The History of Transcranial Doppler (TCD) Equipment – Part 2

If you are looking for a new Transcranial Doppler machine, take a look at this two-part history review of how the TCD technology started and the global impact it had over the last 4 decades.
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History of TCD Devices Continues

In part 1 of this review, we covered the first 2 decades of Transcranial Doppler (TCD) equipment in driving the TCD market. This short review will discuss the next 2 decades or so of TCD equipment development for extended neuro-applications and cerebral diagnosis.

Introduction of Digital TCD Equipment and Emboli Detection

The systems in the early days of TCD were based on standard analog Doppler technology. The late Dr. Merrill Spencer shifted the focus of both Doppler insonation and clinical applications with new ideas and co-founded Spencer Technologies™ (USA).

Spencer Technologies™ based its TCD devices for the first time on digital technology platforms. In addition, Dr. Spencer focused much of his and the companies’ research on emboli detection. As a result, Spencer Technologies™ patented the Power M-Mode algorithm and display, which allowed clear visualization of emboli traveling within the bloodstream.

Their initial TCD model was the TCD100M™, followed by the ST2™ and ST3 ™ Transcranial Doppler models.

The Industry Followed the Footsteps of Spencer Technologies™

During the first decade of the 21st century, most TCD companies switched to digital Doppler platforms. The first company to switch to digital a digital platform was Biobeat Medical, which developed the Sonara™ TCD machine. In 2006, Viasys™ Healthcare acquired both Sonara™ and Sonara/tek™ TCD machines. Viasys™ included them as part of their Nicolet brand as a Nicolet Sonara™ TCD system. With the acquisition of Viasys by Cardinal Health™ (and Carefusion™), the Sonara became a Carefusion™ product. Later on, Natus™ (USA) acquired the rights to the Sonara and continued the worldwide distribution of this unique product.

DWL™ followed up and switched most of its Multi-Dop™ products to digital technology. Likewise, Rimed™ developed its first digital TCD machine called Digi-Lite™. Delica™, a company out of China, also appeared in the TCD arena with its EMS™ product line. Delica™ collaborated with Multigon™ in this market. And in France, Atys™ introduced the Waki™ TCD systems.

Introduction of Transcranial Doppler Modules

Another significant change in the TCD market during the first decade of the 21st century was the introduction of TCD modules. The idea of the TCD module is that it can connect to any computer and display for operation.

The first company to introduce such a TCD module was Biobeat Medical, which developed the Sonara/tek™ system, later known as the Nicolet SonaraTek™ TCD module or Natus™ SonaraTek™ TCD module. In parallel, and around the same time, DWL™ also introduced its version of a TCD module to the market, and it was named the Doppler Box™ system.

Most other TCD companies followed in these footsteps, introducing the EMS-9F™ by Delica™ or the Digi-One ™ by Rimed™. Later on, Viasonix™, a company specializing in vascular technology and diagnostics, introduced the modern Dolphin/IQ™ TCD module as the natural advanced successor to the Nicolet SonaraTek™ TCD machine.

Introduction of Robotic TCD Headsets

The use of TCD requires experienced and professional sonographers. This poses a limitation when TCD needs to be used in settings where experienced neurosonologists are not present. Such typical clinical settings include operating rooms (OR), intensive care units (ICU), and emergency rooms (ER). In addition, performing bilateral monitoring can frequently pose a significant challenge even to experienced neurosonologists that need to use the standard TCD monitoring headsets.

During the past decade, TCD robots were developed to overcome these challenges and assist users in monitoring cerebral blood flow velocities in critical care conditions and during standard monitoring sessions.

Delica™ (China) was the first to develop a TCD robotic probe that can be placed over a standard-looking monitoring headset. This robot is also presented by Multigon Industries™ (USA) with the Nexgen Robotic TCD system, ROBOTOC9MD™.

Atys™ (France) designed the TCD-X™ robot but with a different concept. Atys designed the robot to be a TCD holter, intended to be carried by the patient during the cerebral monitoring session. The Atys device is placed on an eyeglass type of headset and measures the flow only on one side (unilateral).

In 2013 a new company was initiated in the USA called Neural Analytics™. Neural Analytics™ designed the Lucid™ TCD system and the NeuralBot™ bilateral TCD robotic probe that requires dedicated robot equipment. Neural Analytics™ recently changed its name to NovaSignal™, and the NovaSignal™ robotic probe was changed to NovaBot™ together with the NovaGuide™ TCD intelligent ultrasound platform.

Changing the TCD Market with Modern Devices

Viasonix™ is based on the same TCD engineering team that originally developed the Nicolet Sonara™ and Sonara/tek™ products. Viasonix introduced to the TCD market the advanced Dolphin/4D standalone TCD device, which is the natural successor to the Nicolet Sonara™ systems. The Dolphin TCD product family introduced many high-end options and features to the market, such as advanced post-processing abilities and emboli detection capabilities.

Viasonix was the first company to address an immediate need of the TCD community and developed the battery-operated Dolphin/MAX standalone system. This TCD machine allows ease of operation in settings that require the machine to be frequently moved from bed to bed or from site to site.

To conclude this review, it is important to mention the most recent advancement in the TCD market made by Viasonix. Viasonix joined the selected group of companies with TCD robotic solutions and designed the Dolphin/XF TCD robot. This powerful TCD robot with its comfortable headset is considered by many to overcome all of the limitations posed so far by other TCD robots. It is easy to place, simple to use, fast, effective, and can scan the brain bilaterally in just a few seconds.

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