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.