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EDITOR’S NOTE I N I M AG I N G | 2 0 24
Viveka Roychowdhury, Editor viveka.r@expressindia.com
IRIA 2024 to imagine the next in imaging
W
ith the tagline line, IMAGING - BEYOND IMAGINATION, the 76th Annual Conference of The Indian Radiological & Imaging Association (IRIA) in Vijayawada from January 25th to 28th, 2024 promises to be four days of intense networking with peers, catching up with the latest trends across modalities. All in all, the event is geared to fulfil the pledge of organising chairman Dr Mohan Prasad GV to ensure that India’s radiology fraternity is "AHEAD OF TIMES IN IMAGING". A must attend session on day one at the conference would be the Royal College of Radiologists’ Radiology Events and Learning (REAL) update, with the lead session focusing on ‘learning from errors without blame or shame (by Dr Jonathan Smith (UK)) followed by Errors and Uncertainty in Diagnostic Radiology (Dr Michael Bruno US). Dr Ram Chittal (UK) then will share the top lessons from cases published in REAL newsletters, followed by a session on the role of AI in reducing radiology errors Dr Sridhar Redla (UK). Another session by Dr Mandeep Garg, on the ‘long tail of COVID 19- Lessons learned’ would also rate among the most attended sessions. Dr Vikram Khanna’s talk on how strong imaging is making a difference in emergency trauma settings, would no doubt highlight the role of a valued radiologist of
IN IMAGING / 2024
the trauma team, an acknowledgement of the widening acceptance of radiology and radiologists in multiple healthcare delivery settings. Balancing the clinical sessions, day 4, hall D has the Radiology Renaissance track, acknowledging that radiologists are also human beings and need to consider ‘Healing from Within: The Role of Lifestyle Medicine for Radiologists’ (Dr Mukesh Gupta). They also need to pursue their ‘Financial Empowerment: A Radiologist's Guide to Economic Literacy’ (Dr Pramod Lonikar) as well as consider ‘Entrepreneurship in Radiology’ (Dr Sumer Sethi). With patients becoming more assertive, ‘Medicolegal aspects of Radiology’ (Dr Chaitanya Tapasvi) and ‘PCPNDT ACT - Red flags for radiologists’ (Dr Nadarajan) would be good primers and catch up sessions on how these legal missteps can be avoided. Quite a few sessions across all days talk about the expanding use of new tech like artificial intelligence (AI), machine learning (ML) in radiology, the opportunity of teleradiology to serve patients in non-metro areas, etc. There is a dearth of radiologists in India, with IRIA’s records putting the number at just around 20,500 radiologists to serve a population of 1.4 billion. New tech is the obvious answer, with AI, ML etc stepping in to speed up the diagnosis process, allowing
hospitals in metro areas to expand their business to the surrounding areas, receiving scans and sending back reports. As the volumes of such remote diagnosis increases, with radiologists getting less time per scan, AI is being seen as an enabler. In the same vein, a recent paper in a recent edition of The Lancet Regional Health - Southeast Asia , titled, ‘Teleradiology and Technology innovations in radiology: status in India and its role in increasing access to primary health care’, focuses on the inequitable distribution of radiology facilities in India and how teleradiology could help address some part of this problem. The scoping review suggests that teleradiology when combined with AI and mobile digital imaging units, can address radiologist shortages, as well as strengthen programmes aimed at population screening and emergency care. However, The Lancet study struck a cautionary note, concluding that there is insufficient data on the scale of teleradiology networks within India; needs assessment; cost-effectiveness; the facilitators and barriers for implementation of teleradiology and newer technologies solutions in primary healthcare settings. Also, regulations governing quality standards, data protection, and confidentiality are as yet unclear in the country. One hopes that these aspects too come up for debate/discussion at the upcoming IRIA convention.
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CONTENTS IN IMAGING | 2024
INTERVIEW P12: Dr (Lt Col )Priscilla Joshi, Prof and Head-Department of Radiodiagnosis, Vice Principal PG Academics, Bharati Vidyapeeth (DU) Medical College, Pune COVER STORY P17: Dr Sanjay Dhawan
P19: Dr Aarushi Garg
Head-Radiology & Imaging, Paras Health and Group Director, Clearmedi Healthcare
Consultant & Unit Coordinator-Radiology & Imaging, HCMCT Manipal Hospital, Dwarka
P17: Dr Reddi Prasad Yadavali Chairman, HOD & Consultant – Interventional Radiology, Manipal Hospital Old Airport Road
P17: Dr Naveen Chandrashekhar Consultant Interventional Radiologist, Gleneagles Hospital Kengeri, Bengaluru
P18: Dr Anita Aggarwal Director & Chief of Radiology, Indian Spinal Injuries Centre, New Delhi
P18: Dr Rajeev Sivasankar, Senior Consultant Neurology & Peripheral IR & HOD-Imaging and Interventional Radiology, Fortis Hospital Mulund
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P20: Dr Arjun Kalyanpur Founder CEO and Chief Radiologist, Telerad Group
P20: Dr Vikas Rastogi (Col) Senior Consultant & Director, Interventional Radiology, Radiology, Dharamshila Narayana Superspeciality Hospital, Delhi
P21: Dr Ayush Jain Consultant Radiologist, Primus Super Specialty Hospital
P22: Dr Gur Prasad Vasishtha Director-Imaging & Radiology, Asian Hospital Faridabad
P19: Dr Syed Tauqueer Fazal
P22: Dr Meinal Chaudhry
Head & Coordinator-Diagnostic Radiology, Artemis Hospital, Gurugram
Director-Radiodiagnosis and Intervention Radiology, Aakash Healthcare, New Delhi
P19: Dr Gaurav Malhotra
P22: Ravi Ramakantan
Sr. Consultant, Radiology, Sri Balaji action medical institute, New Delhi
Honorary Consultant, Radiology, Kokilaben Dhirubhai Ambani Hospital, Mumbai
IN IMAGING / 2024
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IMPRINTLINE
P24: Dr Janardhana Reddy
Chairman of the Board
Consultant-Radiology, SRV Hospitals
Viveck Goenka Sr.Vice President-BPD
P24: Dr Nikhil Kamat Head-Department of Radiology and Consulting Radiologist, Jupiter Hospital, Thane
Neil Viegas Vice President-BPD Harit Mohanty
P24: Dr Aakaar Kapoor CEO and Lead Medical Advisor-City X-Ray and Scan Clinic
Editor Viveka Roychowdhury* Editorial Team
INSIGHT
Lakshmipriya Nair Kalyani Sharma
32 Partnerships in radiology: Aiming for better public healthcare 34 HIFU for prostate cancer: Ongoing research and future trends
DESIGN Art Director
36 AI-powered imaging: A game-changer in early detection of breast cancer
Pravin Temble
37 Revolutionising cancer care: Power and precision of MR linac technology
Senior Designer Rekha Bisht
38 Transforming healthcare: Impact of AI on radiology and imaging Senior Artist
39 Technology trends in imaging
Rakesh Sharma
PRODUCT UPDATE
Marketing Team
Empowering Healthcare Providers with Advanced Imaging Technology for
42 Precision Diagnostics and Enhanced Patient Care
45 Phantom Healthcare is revolutionising the refurbished radiology market Transforming medical imaging: Allengers' advanced remote controlled
46 digital radiography and fluoroscopy systems 48
Rajesh Bhatkal Douglas Menezes Ashish Rampure Production Co-ordinator Dhananjay Nidre
Conquering radiology's challenges with AI: DeepTek.ai leads the way
Scheduling & Coordination
50 FUJIFILM India paving the way for innovations in healthcare
Pushkar Waralikar
52 Konica Minolta’s Dynamic Digital Radiography (DDR)
CIRCULATION
54 Sequoia Healthcare introduces the inspiration 64 Slice CT Scanner IN IMAGING / 2024
Mohan Varadkar
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INTERVIEW
Present dayradiologist is leaning towards “subspecialisation” Dr (Lt Col )Priscilla Joshi, Prof and Head-Department of Radiodiagnosis, Vice Principal PG Academics, Bharati Vidyapeeth (DU) Medical College Pune in an interaction with Express Healthcare talks about the training and education of next gen radiologists in India and Dynamic Digital Radiography (DDR)
Can you provide an overview of the current state of radiology in India? How has the field of radiology evolved over the years in the country? India has seen evolution in the field of radiology in many ways ◆ Technological advancements : There has been a surge in in the adaptation of advanced imaging techniques like MRI , CT and PET CT as well as digital mammography. Technology offering higher precision and better imaging quality with reduced ionising radiation is being resorted to, keeping in view the ALARA principle. Teleradiology and telemedicine services have grown with the expansion of digital infrastructure allowing remote interpretation of images. This has improved accessibility to radiology services in some of the remote areas. ◆ Subspecialisation: Instead of being a “Jack of all trades and Master of none” the present day radiologist is leaning towards “subspecialisation” in specific areas like musculoskeletal imaging,
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TELERADIOLOGYAND TELEMEDICINE SERVICES HAVE GROWN WITH THE EXPANSION OF DIGITAL INFRASTRUCTURE ALLOWING REMOTE INTERPRETATION OF IMAGES
neuroradiology, paediatric imaging, woman’s imaging, body imaging, onco imaging and interventional radiology. This is especially important when interpreting complex cases . A number of subspeciality imaging bodies are also there with regular annual subspeciality conferences. Here I must mention that Interventional Radiology (IR) has over the years developed into a superspeciality and a large number of patients benefit from this as a number of conditions can be treated or assisted by interventional radiology procedures reducing the morbidity and mortality. ◆ Maintaining quality: With NABH (National Accreditation board for Hospitals) being implemented in most hospitals and diagnostic centre , there is a focus on strictly adhering to the norms and standards hence ensuring patient safety, comfort as well as high imaging standards. ◆ Medical education, research and collaboration: There has been
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a change in the syllabus for MD Radiodiagnosis over the years along with certain minimal requirements of the National medical commission as far as equipment and workload in Medical colleges is concerned. This ensures adequate exposure for the post graduate students. Doing away with the Diploma (DMRD) was also a step in the right direction as nobody can learn Radiodiagnosis in 2 years. More collaborations with sister institutions as well as international institutions in the recent past have encouraged more research. ◆ Patient centric: Radiology is now more patient centric reducing radiation dose , increasing patient comfort, improving communication with patients and referring doctors. This has resulted in improved patient care and satisfaction. How is the training and education of radiologists in India evolving to keep up with technological advancements? The requirement for trained radiologists has increased in view of the increase in the number of modalities and sophisticated equipment available. Public awareness of the applications of sophisticated imaging techniques has also increased with rising health awareness, lifestyle diseases and growing elderly population. When we trained as radiologists (1982 – 1985) there was just conventional Xray machines/ radiography equipment available . The first few ultrasound machines had just come in and the first Static ultrasound machine had come to the
IN IMAGING / 2024
DDR GOES BEYOND STATIC IMAGES PROVIDED BY TRADITIONALX-RAYS OR EVEN STANDARD DIGITAL RADIOGRAPHYBY CAPTURING ASERIES OF IMAGES OVER TIME
Department of Medicine (not Radiology) at the BJ Medical College and Sassoon Hospital where I did my MD. The CT scan was a “Head CT scan” machine at Ruby Hall clinic and the first 0.5 Tesla Shimadzu MRI machine was installed in Poona at Ruby Hall Clinic around the same time. The first MR machines was installed at INMAS New Delhi and Breach Candy Mumbai . As residents we had to try to get conversant with these modalities and start reporting scans over a period of time. Residents now have all modalities available wherever they train (as per National Medical Commission guidelines) and exposure to their applications and imaging findings are part of their training. More “hands on training” and practical exposure help the radiologists in training to become proficient in using advanced technology. Collaborations with international institutions and research centers allow exposure to cutting-edge research, fostering innovation and
knowledge exchange in the field. There are a number of CMEs and conferences which are broad speciality as well as subspeciality along with “Hands on” workshops which teach them to hone their skills. These are both online and offline, the former being the norm during the recent COVID pandemic. There was no dearth of teaching for the residents during the pandemic and thereafter. What role do you foresee partnerships playing in the future of radiology in India? Are there emerging trends or areas where collaborations are expected to grow? Partnerships in the future of radiology in India are expected to play a crucial role in several areas: ◆ Technology adoption and access: Collaborations between healthcare institutions and technology providers can facilitate the adoption of advanced imaging technologies as they would enable access to cutting-edge equipment, software, and expertiseTelemedicine and teleradiology services: Collaborations between radiology departments, telemedicine platforms, and IT companies can enhance teleradiology services, leading to improved accessibility, timely reporting, and remote consultations, especially in areas with a shortage of radiologists. ◆ Education and training, research and innovation: Partnerships between medical institutions, industry and academic bodies can enhance radiology education and training. Joint
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programs, workshops, and knowledge exchange initiatives help keep professionals updated with the latest advancements. Joint research initiatives can lead to the development of new imaging techniques, AI applications, and diagnostic tools. ◆ Subspecialty expertise: Collaborations between hospitals and specialised radiology centers facilitate sharing of expertise in subspecialty areas leading to improved patient care, accurate diagnoses, and better management especially in complex cases. ◆ Quality assurance and standards: Quality standards in radiology practice can be ensure with collaborations between regulatory bodies, healthcare institutions, and professional associations ensuring adherence to guidelines, patient safety, and consistent quality of services across the country. Are there specific challenges unique to the Indian healthcare system that impact radiology practice? India has unique challenges due to the large population, diversity and the urban – rural divide. Challenges faced are: ◆ Inadequate access to advanced imaging technology in remote areas limiting accurate timely diagnosis. ◆ Cost and accessibility: Affordability is a major concern – restricted access to advanced imaging techniques. ◆ Data management and integration: The systems for managing patient data vary across various health providers hindering
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seamless treatment and diagnosis. All this would require significant investment in infrastructure , technology to ensure better accessibility and affordability as well as quality of radiology services across India. How would you define digital radiography, and how does it differ from traditional radiography? Digital radiography involves capturing of radiographic/ X-ray images using digital sensors rather than traditional film based techniques used earlier where the images had to be chemically processed before viewing. in digital radiography the X-ray Flat panel detectors are used in place of the conventional X-ray films and cassettes. The image is recorded onto a digital sensor allowing immediate image acquisition and manipulation. Easy image storage, retrieval and transmission of images is possible so that multiple healthcare professionals can access the images immediately. Image quality is better controlled reducing the number of retakes. The radiation dose is also lower. Can you share your experience with adopting Dynamic Digital Radiography (DDR) technology by Konica Minolta in your facility? DDR is an advanced imaging technique that captures X-ray images in real time allowing for the visualisation of moving body structures and functions. It goes beyond static images provided by traditional X-rays or even standard digital radiography
by capturing a series of images over time. It uses a conventional Xray machine with advanced detectors and software-Xray images are reconstructed into a dynamic video like sequence. My first exposure to DDR was at the IRIA 2020 in Gandhinagar-just pre-COVID when I visited the Konica stall and saw a video film on it . It seemed to be a very promising and exciting development, so when we were looking at acquiring a new DR (our previous DR is also Konica’s first installation in India) and we were offered this machine as the first installation in India – I was quite excited about it. Of course none of us really knew all its applications and capabilities and we are still discovering a number these with the help of the applications team from Konica. Evaluation of lung perfusion with a breath hold of 7 secs seems very promising and we have compared DDR with pulmonary angiography for detection of Pulmonary embolism. We had a paper presentation on this from our institute at the RSNA 2023. There are multiple installations in the United States and Japan as well as the United Kingdom . We visited the University of Alabama Hospital in Birmingham where they have a DDR installed and are doing many research projects. We are also looking at a couple of more studies in this direction as well as various orthopedic applications for the shoulder joint and maybe even the spine. I think this equipment is really worth investing in as far as academic institutes/medical colleges go.
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COVER STORY
EMERGING TECHNOLOGIES AND IMPACT
Beyond traditional image analysis, radiomics is a new field in medical imaging
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t focuses on obtaining various quantitative features from radiology images in order to diagnose, prognosticate, and predict outcome. Through exploring these fine-grained image characteristics, radiomics aims to improve
understanding of disease, design treatment, and personalise patient care. This novel approach has the potential to revolutionise the identification and management of a wide range of medical ailments, ushering in a period of healthcare that is more precise and effective.
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Dr Sanjay Dhawan, Head-Radiology & Imaging, Paras Health and Group Director, Clearmedi Healthcare
adiomics, a quantitative approach to extract valuable information from imaging data, is applied in screening large-parameter spaces for sensitive markers in diagnosis and response assessment. It utilises AI methods in medical fields, particularly oncology, to quantify textural information from imaging techniques like CT and MRI. This non-invasive method enhances precision medicine by correlating quantitative radiology data with clinical outcomes. Key steps include
Dr Reddi Prasad Yadavali, Chairman, HOD & Consultant – Interventional Radiology, Manipal Hospital Old Airport Road
initial image processing, segmentation for pathological identification, and feature extraction covering volume, shape, surface, density, and intensity of surrounding tissues.
Intervention radiology is the way forward
I
n the current era of patient care, medical specialities and super specialities have reflected tremendous upgrade in terms of technology, research and data driven evidence. Intervention radiology is largely a mini surgical spectrum where lot of advances has already happened globally and we in India are providing comparative treatments with good results to our patients. Intervention Radiology is the way
IN IMAGING / 2024
Dr Naveen Chandrashekhar, Consultant Interventional Radiologist, Gleneagles Hospital Kengeri, Bengaluru
forward as today we are not just helping patients with diagnosis but also providing them extensive treatment options with cutting edge technologies in terms of hardware and machines. Intervention radiology is also attracting lots of young radiologist who are motivated for further training to make themselves work closely with other physician and surgical colleagues in diagnosing and treatment of array of illness .
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AI: Ushering a new era of image interpretation
Dr Anita Aggarwal, Director & Chief of Radiology, Indian Spinal Injuries Centre, New Delhi
I
n recent years, India has undergone a revolutionary metamorphosis in the realm of healthcare, particularly within the dynamic field of radiology and medical imaging. What was once solely a diagnostic discipline has now evolved into an active participant in patient treatment, spearheaded by the integration of Artificial Intelligence (AI) and Machine Learning (ML) into radiology practices. This integration has ushered in a new era of image interpretation, vastly improving diagnostic accuracy and expediting decision-making processes for radiologists. Across the nation, healthcare institutions are fervently adopting AI-powered imaging tools. The primary goal is not only to reduce interpretation time but also to enhance patient outcomes through
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precise diagnostics. The impact of AI is particularly pronounced in ultrasound, where it is transforming the handling of vast amounts of data, leading to improved diagnostic precision and efficiency. Furthermore, the collaborative nature of healthcare facilities has been greatly facilitated by vendorneutral archives (VNAs). These archives extend beyond radiology, enabling the seamless storage and exchange of clinical content in various formats, promoting interoperability and comprehensive patient care. In the realm of public health management, AI has the potential to revolutionize care delivery, particularly through initiatives like Ayushman Bharat's Health and Wellness Centres (HWCs). AI can play a pivotal role in reading X-rays and sending reports to the relevant centers, addressing the shortage of professionals. Algorithmic intelligence, powered by vast datasets, aids in corroborating patient diagnoses based on signs, symptoms, and other reports.
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n healthcare, particularly in Radiology, AI plays a pivotal role in image analysis, aiding the interpretation of complex imaging data, lesion detection, treatment planning, and predicting patient outcomes. AI salience software assists radiologists by highlighting and prioritising regions of interest within the vast number of medical images generated by scans, significantly improving efficiency
Dr Rajeev Sivasankar, Senior Consultant Neurology & Peripheral IR & HOD-Imaging and Interventional Radiology, Fortis Hospital Mulund
and accuracy. For instance, commercially available AI Stroke software is integrated with MRI or CT perfusion studies for patients with Acute Ischemic Stroke. This software rapidly generates colour maps, clearly delineating salvageable areas of the brain, thereby expediting decision-making for emergency stroke treatment. During the COVID-19 pandemic, the development of AI-based software for Chest X-ray and CT scan interpretation further accelerated the adoption of AI in Radiology. The last two years have witnessed the inception of robotassisted interventional neuroradiology procedures for cerebral aneurysms. It's only a matter of time before radiology and medicine experience a profound
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and widespread integration with AI, revolutionising the field and enhancing overall patient care.
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I contributes to workflow optimisation in radiology departments by automating routine tasks, allowing radiologists to focus on complex cases that require human expertise. The integration of AI in Radiology not only augments diagnostic capabilities but also holds the potential to improve resource utilisation, reduce
Dr Syed Tauqueer Fazal, Head & Coordinator-Diagnostic Radiology, Artemis Hospital Gurugram
healthcare costs, and enhance overall patient outcomes. Despite these advancements, challenges such as data privacy, regulatory compliance, and the need for ongoing validation persist. Continued collaboration between technologists, radiologists, and policymakers is crucial to harness the full potential of AI in Radiology and Imaging, ensuring its seamless integration into clinical practice while upholding patient safety and privacy standards.
The emergence of teleradiology and telemedicine is revolutionising the landscape of healthcare in India
Dr Gaurav Malhotra, Sr. Consultant, Radiology, Sri Balaji action medical institute, New Delhi
T
eleradiology refers to practice of radiologist interpreting medical images while not physically present in the location where images are generated.
IN IMAGING / 2024
Teleradiology, a key component of telemedicine, allows for the remote interpretation of medical images, effectively bridging healthcare gaps in rural and underserved areas. This transformative integration not only enhances accessibility but also promotes more equitable healthcare access across the nation. Apart from financial reasons where small centres with less volume of radiology patients can have access to accurate diagnosis, teleradiology also helps to get second opinion and can be life saving in particular cases. As India embraces these technological advancements, the impact of teleradiology promises a future where healthcare is not only more accessible but also increasingly personalised and efficient with a 24/7 access to medical facilities even in the remote places.
Dr Aarushi Garg, Consultant & Unit Coordinator-Radiology & Imaging, HCMCT Manipal Hospital, Dwarka
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adiology is a field of medicine which has a vast potential. We have emerged from X rays to present state of art diagnostic techniques like MRI, C T coronary
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angiography, perfusion imaging, spectroscopy and tensor imaging. Enormous scope has further been revealed in radiology with tele radiology, artificial intelligence and digital imaging stepping into this world. Teleradiology involves the remote transmission of radiological images for interpretation of radiologists. It facilitates faster diagnosis and expert consultations especially in areas with limited access to health care professionals. This way even a remote village in far away areas has now got best diagnostic consultations.
T
he dominant trend in Radiology and Imaging today continues to be that of ongoing crippling
Dr Arjun Kalyanpur, Founder CEO and Chief Radiologist, Telerad Group
Radiologist shortages, which show no sign of abating. Industry experts observe that the shortage is the worst that has been seen in the past several decades and is likely to last for the foreseeable future. Given this scenario, there is a corresponding rapidly growing need for teleradiology support, as demonstrated by market reports that show ongoing robust increase in market size of the teleradiology industry. In parallel there is a strong trend especially in the US and Europe, towards AI adoption into radiology workflow. At this time, algorithms in the space of Acute Stroke detection are of maximum clinical impact given the public health impact of stroke.
Digital imaging: The game-changer
T
he landscape of medical imaging is undergoing a profound transformation as the traditional realm of two-dimensional imaging yields ground to the advancements in 3D and 4D imaging techniques. These innovations usher in a new era of medical diagnostics, offering a more comprehensive understanding of anatomical structures and introducing the dimension of time to assessments of organ function. In fields such as cardiology, obstetrics, and oncology, the shift to 3D and 4D imaging is proving to be a game-changer. These advanced techniques provide enhanced visualisation of intricate medical conditions, elevating the precision of
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Dr Vikas Rastogi (Col), Senior Consultant & Director, Interventional Radiology, Radiology, Dharamshila Narayana Superspeciality Hospital, Delhi
diagnoses and refining treatment planning. The fourth dimension, time, allows for dynamic assessments, particularly valuable in understanding the evolving nature of conditions over time. The integration of multiple imaging modalities through fusion imaging is another significant development, providing a more comprehensive and detailed view of anatomical structures and pathological conditions. In oncology, combining technologies like positron emission tomography (PET) with computed tomography (CT) or magnetic resonance imaging (MRI) enhances diagnostic accuracy, enabling tailored treatment plans with unprecedented precision.
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SKILLING AND TRAINING
Key aspect of preparing the next generation of radiologist involves integrating AI into the curriculum
I
n an era marked by rapid technological advancements and evolving healthcare landscapes, the preparation of radiologists for the future is paramount. As medical imaging continues to play a pivotal role in diagnostics and treatment planning, training the next generation of radiologists becomes a crucial endeavor. The future of radiology is shaped by various factors, including technological innovations such as AI, advanced imaging modalities, and the increasing integration of digital health solutions. To equip aspiring radiologists with the skills and knowledge necessary to navigate this dynamic landscape, training programs must adapt and evolve. One key aspect of preparing the next generation of radiologists involves integrating AI into the curriculum. AI has demonstrated its potential in improving diagnostic accuracy and efficiency, and radiologists of the future must be adept at leveraging these technologies. Training programs should focus on developing a nuanced understanding of AI algorithms, ensuring that radiologists can collaborate effectively with these tools to enhance patient care. Additionally, exposure to cuttingedge imaging modalities is crucial for staying ahead in the field. Training programs should provide hands-on experience with emerging technologies such as 3D imaging, molecular imaging, and functional MRI. Familiarity with these
IN IMAGING / 2024
Dr Ayush Jain, Consultant Radiologist, Primus Super Specialty Hospital
EXPOSURE TO CUTTING-EDGE IMAGING MODALITIES IS CRUCIAL FOR STAYING AHEAD IN THE FIELD.TRAINING PROGRAMS SHOULD PROVIDE HANDS-ON EXPERIENCE WITH EMERGING TECHNOLOGIES SUCH AS 3D IMAGING, MOLECULAR IMAGING, AND FUNCTIONALMRI modalities not only broadens the diagnostic capabilities of radiologists
but also ensures their proficiency in interpreting results from the latest advancements in medical imaging. Furthermore, cultivating a multidisciplinary approach to training is essential. Radiologists increasingly collaborate with other healthcare professionals, contributing to a holistic approach to patient care. Interdisciplinary training, including collaboration with clinicians, pathologists, and technologists, enhances communication skills and promotes a comprehensive understanding of patient cases. As healthcare systems worldwide strive to enhance efficiency and reduce costs, radiologists must also be trained in practices that prioritise value-based care. This involves understanding the economic implications of imaging decisions and actively participating in initiatives aimed at optimising resource utilisation. In conclusion, preparing the next generation of radiologists for the future involves a multifaceted approach. From embracing AI and advanced imaging modalities to fostering interdisciplinary collaboration and instilling a commitment to value-based care, training programs must evolve to meet the challenges and opportunities that lie ahead. By doing so, we can ensure that radiologists continue to be at the forefront of medical innovation and contribute to improved patient outcomes in the years to come.
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Preparing the next generation of radiologists involves navigating a sea of innovations
Dr Gur Prasad Vasishtha, Director-Imaging & Radiology, Asian Hospital Faridabad
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reparing the next generation of radiologists involves adapting to the evolving landscape of technology in
radiology. Advancements in radiology are happening faster than ever. New technologies are changing how radiologists work, giving clearer images and faster, accurate results from machines they interact with. The significance of radiology has grown immensely due to the advent of cuttingedge imaging technologies, but many radiologists face challenges in keeping up with these advancements..
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adiology is undergoing a profound transformation fueled by cuttingedge technologies. Preparing the next generation of radiologists involves
Dr Meinal Chaudhry, DirectorRadiodiagnosis and Intervention Radiology, Aakash Healthcare, New Delhi
navigating a sea of innovations, ensuring that they not only understand but master these advancements.
We are far away from the time when AI will replace radiologists
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I technology is likely to improve in leaps and bounds in the next few years. However, we are far away from the time when it will replace radiologists for image interpretation. In fact, this will never happen. On the other hand, one thing is certain. Some of the work of radiologists will be taken over by machines that will read images to a greater or lesser extent for better or worse. What is certain is that an average diagnostic radiologist is likely to have “free time” on hand. How we use that to contribute to better patient care is not a challenge but an opportunity. This is what I see being done during that time. For one thing more radiologists may take to performing sonography and interventions. Perhaps, then sonographers will be replaced and radiologists will have to learn the skill of
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Ravi Ramakantan, Honorary Consultant, Radiology, Kokilaben Dhirubhai Ambani Hospital Mumbai
proper scanning of patients. On the other hand, a diagnostic radiologists could join their referring physicians on patient rounds, a healthy dialogue can take place where the
radiologist understands - first hand -the clinical indications for a study. This is also an opportunity for the radiologist to tailor make the order of radiological exanimation is such a way that the answer to the clinical question is available with the least number of studies reducing radiation exposure. Once so deeply involved in patient care, such radiologists can also schedule patient studies better to reduce waiting time. In effect, image interpretation will become more and more clinically driven and communications between radiologists and patients will become more meaningful. In essence, a radiologist will have to learn are better communication with patients and dialogues with referring physicians. along the way – learning bedside skills.
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PARTNERSHIP IN RADIOLOGY
Fostering collaboration between technology developers, healthcare professionals, and regulatory bodies
Collaborations facilitate the exchange of knowledge, ostering collaboration between technology developers, F resources,and healthcare professionals, and regulatory bodies is essential not only expertise
Dr Janardhana Reddy, ConsultantRadiology, SRV Hospitals
for fostering innovation but also for upholding the fundamental principles of patient safety and data confidentiality. Moreover, it is crucial that before making substantial technological investments, conducting thorough cost-benefit analyses is essential. Such evaluations enable healthcare institutions to prudently assess potential benefits against both financial and operational considerations.
PPPs hold promise in bolstering radiology training infrastructure
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iming for better public healthcare collaborations between industries and academia are crucial for enhancing radiology education. Modules focusing on medical imaging and partnerships with leading hospitals can provide practical experience, enriching the learning curve. Public- Private Partnerships (PPPs) hold promise in bolstering radiology training infrastructure, fostering investments in Centers of Excellence and skill development initiatives.
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Dr Nikhil Kamat, Head-Department of Radiology and Consulting Radiologist, Jupiter Hospital, Thane
Dr Aakaar Kapoor, CEO and Lead Medical Advisor-City X-Ray and Scan Clinic
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he synergy between industry and academia is crucial for developing advanced training programs. Collaborations facilitate the exchange of knowledge, resources, and expertise, ensuring that radiology education remains at the forefront of technological advancements. Industry-academia partnerships contribute to a wellrounded curriculum that combines theoretical knowledge with practical applications. PPPs play a pivotal role in creating a holistic approach to radiology education. By bringing together public and private entities, these partnerships foster innovation and the development of cutting-edge technologies. The collaborative environment nurtured by PPPs contributes to improved patient outcomes and better public healthcare services.
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Vision of 76th IRIANational Conference is to pioneer innovation in radiology Dr GV Mohan Prasad, Chairman, IRIA 2024, Vijayawada and Dr Kuldeep Chalasani, Organising Secretary, IRIA 2024, Vijayawada in an interaction with Express Healthcare shares goals and highlights of 76th IRIA National Conference In what ways does the 76th IRIA National Conference stand out from previous conferences? What specific goals does the conference aim to achieve in terms of advancing skills and knowledge in radiology? Dr Prasad: The 76th IRIA National Conference stands out by focusing on "Imaging Beyond Imagination" and incorporating newer technologies like Artificial Intelligence (AI). The inclusion of a vast faculty, a diverse range of scientific content, rare film displays, and a substantial trade exhibition sets it apart from previous conferences, fostering a holistic exploration of advancements in radiology. The conference aims to advance skills and knowledge in radiology by providing a platform for over 330 faculty members to share expertise. With around 1200 epapers and scientific posters, it promotes the exchange of cuttingedge research. The display of rare films, including the lifetime collection of late Prof Dr Kakarla Subbarao, enriches understanding, while workshops with worldrenowned specialists in Ultrasound contribute to skill
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Dr GV Mohan Prasad
Dr Kuldeep Chalasani
development. The extensive trade exhibition ensures exposure to the latest innovations, fostering continuous learning and professional growth.
and diagnostic practices. Through the participation of over 330 faculty members, diverse scientific content, rare film displays, and a comprehensive trade exhibition, the conference seeks to set a new standard for advancing knowledge, skills, and the overall landscape of radiology.
What is the vision and mission of this year's conference? Dr Prasad: The vision of the 76th IRIA National Conference is to pioneer innovation and collaboration in the field of radiology, exemplified by the theme "Imaging Beyond Imagination." The mission is to push the boundaries of imagination by exploring and integrating newer technologies, with a special emphasis on AI, into radiological
How do you envision the impact of the conference on the future of radiology and imaging practices? Dr Chalasani: Conferences of this magnitude play a crucial role in advancing knowledge and fostering collaboration. For radiology and Imaging practices,
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this conference could facilitate the exchange of cutting-edge research from the renowned radiologists across the globe, emerging technologies being showcased by OEM’s, best practices, driving innovation with latest in AI and improving patient care. It might also create networking opportunities for professionals, fostering interdisciplinary collaborations that could shape the future of the field in radiology. What message would you like to
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THE CONFERENCE AIMS TO ADVANCE SKILLS AND KNOWLEDGE IN RADIOLOGYBY PROVIDING APLATFORM FOR OVER 330 FACULTY MEMBERS TO SHARE EXPERTISE
convey to all the radiologists attending the 76th IRIA National Conference? Dr Chalasani: Embrace the opportunity to exchange insights, explore innovations, and build connections at the 76th IRIA National Conference. Your collective expertise fuels progress in Radiology, contributing to advancements that enhance patient care. Collaborate, learn, and inspire each other to shape the future of medical imaging practices.
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B-TACE Therapyis an advancement of TACE Dr Amar Mukund, Professor-Interventional Radiology, ILBS in an interaction with Express Healthcare talks about minimally invasive therapy B-Tace Provide details on the intricacies of Balloon-TACE (B-TACE) therapy. B-TACE Therapy is an advancement of TACE. TACE is the older therapy. To know B-TACE we need to first understand TACE. TACE is trans-arterial chemoembolisation which is a clinical-guideline recommended, minimally invasive management option for intermediate stage liver cancer. In this therapy, we go through the artery of the thigh, ascend upwards towards the artery of the liver and try to find the artery of the tumour. We then go inside that artery, which is supplying to the tumour, inject medicine and block it. But while injecting, some of the drug which should ideally go into the tumour, due to reflux goes to the normal part of the liver, which is harmful for the liver and on the other hand the tumour receives a lesser dose. In B-TACE (Balloon Trans arterial chemoembolisation), the microcatheter has a very fine balloon at its tip. This microcatheter is advanced into the small artery supplying blood to the tumour. Once we reach there, the balloon at the tip of the catheter is inflated which occludes the artery thus prevents any reflux of drug into the normal liver tissue.
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have taken the initiative of bringing this therapy.
Simultaneously a high dose of drug is injected into the tumour in a uniform manner, this balloon acts like a valve which allows the drug to selectively reach the tumour in high dose while preventing any reflux thus, sparing normal liver parenchyma. Hence a high treatment response is achieved with lesser side effects. Here, patients can benefit from more precise and targeted delivery of chemotherapy drugs to the tumour. This is associated with improved tumour response; thus, fewer repeat treatments are required as compared to TACE done using regular microcatheters. India is lucky that some companies
Who stands to benefit from this therapy? Normally TACE is done for primary liver tumours like Hepatocellular Carcinoma (HCC). Now there are many treatments for HCC right from the ablation to TACE and TARE. But each is indicated in different settings and different sizes of the tumour. TACE is generally recommended for the intermediate stage HCC, that is if the lesion (cancerous tumour) is neither in an early stage nor in a late stage. To be very specific BTACE should be a good treatment for lesions ranging from 3cm to 7cm. However, in the coming days we may use it for other primary tumours like Cholangiocarcinoma and benign tumours like hemangioma as well. How does this therapy compare to previous therapies in terms of usage and benefits? Previous therapy is TACE. In TACE we were unable to deposit the required dose of drug within the tumour as some amount of drug used to escape out from adjacent arteries into the normal part of the liver. We always wanted to prevent it, but the regular
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microcatheters had no mechanism to prevent this. With this Balloon microcatheter: we are able to preserve and spare the normal liver as there is no reflux of drug once the balloon is inflated. Further, it enables us to inject a much higher concentration of drug within the substance of tumour which leads to a much improved response and tumour death. One interesting aspect is that TACE is considered a palliative therapy as a complete cure is rarely achieved. So, now with the availability of B-TACE we may achieve complete tumour death (complete response) in some of the patients having tumour up to 5 cm thus achieving a complete cure. What is the duration of effectiveness for this treatment in patients? Unlike other chemotherapy which is intended to be given in cycles and fixed time periods such as every two weeks, three weeks or months, TACE requires one session and thereafter treatment response is assessed using a CT scan and next session is planned if there is any residual tumour (on demand TACE). As per initial results and data, B-TACE will give very good results in 3-5 cm tumours. These tumours generally require 2-3 sessions of TACE. But with B-TACE, they may be completely treated in one session. This is very beneficial as it can reduce time as well as the treatment cost for the patient. The initial expenditure might seem high, but it may turn out to be more
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IN THIS THERAPY,WE GO THROUGH THE ARTERYOF THE THIGH,ASCEND UPWARDS TOWARDS THE ARTERYOFTHE LIVER AND TRYTO FIND THE ARTERYOF THE TUMOUR cost effective in the long run. What are the potential drawbacks or limitations of BTACE? When a high amount of drug is being injected into the tumour followed by embolising the arteries supplying the tumour to achieve complete tumour death, sometimes some vital structure like biliary radicles also receiving blood supply from the same artery may get involved. This is especially problematic in patients having biliary dilatation as they may develop liver abscess. Thus, biliary dilatation is considered a contraindication for B-TACE. Similarly, patients having a large tumour (8 cm or more) should not get B-TACE. So, regarding drawbacks of this novel technique, TACE may be done for large tumours having size above 8 cm but B-TACE should not be done for tumours of size 8 cm or more due to severe side effects and complications. What are the prospects for the
future of B-TACE in India, and is it poised for scalability in the healthcare landscape? B-TACE is an exciting development. It’s a great therapy and would definitely give more patients the opportunity to get a complete cure. Previously only ablation was curative therapy. Most patients with large tumours are suitable for palliative care and some may be fit for combination of therapies like ablation and TACE to achieve complete response (cure). Now with B-TACE therapy, patients with tumours up to 5 cm may get a complete response with only 1 therapy. B-TACE can be performed either the conventional way using lipiodol-drug emulsion or using drug-eluting beads (DEB-TACE). It is a catheter which is making the therapy more effective. This balloon microcatheter is expanding the scope of the treatment. Previously the treatment was labelled as palliative care. B-TACE has the potential to make it curative care for some of the patients. Balloon microcatheter enabling B-TACE can be a revolutionary thing for patients being considered for TACE therapy. When a patient suffering from cancer gets an option of a complete cure, they will be eternally thankful to God. Still a long way to go. We are excited by the results so far. We further need to see how it works on our patients (Indian patients) with HCC. But it is definitely a good step in the right direction. I will be in a better position to give more inputs after a year or so.
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Synergyof radiation oncologyand immunotherapy Dr Vividha Dubey, MD Radiation Oncology, HCG hospitals emphasises that the complementary modes of action of radiation oncology and immunotherapy contribute to their synergy
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ancer has long been one of modern medicine’s most powerful rivals, costing millions of lives worldwide. While substantial progress has been made in cancer treatment, the search for more effective and less invasive medications continues. In recent years, the merger of radiation oncology and immunotherapy has emerged as a game-changing technique, giving cancer patients a fresh hope, and significantly increasing treatment outcomes. Traditionally, radiation therapy and immunotherapy were seen as separate concepts in the fight against cancer. For decades, radiation therapy has been a cornerstone in cancer treatment, involving the use of high-energy X-rays or other particles to target and treat cancer cells. Immunotherapy, on the other hand, uses the immune system’s ability to recognise and remove cancer cells. Each method has its own advantages, but their combined effect has proven to be synergetic.
producing a pro-inflammatory environment, making it easier for immune cells to recognise and target cancer cells. Immunotherapy, on the other hand, boosts the immune system’s reaction. Checkpoint inhibitors and adoptive cell treatments, for example, can prevent immune cells from detecting and destroying cancer cells by blocking inhibitory signals. When paired with radiation therapy, immunotherapy can produce a powerful immune response that targets both the main tumor and distant metastases, resulting in better local and systemic disease management.
Understanding the synergy The complementary modes of action of radiation oncology and immunotherapy contribute to their synergy. Radiation therapy not only kills cancer cells directly, but it also changes the tumor microenvironment, making it more prone to immune response. Radiation therapy functions as a “primer” for the immune system by stimulating the production of tumor antigens and
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Clinical benefits Combining radiation oncology and immunotherapy has shown clinical benefits in numerous cancer types, including melanoma, non-small cell lung cancer, and head and neck squamous cell carcinoma, and others. This combination approach can lead to: Enhanced tumor control: Radiation therapy not only minimises tumors but
also triggers the immune system to seek out and eliminate leftover cancer cells, decreasing the chances of recurrence. Improved survival rates: Patients who undergo both radiation therapy and immunotherapy tend to have better prognosis than those who received either treatment alone. Reduced side effects: Immunotherapy paired with radiation therapy frequently has less side effects than traditional treatments such as chemotherapy, as immunotherapy is task targeted modality. Cure potential: The combination of radiation therapy with immunotherapy has resulted in positive response and even long-term cures in some cases, particularly in metastatic cancers. Combining the techniques of radiation oncology with immunotherapy is one of the turning points in the fight against cancer. This combination has shown the ability to improve treatment outcomes, providing new hope to cancer patients. As research advances, we should expect to see even more groundbreaking discoveries and advanced treatments that capitalise on the synergy between these two effective techniques. Integration of radiation therapy and immunotherapy may become the standard of care in the near future, enabling more effective, less intrusive, and ultimately more successful therapies for cancer patients globally.
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Stress the value of qualityassurance in radiology Dr Madhuritu Banerjee, Radiologist, Amrita Hospital, Faridabad shares some important tactics that are important to train the next generation of radiologist
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their participation in research projects.
o prepare the upcoming generation of radiologists for the changing field of medical imaging, a comprehensive approach to training is needed. Important tactics consist of:
Ethics and communication skills Medical ethics, patient communication, and effective reporting should all be incorporated into radiologists' training to help them convey findings to patients and other healthcare providers in a clear and compassionate manner.
Comprehensive education programmes Create comprehensive educational programmes that address the most recent developments in radiology technology and practices in addition to basic concepts.
Extensive hands-on clinical experience Give trainees plenty of opportunities to practice using their theoretical knowledge in real-world situations while being supervised by seasoned radiologists.
Global health perspective
Ongoing professional development Stress the value of ongoing education and professional growth, urging radiologists to stay current with new developments and technology throughout their careers.
Simulation training Technology integration To guarantee that radiologists are qualified to operate and interpret contemporary diagnostic equipment, including training on artificial intelligence applications, cutting-edge imaging technologies, and other digital tools.
Interdisciplinary training Promote cooperation with other medical disciplines to improve comprehension of how radiography fits into more comprehensive patient care, fostering efficient communication.
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Include simulation training so that students can hone their abilities in a safe setting by performing various diagnostic procedures and scenarios.
Programmes for mentoring Create mentorship programmes that pair together seasoned radiologists with aspiring ones in order to impart advice, exchange perspectives, and aid in the transfer of knowledge.
Prospects for research To promote a culture of creativity and critical thinking among trainees and to progress the discipline, encourage
Expose radiologists to a global health perspective that addresses a variety of patient groups and healthcare contexts, equipping them to work in a variety of situations.
Training for quality assurance Stress the value of quality assurance in radiology, which includes reporting, routine image audits, and following set procedures to guarantee precise and trustworthy diagnosis.
Training in telemedicine and remote learning Incorporate telemedicine and remote learning into your training programme to help radiologists get ready for the growing role that digital platforms will play in the delivery of healthcare. The future generation of radiologists may effectively contribute to the area of medical imaging by utilising these tactics, which will equip them with a well-rounded skill set, adaptability to technology changes, and a patientcentered attitude.
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Partnerships in radiology: Aiming for better public healthcare Dr Prem Sai Reddy, M.D (Radio Diagnosis),Apollo Spectra Hospital, Bangalore stresses on the benefits of collaborative radiological partnerships
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adiology, an indispensable field within healthcare, harnesses imaging techniques to peer inside the human body, uncovering hidden ailments and guiding treatments. Through diverse modalities like X-rays, ultrasounds, CT scans, and MRIs, radiology illuminates the inner workings, enabling accurate diagnoses and aiding in therapeutic decisions. Its evolution from rudimentary X-rays to sophisticated technologies has not only transformed diagnostics but also revolutionised medical interventions, contributing significantly to patient care and outcomes in the modern era of medicine
Evolution of radiology partnerships In the annals of medical history, the evolution of radiology partnerships stands as a testament to the transformative power of collaboration. Initially, radiology existed as an independent discipline, somewhat secluded within the vast healthcare landscape. However, as the intricate role of imaging in diagnostics and treatment became increasingly evident, the paradigm shifted. Radiologists recognised the need to intertwine their expertise with that of clinicians, surgeons, and specialists, thus birthing interdisciplinary collaborations. This alliance marked a pivotal
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within the medical community. This cultural shift, emphasising unified decision-making, knowledge sharing, and continuous learning, propelled radiology into a new era of interconnectedness and collaborative excellence.The ongoing journey of radiology partnerships transcends boundaries, heralding a future where collaborative endeavors are the bedrock of cutting-edge diagnostics, personalised medicine, and global healthcare accessibility.
Benefits of collaborative radiological partnerships moment, where the fusion of diverse skill sets catalysed a revolution in patient care. The integration of various perspectives significantly elevated diagnostic accuracy, tailored treatment plans, and ultimately, patient outcomes.The subsequent phase witnessed the emergence of publicprivate partnerships, a union that propelled radiology beyond the confines of traditional healthcare settings. These alliances facilitated infrastructural development, resource sharing, and expertise exchange, extending the reach of advanced radiological services to underserved regions.However, the evolution of radiology partnerships is not merely a tale of technological prowess; it symbolises a cultural metamorphosis
◆Interdisciplinary collaborations between radiologists, clinicians, and allied healthcare professionals amplify diagnostic precision and treatment efficacy, ensuring holistic patient care. ◆Through shared expertise, diverse perspectives, and unified efforts, these partnerships enhance clinical outcomes while optimising resource utilisation. ◆Public-private collaborations bridge accessibility gaps, expanding radiological services to underserved communities by bolstering infrastructure and expertise exchange. ◆Technology partnerships drive innovation, ushering in cutting-edge advancements such as AI-enabled diagnostics and novel imaging modalities, elevating radiology's
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capabilities. ◆These alliances cultivate a culture of continuous learning, fostering skill development and knowledge sharing, crucial for staying abreast of rapid technological advancements. ◆Collaborative radiological partnerships epitomise the synergy among stakeholders, augmenting patient care, amplifying accessibility, and steering healthcare towards a future of comprehensive and equitable services for all.
Types of radiological partnerships Radiological partnerships encompass diverse collaborative models, each vital in advancing healthcare. Interdisciplinary collaborations between radiologists, clinicians, and specialists amplify diagnostic accuracy and treatment efficacy, fostering comprehensive patient care. Publicprivate partnerships bridge resource gaps, enhancing infrastructure and expertise, particularly benefiting underserved populations. Technology collaborations with innovators drive advancements, ushering in AI-driven diagnostics and cutting-edge imaging technologies. These partnerships, instrumental in research and development, extend the boundaries of radiology's capabilities. Furthermore, community collaborations promote health education and outreach, fostering preventive care and raising awareness. Embracing these varied partnerships forms a robust tapestry, enriching radiology's impact, expanding accessibility, and ensuring that the benefits of technological advancements are equitably distributed for the betterment of public healthcare.
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Challenges and solutions in radiology partnerships ◆While the benefits are evident, challenges persist. Navigating partnerships in radiology presents a tapestry of challenges, notably including interoperability hurdles, disparate information systems, and financial barriers. ◆Siloed data systems hinder seamless information exchange among healthcare entities, impeding collaborative decisionmaking. ◆Financial considerations often strain the viability of partnerships, necessitating sustainable funding models to support collaborative initiatives. Solutions lie in standardising interoperable platforms, facilitating unified data sharing while safeguarding patient privacy. Establishing common protocols and frameworks fosters cohesion among diverse stakeholders, enhancing communication and resource optimisation. Additionally, fostering a culture of collaboration through educational initiatives and shared governance models cultivates trust and fosters a collaborative spirit. Embracing these solutions not only surmounts existing challenges but also paves the way for more robust and effective partnerships in radiology, bolstering healthcare delivery and patient outcomes.
Policy implications and future directions ◆Governments and regulatory bodies play a crucial role in establishing frameworks that foster effective and ethical collaborations. ◆Standardised protocols for data sharing, ensuring patient confidentiality, and maintaining high-quality standards
become imperative to ensure the integrity of collaborative ventures. ◆Integration of Artificial Intelligence (AI) holds immense potential, revolutionising diagnostic accuracy and expediting patient care. ◆Tele-radiology emerges as a critical avenue, promising expanded access to radiological services in remote or underserved regions. ◆The convergence of technology and partnerships fuels global health initiatives, aiming to bridge healthcare disparities worldwide. To navigate these future directions successfully, adaptable policies are essential, ones that encourage innovation while safeguarding patient rights and care standards. Encouraging cross-disciplinary collaborations and embracing these technological advancements will pave the way for a future where radiology partnerships become pivotal in delivering transformative and equitable healthcare on a global scale.
Conclusion In the landscape of radiology, partnerships emerge as the linchpin for transformative healthcare. Their collective strength, uniting healthcare providers, technological innovators, and policymakers, steers the course toward enhanced patient outcomes and equitable access to top-tier radiological services. As these partnerships evolve, they bolster efficiency, foster innovation, and bridge gaps in healthcare delivery. Embracing a future woven with interconnected collaborations promises a healthcare landscape where radiology stands not just as a diagnostic tool but as a beacon of collaborative excellence, ensuring better health for all, transcending boundaries and disparities.
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HIFU for prostate cancer: Ongoing research and future trends Dr Yuvaraja T.B, Head, Robotic Surgery; Consultant, Surgical Oncology (Uro Oncology), Kokilaben Dhirubhai Ambani Hospital, Mumbai explains the role of HIFU technology used for prostate cancer treatment
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ver the past 25 years, the average life expectancy for men has increased, and the age of prostate cancer detection has decreased an average of 10 years with diagnosis increasingly made at early-stage disease where curative therapy is possible. The age at diagnosis and the degree of malignancy have changed, revealing limitations in the conventional curative therapies for prostate cancer. These limitations include a high risk of an aggressive cancer recurrence, a risk of long-term genitourinary morbidity, and a negative effect on the quality of life (QOL) of the patient. The qualities of high-intensity focused ultrasound (HIFU) make it a desirable alternative for curative therapy. HIFU is a noninvasive method that eliminates tumor cells without the need for radiation or surgical removal by using precisely delivered ultrasonic energy. Since the 1990s, HIFU therapy for localised prostate cancer has been the subject of clinical study, and around 65,000 individuals have received this treatment.
threshold, causes tissue coagulation and leads to irreversible tissue damage through coagulative necrosis while sparing the tissue-sensitive adjacent structures such as the rectum, external sphincter, and the neurovascular bundles. ◆ Mechanical The mechanical effects of HIFU are induced by the effects of negative pressure of the ultrasound wave on the targeted tissue.
Efficacy of HIFU as primary therapy biologic structure alterations as a result of high-energy parabolic-focused ultrasound. ◆ Thermal Warmth The targeted tissue absorbs the ultrasonic energy produced by HIFU and transforms it into heat. A “thermal dose,” which exceeds a certain
Efficacy in localised disease Similar to efficacy studies with External Beam Radiotherapy (EBRT), brachytherapy, and cryoablation, biochemical markers and biopsy findings have been used as indicators of long-term cancer control with HIFU. With ongoing refinements in execution and outcome measurement, the efficacy
HIFU mechanisms and technology ◆ Mechanism of action of HIFU In 1944, Lynn and Putman reported the first application of HIFU for local tissue destruction. Targeted cells undergo mechanical modification and
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localise tumor lesions and foci. When this goal is reached, HIFU will be the ideal therapeutic tool for focal prostate cancer treatment. Today, already available serial HIFU devices show significant technologic and applicable differences, in handling and efficacy; besides picture fusion, several advancements are being investigated, including multiparametric MRI, highresolution TRUS, contrast-enhanced ultrasound, elastography, and Doppler for precise lesion targeting. Ideal indication for high-intensity focussed ultrasound as primary procedurea
Clinical
T1-T2 N0M0 prostate cancer
Gleason score
≤7
PSA level
<15 ng/ml
Prostate volume
<40 ml
than 95 per cent ten year metastases free survival in various studies. HIFU-related morbidity The most common side effects of primary HIFU therapy include prolonged voiding dysfunction and
Conclusion Prostate cancer is now diagnosed at an earlier disease stage in younger patients with a longer life expectancy, as a result, a greater emphasis is now placed on treatment-related morbidity and its impact on patient's quality of life. The use of HIFU should not be
Advantages and disadvantages of HIFU as primarytreatment of prostate cancer Advantages
Disadvantages
Outpatient procedure
Possible permanent damage to erectile function
Noninvasive
Difficult to reach the anterior parts of the gland
Low postoperative morbidity
Short follow-up
Repeatable
Difficult in definition of response
Not preclude subsequent radical treatment (surgery, radiotherapy) of HIFU in locally confined prostate cancer is now comparable to those of radiotherapy and RPE, which according to the CaPSURE database are characterised by failure rates of 63 per cent at a mean of 38 months posttreatment and 30 per cent at a mean of 34 months post-treatment, respectively. Long-term outcomes of whole-gland HIFU has been studied and has produced more than 98 per cent tenyear cancer specific survival and more IN IMAGING / 2024
retention caused by edema, necrosis, or bladder outlet obstruction, as well as erectile dysfunction.
Future directions of HIFU for prostate cancer The efficacy in cancer control of HIFU and other focal therapies will depend less on the development of therapeutic tools than on diagnostic technologies that can more accurately image and
viewed as a substitute or replacement for classical therapy, but instead as a therapeutic first choice in monofocal well-differentiated disease. The initial use of HIFU can help postpone the need for invasive therapies associated with greater morbidity such as surgery or radiation, allowing the patient a longer period without the risk of living with treatment-related genitourinary side effects. 35
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AI-powered imaging: Agame-changer in early detection of breast cancer Dr Ashay Karpe, Founder & Director, Sunrise Oncology Centre explains how the integration of AI into breast cancer imaging is poised to address challenges
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n the dynamic landscape of healthcare, Artificial Intelligence (AI) is making significant strides, particularly in the field of medical imaging. One area where AI is proving to be a game-changer is in the early detection of breast cancer. With advancements in technology, AIpowered imaging is revolutionising the way we approach breast cancer screening, diagnosis, and ultimately, treatment. Traditionally, mammography has been the gold standard for breast cancer screening. While effective, it is not without limitations, including false positives and negatives. The integration of AI into breast cancer imaging is poised to address these challenges and usher in a new era of precision and accuracy.
How AI enhances early detection ◆ Improved accuracy: AI algorithms are designed to analyse vast amounts of imaging data with remarkable speed and accuracy. This capability significantly reduces the likelihood of false positives and negatives, providing a more reliable screening process. ◆ Early identification of lesions: AIpowered imaging can detect subtle changes and anomalies in breast tissue that may indicate the presence of cancer at an early stage. This early identification is crucial for prompt
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intervention and improved treatment outcomes. ◆ Personalised risk assessment: AI systems can assess individual risk factors and tailor screening protocols accordingly. This personalised approach ensures that individuals with a higher risk of developing breast cancer receive more frequent and targeted screenings.
The role of AI in streamlining diagnostic procedures ◆ Efficient image analysis: AI expedites the image analysis process, allowing healthcare professionals to interpret results more swiftly. This efficiency is vital for reducing the time between screening and diagnosis, offering patients timely information
for decision-making. ◆ Integration of multiple imaging modalities: AI facilitates the integration of data from various imaging modalities, such as mammography, MRI, and ultrasound. This comprehensive approach enhances diagnostic accuracy and provides a more complete picture of the breast tissue. In regions with limited access to specialised healthcare professionals, AI-powered imaging can act as a force multiplier, extending the reach of early detection capabilities to a broader population. AI has the potential to bridge the gap in breast cancer detection by ensuring that even in underserved communities, individuals have access to advanced screening technologies, promoting early diagnosis and intervention.
Future prospects and challenges While AI-powered imaging holds immense promise, challenges such as data privacy, ethical considerations, and ongoing technological advancements need careful consideration. Striking a balance between innovation and ethical practice will be crucial as we continue to leverage AI in breast cancer detection. Continued on Page 41
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Revolutionising cancer care: Power and precision of MR linac technology Dr Pradeep Kumar Karumanchi, Consultant Radiation Oncologist, Yashoda Hospitals explains the role of MR linac and highlights its benefits over conventional radiotherapy What is MR linac? MR linac stands for magnetic resonance-guided linear accelerator. It is an innovative and advanced approach that combines two technologies - an MRI scanner and a linear accelerator. This technology allows the doctor to visualise the tumours in real-time during radiotherapy and also provides accurate monitoring and positioning of the radiation beams directly on the tumour.
What is MR linac used for? MR linac is used to treat patients who are suffering from cancer. It delivers high-energy x-rays to the region of the patient’s tumour. Radiation oncologists use these kind of machines to targets and kills the cancer cells while sparing the surrounding healthy tissue unharmed with precision. Continuous MRI is used by the MR linac to view the motion of the organs and soft tissue. This enables medical professionals to monitor tumour migration and adjust treatment plans accordingly. This is helpful for tumours that have a tendency to move about in the liver, pancreas, intestines, bladder, prostate, cervix, uterus, breast and lungs.
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Why MR linac? Unlike conventional or traditional approaches, the MR-Linac uses magnetic resonance imaging (MRI) to monitor the target area while delivering radiation beams. With this unique combination of technology, doctors can see the tumour and internal anatomy in real time, giving them exceptional control over radiation delivery by visualising internal anatomy. They can personalise and adapt each treatment with never-before-seen precision and accuracy.
What are the benefits of MR linac over conventional radiotherapy? The advantages of MR linac over
conventional radiotherapy are as follows: ◆ Precise delivery: MR linac enables high doses of radiation to the tumour in less time. ◆ Superior imaging capabilities compared to CT: While the linear accelerator precisely focuses on the tumour and delivers high-energy beams, the MRI component generates highdefinition, real-time images of the tumour. ◆ Detailed visualisation of tumours with 1.5 Tesla MR-Linac device: Many tumours shift throughout therapy and in between sessions due to changes in body composition or functioning. MR Linac assists in continuously monitoring these modifications and re-optimising treatment. Precise tumour differentiation, preserving adjacent healthy tissue, and customised tumour cell targeting: Each patient has different treatment requirements, and MR linac ensures high-precision tumour targeting while minimising damage to surrounding tissues by visualising the position, size, and form of the tumour. Continued on Page 41
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Transforming healthcare: Impact of AI on radiology and imaging Dr Prerna Garg, Consultant Radiology, RGCIRC & Dr Sunil Kumar Puri, Director Radiology, RGCIRC explains how AI can help radiologists in making more accurate and timely diagnoses
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adiology encompasses a wide spectrum of techniques that act as the fulcrum on which disease management pivots. Radiology and Imaging if used optimally can reduce medical costs and improve patient outcomes through early disease detection and diagnosis. The role of radiology in healthcare is pivotal, particularly in the domain of cancer care as it encompasses all aspects of cancer care from early diagnosis to treatment response, prognostication, and follow-up evaluation. Radiology plays a crucial role in the early detection of cancer through techniques like mammography, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). These technologies allow for precise localisation and characterisation of tumors, enabling healthcare professionals to tailor treatment plans based on individual patient needs which is also known as personalised medicine or precision medicine. Advanced hybrid imaging techniques like PET CT and PET MRI not only detect the location but also help in deciphering the molecular makeup of the tumors. Additionally, image-guided therapies, like interventional radiology procedures, allow for targeted
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Dr Prerna Garg
Dr Sunil Kumar Puri
treatments with minimal impact on healthy tissues. This precision is particularly beneficial in treating complex cancers in extremely sick patients where traditional surgical approaches might not be feasible and are challenging. Artificial Intelligence (AI) has been the talk of the decade and is not a buzzword anymore. It’s evolving and growing by leaps and bounds. The year 2023 has seen a steady growth in the application of AI in healthcare especially in radiology and imaging. AI can analyse vast amounts of data to identify subtle patterns and abnormalities in imaging studies, aiding radiologists in making more accurate and timely diagnoses.
This not only expedites the diagnostic process but also reduces the chances of oversight. AI-based algorithms are being used not only for diagnosis but also to predict outcomes, and treatment response and have even performed better than trained eye in certain circumstances. An important example of the application of AI-based algorithm was in the COVID pandemic wherein AI would act as the first reader of data and grade the lung involvement in the light of the manpower crisis. It is also being applied on a large scale in screening settings, especially for the detection of breast cancer. Continued on Page 40
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Technology trends in imaging Dr Pranav Mahadevkar, Consultant Radiologist and HOD, Ruby Hall Clinic explains about various imaging technologies that are expected to gain further traction in 2024
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fficient workflow management , increasing workloads and economic considerations continue to challenge healthcare providers, especially in diagnostic imaging services. Increasingly, holistic healthcare leaders also must identify their responsibility to improve healthcare quality, as well as the need to reduce the sector’s carbon footprint. Here is a list of few healthcare technology trends that are expected to gain further traction in 2024. ◆ Helium-Free MRI: The MRI machine needs approximately 2,000 liters of ultra-cold liquid helium to keep its magnets functional. The cost of helium can be as high as Rs 3200/per liter in India. Helium-a nonrenewable resource found deep within the Earth’s crust is running low leaving hospitals wondering how to plan for a future with a much scarcer supply. The newer breed of heliumfree MRI machines eliminate the need for periodic helium refilling enabling us in cost saving, reduces machine downtime/interruptions & also is environmentally friendly. ◆ Artificial Intelligence (AI) in MRI: Latest AI & machine earning based algorithms enable us in greater acceleration times: eg : MRI brain on 3T conventionally takes about 20 mins whereas with AI based algorithms takes up to 6 mins; Conventional 3T MRI knee takes upto 25 mins but same
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can be accomplished within 7 mins with AI-based acceleration. AIrendered images also have better resolution than conventional images. The latest upgrades enable faster scan times even with patients who are in pain, are claustrophobic or struggle to hold their breath during an exam. All in all, radiology departments can scan more patients in a day with better diagnostic quality and improve the patient experience at the same time. ◆ Virtual cockpit: Integrated workflow across multiple branches/diagnostic setups is possible by means of Virtual Cockpit Concept provided by few vendors. This offers remote scanning support by radiologists/technologists sitting several kilometers away independent of location – understandably this is very important in peripheral/tier 2 & 3
cities in which there may be lack of experienced technologists to perform complex studies. ◆ MRI in a truck/MRI in container concept: Internationally this is not uncommon. An MRI machine is installed in a container mounted on a truck helping to provide portable MRI solutions and making MRI access available to all. In India, this concept has not picked up one of the reasons being PCPNDT related & other logistic considerations. ◆ Photon Counting CT scanners: Some latest FDA approved state of the art breed of premium CT scanner launched internationally in 2022, yet to be installed in India one of the reasons being cost factor. Quantum Technology is transforming CT by introducing photon-counting technology into clinical routine. At its core is the QuantaMax detector, which is equipped with a crystal semiconductor that is substantially different from a standard scintillation detector. QuantaMax detectors create CT images at high spatial resolution, without electronic noise, and with an improved contrast-to-noise ratio, intrinsic spectral information, and at a lower radiation dose. Dual energy spectral CT is becoming increasingly common in clinical practice due to vast advantages over conventional singleenergy CT few of which include virtual non contrast imaging , lesser
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radiation dose, lesser contrast medium usage, broad medical applications in gout, characterisation of renal stone, reducing metal hardware related artifacts , various oncology related applications amongst others. Radiology department can save upto 40 per cent contrast usage per patient – this is also very useful in patients with renal disease in whom contrast administration can aggravate renal issues. Due to significantly lesser radiation dose delivered during CT scanning these can be implemented on larger scale especially in ultra low dose cardiac and thoracic imaging/screening prams/health check ups. ◆ 3D CAMERA: Available with most of the high end CT scanners
internationally, it is mounted on ceiling above the gantry & scans patient with AI technology to optimise radiation dose delivered to patient based on patient body size, part thickness, etc. Interestingly in India it is pending AERB approval which is expected any time soon. ◆ Virtual biopsy: Few AI software based algorithms have recently gained FDA approvals for ‘virtual’ non invasive histopathological diagnosis on MRI especially in oncology setting. Virtual biopsies could be next step in patient care and resemble a very likely future development for the diagnosis and management of certain diseasesliver, cardiac , prostate amongst others. These are mainly in research/academic stage at present and cannot replace conventional
histopathological assessment. ◆ MR LINAC: It is a magnetic resonance-guided linear accelerator that combines MRI with radiation therapy to target and treat cancers. MRI guidance allows doctors to adjust the radiation therapy in real time with better soft tissue resolution and deliver it more accurately and effectively. The USFDA approved MR LINAC for clinical use in 2018. There are a handful of machines in use worldwide, with more expected to come in the future. ◆ In bore MRI cinema: One of the vendor provides interesting third party solutions like in bore cinema where patients can watch movies inside MRI machine while scan is going on – this is extremely useful in pediatric & claustrophobic patients.
Transforming healthcare: Impact of ... Continued from Page 38
Challenges and way forward Healthcare in radiology and imaging faces challenges such as the need for improved interoperability of imaging systems, ensuring data security and patient privacy, managing the increasing volume of imaging data, and addressing issues related to standardisation of imaging protocols. Additionally, there are challenges in adopting and integrating advanced technologies like AI for image interpretation and diagnosis, along with the necessity for training healthcare professionals to effectively utilise these technologies. The future of radiology and imaging
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holds exciting prospects. Advancements in AI will further refine diagnostic accuracy, automating routine tasks and aiding in the interpretation of complex images. Integration of machine learning algorithms will enhance predictive analytics, facilitating early disease detection. Quantum leaps in imaging technology, such as photon-counting CT and functional MRI, promise higher resolution and improved tissue characterisation. Telemedicine and remote monitoring will become more prevalent, expanding access to imaging services globally. Collaborations between radiologists and data scientists will drive innovation, shaping a future where personalised medicine
and targeted therapies based on advanced imaging findings become increasingly common place, ultimately improving patient outcomes and transforming the landscape of healthcare. In conclusion, the evolution of radiology and imaging in healthcare has significantly impacted cancer care. From early detection to personalised treatment strategies, radiology plays a central role in improving patient outcomes. While the initial financial investment in advanced imaging technologies may be substantial, the long-term benefits, both in terms of patient health and healthcare system efficiency, underscore the importance of continued advancements in radiology for cancer care.
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Revolutionising cancer care: Power and ... Continued from Page 37
◆ Enhanced clinical outcomes: MR Linac's adaptive customisation and real-time visualisation enable optimal radiation treatment, ensuring the best potential treatment outcomes. ◆ Enhanced local control and less toxicity: Daily dose reshaping and treatment adaptation are made possible by MR-Linac, which also reduces the risk of complications and increases progression-free survival rates by optimising the radiation dose administered to the tumour while minimising radiation exposure. ◆ Dynamic seamless sessions: Radiation is given with continuous target visualisation during the course of treatment. This enables real-time plan modification and adaptation to guarantee the best possible results. ◆ Shorter treatment duration: MR Linac can deliver high doses of radiation in shorter span of treatment time with precision and accuracy so that overall treatment time can be greatly reduced compared to conventional LINAC.
Who operates MR linac? The appropriate dosage and volume of treatment are prescribed by the radiation oncologists. The medical physicist and the dosimetrist figure out how to deliver the prescribed dose. They also calculate how long the accelerator will need to deliver that dosage. In addition to administering patient’s daily treatments, radiation therapists operate the linear accelerator and the MRI scanner. What are the clinical applications of MR linac? ◆ MR linac is used for cancers such as: ◆ Prostate cancer ◆ Head and neck cancer ◆ Rectal cancer ◆ Pancreatic cancer ◆ Breast cancer ◆ Brain cancer ◆ Bladder cancer ◆ Liver cancer ◆ Lung cancer ◆ Cervical cancer ◆ Uterine cancer
◆ Bladder cancer ◆ Gall Bladder cancer ◆ Esophageal cancer
How safe is MR linac? The MR-linac is a device that has FDA approval. To make sure it will administer the dosage as instructed, security features have been built into it. It is regularly checked by medical physicists to make sure it is operating correctly. ◆ Before treatment: The radiation oncologist creates a plan before therapy. The plan is assisted by the medical physicist and radiation dosimetrist. To guarantee that they provide the treatment according to plan, the treatment team carries out quality-assurance processes. ◆ During treatment: The radiation therapist uses a closed-circuit television monitor to watch the patient as they receive therapy. In order to facilitate communication between the patient and staff, a microphone is also provided in the treatment area.
AI-powered imaging: Agame-changer... Continued from Page 36
AI-powered imaging stands at the forefront of a transformative era in breast cancer detection. The synergy between advanced technology and medical expertise is
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paving the way for more accurate, personalised, and accessible early detection methods. As we navigate this exciting frontier, the potential to save lives through timely interventions and improved treatment outcomes has never been
more promising. AI is not just augmenting our capabilities; it's redefining the way we detect and combat breast cancer, offering hope for a future where early detection becomes synonymous with effective prevention.
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Empowering Healthcare Providers with Advanced Imaging Technology for Precision Diagnostics and Enhanced Patient Care
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n the fast-evolving landscape of healthcare technology, United Imaging's uMR 580 machine stands out as a beacon of innovation, and Medikabazaar serves as the gateway for healthcare institutions to access this cutting-edge imaging solution. Let's delve into the key features and advantages that make the uMR 580 a game-changer in the realm of medical diagnostics.
The uMR 580 Machine: Redefining MRI Imaging The uMR 580 machine, a flagship product from United Imaging, represents a paradigm shift in Magnetic Resonance Imaging (MRI) technology. This state-of-the-art machine is equipped with features that set it apart in the competitive healthcare imaging landscape. 1. High-Resolution Imaging: At the heart of the uMR 580 is its ability to deliver exceptionally highresolution images. This capability empowers healthcare professionals with detailed and precise visuals of internal structures, enabling accurate diagnoses and informed
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treatment plans. 2. Advanced Technological Integration: United Imaging has consistently been at the forefront of incorporating advanced technologies into its imaging equipment. The uMR 580 is no exception, featuring artificial intelligence (AI) enhancements that optimize imaging processes, reduce scan times, and elevate diagnostic confidence. 3. Versatility for Diverse Imaging Needs: The uMR 580 machine is designed with versatility in mind, catering to the varied imaging requirements of different medical specialties. Whether it's neurological imaging, musculoskeletal studies, or cardiovascular assessments, this machine offers a comprehensive solution for a wide range of medical applications. 4. Patient-Centric Design: Recognizing the importance of
the patient experience, the uMR 580 boasts a patient-centric design. It addresses common challenges associated with traditional MRI machines, such as noise and discomfort, by prioritizing a quieter environment and optimizing scan times, ensuring a more pleasant experience for individuals undergoing imaging procedures.
Transformative Imaging for Enhanced Patient Care United Imaging's uMR 580 machine, available through Medikabazaar, represents a milestone in the evolution of healthcare imaging. With its high-resolution capabilities, technological innovations, versatility, and patient-friendly design, the uMR 580 is poised to revolutionize diagnostic procedures, ultimately leading to improved patient outcomes. As healthcare institutions embrace this advanced imaging solution, the collaborative efforts of United Imaging and Medikabazaar pave the way for a future where cutting-edge medical technologies are within reach for all.
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Unstoppable Force: United Imaging's Revolutionizing India's Imaging Industry
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nited Imaging Healthcare (UIH) and Medikabazaar are thrilled to mark the completion of their third year of collaboration in India. Over the past three years, UIH and Medikabazaar have worked hand in hand to revolutionize the medical imaging industry in India, setting new benchmarks for excellence and accessibility. Since the inception of their partnership in 2020, United Imaging Healthcare and Medikabazaar have achieved remarkable milestones together. The collaboration has resulted in the successful of over 500 orders of AI enabled MRI, CT, and Digital PET-CT equipment, enabling healthcare institutions across India to enhance patient care and improve diagnostic capabilities. One of the key achievements of the partnership has been the widespread presence of United Imaging Healthcare's state-of-the-art solutions across the country. Through Medikabazaar's extensive network and distribution capabilities, UIH's advanced medical imaging systems, including MRI, CT, and Digital PETCT scanners, have reached healthcare facilities in even the most remote corners of India. This has significantly contributed to bridging the healthcare divide and bringing world-class diagnostic tools within reach of millions of patients. With highly competitive
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technologies and ground breaking products, United Imaging Healthcare has steadily increased its brand influence and market share worldwide. Currently, more than 23,600 United Imaging products are in service across 10,700 hospitals and research institutions in 59 countries and regions worldwide, including China, the U.S., Europe, Japan, the Middle East, India, Southeast Asia, Africa, and South America. To ensure seamless implementation and exceptional customer experience, United Imaging Healthcare and Medikabazaar have established a dedicated service team. Comprising highly trained professionals and technical experts, the service team is readily available to provide comprehensive support, including installation, maintenance, and training, thereby maximizing the value and effectiveness of UIH's cutting-edge medical equipment. UIH has secured a spot among the top three positions is truly impressive. Despite being a relatively new player in the field, UIH has swiftly gained acknowledgment for its state-of-theart radiology products and solutions. United Imaging's dedication to providing comprehensive, all-in-one configurations along with assured upgrades has catapulted them to the forefront of the industry. Speaking about the successful partnership, Dr Jusong Xia, President of International Business at United
Imaging Healthcare, expressed their enthusiasm, stating, "We are thrilled to celebrate our second year of partnership with Medikabazaar. Together, we have been able to make a significant impact in the healthcare landscape of India. Our collaboration has not only expanded the accessibility of advanced medical imaging solutions but also strengthened the overall healthcare infrastructure. We look forward to continued success in the coming years." Medikabazaar's CEO & Founder, Vivek Tiwari, also highlighted the significance of the partnership, saying, "United Imaging Healthcare has been a valuable partner in our mission to transform healthcare delivery in India. By providing healthcare institutions with the latest medical imaging technology, we have enabled them to provide accurate diagnoses and improve patient outcomes. We are proud of the milestones we have achieved together and excited about the future prospects of our collaboration." As United Imaging Healthcare and Medikabazaar enter the third year of their partnership, they remain committed to driving innovation, empowering healthcare providers, and advancing healthcare accessibility across India. With a shared vision of revolutionizing healthcare, both organizations are poised to deliver even greater value and impact in the years to come.
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Phantom Healthcare is revolutionising the refurbished radiologymarket Brijesh Suneja, MD and Rochi Nargotra, CEO & MD, Phantom Healthcare gives an overview of various radiological equipments offered by their company
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s per the latest reports and market trends, the refurbished medical imaging equipment market size was valued at USD 11.49 Billion in 2020 and is projected to reach USD 27.34 Billion by 2028, growing at a CAGR of 11.5 per cent from 2021 to 2028. Phantom Healthcare is one of the key players in the market. Over time our organisation has been consistently mentioned in various market research reports. Our Group started operating in the year 2011 and has become one the leading 3rd party, refurbishers, and reassemblers of pre-owned superconductive MRIs and CT Scanners in India. In the initial years, our focus was on GE MRIs and CT Scanners and we were successful in installing equipment on a pan-India basis. As time progressed, we started dealing with other radiological equipment, Complete radiology solutions: As of now Phantom Healthcare deals in refurbished equipment of MRI Machines, CT Scanners, PET-CT Scanners, Cath-Lab Machines, and Bone Densitometer. We provide complete turnkey solutions, from site planning to the final installation of the equipment with financial assistance. We also provide de-installation and upgrades for your existing medical equipment. Large inventory: We have a large inventory of spare parts for your
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“Our mission is to provide affordable medical radiology setup. The market growth stage is high, and the pace of the market growth is accelerating. The global market has witnessed a significant degree of innovation”
“We are establishing our presence in the USA and Arab-Gulf region. Our future vision is to expand business in the African regions and other international markets”
Brijesh Suneja, Managing Director, Phantom Healthcare
Rochi Nargotra CEO & Managing Director Phantom Healthcare
existing medical equipment, we do repairs, upgrades, and exchanges of parts. We deliver parts around the globe and to remotest of the areas if possible. Global service providers: We provide service packages AMC (Annual Maintenance Contract) or CMC (Comprehensive Maintenance Contract). In the last few months, we have been actively providing services and upgrades in the US region Our service team is spread all across India serving our clients 24*7. Phantom Healthcare strives to provide professional support with quality services that are custom fit to the needs of today’s growing healthcare industry. We aim to develop long-term
relationships with our clients and do our best to keep Imaging equipment up-todate and working like new. In the dynamic world of healthcare, technological advancements are crucial in improving patient care and diagnostic accuracy. Radiology, a cornerstone of medical imaging, relies heavily on cutting-edge equipment to provide healthcare professionals with the tools they need for accurate diagnoses. However, the high cost of acquiring new radiology equipment can be a significant barrier for many healthcare facilities. This is where refurbished radiology equipment emerges as a cost-effective and sustainable solution.
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Transforming medical imaging: Allengers' advanced remote controlled digital radiographyand fluoroscopysystems The flagship product, “Angio Vision 9090”, sets a new standard in digital radio fluoroscopy systems, delivering exceptional image quality at remarkably low radiation doses
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n the ever-evolving landscape of medical imaging, the Remote Controlled DRF Table from
Allengers stands out as a cutting-edge technological marvel. Allengers, a leading name in medical systems
manufacturing, has ingeniously harnessed the power of Radiography and Fluoroscopy (RF) capabilities into
NEW LAUNCH
ANGIO VISION 9090
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one equipment. Core of these groundbreaking equipments is the powerful x-ray generator and a long-lasting x-ray tube. A dedicated imaging system along with stable x-ray source plays a pivotal role in capturing high-quality medical images. The DRF Table's standout feature is its ability for real-time adjustments without interrupting imaging, enhancing precision. With live X-ray imaging through the fluoroscopy feature, it visualises anatomical structures dynamically, crucial for various medical procedures. Engineered for versatility, the table adapts to diverse imaging procedures, catering to a wide spectrum of medical diagnosis in the domain of RF like gastroenterology, gynecology, routine fluoroscopy, urology, orthopedics, routine radiography in all patient positions. Prioritising wellbeing, the table ensures patient comfort during imaging with integrated safety features. Seamless integration with imaging systems enhances workflow efficiency, facilitating data transfer to Picture Archiving and Communication System (PACS). The user-friendly interface empowers healthcare professionals with a sophisticated yet accessible tool.
Angio Vision 9090 The flagship product, “Angio Vision 9090”, sets a new standard in digital radio fluoroscopy systems, delivering exceptional image quality at remarkably low radiation doses. Its dual capability ensures versatility, allowing medical professionals to conduct a diverse range of examinations with precision. The
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THE SECOND VARIANT IN THIS FAMILYIS “ANGIOTAB 9030 DRF”. THIS TABLE IS EQUALLY ROBUSTAS OFTHE FLAGSHIP PRODUCT. THIS TABLE CAN STAND VERTICALON ONE SIDE AND CAN PROVIDE A HEAD TILTOF 30 DEGREES ON THE OTHER SIDE
system brings fully digital, motorised, and auto-tracking capabilities to the forefront of digital radiography and fluoroscopy examinations, exemplifying a commitment to innovation and providing a comprehensive solution for modern medical imaging practices. This table gives benefits of tomography also where tube and FPD move independently. Along with that the flexible Mechnical design enables to it give RF imaging in vertical position on each side and it can attain very low height during patient transfer. The second variant in this family is “AngioTAB 9030 DRF”. This table is equally robust as of the flagship product. This table can stand vertical on one side and can provide a head tilt of 30 degrees on the other side.
The new entrant in this family is economical and highly versatile “Eco Track-DRF”, another state-of-the-art system from Allengers, brings fully digital, motorised, and auto-tracking capabilities to the forefront of digital radiography and fluoroscopy examinations. With a plethora of advanced features, it stands as a beacon of precision and user-friendly design. This light weight, floor mounted design is highly revolutionary because it brings plethora of advanced features at very affordable cost. Key benefits and features of this product family include table tilting movement, motorised tube movement with rotation, motorised LBD with auto shut-off light and exposure area adjustment, X-ray parameter adjustment from acquisition software and touch panel, and full compatibility with DICOM 3.0 interface. Besides these features high end options are also available like Head-to-Toe automatic image stitching, Dual energy x-ray And Angiography Suite. In conclusion, the Remote Controlled DRF equipment family exemplifies the pinnacle of medical imaging technology. These innovations from Allengers underscore the commitment to precision and versatility, highlighting the continuous pursuit of advancements that enhance the quality of patient care. As the healthcare industry embraces these state-of-the-art solutions, the future of medical imaging is undoubtedly brighter and more patient-centric than ever before. For the latest and more detailed information, please check out www.allengers.com.
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Conquering radiology's challenges with AI: DeepTek.ai leads the way Dr Amit Kharat, Co-Founder, DeepTek.ai highlights that DeepTek's AI algorithms have demonstrated a 97 per cent accuracy rate in identifying critical abnormalities in chest X-rays, such as pneumonia or lung nodules. These life-saving insights are delivered swiftly, allowing clinicians to initiate timely interventions and potentially saving countless lives
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or decades, Picture Archiving and Communication Systems (PACS) have faithfully managed the medical gaze, meticulously storing and retrieving mountains of X-rays, CT scans, and MRIs. However, like any seasoned veteran, PACS is starting to strain under the weight of its own success. The sheer volume of images, particularly in countries like India with a critical shortage of radiologists, threatens to overwhelm healthcare systems. This is where DeepTek.ai steps onto the stage, not as a replacement but as an evolution. Our ?agship Radiology AI deployment platform, Augmento, doesn't just manage the deluge; it transforms it. Imagine a radiology department where critical cases leapfrog to the top of the queue, ?agged by AI with the precision of a hawk. Fractures, tumors, lung nodules – no abnormality escapes its watchful eye. This isn't just about speed; it's about focus. Senior radiologists, freed from the tyranny of endless image queues, can dedicate their expertise to the most complex cases, while Augmento, their tireless AI assistant, diligently scrutinises
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every scan, whispering of potential dangers with uncanny accuracy. Previously considered a futuristic luxury, AI is now emerging as a necessity to ensure equitable healthcare access. DeepTek's AI algorithms have demonstrated a 97 per cent accuracy rate in identifying critical abnormalities in chest X-rays, such as pneumonia or lung nodules. These life-saving insights are delivered swiftly, allowing clinicians to initiate timely interventions and potentially saving countless lives. But Augmento's brilliance goes beyond image analysis. It's a symphony of automation, generating reports with a click, fostering
seamless communication between technicians, radiologists, and referring physicians. No more drowning in paperwork, no more missed connections – just a team empowered by AI, delivering the best possible care. A US FDA-cleared platform, its impact ripples outward beyond the four walls of the radiology department. Early disease detection, once a luxury, becomes a reality, offering a lifeline to underserved communities. Precision medicine, fueled by AI insights, paves the way for targeted treatments and improved patient outcomes. This is healthcare democratised, social gaps bridged by the invisible hand of technology. A distinctive feature of Augmento is its vendor-neutral approach, allowing easy integration of any thirdparty AI model into existing work?ows. Notably, key hospitals in Singapore, as part of the National AI strategy, have embraced Augmento for its transformative impact. While the integration of AI into healthcare holds promise, it comes with its own set of challenges. The complexity of AI systems introduces a heightened risk of errors, unintended biases, and potential discrimination in
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results, posing serious consequences for patient safety and fairness. Recognising these challenges, the healthcare community is actively developing responsible AI frameworks and establishing guidelines to ensure the conscientious deployment of AI in clinical practice. Amid concerns regarding the 'black box' nature of AI, where the inner workings and decision-making processes of models are opaque, we at DeepTek.ai challenge this perception. Placing a strong emphasis on transparency and explainability practices, we provide a suite of responsible AI features, including an interactive interface for studying and ?ne-tuning AI thresholds, enabling effective post-deployment surveillance. This commitment to responsible AI aligns with the evolving healthcare landscape, ensuring that advancements are not only cutting-edge but also ethical and accountable.
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ADISTINCTIVE FEATURE OF AUGMENTO IS ITS VENDORNEUTRALAPPROACH, ALLOWING EASY INTEGRATION OFANY THIRD-PARTYAI MODEL INTO EXISTING WORK?OWS. NOTABLY,KEYHOSPITALS IN SINGAPORE,AS PARTOF THE NATIONALAI STRATEGY, HAVE EMBRACED AUGMENTO FOR ITS TRANSFORMATIVE IMPACT The inevitable synergy between AI and PACS emerges as the anchor for smarter healthcare, poised to bridge
the gap between data and diagnosis. This symbiotic relationship heralds a future-ready radiology landscape, where the fusion of cutting-edge technology and AI, led by the visionaries at DeepTek.ai, promises to reshape the contours of healthcare delivery. Get ready for a healthcare revolution! With an impressive portfolio of patents and research papers, our products have been certi?ed by US FDA, Thai FDA, CDSCO further a?rming the quality and safety of our innovations. Serving over 500 customers across the globe, our groundbreaking AI solutions touch the lives of more than 1 Million individuals every year. DeepTek’s AIpowered lung health screening solution Genki has screened over half a million people for TB across India and the Philippines, taking us a step closer to a TB-free future! To know more visit : www.deeptek.ai or connect with us at info@deeptek.ai
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FUJIFILM India paving the wayfor innovations in healthcare FUJIFILM India offers a diverse range of cutting-edge ultrasound systems that deliver seamless and precise imaging diagnostics across various medical settings, including the comfort of home
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ith the advent of cuttingedge technologies, the healthcare industry has undergone a transformational change in recent years equipping healthcare providers and healthcare professionals with innovative solutions to enhance patient outcomes. FUJIFILM India has significantly leveraged these revolutionary advancements and emerged as a pioneer in the healthcare industry with their stateof-the-art medical products. In 2021, the acquisition of diagnostic imagingrelated business of Hitachi by Fujifilm strengthened the multivariate products portfolio of FUJIFILM Healthcare, a gigantic entity of the Fujifilm Group to provide extensive solutions of even greater quality in the world of healthcare. With a comprehensive range of cutting-edge CT scanners, MRI systems, X-ray equipment, and IVD, FUJIFILM India also introduced FUJIFILM Connectthe future of healthcare solutions to transform the landscape of medical diagnostics, enabling accurate diagnoses, efficient treatment planning, and improved patient outcomes. These advanced technologies provide healthcare professionals with
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TO REVOLUTIONISE THE HEALTHCARE INDUSTRY, FUJIFILM INDIAHAS BROUGHTFORTH THE MOBILE APPLICATION 'FUJIFILM CONNECT.' POSITIONED AS A COMPREHENSIVE HEALTHCARE SOLUTION PROVIDER,FUJIFILM CONNECTOFFERS HEALTHCARE PROFESSIONALS A STREAMLINED PLATFORM TO MANAGE SERVICE AND SUPPORTFOR THEIR MEDICALDIAGNOSTIC DEVICES indispensable tools to visualise and analyse internal structures and abnormalities, aiding in the accurate identification and diagnosis of various
medical conditions. At the forefront of FUJIFILM India's medical imaging portfolio are its products like Flexible Endoscopes, CT scanners, MRI systems, FFDM (Full Field Digital Mammography), DEXA, ultrasound machines, and X-air equipment among others, born out of remarkable innovation from Fujifilm.
Connect anytime and anywhere with Fujifilm for medical products To revolutionise the healthcare industry, FUJIFILM India has brought forth the mobile application 'FUJIFILM Connect.' Positioned as a comprehensive healthcare solution provider, FUJIFILM Connect offers healthcare professionals a streamlined platform to manage service and support for their medical diagnostic devices. With real-time push notifications, the app keeps users updated and saves valuable time. This one-stop solution allows users to easily create and track service requests with efficient technical support just a tap away.
Advanced ultrasound systems for comprehensive diagnosis: FUJIFILM India offers a diverse range of cutting-edge ultrasound systems that deliver seamless and
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precise imaging diagnostics across various medical settings, including the comfort of home. The ARIETTA Series stands out for its exceptional diagnostic capabilities and userfriendly interface, making it a preferred choice for medical professionals.
Innovations in women's health FUJIFILM India recognises the importance of women's health and offers innovative solutions in mammography. The Amulet Innovality, a cutting-edge digital mammography system, plays a vital role in the early detection of breast cancer, promoting women's wellbeing and allowing them to be true to themselves, vibrant, and beautiful. FUJIFILM's Digital Mammography, a computerized breast cancer detection support system, employs proprietary algorithms to identify areas on breast images that may indicate cancer, aiding in early detection and timely treatment. These women-centric imaging solutions underscore FUJIFILM's commitment to prioritising the health and well-being of women.
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Leading the way in MRI and CT systems FUJIFILM India boasts a wide array of sophisticated MRI and CT systems, characterised by high image quality, advanced functionality, and a patientfriendly environment. The 1.5T Superconductive Magnet MRI System utilises a powerful magnetic field to produce precise diagnostic images. For patients seeking a more comfortable experience, FUJIFILM offers Permanent Magnet Open MRI Systems with an open structure. The whole-body X-ray CT System provides comprehensive imaging capabilities for various medical applications. Additionally, FUJIFILM is at the forefront of integrating Artificial Intelligence (AI) modules into medical imaging. By leveraging deep learning AI and advanced image processing, their open AI platforms support diagnostic imaging, enhancing efficiency and accuracy in clinical settings.
Advancing in-vitro diagnostics FUJIFILM India's point-of-care testing solutions, based on dry chemistry technology, provide
immediate and reliable results for medical practitioners. These solutions are especially valuable for on-site testing, enabling early patient treatment and care. With a focus on efficiency and accuracy, FUJIFILM's In Vitro Diagnostics solutions contribute to improved healthcare outcomes.
Conclusion In this era of transformative medical advancements, FUJIFILM India stands at the forefront, revolutionising medical diagnostics and contributing to the progress of healthcare as a whole. Its dedication to healthcare extends beyond the development of cutting-edge imaging technology. The company is deeply committed to enhancing the overall healthcare ecosystem by fostering collaborations, conducting research and development, and promoting awareness and education. By prioritising user-friendly designs and workflow optimisation, FUJIFILM India enhances the efficiency and effectiveness of healthcare professionals, ultimately improving the quality of patient care.
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Konica Minolta’s Dynamic Digital Radiography(DDR)
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onica Minolta’s Dynamic Digital Radiography (DDR) is a breakthrough X-ray technology (xraythatmoves.com) that uses our flagship Generation 5 detector AeroDR3 HD2 which captures a series of individual digital images acquired at high speed and low dose. The resulting
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cine loop enables clinicians to observe the dynamic motion of anatomical structures over time, enhancing diagnostic capabilities. The motion series can be analysed and quantified with the DDR advanced image processing capability. In less than a minute, X-ray that Moves gives
clinicians up to 20 seconds of physiological movement with a simple acquisition, performed by radiology staff without the need for physician presence. Much shorter acquisition times can also be employed. DDR is a promising platform for AI (Artificial Intelligence) applications.
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Elevating Outcome Through Innovation
SONIMAGE® MX1 PLATINUM
AEROSCAN CD50 PRO AI
I
I
ntroducing the next-generation, compact point-of-care ultrasound system, the SONIMAGE® MX1 PLATINUM Ultrasound System, with detail resolution for superior image quality. The system brings exceptional imaging, extreme portability with just 4.5kg weight to the places you need it most, with an extended battery life enabling 2 hours of continuous scanning time. A perfect solution for the demands of point-of-care environments. The Platinum series now supports up to 18Mhz high frequency and Hockey Stick probe
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t is our commitment to make the user interaction with ultrasound as delightful and easy as possible through an ingenious design and diverse automation tools. Aeroscan CD50 Pro AI, with its Remarkable Breakthrough in built Artificial Intelligence Technology, is exactly a combination of both and enhances efficiency greatly by reducing keystrokes
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Sequoia Healthcare introduces the inspiration 64 Slice CTScanner It provides exceptional CT experience for the end users
S
equoia Healthcare, based out of Bangalore and intensely focused on driving global innovation in the imaging solution segment manufactured indigenously in the country, has launched an advanced yet affordable Inspiration 64 Slice CT scanner with smart features and bore design recently. The Inspiration 64-smart large bore Slice CT Scanner comes with a 3D vision camera with auto-positioning and remote control. It brings in the finest quality of images and stable performance consisting of innovative
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workflow for topogram to diagnosis by generating HD Image Chain of 024 matrix. It is a new detector design for shortening the X-RAY path and improving on the image quality with the help of a 75 cm Gantry aperture that offers extra scan facilities as compared to the standard scanning. According to S. Viswanathan, Chief Executive Officer, Sequoia Healthcare, “The company’s purpose is to improve the quality of human life by helping healthcare providers to do more with technology. It guides our actions and is
the key to deliver our strategy. Inspiration 64’s precision tomography is independently developed in a HiResolution, High-Definition Algorithm. Inspiration 64 adopts a unique low-dose technique to minimise the radiation dose to patients, which is better known as iDream. The adequate X-Ray tube heat storage and generator capacity are increased 2.7 times with the help of iDream software. He further said, “Sequoia Healthcare strives to bring in advanced and affordable international technology, which serves in cost-effective healthcare. Sequoia believes in delivering radiology equipment accessibility for cost-effective healthcare. In short, we want to bring diagnostic reach to all. With high-tech services accompanied with new world Artificial Intelligence (AI), robotics, etc., Sequoia aims to become the number imaging devices manufacturer in the world.”
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