4DDI | Four Dimensional Digital Imaging



4DDI comparison to state of the art


4DDI dynamic scanners are capable of providing accurate, sub-millimeter-resolution images in formats allowing 4D visualization of the complexity of any musculoskeletal or other soft tissue region. 4DDI’s robotics enablers reduce scan time and data fusion time; EQUIMAGINE provides multimodal imaging (conventional panoramic and anthropometric, in addition to stereo-CBCT-TOMOSYNTHESIS images); improving anti-scatter protocols, soft tissue contrast; and incorporating task-specific protocols to minimize patient dose. The increasing availability of this technology provides the practitioner with a modality that is extending musculoskeletal imaging from diagnosis to image-based real-time guidance of surgical procedures.


1)  Significant improvement in spatial resolution i.e. slice –out of plane- thickness resulting in better resolution-up to 0.002mm slice thickness comparing to 0.5mm that is the best available in the market;

2)  In-plane image resolution that can be 3-5 times greater than competition; similar improvement in brightness and contrast help reduce significantly the dosage at no image quality loss;

3)  Data acquisition rates can be as high as 4-16,000 frames-per-second, allowing moving targets to stay in the frame longer so that more of the recorded event can be seen by the naked eye; no blurriness during moving tissue imaging;

4)  Accuracy one order of magnitude higher than current direct in-vivo skeletal motion measurement techniques (0.03 mm in translation and less than 0.5 Degrees in rotation) as compared to 2-3cm from competition;

5)  Our imagers offer radiation dosage reduction up to 300% of best existing in market;

6) Unprecedented system architecture for workflow efficiency and fractional production costs-ONE DEVICE performs SIX MODALITIES (replaces six competitive products).

Today’s capabilities in medical imaging are certainly effective.  For instance, CT scanning can be highly accurate and provide three-dimensional images that help determine morphology, provide intraoperative surgical guidance, and contribute heavily in the process of diagnosis.  CT is particularly useful and effective in imaging bone, but when images of organs or soft tissues are required, this modality is not as optimal, requiring contrast media and high radiation.  In addition, there is great variability in dosing because of the variability in imaging protocols, lack of standardized control of dosage, and inconsistencies in radiation technician training.

High radiation inhibits CT from being used much more often, even though it is a very effective instrument.  Because of the radiation, MRI and ultrasound have been used for imaging almost every traumatic and non-traumatic medical condition needing direct visualization.  In effect, the dangers of exposing patients to multiple doses of radiation, or even a single dose of high radiation in a CT scan has prompted a compromise in the quality of the imaging by using ultrasound and MRI.

The quality of an image poses risk in several ways.  Where morphology, sizing and tissue dynamic changes are of importance, accurate edge detection is required.  This is where MRI, fluoroscopy, and ultrasound are inadequate for most purposes of surgical guidance and diagnoses where static and dynamic accuracy are important, such as with joint stability, where direct assessment of sliding, gliding and rolling of articular surfaces ultimately determines the correct kinematics.

The static accuracy numbers demonstrated in this table and those referred to state of the art dynamic accuracy of current fluoroscopy cannot be effectively applied in characterizing joint stability, total joint device loosening, ligament laxation, issue balancing, arthritic dynamic cartilage behavior, soft-tissue differentiated imaging during high speed of motion,  vascular and neurologic imaging or imaging for surgical navigation during highly invasive procedures…these modalities are static, or too slow to capture these dynamic in nature pathologies…

Comparisons of STATIC and DYNAMIC accuracy for the most widespread commercial scanners and 4DDI products

Error in Tissue Motion Measurement in conventional video-based and skin marker based motion analysis system.

4DDI | Four Dimensional Digital Imaging

Conventional motion analysis techniques using skin markers attached to specific bony landmarks are acceptable in the study of osteokinematics but cannot be used to directly assess arthrokinematics. Indirect assessment of skeletal kinematics using skin markers introduces skin artifacts i.e. skin motion errors that can be as high as 2-5 cm during strenuous activities (running, jumping etc.)

4DDI | Four Dimensional Digital Imaging

Stereo biplane radiophotogrammetric analysis (DRSA)  at 200fps demonstrates that skin marker error can be more than 30mm during support phase of slow gait for the patient that is also assessed with conventional gait analysis methods.

The vertical displacement of the knee-epicondyle skin marker assessed by conventional motion analysis techniques is characteristically erroneous when compared to the bone kinematics assessed by rigidly fixed-to-the-bone markers using DRSA.

This 30mm error is equivalent to the averege  size of cartilage thikness, i.e., the size of the organ to be assessed is equal to the accuracy-resolution of the measurement system: more than 100% error in arthrokinematics. This error has been prevailing in orthopedic biomechanics studies assessing clinical outcomes in the past 40 years.”

Contrast and Brightness difference with competition

1000 F/s offers complete motion freeze and 99.9% elimination of blurriness

Higher sampling rates and up to 7000F/s are used to reduce the patient dosage


4DDI | Four Dimensional Digital Imaging

4DDI Products

4DDI | Four Dimensional Digital Imaging