The Future of 3D CT Imaging: Xoran Technologies is Facilitating Better Diagnosis through Point-of-Care CT Systems

“Xoran’s vision is to improve patient care by delivering innovative CT imaging solutions for instant diagnosis at the patients’ point of care. Xoran makes the complex simple.”

The rising prevalence of chronic diseases and recent developments in the healthcare sector fuel the demand for advanced imaging systems, including computed tomography (CT) systems. Computed tomography is a medical imaging system widely used in healthcare facilities for diagnostic and therapeutic purposes. CT has evolved as an important tool in managing and diagnosing several diseases such as cardiovascular, oncology, neurology, and orthopedic diagnoses. Therefore there has been a steady increase in demand for CT scan machines. Also, the introduction of technologically advanced CT scanners is one of the major factors stimulating market growth.

Currently, only a handful of players operating in the market are providing technologically advanced truly mobile cone-beam CT scanners. Xoran Technologies is one of them. Misha Rakic, CEO, and his company Xoran Technologies are on a quest to improve patient care, and reduce waste and inefficiency in healthcare by developing the most innovative solutions for medical imaging at the patient’s point-of-care, meaning directly where the clinician is seeing and diagnosing the patient. The company is creating robust products and services by leveraging its core competencies in medical imaging, information technologies, and customer service.

Xoran Technologies | Synopsis

Since Xoran’s beginning in 2001, the innovator and medical market leader in cone-beam computed tomography (CBCT) imaging has been passionate about developing common sense solutions to complex problems. These groundbreaking technologies enable clinicians to treat patients more efficiently and effectively.

Xoran’s product line includes the upright MiniCAT™ in-office CT systems, the xCAT™ suite of truly mobile CT devices, their suite of veterinary 3D CT products, cloud-based image viewing and back-up through XoranConnect^®, as well as future grant-enabled projects in spine and lung.

“As Xoran’s flagship product, the MiniCAT, is designed specifically for ear, nose, and throat (ENT) surgeons and allergists,” says Rakic. “For two decades, Xoran has been the pioneer and medical market leader in bringing affordable, high-resolution CT imaging directly into the clinic. In fact, Xoran began commercializing MiniCAT in 2005, and today we are proud to say that there are over a thousand MiniCATs in use by thousands of providers globally.”

The American Academy of Otolaryngology-Head and Neck Surgery Position Statement on point-of-care imaging (POC) states, “With point-of-care CT imaging, the otolaryngologist is provided with digital 3-D images which can be reviewed in conjunction with the patient at the time of the initial office visit, which improves patient education, reduces patient anxiety, and improves patient compliance with prescribed treatment.” [entnet.org]

Indeed, implementing POC CT for the ENT surgeon means that patient treatment compliance drastically increases. When the ENT surgeon performs minimally invasive sinus procedures under local anesthesia directly in their office (as opposed in the hospital), practice revenue and throughput also increase. POC CT means lower radiation dose, faster treatment, and simply less hassle for the patient.

The Evolution of the Imaging Industry

In 2008, Xoran introduced the truly mobile xCAT™ for ENTs to use intraoperatively. At the time, the technology was such that imaging capability for brain imaging was not clinically sufficient for neurosurgery. However, as components evolved, Xoran developed and released the xCAT IQ—”IQ” stands for image quality— with soft tissue image quality detailed enough to visualize the brain.

“The potential for improved patient care cannot be understated,” notes Rakic.“Because the xCAT IQ easily maneuvers in small spaces, it is uniquely suited for use in the intensive care unit (ICU) and the operating room.”

Patients experiencing head trauma, seizures, brain cancer, among other symptoms and diagnoses, are generally monitored in the ICU—often before and after a surgical procedure. The neurologists, neuro intensivists, and neurosurgeons treating them will likely want at least one CT scan (sometimes two to three) of the patient’s head per day to monitor changes in the patient’s condition.

A mobile CT such as Xoran’s xCAT IQ addresses the need for patient comfort and reduces exposure to potentially risky transport from the ICU to the radiology department. Without POC CT, a team—including an ICU nurse and a respiratory technician, just join the transport team to ensure that the patient arrives at radiology with all supplementary devices—breathing and IVs—intact. Up to 80 percent of the time, an adverse event can occur in which the patient has complications from the transport, including even death.

In addition to the ICU, the xCAT IQ and the xCAT XL are uniquely suited for intraoperative imaging. Increasingly, surgeons are moving towards minimally invasive approaches to surgery, meaning that they are avoiding large cuts in anatomy, in turn reducing complications and recovery time. The xCAT IQ provides real-time imaging so surgeons can update their surgical navigation system and work off updated anatomy during neurosurgery. What’s more, because of the small footprint and fast scan times, the lower dose xCAT XL has a unique value proposition assisting neurotologists in cochlear implant placement as well as in craniomaxillofacial (CMF) procedures in which surgeons need intraoperative imaging to confirm that delicate facial bones are put together properly, and mesh placements are correct.

Navigating the Veterinary Landscape

Xoran has been in medical device imaging since its founding. In 2017, they realized that the xCAT suite of products could be used to support the needs of veterinary medicine. Boarded veterinary dentists are highly specialized and trained surgeons who have benefited immeasurably from having 3D CT for their dog and cat patients, wheeled directly to the patients’ tableside.

“Before VetCAT™, veterinary dentists had to rely either on 2D X-ray projections—which are not only imprecise for surgical planning but do not reveal all disease pathologies that are present; or they had to use an expensive, hard-to-find full-body CT,” says Rakic. “But now, with VetCAT, these specialists can 3D image the patient while already under sedation or anesthesia for their standard dental exam. VetCAT improves animal care and is a revenue producer for the veterinary hospital.”

Recognizing clinicians’ needs for tissue imaging (in addition to the bone window imaging offered by VetCAT), in early 2021, Xoran introduced the VetCAT IQ™, which now offers the ability of veterinary ophthalmologists and other specialists to visualize tissue in eyes, as well as the sinuses, ears, brain, and teeth.

The latest addition to Xoran’s veterinary mobile CT suite is the vTRON^TM; an open-bore 3D CT made available for veterinary sale in 2021. Key features of the vTRON are the large open-bore gantry and small footprint, making it easy to implement in all companion animal hospitals. Like the VetCAT suite of devices, vTRON imaging is a major leap forward for diagnostics and treatment planning while also providing an additional revenue source for growing veterinary hospitals and general clinics.

Online Image Viewing Enabled by AI = Democratization of Healthcare

With the CT devices generating vast amounts of images and data, Xoran offers XoranConnect^®, a cloud-based system that stores Xoran CT imaging data and allows remote image-viewing anywhere a clinician or patient has internet.

“Furthermore, XoranConnect will be a perfect solution for future data mining,” states Rakic. “Using technologies such as artificial intelligence (AI) and neural networks to mine those studies and teach the systems how to diagnose certain pathologies will allow vast underserved rural and urban populations in the U.S. and globally to gain access to imaging and diagnostics by specialists who are currently few and in high demand. These AI-enabled tools will augment doctors’ capabilities and help them make better, more accurate diagnoses.”

Innovation Continues at Xoran

In 2019, Xoran announced it received a commercialization grant focused on integrated intraoperative imaging with surgical navigation from the National Institutes of Health (NIH) and the National Cancer Institute (NCI) through the Small Business Initiative Research (SBIR) project. The funds are facilitated by a matching grant from external investors, Decathlon Capital Partners.

Last year, the National Heart, Lung, and Blood Institute of the NIH granted Xoran’s application for lung CT imaging—providing point-of-care lung CT imaging solutions for the ICU.

“Leveraging our knowledge and experience as the pioneer and medical market leader in cone-beam CT, we are introducing—an open-bore, truly mobile CT to assist in the identification of lung disease as a part of the grant,” explains Rakic “We are partnering with specialists in Pulmonary and Critical Care Medicine and Radiology at the University of Michigan, Ann Arbor to facilitate our growth into these new markets and point-of-care solutions.”

“Leveraging our knowledge and experience in the field as the pioneer and medical market leader in cone-beam CT, we are introducing—an open-bore, truly mobile CT to assist in the identification of lung disease as a part of the grant.”

"XoranConnect will be a perfect solution for future data mining. Using technologies such as artificial intelligence (AI) and neural networks to mine those studies and teach the systems how to diagnose certain pathologies will allow vast underserved rural and urban populations in the U.S. and globally to gain access to imaging and diagnostics by specialists who are currently few and in high demand.”