A demonstration with 9-year-old bay mare Hevona of the new robotic-controlled imaging…

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By John George

Horses, the veterinarians at the University of Pennsylvania School of Veterinary Medicine’s New Bolton Center will tell you, are not the best patients when it comes to diagnostic imaging.

“We’ve all seen imaging scanners,” said Dr. Dean Richardson, the Kennett Square, Pa., center’s chief of large animal surgery. “They look like giant Krispy Kremes. We have really big patients and they don’t fit in little tubes.”

Additionally, noted center director Dr. Barbara Dallap Schaer, traditional imaging devices can only scan small areas of a patient’s body, which limits their use for horses.

But now Penn Vet has a new way to get the images they need.

The New Bolton Center showed off its new robotic-controlled imaging system Wednesday, developed in collaboration with Wisconsin-based Four Dimensional Digital Imaging (4DDI). It is designed to be used on standing and moving horses.

The Equimagine imaging system arrived at New Bolton Center in February and has been going through a complex installation process.

The system is capable of capturing a horse’s anatomy in ways never before possible. The system is unencumbered by an enclosed gantry or a C-arm, making it possible to scan any part of the patient.

“The robots can easily move all around the horse in any orientation while the horse is standing, so we can see many parts of the anatomy we’ve never seen before, and do it in a patient that is awake,” Dallap Schaer said.

The robot-powered imaging modality can collect typical, two-dimensional CT images; create three-dimensional images; produce 360-degree digital radiographic studies; and capture fluoroscopic images at up to 16,000 frames per second.

“Three-dimensional imaging provides the opportunity to be more precise in our treatments,” Richardson said. “That’s a big step forward. The goal in veterinary and human medicine is to provide less invasive and more precise surgical procedures. We have a lot to learn about this technology. Three-dimensional imaging opens new doors to diagnosis and treatments. We are very excited to be on the forefront of those discoveries.”

New Bolton Center, Penn Vet’s large-animal hospital on nearly 700 acres in rural Chester County, cares for horses and farm animals. The hospital handles more than 4,000 patient visits a year and its field service treats nearly 37,000 patients at local farms. In addition, New Bolton Center’s campus includes a swine center, and working dairy and poultry units that provide research for the agriculture industry.

“We are thrilled to be the first academic institution to have this technology,” said Dr. Joan Hendricks, dean of veterinary medicine at the University of Pennsylvania.

Penn officials declined to discuss the specific investment it made to acquire and install the robotic-controlled imaging system. Dallap Schaer characterized it as similar to a hospital purchasing advanced imaging technology. Start-of the-art MRIs and CT scanner typically carry price tags in the seven figures.

Richardson believes the technology will have a large impact on the horse racing industry. “It will lesson the number of catastrophic injuries that occur at the racetrack,” he said. “We’ll be able to identify lesions earlier.”

Penn Vet also plans to include using the robotic system to collect images of horses on a treadmill in order to look for patterns to gain a better understanding of why joint degeneration occurs.

Dr. Tom Schaer, director of Penn Vet’s preclinical service core and translation in orthopedic surgery, expects the technology — while being used in animals at the New Bolton Center — will lead to improvements in human care as well.

“The system is going to allow us to explore tissues in a dynamic setting, in motion,” he said. “Being able to image a veterinary or human patient in motion can be a game changer. For example, evaluating joints or the spine when they move will allow us to expand our knowledge to better understand certain clinical symptoms.”

Studying the spine of a back injury patient in motion, he said, could help clinicians understand where the pain is coming from, which in turn can help them determine how best to alleviate the pain.

Schaer noted imaging capabilities such as MRIs and CT scans exist, but they are static.

If, as expected, the robotic system can gather high resolution images of patients in motion, having that ability to compensate for accidental motion in imaging could have applications for children and infants who are too compromised or too sick for sedation or general anesthesia.

Penn Vet specialists are working with colleagues at Penn Medicine and Nemours Children’s Health System to identify and develop applications of the technology in human medicine

Schaer is also excited about the potential research applications. “We will have the opportunity to explore beyond what we have ever been able to do,” he said. “This technology enables us to push the research frontiers in understanding potential new pathologies that haven’t been detected before.”

Another company was also involved in the project. ABB of Zurich, Switzerland, a leading global manufacturer of industrial robots, supplies the robots and many of the control components used in 4DDI systems.

Yiorgos Papaioannou, CEO of 4DDI, said his company — which previously focused on human diagnostics — had not worked in animal health before starting its collaboration with Penn Vet.

“[Horses] are the nicest, most aesthetically pleasing, but most challenging patients you’ll ever find,”

Papaioannou said.