By distributing the benefits of advanced visualization software tools to nearly any computer, anywhere, more and more clinicians are benefiting from thin-client-based advanced imaging techniques. Plus, they can query radiologists live without major workflow interruptions.

Detroit Medical Center in Michigan has been using Vitrea and VitalConnect from Vital Images for almost four years, according to Josh Lutz, senior systems architect, overseeing PACS, cardiology and ancillary systems. The radiology group started out using one workstation and server almost four years ago, but last year went to a site-wide license.

Originally, the software could only be used by radiologists and cardiologists. Now, it is available in a distributed format for all 3,000 referring physicians. Getting the clinicians interested in using the software was very easy, Lutz says. After seeing demonstrations, they took up the cause themselves.

For a facility performing upwards of 800,000 studies a year, the software is useful for virtually every type of case. New features include vessel probing, brain perfusion functionality and improvements to the cardiac package.


Interactive, confident diagnostics

Darlene Meeks, 3D lab specialist in the department of radiology at The Ohio State University in Columbus, has been using AquariusNET from TeraRecon for about a year. The radiology group wanted the software, she says, because its offers the ability to read more interactively.

The thin-client model is “remarkable,” Meeks says. The software is available for radiologists at all the dictation stations. If they are reading a case on PACS and can’t give a definitive diagnosis via the axial or coronal views, they can easily manipulate the images to get to a view that helps them decide, such as whether a tumor is invading vessels, ducts or airways.

A clinician who might be less savvy in creating images can ask for better visualization of, say, a pancreatic duct. The thin-client model lets a technologist perform the reconstructions and send them back to the server. The physician can access that “scene” and manipulate the images from there. The physicians like that the images are not stagnant, but can be turned and twisted. Meeks cites cases where radiologists know there is pathology in the lung, for example, but don’t know to what extent the airway is involved. “They want to give a definitive answer,” Meeks says. “If they have thin slices, they can open the thin client, find specific areas of pathology and pivot on it in any plane.” That can be done with everything from bone fractures to vascular work.

The software serves as a translater or interpreter, says Meeks, especially with CT scans. Multidetector CT scanning can create datasets comprised of 45 to 4,500 images, Meeks says. Surgeons and other clinicians are more likely to think in 3D rather than slice format, like radiologists do. By opening the thin-client model, they can view images technologists have created and plan their procedures accordingly.

What are the advanced viz tools that stand out? Meeks cites cardiac CTA and virtual colonography. With a cardiac CTA, for example, they can take all of the blood vessels and straighten them out, spin and turn them. That helps radiologists and cardiologists create better, more detailed reports and increases diagnostic confidence. “It’s a tool that’s not just used by radiology, but used by everyone,” she says. That tool can facilitate patient management or patient and family education as well.

Those lacking the experience of radiologists can use the software’s conference viewer to pose questions to a radiologist. “It’s great for workflow because you don’t have to stop what you’re doing and find someone who can provide a second opinion,” Meeks says.

Aside from direct patient care, advanced viz software is used in tumor board meetings to stimulate discussion and for teaching. Meeks says researchers appreciate the ability to work with it as well.