Digital Solutions Without Compromise: A Conversation With iCRco CEO Stephen Neushul

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Stephen NeushuliCRco is an established imaging manufacturer and software developer that provides complete digital-imaging solutions. In business for nearly 20 years, the company houses research and development, software engineering, and technical support—as well as sales and marketing teams—under one roof at its headquarters in Torrance, California. iCRco has developed a range of low-dose CR and DR imaging products, in addition to PACS software; together, they constitute complete imaging solutions for a variety of settings, including hospitals, imaging centers, and military installations. spoke with CEO Stephen Neushul about the company’s solutions and his vision for the future of CR and DR. What precipitated iCRco’s entry into the radiography business? Neushul: I’m an engineer, and in 1990, I was working on deployable structures for the space station when I was asked to help in designing a small-format, CCD-based film digitizer. Three years later, I had the idea to create a large-format film digitizer with a lightbox built into it; you placed the film on the lightbox and initiated scanning. The process allowed the end user to confirm the quality of the scan with the film on the lightbox. That method was very useful because it provided instant quality-control feedback to the user. Many of those scanners are still being used today. On a more personal level, in 1990, my dad died of cancer, and he died, in part, because of a misread radiograph. He’s one of my reasons for doing this. He once said to me, “You want to be an engineer, and that’s great—the one thing we really need is better sensors.” It’s very personal, but it sticks to the bone. At iCRco, we strive to make better sensors. The iCRco brand has a strong presence in the international market. Why has that market embraced your technology? Neushul: Our international partners, particularly those that service remote locations, realized very quickly that our machines seldom break down; our products have extremely durable exoskeletons and incorporate True Flat Scan Path™ technology. This ensures that the phosphor plates never leave the cassette and produces lifetime, artifact-free DR images. Our devices routinely process studies for 300 patients a day (more than 900 scans) in high-level hospitals around the world, including those in China, India, and Mexico; other digital systems simply cannot handle that workload without constant hardware support and replacement of phosphor plates. We have always had a strong presence in the United States as well—including, most notably, our US military contract. One of our products, the iDR Long Bone, was recently installed at the Mayo Clinic. The iDR Long Bone can take a radiograph of the whole spine or leg bone without stitching or distortion (or delivering a high dose from multiple exposures). We’ve recently created a new ultralow-dose imaging device. We call it the Fusion DCR™. It is a DR and CR in a single machine—mounted to a wall stand. All upright radiography procedures are done using DR. The CR is used for table work and can achieve a cycle time of nearly twice the speed of the nearest competitor. This solution, with our low-dose needle phosphor, achieves up to a 75% lower patient dose for a chest radiograph. Speaking of iCRco’s military contract, why is your technology so well suited to battlefield conditions, and how have those adaptations informed product development for nonmilitary settings? Neushul: The technology we developed for the military is actually a very compact CR system built into a scan head and using a mechanical drive system. The cassette is drawn across the scan head, and it captures one line of the image at a time, much like a desktop-publishing scanner. This project took well over three years to complete. It’s ultraportable—the size of a backpack—and weighs about 55 pounds. It has a rugged exoskeleton that makes it extremely tough. Although the military unit is small, there was no sacrifice in performance. That technology was the basis we used to develop our iDR, the iDR Long Bone, and now, the Fusion system. Radiography was imaging’s first modality and continues to account for the greatest volume of imaging procedures, but with the transition from analog to digital operation, has it reached maturity? Is there still more information to be gained from the modality? Neushul: We think so, yes. I believe that the transition from analog to digital has really introduced a new modality: With iCRco’s imaging solutions, you can see much more, with much better dose efficiency. Radiography will be around for a long time, and we’re continually trying to improve workflow with products like our Fusion device. With our improved technology, we can sample at 10 line pairs per mm, which provides razor-sharp resolution. I think we are achieving small breakthroughs in imaging, but they will lead to better patient outcomes. How have the budgetary pressures placed on health-care organizations by reform affected the kinds of technologies that US providers want? Neushul: Our proposition to the provider is compelling: We offer an incredible reduction in dose and improvement in resolution with a compact, robust digital machine. We excel at providing products with a low cost of ownership. Our machines do not have a disposable component—they are built to last, and they perform at the same level, year after year, with only routine maintenance. What do you see as the main pain points in radiography, and where are you concentrating your development resources? Neushul: Providers are looking for a differentiator in their modalities that will bring patients to their facilities and let them provide great care once those patients arrive. Our value proposition revolves around ultralow dose, excellent workflow, throughput, and low cost of ownership. We aim to provide solutions for the issues providers are facing today—if radiologists can see more patients and they provide excellent care, they can afford to stay in business and thrive. Cat Vasko is editor of and associate editor of Radiology Business Journal.