Advanced visualization workstations and software have grown up. The fancy computer in the corner of the reading room has become an essential diagnostic tool, and most likely found a more central spot in the reading room and role in diagnosis - enabling radiologists to produce higher quality results in less time than ever before, opening the doors to new exams, more tools for specialists and better patient education.
In just a few mouse-clicks, 3D-savvy radiologists (or technologists) can transform axial CT data into smooth, sleek and high-resolution volumetric reconstructions of anything from coronary arteries to complex fractures or the colon. It's a far cry from the early clunky 3D reconstructions that took an arduous 30 to 45 minutes to complete and resembled a kindergartener's block drawing.
Although CT tends to hog the 3D limelight, MRI also benefits from advanced visualization. "Advanced visualization is extremely useful for MRI imaging, particularly soft tissues and MR angiography," reports Vamsi Narra, MD, co-director of body MRI at Mallinckrodt Institute of Radiology in St. Louis.
Advanced visualization solutions bring a number of benefits to the radiology department including:
- A manageable means of handling the massive data output of multislice CT scanners
- The ability to produce high-quality reconstructions to enable more accurate and efficient diagnosis of orthopedic trauma, coronary artery disease, aneurysms, colon cancer and more
- The ability to grow a practice with new exams like virtual colonoscopy or CT angiography
The heart of the matter
Atlantic Medical Imaging (Galloway, N.J.) relies on GE Healthcare's Advantage Workstation (AW Workstation) and 3D software as the powerhorse of advanced visualization. The GE solution handles CT angiographies, virtual colonoscopies, skeletal and spine studies and cardiac exams.
Medical Director David Dowe, MD, says the Advantage Workstation has made a tremendous difference in the practice and quality of coronary CT angiographies. "At 16 frames per second in a 512 x 512 matrix, image reconstruction and transfer is remarkably fast," states Dowe. The software snips additional time from the procedure via a simultaneous multiphase reconstruction feature, which allows radiologists to process the same vessels at multiple points in time simultaneously, eliminating the need to reload images. Phase registration simplifies the process by creating images of blood vessels using multiple phases. In contrast, manually constructing vessels in individual phases forces radiologists to determine which phases have been complete. Finally, simultaneous multi-vessel analysis enables users to analyze all seven branches of the left coronary artery without stopping and reloading. As a result, Dowe can process most coronary CT angiographies in less than 10 minutes.
While the high-speed process presents a workflow plus, Dowe says the real benefit comes in patient care. Typically, Dowe provides immediate feedback and shows each patient his images before he leaves the office. "Once patients see their [clogged] coronary arteries, they are motivated to take action and go back to their physicians demanding statins," says Dowe.
U. Joseph Schoepf, MD, director, CT research and development and co-director, Center for Advanced Imaging Research at Medical University of South Carolina (Charleston), has seen a brisk increase in cardiac CT business since deploying Siemens Medical Solutions' Somatom Sensation 64 and Leonardo workstation late last year, with the CT scanner and workstation increasingly called on as the solution to detect coronary artery disease. The university's heart and vascular center relies on the Leonardo workstation for 2D and 3D post-processing, reconstruction, visualization and archiving.
"We want to achieve a diagnosis that's as accurate as possible," notes Schoepf. "The heart requires a combination of different approaches [such as maximum intensity projections (MIPs) and 3D volume renderings] to appreciate the full gist of coronary artery disease."
The university center employs streamlined advanced visualization workflow processes. After scanning the patient, techs preview raw data on the acquisition console and select the optimal phase for reconstructions. Techs complete MIPS and multi-planar reformations (MPRs) at the Leonardo workstation according to pre-defined task cards. The final step for techs - 3D volume rendering - is completed in less than five minutes