Breast image technologies on Philips Epiq

[Christine Fenech]

Hi Steve, great breast webinars, I’m just wondering about image optimisation/new technologies on other systems aside from Canon, particularly Philips. Are there any ADF/SMI equivalents? my experience is that the Epiq colour doppler is quite sensitive but are there any improvements I can make to it? Also are there any micropure equivalents or other competing technologies? And are micropure and the speed of sound correction (I’ve forgotten what it was called) A800 technologies only or should I be able to locate that on the 550 or 500 platforms?
Thanks 🙂
Christine

[Stephen Bird]

Hi Christine,

All great questions,

The webinar was originally recorded for Canon Medical and hence I only talk about their technologies.

On the Philips platform there are certainly good options to explore.

They have Colour and Power Doppler options as well as a new feature.

It is called MFI DH and is the Philips version of SMI.

I have used it a few times and it is certainly a lot better in terms of sensitivity when compared to their traditional colour and power Doppler options. Well worth using.

Remember also when using all of these technologies you can switch Doppler freqiuency on the Epiq now. It has a low frequency and a high frequency option as well as an “adaptive” option which I presume selects the best frequency depending on the depth.

Check the filter level and make sure this is on low as sometimes the machine comes with it set on high to make the image pretty with less motion artifact but this setting will cost you sensitivity.

Another thing on the Epiq is that the PRF is not always more sensitive when you reduce the PRF. I find in some cases that I don’t get the best sensitivity with a very low PRF and if I increase it a notch or even two it gives me more sensitivity.
It makes no sense in terms of pure physics, but I suspect when you get to the really low PRF settings the engineers increase the filter level a little to reduce artifact and this causes the reduction in sensitivity. It is all about knowing your machine! So try a few different PRF settings, all in the low range, but you will find which setting works best and it might not always be the one you expect.

I have not seen anything like micropore on other platforms. But I don’t actually use it much on the Canon platform either so i don’t really miss it when I am on another platform.
I think my old eyes see the high level echoes just as well as the technology assisted image.

Yes there is speed of sound adjustments on the Epiq and also the GE systems.

Philips call it TAC and there are 2 choices, TAC1 and TAC2

GE call it SOS,

The Canon is still my pick for these technologies as it offers many more fine graduation choices and it is an automatic process. Simply hold the transducer still and ask for a TSO auto calculation and the machine selects the ideal setting. it is a more manual process on the Epiq, however it is certainly available and worth exploring.

The Canon TSO is available on all platforms, i800, i700, a550 and even the older a500 systems which are now retired from production.

You can only use the automatic TSO function with linear arrays, so that is fine for breast work, but you can also make a manual adjustment on your convex arrays so if I am doing a high BMI abdominal or obstetric scan I would use minus 6 for example and if I am scanning you I would use +2 as an octopus in never fat (haha).

I hope this helps to answer your questions.

I am away teaching at the moment so don’t have an Epiq I can sit and look at so I have done this reply to the best of my memory.
I might be able to add more detail when I get back in front of a machine.

Steve

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