexaris 100 kW Healthineers a­Si / CsI Angio-MR-CT200 μm Power

52 100 kW

Detector

a­Si / CsI

Siemens Healthineers · nexaris Angio-MR-CT

Pixel size

160 μm

Highlights • Smart gantry for optimal C­Arm positioning Highlights • High detector DQE and AutoEx for • InnovaSense patient contouring • Unprecedented imaging capabilities with all the advantages of angiography, dose optimization • Integrated large display monitor and CTintegration imaging of intra­ • MR, Complete • Detector size: 20 x 20 cm • Patient transfer without imaging vascular­ultrasound, FFRrepositioning for barrier­free intraoperative (frontal/lateral) • Innovative treatments that combine multiple imaging modalities in a single procedure

Power

Detector

Pixel size

Bi-Plane

Bi-Plane Canon

Power Canon

Power

Power

100 kW

a­Si / CsI

100 kW

160 μm

Detector

100 kW International a­Si / CsI PRIMAX · CYBERBLOC FP

Pixel size

100 kW

160 μm

Up to 15 kW New Flat Panel Generation Chassis of light aluminum alloy for easy positioning

Highlights • Unprecedented imaging capabilities with all the advantages of angiography, Highlights Highlights MR, and CT imaging • Unprecedented imaging capabilities with all the advantages of angiography, •• Large C-arm depth Patient without repositioning for barrier­free intraoperative imaging MR, andtransfer CT imaging for maximum accessibility Innovative treatments combine multiple imagingintraoperative modalities inimaging a single •• Patient transfer withoutthat repositioning for barrier­free • View station with angle and height • High sensitivity --> low dose procedure • Innovative treatments that combine multiple imaging modalities in a single adjustments operation procedure • Smart power management to handle • Removable grid for paediatric Bi-Plane applications long procedures GE Healthcare · Innova IGS 630 • Image free of any distortion • Full touch “smart” user interface

◼  Interventional Systems

Interventional Systems ◼

Canon Power

· Alphenix Dual Plane Detector 100 kW · Alphenix Dual a­Si / CsI Power Detector Canon Plane 100 kW Healthineers a­Si / CsI Angio-CT Siemens · nexaris Power Detector Power 100 kW

a­Si / CsI Siemens Healthineers a­Si · Arcadis Avantic 100 kW / CsI Power II format

Detector

Pixel size

200 Pixelμm size 194 μm

Bi-Plane 2 × 100 kW

RADBOOK 2019

Detector

a­Si / CsI

Canon · Alphenix Biplane

Power

100 kW

100 kW

GE Hea

Canon Power Power

100 kW

160 μm

Detector

a­Si / CsI

Pixel size

Pixel size

194 μm

Detector

a­Si / CsI

the syst

Siemen Power

RADBOOK 2017

www.indiamedtoday.com Pixel size

Highlig Vascula Highlig speed, p Vascula performp Highlig speed, Biplane •perform Smart g advanta C­Arm Biplane ical innd •advanta High patient dose o ical inno ACompl revolu •patients mu vascula Aand revolu the syst and mu

100 kW

194 μm

Highlights •Cardio Detector size: • SCORE StentView+Plus intervention demands 12" × 12" (30 × 30 cm) × 8" (20 × 20 cm) • SCORE CT speed, precision, and/ 8"optimum •performance. Wide coverage smooth Bi­ operability • SCORE 3D TheforAlphenix •plane SCORE Pro Advance image process­ • SCORE Navi / Navi+Plus is designed to take advantage ofing thetechnology latest technological innovations to• SMART design concept • Comprehensive dose management •reduce Uniquedose pioneering imaging for patients andtechnology: staff. SCOREuser RSMinterface andpackage Amotion­tolerant revolutionary graphic mul­ ti­tasking computer enable the system to fully meet your requirement for high image quality, safety, ease of use, efficiency and improved workflow. Single Plane • Detector size: 20 × 20 cm Power

• Detect

100 kW Power Canon 100 kW

Pixel size Pixel 194sizeμm

Highlights • Optimal detector size for dedicated neuro Highlights •applications A single room X­ray solution with two Designed for both diagnostic and Highlights •Highlights HD,with 3D guiding technology interventional examinations. both imaging Designed for both diagnostic and •Innova AC­Arms singleCT room X­raydedicated solution with two • Advanced Cutting-edge mobile imaging with a larger field oftime view • Integrated large display monitor enhanced 3D imaging • Space, and dose saving technol­ chains for interventional cardiac and interventional examinations. C­Arms both with dedicated imaging •High Large 33 cm (13” intensifier •Highlights detector DQE) image and AutoEx for size:design 30 xdose 30elements cm ogy aretime key of the angiography procedures that share Space, and saving technol­ chains for interventional cardiac anda ••Detector • Powerful 25 kW generator with tube currents of upDual to 250 mA optimization (frontal/lateral) Alphenix Plane. common generator, table, monitors • dose First hybrid suite with a common coordinate system that fuses images instantly ogy are key design elements of the angiography procedures that share a • 2.57 MHU (Mega Heat system. Units) heat capacity Detector × 20 cm / 30 × 40 cm and digital acquisition • Direct access to angiotable, and monitors CT with Quick• Alphenix Switchingsize: Dual20 Plane. common generator, • EASY (Enhanced Acquisition System) with automatic dose, contrast and • Efficient multi­room configurations to share imaging equipment • Detector size: 20 × 20 cm / 30 × 40 cm and digital acquisition system. brightness control • Enabling combined CT and angio guidance in one session • Electromagnetical brakes, multifunctional footswitch (option) and remote Shimadzu · Trinias B12 / B8 unity edition user interface RADBOOK 2019 (option) for control from within the sterile field Power

Highlig Cardio i Highlig speed, ip Cardio performp speed, plane is perform of the isla plane reduce of the la A revolu reduce Ati­taskin revolu image q ti­taskin • Detecq image

25 kW 33 cm

Block Imaging Siemens Healthineers · Artis zee, Artis Q, Artis Q.zen

Enabli •• Efficien • Enabli

Power Siemens Healthineers Detector · nexaris Angio-MR-CTPixel size

Power Detector Design

3.15 kW 31 / 23 / 17 cm

Highlights • Versatile workhorse designed for routine and vascular interventions • SmartVision – a fully digital imaging chain including powerful image processing functions • High quality images at a low dose, time after time • Extended rotation • Optimally designed mobile view station providing a unique intelligent viewing concept

Power

• Interventional Oncology andconfigurations: Aquilion PrimeAquilion One Genesis ventional segments such as: CT processing functions • Interventional Oncology and Aquilion Prime • High quality images at a low dose, time after time • Pulsed acquisition 30 pulses / sec • Rotating anode power

39

Highlig Biplane imaging offers hi ventiona high po • Left­sid for free • Single extend by rota • Ergono smooth • 3D acq

Canon Power

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Vascular functionality Motion • Detectorimaging size: 21 ×with 21 cm / 31 × 31 cm ◼•• Complete  Interventional Systems 3D­portfoliowith including cross­sectional syngo DynaCT and syngo 3D Roadmap

◼  Mammography

• Designed to support infection control measures to maintain highest standards for infection control

Single Plane Hologic · Fluoroscan InSight FD Mini C-Arm imaging system Power Detector Canon Alphenix Core+ Siemens· Healthineers · Artis one

7,5 W (0,1 mA@75 kVp) Tomosynthesis Power Power 100 kW · Artemis Canon Pixel size

CMOS Detector Detector CMOS / a­Si / CsI a­Si / CsI Scan angle

83 μm

30°

Pixel size

75 μm 76 184/ 194 μm μm

GE Healthcare · Discovery IGSzee 730 Siemens Healthineers · Artis

Pixel Pixel size size

Power Power

Scan time

Pixel output

15 s

50 μm / 100 μm / 150 μm

Highlights The compact unit now features a redesigned monitor arm and rail for easy transportation and reduced OR workspace interference. • High Resolution, Imaging Mode Option to utilize full detector resolution. Highlights • Low Dose Rate Mode ­Option speed, to reduce Vascular intervention demands precision, anddesign optimum performance. Highlights •dose Slim­line for easy patient access rates by over 50 percent compared The flexible Alphenix is designed take advantage of the latestfor techno­ Intelligent operation isCore+ enhanced by to a to• Ergonomic system controls auto mode, whileup stillreduce providing clinically Highlights logical innovations to dose for patients and table­side staff. configurable head display, allow­ smooth operation equivalent images The Artemis mammography systemin and• multi­tasking Aing revolutionary graphic interface computer enableupthe you to interact with user the system Full patient coverage imaging • Compact redesigned monitor arm andfor high 2D (Full Field Digital) system toboth fully meet your requirement image aprovides completely new, intuitive way. to 2.10 m quality, safety, ease of integrated keyboard (Digital Breast Tomo imaging. use, high efficiency and×synthesis) improved workflow. •3D Detector: as30, (1,560 1,420 pixels), • Integrated 3D­Imaging and review system system supports andacquisition rate up to 66 f / s •The Detector size: 30of×25 30qm cm2 / 30both × 40screening cm with Small footprint additional work­up examinations and biopsy procedures. GE Healthcare · OEC Elite CFD Ergo-C

Interventional Systems ◼

Medtronic Power

· O-arm system Detector

Pixel size

15 kW CMOS 1.5 ksize Power Pixel IMS Giotto – GMM Group · IGS Giotto Detector 56 GE Healthcare · Discovery 7 ORClass 40000 32 kW Pixel size Power

a­Si ­ 2.0K × 1.5K Detector size Detector

Pixel size

Scan angle

194size μm Detector type Pixel

GEμm Healthcare · Senographe Pristina 85 24 ×/ 30 100 kW a­Si CsIcm

a­Seμm 200

100 μm

<10 s

±12 °

Scan time

Highlights The system is designed to drastically improve the screening and diagnostic throughput thanks to an high rotation speed and an improved vertical run speed Highlights The gantry is ergonomically designed to give patients a • Inviting gantry patient­ and user natural and moredesign relaxedforpositioning • Easy in use: All motions motorized, Highlights comfort featuring easy access and Dueta include: The operating and interventional modalities simple control panel • cmOS Designed for surgery Detector Highlights self­ compression option • Digital • Position memory remembers four 13s 360° 3D scan –examinations Fully mobile (2D) withtrue 1.5mammography x 1.5ksystem Resolution ••••Laser­guided Patented Rh/Mo x­ray(3D) tube for low dose Breast scan positions Flexible intra­operative 2D­ and arm • Integrated 4k UHDTomosynthesis Monitor with articulating Tolerant Subtraction Magnus OR Table (Maquet) •••Multiple andinback­out imaging,parking especially dense breasts Synthesized 2D image generated from 3D dataset •High Easy drapingC­Arm ofDQE thefor breakable 3D­imaging Continous Fluoro and pulsed Fluoro Ergonomic easy andgantry • detector •••positions IsoDose – comparable low dose 2D/3D Combo: Tomosynthesis & digital mammography • Seamless integrating with Stealth­ •••Optimal Large 2D­image size and large AutoTrak and AutoSmartMetal f lexible Positioning • AutoEx: detector sizeguided forexposure hybrid Dynamic exposure optimization AOP –precision Fully automated control • High tomo or stereotactic biopsy Station Navigation 3D scan Dueta, volume up to3D 40(DBT), cm width Vascular functionality with Motion •Integrated Detector size: 21display × 21 cmmonitor / 31 × 31 cm • large •••procedures Option: Seno SenoBright HD Contrast­Enhanced Spectral Mammography (CESM) Detector size: 30 × 40 cm at tableside •Latest Seamless integration in OR workflow ••Functionalities •IMS 3DSerena Advanced applications integration (CESM), (Stereo) Giotto is a company of GMM Group Detector 24easier × 29 cm ••Wide Boresize: 3D for 3D acquisition • Detector size: 31 × 31 / 41 × 41 cm • kV Range: 25 – 49 kV

Hologic · Fluoroscan InSight FD Mini C-Arm imaging system

Power Detector Intermedical · Womam 7,5 W (0,1 mA@75 ·kVp) CMOS GE Healthcare Innova IGS 530 Pixel size Detector size Hologic · Clarity HD High-Resolution Power 85 μm 24 × 30 cm Detector Pixel kW size 100 70 μm (2D) / 140 μm (TOMO)

Scan angle a­Si / CsI 15°

Pixel size

75 μm

57

Detector type Pixel a­Sesize/ a­Si Scan type 200 μm

3.7 s

Highlights The compact unit now features a Highlights redesigned monitor arm available and rail for •Highlights Mammography system Fastest, Highest Resolution 3D Images easy transportation and reduced OR in different versions: analogic, Unleash theand power of the with fastest and highest workspace interference. 2D digital 3D digital tomo­ resolution 3D images in theMode industry with the •synthesis High Resolution, Imaging Option function. pixelfull sizedetector as FFDMresolution. (70 The Clarity to utilize •same AEC with dual modality: PREmicrons). in function HD high­resolution 3D imaging’s breakthrough • Low Dose Rate Mode ­Option to reduce dose of effective breast density and FAST in Highlights detector advanced 3Dcompared imaging algorithm rates byand over 50 percent to function of compressed thickness. • Optimal detector size breast together to deliver exceptional 3D images – auto mode, while still providing clinically •work Version with isocentric C­arm dedicated for combo procedures regardless ofprocedures. breast size or density equivalent images for biopsy • Functionalities integration at tableside ••Fast gantry screening with patient contouring Accelerate and analysis. ••system DICOM 3.0redesigned connectivity. Compact monitor arm and • More than 20 advanced applications •• Optional Designed to clearly see subtle lesions and fine diagnostic workstation available(Innova integrated keyboard 3D CT, Heart Vision, PCI • Integrated large display monitor calcifications to help pinpoint cancers early. with CAD software. ••High detector DQEyou anddiagnose AutoEx for Designed to help patients Assist, with Valve Assist) • Detector size: 30 × 30 cm dose optimization greater certain.

· O-arm system 40Medtronic JanuaryHealthineers 2020 Siemens · Mammomat Revelation Power Pixel size Detector Pixel size Scan Scan angle 32 kW a­Si ­ 2.0K × 1.5K 194type μm 54 78

Pixel Pixel size size

Detector Detector

100 kW a­Si / CsI Fujifilm · Amulet Innovality

200 154 μm Scan time

Scan angle

15° / 40°

4s/9s

Highlights Artis zee multi­purpose is Highlights designed to meet the de­ • Unique detector with Hexagonal pixels mands ofnew interventional for fast, low examinations radiology anddose fluoroscopy. The • Tomosynthesis: Dual angle Highlights system left suspension meetsapproach to tomosynthesis, and its •the Laser­guided system forunsurpassed intervention­ needs of endoscopic applica­ micron pixel output, better al50radiology & cardiology as wellsupport as tions in gastroenterology breast OR screening diagnostic Technology with High • Hybrid Detector: 30 × 40and (1,920 × 2,480 mammo­ pixels),• GE 154Detector μm graphy needs • Can be installed from 35 m². Neither Image Quality & Dose Efficiency Ergonomic system controls for smooth table­side operation Intelligent AEC (iAEC) nor floor • Planning, implementation ••ceiling 2k imaging withmounted highlyoptimizes practical the andX­ray user­friendly handling featuresand evalua­ dose for each breast type • Meets high hygienic requirements tion of PCI, TAVI, (T)EVAR and more 3D acquisition rate up to 75 f / s • Dedicated mammography acquisition Workstation (AWS)

Mammography ◼

MAMMOGRAPHY IMSHealthcare Giotto – GMM GroupIGS · Giotto GE · Innova 540 Class Pixel size Power

Scan angle Detector

Pixel size

Scan angle

RADBOOK 2019 Scan size time Pixel

Hologic · 3Dimensions 85 μm 38.6°/ CsI 100 kW a­Si

13 sμm 200

70 μm (2D) / 140 μm (TOMO)

3.7 s

15°

Scan type

Highlights Giotto Class is an advanced and innovative three dimensional breast imaging technology Highlights able to perform A Breast Tomosynthesis Exam with Results Like No •Other. DigitalOnly mammography examinations (2D) exam: the Hologic 3D Mammography •• Breast ProvenTomosynthesis to detect up to(3D) 65 % more invasive breast • Synthesized cancers than2D 2Dimage alone.*generated from 3D Highlights dataset •• Large The only mammogram FDA approved as superior imaging Field of View • Combo: Tomosynthesis & digitalcompared mammo­to 2D for women with dense breasts • High detector DQE and AutoEx graphy mammography. dose optimization ••for Stereotactic biopsy in prone or upright More than 200 studies demonstrate the exam’s • Latest 3D­guiding solutions position clinical efficacy. •• Integrated large display monitor Contrast­Enhanced Spectral Mammography (CESM) Now you can have these clinically proven results •IMS Functionalities integration tableside is aHologic company of at GMM Group withGiotto the new 3Dimensions 3D Mammography system. • Detector size: 41 × 41 cm

* Results from Friedewald, SM, et al. “Breast cancer screening using tomosynthesis in combination with digitalmammography.” JAMA 311.24 (2014): 2499-2507

Planmed Oy · Clarity 3D GE Healthcare · Innova IGS 520 Scan time Scan angle · SmartCurveDetector – Breast StabilizationPixel System 15° 13 ssize

Pixel size Hologic Power 83 μm Pixel kW size 100

Scan angle a­Si / CsI –

Scan type 200 μm –

Highlights More comfortable mammograms. More satisfied patients. • Curved compression surface applies Highlights uniform compression over the entire • Digital mammography system for conventional 2D breast. imaging, diagnostic imaging, stereotactic biopsies • Shown to improve comfort in 93 % and Digital Breast Tomosynthesis (DBT) Highlights • There’s no change in positioning tech­ of patients who reported moderate Continuous Sync­and­Shoot tomosynthesis imaging •• Optimal size with for cardiac nique or workflow for technologists. to severedetector discomfort standard method with iterative reconstruction and Tomo­ ••High detector DQEaand AutoEx for interventions Can be used with MammoPad compression paddles.* Marker technology to enable sharp and artifact dose ••AProcessing set of advanced clinical tools to breastoptimization cushion for additional software takes paddle free images monitor help Plan, Guide, Assess complex cushioninglarge and display increased tissue geometry into account, so there’s no • Integrated • procedures Intuitive Planmed Clarity Flow touch screen • Easy accessibility to functions at capture.** impact on image quality.* based user with interface table side paddle (18 × 24cm) patientHologic’ contouring *• Fast In an gantry internal study comparing s flat paddle to the SmartCurvE **system Coryell T. Increasing Mammography Tissue Acquisition •through Positioning andcm Use of a Foam Breast Detector size:Training 20 × 20 Cushion.

Siemens Healthineers · 50° wide-angle Tomosynthesis Pixel size

Scan angle

Scan time

RADBOOK RADBOOK 2019 2019


◼  R/F Digital Mobile DR

KonicaDR Minolta · AeroDR X30 Mobile Fujifilm · Amulet Innovality Pixel output

50 μm / 100 μm / 150 μm

Power

Konica Minolta · AeroDR X30

Scan time

Scan angle

15° / 40°

4s/9s

Skanray Microskan Scan DRangle 70 μm (2D) / 140 μm (TOMO) 15°

Power

Weight

Power

67 cm

530 kg

20 / 32 / 40 / 50 kW

67 cm

530 kg

Width

Highlights • Fully integrated digital mobile Highlights X­ray system • Fully integrated digital mobile • Completely motorized and very X­ray system easy to manoeuvre: can be • Completely motorized and very controlled with one hand easy to manoeuvre: can be • The AeroDR detector can easily controlled with one hand be stored and at the same time • The AeroDR detector can easily automatically charged in the bin, be stored and at the same time even during driving automatically charged in the bin, • 100 % wireless communication for even during driving effortless usage at patient's bedside • 100 % wireless communication for effortless usage at patient's bedside

R/F Hologic DIGITAL · 3Dimensions

Weight

20 / 32 / 40 / 50 kW Power

Highlights • Unique new detector with Hexagonal pixels for fast, low dose examinations • Tomosynthesis: Dual angle approach to tomosynthesis, and its unsurpassed 50 micron pixel output, better support breast screening and diagnostic mammo­ graphy needs • Intelligent AEC (iAEC) optimizes the X­ray dose for each breast type • Dedicated mammography acquisition Workstation (AWS)

Pixel size

Konica

Width

Konica

26 – 32 k

26 – 32 k

Highlig • Fully in Highlig system • Fully in • The Ae system stored • The Ae matica stored matica

• Retractable, telescopic column • Detector sharing with X­ray rooms • Retractable, telescopic column • Detector sharing with X­ray rooms

Mindray Medical · MobiEye 700 Mobile System version Shimadzu · MobileDaRt Evolution MX8 –DR Pediatric Weight Width · MobiEye 700 Mobile DR System Weight Width

Power Mindray Medical Power

30 32 kW kW / 50 kW Power 30 kW / 50 kW

Scan type

3.7 s

47 cm 56 cm Width 47 cm

Primax Shima

Power Primax Power

370 kg 440 Weightkg 370 kg

40 kW kW 32 Power 40 kW

2.8kW, 200kHz, 60mA with APR Highlights • Hand-held and integrated console Highlights for parameter setting and exposure Acontrol Breast Tomosynthesis Exam with Results Like No • 90° collimator rotation tube-head exam: Other. Only the Hologic 3D&Mammography •rotation Proven to detect up to 65 % more invasive breast • cancers Flat panel with ISS & Smart thandetector 2D alone.* Switch technology with CsI (Cesium • The only mammogram FDA approved as superior Iodide) Scintillator for women with dense breasts compared to 2D • 2304 x 2880 Pixels/150 μm pixel mammography. pitch ••Approx More than 200 studies demonstrate the exam’s 1 to 8 sec. Cycle time (wired clinical approx efficacy.11 sec. Cycle time mode); Now you can have these clinically proven results • Detector’s external size (wireless mode) 384x460x14.8 mm/3.5 kg • Wireless standard IEEE 802.11n,3D Mammography with the new Hologic-3Dimensions system. for NICU, ICU, Trauma, GHz; *5.2 Results fromBattery Friedewald,recharging SM, et al. “Breasttime cancer-screeningSuitable using tomosynthesis in combination with digitalmammography. ” JAMA 311.24 (2014): 2499-2507 Ortho & Ambulance Approx. 3h

Highlights • Marvelous Mobility with Highlights intelligent operation • Marvelous Mobility with • Bionic design manipulator with Highlights intelligent operation high flexible mechanical • eight High­sensitive wireless FPDwith type Bionic design manipulator joints CXDI­810C (CsI, 14 × 11") eight high flexible mechanical Superior Power •• joints Handling benefitmanagement through easy technologye.g. in standard incubators placement, • Superior Power management Remote motion control remote •• technology X­ray images within twoand seconds control operating • exposure Easy and advanced Remote motion control and remote • functions 19 Inch Multiple­touch Screen exposure control • 19 Inch Multiple­touch Screen

Protec Proslide 32 B · Mobilett Elara Max Siemens· Healthineers · Proslide 32 BWidth Footprint

CARESTREAM DRX-Revolution Hologic · SmartCurve – Breast Stabilization System

Power Protec Power

Pixel size Highlights

Power

Scan angle

–• The tube head and collimator –

• Energy saving collimator with a bright irradiation filed through LEDs Lighter and smaller •• Fully DICOM compliant High reliability and compatibility •• WLAN connectivity Lighter and smaller •• mAs Detector auto­charging 0.32and – 320 High range: reliability compatibility • Detector auto­charging

32 kW kW 35

Scan type

32 kW

57.6 cm 127.8 cm (l) × 59.8 cm (w) Width 57.6 cm

Protec SIUI ·

Power Protec Power

Weight Weight

kW 232 kW Power 32 kW

397 kg 380 kg Approx. Weight 397 kg

are smaller, lighter and better balanced, for easier use and faster positioning.

Highlights • Display screens are more More comfortable mammograms. responsive, with enhanced More satisfied function, andpatients. redesigned to against liquidapplies •better Curvedprotect compression surface ingress. uniform compression over the entire • breast. Brakes and drive motors quieter and lesscomfort likely toin 93 % •are Shown to improve disturb patients. of patients who reported moderate severe discomfort with standard • toFunctional LED lighting provides the technologist with compression paddles.* point of visibility of •another Processing software takes paddle system status. geometry into account, so there’s no impact on image quality.*

• There’s no change in positioning tech­ nique or workflow for technologists. • Can be used with a MammoPad breast cushion for additional cushioning and increased tissue capture.**

* In an internal study comparing Hologic’s flat paddle to the SmartCurvE paddle (18 × 24cm) ** Coryell T. Increasing Mammography Tissue Acquisition through Positioning Training and Use of a Foam Breast Cushion.

RADBOOK 2019

Highlights • High­end, fully digital mobile X­ray system • Compact system design, easy maneuverability, flexible positioning Highlights with the MAXreach arm and consist­ • ently High­end motorized mobile X­ray system high­quality images Highlights Powerfulantimicrobial 32 kW generator for and ••• Unique coating • The MAX effect: Combine with other High­end motorized mobile X­ray system comprehensive application range easy­to­clean design MAX systems for additional benefits • Powerful 32 kW generator for arm enables •• Telescopic Intuitive and fully digitalperfect in standardization, savings and syngo comprehensive application range positioning even in difficult conditions satisfaction FLC workflow, wireless • Telescopic armexcellent enables perfect • connectivity, Front sensorsvirtual to avoid collision and • Detector: 35 × 43 cm (MAX wi­D) workstation positioning even in difficult conditions • cybersecurity System autonomy of > 8000 mAs 24 × 30 cm (MAX mini) package • Front sensors to avoid collision • System autonomy of > 8000 mAs

114 Stephanix 114 Power

· Movix 4 / 8 DReam Width

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Stepha Power


EVENTS AHPI GLOBAL CONCLAVE 2020 Date: 7-8 Feb, 2020 Location: Ramaiah Medical College,

Auditorium City: Bengaluru Organizer: Association of Healthcare

Providers, India (AHPI) Click: http://ahpi.in/ahpi_global_conclave/

index.html Contact: Shikhar Gupta - Assistant Director 9540859694

H

ealthcare has firmly become political agenda and that makes it receiving dueattention by policy maker sand powers that be.Government will be promoting social welfare health insurance schemes, it will bringe normous pressure on hospitals to financial sustain owing to inherently lowre imbursement models.

Hospitals will be expected to partner the government led initiatives forclean drinking water, nutrition, clean environmentan duse of tele-health in screening for NCDs. It will give push for hospitals to be truly LEAN, GREEN and SMART. Allinall, healthcare is going to be in new AVATAR in next decade. The AHPI conclave will capitulate all dimensions of this AVATA Rand how it will impact all stake holders including Patient, Provider, Payer, Pharmaceuticals, Medical Technology and Government/Regulating Bodies etc. The conclave will also encompass the unique blend of 6th edition of ’ AHPI AWARDS for Excellence inHealthcare’ in defined categories and will be presented over Galad inneroneve of 7th February 2020.

MEDICALL 2019

ARAB HEALTH 2020

Date: April 3-5, 2020 Organiser: HITEX Exhibition CenterIzzat City: Hyderabad Contact: Mr. K Sundararajan, 91-7305789789 Click:nfo@medicall.in

Date: Jan 27-30, 2020 Venue: Dubai WTC City: Dubai Click: www.arabhealthonline.com Organiser: Informa Markets Contact: ahcongress@informa.com

Medicall is India’s largest B2B trade fair for medical devices and hospital supplies. Approx. 750 exhibitors and 15,000 trade visitors from over 20 countries, among them physicians, but also biomedical engineers, sales people, decision makers, consultants and hospital owners, are represented at this important industry event. In addition to the presentation of the best and the latest medical and medical-technical equipment, software, supplies and other devices the market has to offer the fair mainly serves as a platform to exchange knowledge and experiences among renowned industry experts. Various conferences and innovation awards in different categories complement the event.

For 45 years Arab Health has brought you the latest innovations in healthcare. From stateof-the-art imaging equipment to the most cost-effective disposables; developments in surgery to advances in prosthetics, Arab Health continues to be at the heart of healthcare in the Middle East. As the largest collection of healthcare product manufacturers and service providers under one roof, Arab Health is your onestop shop for all your healthcare sourcing and procurement needs. With thousands of products to explore, coming in from more than 66 countries, make sure you don’t miss this essential business medical event in Dubai. The show is free to visit. Arab Health prides itself as the leading

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January 2020

healthcare business platform in the Middle East. Connecting manufacturers and service providers with clinicians, procurement professionals, dealers and distributors is the primary goal of the event. Leverage the success of the show and make key business contacts by utilising our multiple channels to connect you to the region’s healthcare industry.

MEDICAL FAIR INDIA 2020 Date: Mar 5-7, 2020 Venue: Bombay Convention & Exhibition

Center City: Mumbai Organiser: Messe Düsseldorf GmbH Contact: JoshiS@md-india.com MEDICAL FAIR INDIA is India’s leading Trade Fair for the medical and healthcare industry. For the last 25 years, Medical Fair India has been successfully addressing the various needs of Hospitals, Health Centres& Clinics. The main segments on display at MEDICAL FAIR INDIA 2019 include: medical products and devices, laboratory technology and diagnostics, clinic and health centre furniture, and the health IT segments now so on trend the world over as well as mobile health solutions.

CRITICARE 2020 Date: Feb 26-27, 2020 Venue: Hyderabad International Convention

Center City: Hyderabad The 26th Annual Conference of “Indian Society of Critical Care Medicine”, CRITICARE 2020, will have exciting and informative scientific programme that will be broad and varied, encompassing plenary lectures, breakout sessions and workshops by renowned National & International experts. The programme will feature streams with a wide variety of topics, taking into consideration conference theme, ‘PRECISION IN INTENSIVE CARE” enabling visitors to tailor the programme specifically to their own interests and clinical practice, as well as information packed Pre Congress Workshops.


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