Entries by Fernanda Fraga


KA Imaging to Present Poster on unprecedented Lateral Dual-Energy X-ray Views at ECR 2021

WATERLOO, ON (February 24, 2021)Business Wire – KA Imaging, a company that develops innovative X-ray imaging solutions, announced that a poster reporting on results from a study examining the feasibility of lateral chest dual-energy subtraction radiography using a stacked single-exposure multi-layer x-ray detector will be presented by Sebastian Maurino, a medical physicist at KA Imaging, at this year’s European Congress of Radiology (ECR).As highlighted in the poster, KA Imaging’s novel approach allows radiologists to take full advantage of lateral dual-energy images by obtaining both conventional and dual–energy subtraction lateral images simultaneously, thereby making it considerably easier to differentiate between materials behind the heart.

Quoting directly from the poster, “The DE lateral image also visualizes calcified joints and masses behind the heart that are not visible in the [Posterior-Anterior (PA)] image. Multi-layer detectors were shown to provide DE PA and lateral images of the chest at conventional patient dose levels.”

“Older generation dual-energy subtraction X-ray machines need two X-ray exposures. This results in considerable additional radiation exposure for the patient, helping to explain why lateral dual-energy images are so uncommon today,” said Karim S Karim, Ph.D., CTO of KA Imaging. “KA Imaging’s proprietary technologies have eliminated these extra radiation concerns by working with only one single standard chest X-ray exposure that has the added benefit of zero motion artifacts.”

ECR, being held virtually this year from March 3 – 7, is one of the largest medical meetings in Europe and the second-largest radiological meeting in the world. ECR attendees span all areas of the radiology arena including: radiology professionals, radiographers, physicists, industry representatives, and press reporters for both the medical and consumer press. In addition to participating in the scientific program of ECR 2021, KA Imaging will also host a virtual exhibition booth throughout the meeting.


Soft tissue image

Bone image

About KA Imaging

A spin-off from the University of Waterloo, KA Imaging specializes in developing innovative X-ray imaging technologies and systems, providing solutions to the medical, veterinary, and non-destructive test industrial markets. For more information, please visit www.kaimaging.com.


Fernanda Fraga 
Media Relations
T: 226.215.9897

Stephen Kilmer
Investor Relations
T: 647.872.4849

Detecting Small Pulmonary Nodules

Click here to fill the form and receive the PDF.

Fill the form to unlock the PDF.

KA Imaging is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as well as other content that may be of interest to you. If you consent to us contacting you for this purpose, please tick below to say how you would like us to contact you:

You can unsubscribe from these communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our Privacy Policy.

By clicking submit below, you consent to allow KA Imaging to store and process the personal information submitted above to provide you the content requested.

HOW dual-energy x-ray CAN overcome the common problems of using conventional radiography


The Reveal™ 35C X-ray detector is KA Imaging’s solution to address the shortfalls of conventional chest radiography. Reveal™ 35C provides dual-energy subtraction X-ray images along with conventional chest radiographs that can help to better detect small pulmonary nodules.

The Reveal™ 35C detector is portable and universally compatible, which means it can replace detectors in any existing chest radiography systems including fixed and mobile machines. Reveal™ 35C is also more affordable than other fixed dual-energy subtraction X-ray technologies and can be taken right to a patient’s bedside in an emergency room or intensive care setting.

Read the blog post below for a summary of the article.

Three Problems with using Conventional Radiography for Detecting Small Pulmonary Nodules – And How Dual Energy Can Help


Conventional chest radiography is still the most common technique used for the detection of small pulmonary nodules and other chest diseases. It is simple and inexpensive, readily available, portable and uses the least amount of radiation when compared to computed tomography (or CAT) scans. Unfortunately, chest radiography has proven to be inconsistent.

Pulmonary nodules are small round or oval shaped growths in the lung. Countless small pulmonary nodules are discovered each year during chest X-rays or CAT scans, but many go undetected. Although most are noncancerous (benign), some could be potentially dangerous for a patient. There are usually no symptoms associated with pulmonary nodules, and they can be due by infectious causes, disorders, or even be an early sign of lung cancer.  

The Reveal™ 35C X-ray detector is KA Imaging’s solution to address the shortfalls of conventional chest radiography. Reveal provides Dual-energy Subtraction X-ray images along with conventional chest radiographs that can help to better detect small pulmonary nodules5. The Reveal detector is portable and universally compatible, which means it can replace detectors in any existing chest radiography systems including fixed and mobile machines. Reveal is also more affordable than other fixed dual-energy subtraction X-ray technologies and can be taken right to a patient’s bed side in an emergency room or intensive care setting.

Detecting pulmonary nodules. The image has a huge magnifier showing cancer in the lungs and doctor with document folder. Lung cancer, trachea and bronchus concept on white background.

Here are the top 3 problems with conventional radiography, and how Dual Energy can help.

Problem 1: The false negative rate for detection is high

The false negative rate for the detection of pulmonary nodules has been reported to be anywhere within the range of 19 to 72%3. Interpreting X-ray images or even CAT scans can also be a lengthy and difficult process for radiologists. This is due to not only the quality of the technology used, but the irregularity shown in the nodules or small masses themselves.

How Dual Energy can help

Reveal is a dual-energy detector and has a unique patented technology: it is capable of simultaneously capturing dual-energy subtraction images and very high DQE digital chest radiography images6,7. The Reveal detector provides conventional, and separate bone and soft tissue images with a single X-ray shot thus identifying hidden nodules that may be obscured in the tricky bony apical regions or the retrocardiac areas of the chest.

Problem 2: Pulmonary nodules can be very small and dense

Conventional chest radiography often fails to detect small pulmonary nodules because of their size and density. In fact, small pulmonary nodules are labelled as such when their size is less than approximately 1.2 inches1. Any larger than this, and they are likely to be identified as a pulmonary mass which could represent a cancer.

How Dual Energy can help

Dual-energy subtraction X-ray imaging has been reported to increase sensitivity up to 50% to aid in early diagnosis and monitoring5. Reveal 35C provides clear high-quality images that enable bone and soft-tissue differentiation. Three different images give radiologists options and comparisons to aid in diagnosis as well as identifying calcified from non-calcified nodules.

Problem 3: Bones and internal structures can obscure these small growths

Detecting lung nodules is further complicated by the structures obscuring them from view, such as the ribs, clavicles, mediastinum, and pulmonary vessels. 82-95% of lung cancers missed by radiologists were partly obscured by overlying bones in one study3.

How Dual Energy can help

Reveal is a dual-energy detector and has a unique patented technology. Its single 120kVp exposure generates three separate X-ray images. Conventional chest radiography routinely ignores the useful information encoded in the regular energy spectrum of the transmitted photons. Reveal can obtain this information by performing spectral decomposition of the X-ray beam. This additional spectral energy information enables selective removal of anatomical background, enhancing detectability of anatomies of interest. With one shot, Reveal provides a high-quality chest radiograph , a bone-subtracted image, and a tissue-subtracted image.


1.     Cleveland Clinic. Pulmonary Nodules. Disease & Conditions, Health Library. https://my.clevelandclinic.org/health/diseases/14799-pulmonary-nodules#:~:text=A%20pulmonary%20nodule%20is%20a%20small%20round%20or,likely%20to%20represent%20a%20cancer%20than%20a%20nodule.

2.     Li, B., Chen, K., et al. (2013) Detection of Pulmonary Nodules in CT Images Based on Fuzzy Integrated Active Contour Model and Hybrid Parametric Mixture Model. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652289/

3.     Oda, S., Awai, K., et al. (2009) Detection of Small Pulmonary Nodules on Chest Radiographs: Efficacy of Dual-energy Subtraction Technique Using Flat-panel Detector Chest Radiography. Clinical Radiology, Elsevier Health.

4.     Shah, PK. Austin JH, White CS, et al. Missed non-small cell lung cancer: radiographic findings of potentially resectable lesions evident only in retrospect. Radiology 2003, 226: 235-41.

5.     Oda, Seitaro, Kazuo Awai, Yoshinori Funama, Daisuke Utsunomiya, Yumi Yanaga, Koichi Kawanaka, Takeshi Nakaura et al. “Detection of small pulmonary nodules on chest radiographs: efficacy of dual-energy subtraction technique using flat-panel detector chest radiography.” Clinical radiology 65, no. 8 (2010): 609-615.

6.     Maurino, S. L., Ghanbarzadeh, S., Ghaffari, S., Zhang, T., Cunningham, I., & Karim, K. S. (2018, June). Evaluation of A Novel Stacked Triple-Layer Flat-Panel X-Ray Detector for Dual-Energy and Digital Radiography Imaging. In Medical Physics (Vol. 45, No. 6, pp. E137-E137). Wiley.

Maurino, S. L., Badano, A., Cunningham, I. A., & Karim, K. S. (2016, March). Theoretical and Monte Carlo optimization of a stacked three-layer flat-panel x-ray imager for applications in multi-spectral diagnostic medical imaging. In Medical Imaging 2016: Physics of Medical Imaging (Vol. 9783, p. 97833Z). International Society for Optics and Photonics.

World Cancer Day Raises Awareness Of Disease And Prevention

World Cancer Day is observed on February 4. It is the global uniting initiative led by the Union for International Cancer Control (UICC). 

Here at KA Imaging, we are proud to have partnered with Grand River Hospital to test the effectiveness of the Reveal 35C x-ray detector in patients with lung cancer

Learn more about this disease, which is considered the 2nd leading cause of death in the world.

infographic showing different statistics on Cancer in Canada, the US and globally. Feb 4 is World Cancer Day.



1.World Health Organization. Cancer. Retrieved February 1, 2021 from https://www.who.int/news-room/fact-sheets/detail/cancer

2.World Health Organization. Cancer Tomorrow. Estimated number of new cases from 2020 to 2025, Both sexes. Retrieved February 1,2021 from https://gco.iarc.fr/tomorrow/en/dataviz/isotypeyears=2025&single_unit=1000000&types=0&group_populations=0&multiple_populations=0&populations=900

3.World Health Organization. Cancer Tomorrow. Estimated number of deaths from 2020 to 2025, Both sexes. Retrieved February 1,2021 from https://gco.iarc.fr/tomorrow/en/dataviz/isotypeyears=2025&single_unit=1000000&types=1&group_populations=0&multiple_populations=0&populations=900

4.Brenner D.R., et al. (2020). Projected estimates of cancer in Canada in 2020. CMAJ. doi: 10.1503/cmaj.191292

5. American Cancer Society. (2021). Cancer Facts & Figures 2021. Retrieved February 1, 2021 from https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2021/cancer-facts-and-figures-2021.pdf

6. National Cancer Institute. (2020). Cancer Prevention Overview (PDQ) – Patient Version. Retrieved February 1,2021 from https://www.cancer.gov/about-cancer/causes-prevention/patient-prevention-overview-pdq


inCiTe FAQ series

Welcome to the inCiTe FAQ series. Every week, we will release a new video on some frequently asked questions about our inCiTe™ micro-CT.


What is micro-computed tomography?


Download the technical note to learn more.

What is the difference between direct and indirect x-ray detection? 

What factors can affect the resolution of the micro-CT?

What is phase-contrast technology?

How does BrillianSe work and how does this detector impact the quality of inCiTe?

What are the applications of the inCiTe Micro-CT?

What makes inCiTe unique?


KA Imaging’s CTO Discusses X-ray as a COVID-19 Screening and Monitoring Tool

Medical team looking after infected patient in hospital, coronavirus concept.

“Since last March 2020 to now, we have learned a lot and the approach is now better,” said Dr. Karim S. Karim, Founder and CTO of KA Imaging, about COVID-19 detection methods. Karim was one of the panelists in the Canadian Innovative COVID Solutions panel discussion last January 26, 2021. He discussed X-ray as a screening and monitoring tool. 

This event, attended by nearly 150 people, was hosted by the Government of Quebec, in partnership with the Bureau du Québec à Toronto, the Canadian and International Innovation Partnerships Directorate and Clinical Trials Ontario. Experts from Québec and Ontario were invited to discuss the different resources and innovative solution to counter COVID-19 and other pandemics.

Although PCR testing is very accurate, it has many limitations. “The biggest concern is supply chain”, emphasized Dr. Karim. There is trouble securing the tests, as it takes between three to six days until the results are ready. Ensuring raw materials and manufacturing capacity is time consuming. In addition, many countries cannot afford PCR tests, forcing them to resort into alternative methods for screening patients with COVID-19.

Chest x-ray is not a diagnostic tool for COVID but is reasonable enough for screening. “It is a good alternative in emergency situations. It is accurate and gives faster results, allowing physicians to make decisions quicker”, added Dr. Karim. Countries resorting to extensive use of diagnostic radiology to detect COVID end up getting a positive outcome by suppressing the early surges of this infectious disease.

“Digital health is definitely a trend”, said the Founder and CTO of KA Imaging. KA Imaging is improving X-ray. Reveal™ 35C is a detector with high sensitivity that is making use of the spectral information in the X-ray beam, which is also used in the hospitals. KA Imaging’s X-ray technology can use information contained in the X-ray spectrum to form a traditional DR, soft-tissue, and bone images. The dual-energy detector is currently being used in a clinical study in Toronto on pneumonia patients, including COVID induced pneumonia patients. “There are promising results, which will be published in the near future”, said Dr. Karim.



Zu, Zi Yue, Meng Di Jiang, Peng Peng Xu, Wen Chen, Qian Qian Ni, Guang Ming Lu, and Long Jiang Zhang. “Coronavirus disease 2019 (COVID-19): a perspective from China.” Radiology 296, no. 2 (2020): E15-E25.


KA Imaging Appoints Seasoned Industry Executives To Key Leadership Positions

Manufacturer KA Imaging has appointed Shawn Campbell as Vice President of Operations and Robert Moccia as Vice President of Sales, USA and Canada. 

Shawn has over 30 years of experience in business development and operational leadership.  Shawn served as an executive at General Electric (GE) Healthcare for 25+ years. Most recently, he was the VP of operations at Neurolign Technologies, Inc. Skilled in operations and strategic planning, Shawn will be a key contributor to KA’s growth.

In addition to Shawn, KA Imaging recently hired healthcare veteran Robert Moccia as VP of Sales in the United States. Bob brings over 20 years of management experience in the medical device industry to KA Imaging. Prior to joining KAI, Bob held various executive commercial roles with GE Healthcare in the areas of ultrasound and mammography. 

After the recent FDA 510(k) clearance and Health Canada approval for KA’s dual-energy flat panel Reveal™ 35C, the company that was founded as startup shows that it is ready to scale.

Shawn Campbell, VP of Operations

Robert Moccia, VP of Sales, USA


inCiTe Micro-CT Photo Friday: Flannel Sample

How long  does it take before a cloth mask becomes inefficient as protection? We used inCiTe Micro-CT to see a small flannel cloth sample. 

Flannel is a soft woven fabric that is originally made from carded wool or worsted yarn, but is now made from either wool, cotton, or synthetic fiber. Flannel can be found in any clothing item, especially in cloth masks – yes, those ones we have been all using to prevent the spreading of COVID-19.

Cloth masks have many advantages, such as affordability, reusability, and longevity. They effectively stop fluids from coughs and sneezes, making their overall protection higher1. It is recommended to change the mask every 8 hours and should wash it regularly1.

But do you know how long it takes before
a cloth mask becomes inefficient against viral protection?

With inCiTe™ Micro-CT, we were able to see a small flannel cloth sample down to its fibers
because some of our collaborators wanted to observe how multiple washes affect
a cloth mask.   

Specialists advise that masks should be washed regularly and discarded if you notice any visible deterioration.  Visit the Health Canada website for more info on how to properly storage and wash cloth masks.


  1. Kluziak, M. & Miszewska, D. (2020). Coronavirus Mask Calculator. Retrieved from https://www.omnicalculator.com/everyday-life/coronavirus-mask

Dual-Energy Subtraction: The Future Of X-Ray Imaging

“Dual-energy subtraction is really the future of X-ray imaging” said Dr. Karim S. Karim, CTO of KA Imaging Inc., in a GEDI Exchange webinar held in January 2021.

The GEDI Exchange is part of the Gateway for Enterprises to Discover Innovation at University of Waterloo. Its mission is to support startups, founded by the university’s faculty, to develop and grow the enterprises to their full potential.

Alongside Dr. Karim, Carla Girolametto, Director of Research, Innovation and Clinical Trials from Grand River Hospital (GRH) made an appearance in the panel discussion.

In 2018, GRH and KA Imaging started a case study to test KA Imaging’s new product RevealTM 35C, the world’s first and only mobile dual-energy x-ray detector. RevealTM uses KA’s patented single-exposure dual energy technology, SpectralDRTM . This ground-breaking technology acquires the full spectrum and multiple energies in one
standard chest X-ray exposure, thus maintaining the radiation dose of a
conventional chest X-ray. This technology produces sharp X-ray images that
contain zero motion artifacts. The goal of the study is to look for nodules (calcified or not) and any hidden lesions behind the rib cage, by comparing dual-energy x-ray and conventional X-ray images using CT as a gold standard. Girolametto emphasized how clinical and academic partnerships have helped GRH remain a healthcare facility that is welcoming of innovation for almost two decades.

The clinical trial is still ongoing and shows promising initial results. With Reveal TM 35C, Radiologists were impressed by the clarity of the images captured – hidden masses were discovered in the soft tissue dual energy image that the conventional X-ray image did not pick up.

Dr Karim also talked about Artificial Intelligence (AI), a topic that is always present when it comes to Radiology. He believes that AI is a “second reader to assist radiologists by allowing them to be more accurate and efficient”.  The more information you can get from a detector, the better AI will perform. The three-layered design of Reveal improves the capability of machine learning, as Reveal produces three different levels of raw X-ray spectral information. “It’s a win-win situation. It allows for better management” he added.

Reveal’s Dual-Energy technology simultaneously acquires 3 images in one single shot, improving visualization of bone and tissue. Use the slider to transition between a traditional DR and the two dual-energy images created by Reveal.

KA Imaging X-Ray Systems Celebrates 2020 Milestones

KA Imaging is unstoppable. Looking back to 2020, the X-ray systems manufacturer KA Imaging can describe it as “rewarding”. Despite all the difficulties brought by the global COVID-19 pandemic, the team was capable of remarkable achievements. Reveal™ 35C: ready to go Reveal™ 35C, the world’s first portable single exposure dual-energy X-ray detector, received FDA Clearance […]