Clinical Demand Drives Visualization Advances Across the Enterprise

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AV.jpg - Advanced Visualization
Source: (Clockwise): Ziosoft, Vital Images, Visage Imaging, Vital Images.

Coming soon to a display near you: Anytime, anywhere advanced visualization DICOM image set reconstructions. The advent of server-side processing technology permits image manipulations to take place on a central server before being transmitted to a monitor—either a diagnostic workstation, a laptop, a smart phone, or an operating theater display. This structure allows virtually latency-free viewing of images at any location, and in the process, is expanding the role of radiology throughout healthcare.

The University of Pittsburgh Medical Center (UPMC) is one of the largest non-profit integrated healthcare systems in the United States and consistently lands near the top of industry rankings as one of the best facilities in the nation. Its strong reputation draws patients from throughout the United States and from more than 30 countries around the world. UPMC employs more than 5,000 physicians, performs more than one million radiographic studies each year, and consists of a 19-hospital network spanning more than 160 miles.

The wide geographic area served by UPMC creates a distributed environment where specialists and referring physicians often perform procedures at three or four different facilities within the network. Patients, too, migrate within the network; receiving healthcare services at different facilities within the larger enterprise.

“One of the main drivers toward enterprise-level advanced visualization has been the emergence of thin-client technology,” says Rasu B. Shresta, MD, medical director of digital imaging informatics and chief of the division of radiology informatics at UPMC.

“There is going to be a paradigm shift in the way 3D imaging is being delivered in healthcare,” Shresta says. “Up to now, radiologists would take a snapshot or two of a pertinent anatomy, for example an aneurysm visualized in 3D, and would then send this back to PACS as a still image—and this was at best what the referring clinicians and the surgeons got from radiologists. But now, they have the ability to not just view the snapshot, but to click and restore this snapshot to the state that the radiologists left it at; with access to all of 3D tool sets—so that he or she can rotate the study, perform further image post-processing and look at relational anatomical structures etc. This is a paradigm shift in the way imaging is being delivered—and the benefits of having access to these 3D images and tools, not just in reading rooms, but in clinicians’ offices, and ORs and other locations will be tremendous.”

Shresta and his colleagues utilize Vital Images’ Vital Enterprise as their enterprise advanced visualization solution, but legacy dedicated 3D technology workstations from a variety of developers still have a place in the clinical continuum at UPMC. “Certainly, these are workhorses of the system, and are still very much part of the workflow,” he says.

There are multiple advantages to deploying an enterprise-level advanced visualization solution at UPMC, Shresta says.

“The first is ease of deployment. Up to now, the technologists at each modality needed to ensure that studies that needed 3D post-processing were directed to the appropriate thick-client workstation or thin-client server. With this new technology from Vital Images, all the modalities push their data to a centralized server, and the server intelligently routes the 3D studies out to the appropriate environment—either thick- or thin-client. All the image manipulations take place on a central server before being transmitted to a workstation and this enables any study to be available on demand anywhere in our system.”

Continuity of clinical workflow is another advantage that Shresta cites to the UPMC enterprise strategy.

“A technologist or radiologist [such as one of our fellows] can perform portions of the post-processing, and then another colleague [like a radiology attending] can complete the rest of the post-processing.”

Because the technology has been in place only a short time, Shresta says that it has been deployed to a small audience beyond the radiology department.

“We’ve moved the application out to our orthopedic surgeons, cardiologists, neurosurgeons, vascular surgeons and our oncologists at present. Their response has been very enthusiastic. We’re bracing ourselves for even more system users as we plan on bringing on even more clinical specialties shortly.”

Advanced visualization capabilities have also helped renew the relationship radiology has with other