Although 3D rendering technology has existed for 20 years, it is just beginning to hit its stride. Facilities of all sizes and configurations are deploying an array of 3D rendering solutions to help radiologists navigate through the onslaught of data generated by today’s scanners. Cardiac CT angiography, which has skyrocketed with the advent of 64-slice CT, is driving adoption; however, other studies such as spine CTs and MR studies also benefit from 3D reconstruction technology.
While naysayers may peg 3D reconstructions as pretty pictures just for surgeons, 3D has become an important clinical tool, says John Warner, MD, radiologist and co-chairman, department of radiology at Marshfield Clinic in Marshfield, Wis. “3D volume-rendered images are essential for certain studies like MR angiography and complex spine cases. It makes the anatomy so much clearer and increases radiologists’ sensitivity and specificity for aneurysms [and other conditions].” What’s more, 3D may be cost-effective. “3D reconstructions could save money by eliminating unnecessary interventions or problems associated with less detailed and incomplete diagnostic information,” says Norbert Wilke, MD, chief of cardiovascular MR and CT services at University of Florida Health Center Jacksonville.
Facilities can choose from an assortment of 3D technologies and configurations. Stand-alone workstations provide the processing power to handle gargantuan datasets, and some functions such as coronary CT angiography post-processing and virtual colonoscopy may be available only on proprietary workstations. On the downside, stand-alone workstations can limit flexibility and disrupt workflow.
3D software, thin-client systems and PACS integrations provide greater flexibility and more readily distribute 3D technology across the enterprise. And 3D is invading the enterprise, too. “Radiologists aren’t the only 3D users,” says Steve Smith, PACS administrator at Alpena Regional Medical Center in Alpena, Mich. Surgeons, in particular, are turning to 3D for surgical planning, which means sites need a plan to distribute 3D functionality.
Another major issue to tackle is the 3D post-processing workflow. Who performs 3D reconstructions? Options include supertechs operating in a 3D lab. Alternately, radiologists can tackle the task and add it to their ever-growing to-do list, or a combination approach may best meet site needs.
This month, Health Imaging & IT visits with several sites to learn about their 3D programs. What software and hardware have been deployed? How are 3D tasks handled? And what are the benefits and challenges associated with the various options?
The 3D tech model
University of Florida Health Center Jacksonville has used and trained technologists and physicians on TeraRecon’s AquariusNET server and Aquarius workstation’s 3D rendering solutions. The university center instituted a 3D lab approach to reconstructions. “3D has become so prevalent that it has created a new job — the 3D post-processing technologist,” explains Wilke. The 3D tech is able to complete all post-processing for the radiologist; however, adequate training in anatomy, data acquisition and software applications is essential and must be taught prior to implementation.
The lab approach lets sites offer full 3D services, says Wilke. “It’s easier to train physicians to focus only on some specific applications they need rather than forcing them to learn all about 3D advanced post-processing functions. Relying on 3D techs reduces anxiety among physicians and opens the door to 3D imaging, especially if radiologists start with coronary or vascular MR/CT imaging.”
Whole body MR/CT angiography and cardiac imaging is patient-friendly and can be cost-effective in the long run. CT or MR angiography can be used to replace an invasive diagnostic test such as x-ray coronary or vascular angiography. The new option is brief, non-invasive and patient-friendly. “Imaging takes just a minute or two, and there is less risk to the patient. Plus, CT and MR angiography provide a full 3D/4D assessment of the anatomy and patho-morphological findings. Instead of looking only at the lumen of the vessel, CT/MR angiography helps the physician assess the vessel wall and measure plaque formation and atherosclerotic diseases at an earlier state,” notes Wilke.
Henry Ford Hospital in Detroit, Mich., also uses the 3D lab model. The lab and radiology department are outfitted with Vital Images Vitrea workstations, and three