Development of new SUREengine FAST Technology

Significant reduction in exposure dose in endoscopic examination of bile and pancreatic ducts


Shimadzu has developed the new SUREengine FAST (Fluoroscopy Assisted Studies and Treatments) image processing technology for the SONIALVISION G4 R/F system. This technology significantly reduces the X-ray irradiation dose in endoscopic retrograde cholangiopancreatography (ERCP), which is used in the examination and treatment of bile and pancreatic ducts using endoscopes.

A pulse rate of 15 fps is used as standard with SONIALVISION G4 in fluoroscopy during ERCP-related procedures. Comparisons made at this pulse rate have proved that the introduction of this new advanced technology allows the X-ray irradiation dose to be reduced by approx. 45 % while maintaining image quality, thereby reducing exposure for both patients and medical staff.

Shimadzu will include this technology as standard in SONIALVISION G4 systems in future.


Background to the development

The ERCP procedure is utilized in pancreaticobiliary duct biopsies for a detailed examination of pathological changes in pancreatic cancer and other diseases, and for treatments such as the removal of gallstones. In the ERCP procedure, an endoscope is introduced through the mouth and into the duodenum. Contrast radiography is then performed for the biliary system and pancreatic ducts directly from a narrow tube (catheter) attached to the tip of the endoscope. In this procedure, the fluoroscopic functionality of an R/F X-ray system is utilized to confirm the position of the catheter and the status of the contrast radiography. Such techniques require high-quality fluoroscopic images. However, these examinations sometimes take considerable time, so there is a need to reduce the radiation dose following the ALARA principle (As Low As Reasonably Achievable) in order to even better protect patients and medical staff.

To this end, Shimadzu has developed a new digital filter processing technology for SONIALVISION G4, the company’s leading R/F imaging system. This SUREengine FAST technology uses high-speed computational processing to reduce image noise and lag, even at low radiation dose rates. It significantly reduces the X-ray dose while maintaining the excellent X-ray image quality and real-time performance required in endoscopic examinations. Shimadzu’s next goal is to apply this low-exposure image processing technology to the examination of nonvascular systems, not just to endoscopic examinations.


Features of the new technology

Comparison was made at the fluoroscopic X-ray irradiation pulse rate (15 fps) used during conventional endoscopic examinations with SONIALVISION G4, and it has shown that the introduction of the new technology allows the fluoroscopic exposure to be reduced by approx. 45 % while maintaining image quality and real-time performance. Furthermore, if the pulse rate is reduced to 7.5 fps while using the new technology used, fluoroscopic exposure is reduced by approx. 70 % in comparison to the dose during conventional 15 fps examinations.




SONIALVISION G4 is one of the leading global models in the medical imaging diagnostic systems sector. Since its release, more than 700 of these systems have been installed on the global market – an impressive achievement. Thanks to a wealth of applications including Tomosynthesis and SLOT Advance (SLOT radiography), as well as the introduction of technology for reducing exposure dose, it can accommodate a variety of examinations beyond endoscopic procedures, in a range of fields such as urology and orthopedics. This way, it contributes to improving the quality of healthcare in many countries all over the world.


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