The typical PACS doesn’t always cut it when it comes to nuclear medicine. Mainstream medical imaging technologies have not been designed to handle nuclear medicine’s unique demands, proprietary protocols, or programs, which make them incompatible with radiology PACS. Hospitals nationwide are finding they have to explore new options when it comes to needs such as display functionality to support nuclear medicine studies. Some nuclear medicine departments have invested in pioneering nuclear medicine solutions or interfaced to radiology department PACS, while others prefer an enterprise-wide, integrated solution.
Nuclear medicine requires specific display capabilities, such as grayscale or color, functional, quantitative and fusion data. Static displays just won’t do for dynamic nuclear medicine studies, planar gated studies, SPECT, PET or PET/CT. PET/CT image review involves viewing of transaxial, coronal and sagittal and maximum intensity projection (MIP) images. For that, physicians need a separate solution to translate data among different file formats.
Nuclear medicine departments across the country have integrated new image management models that facilitate nuclear medicine data flow to benefit department and enterprise workflow.
Solution for all needs
The University of Miami Hospital and Clinics (UMHC) in Miami, Fla., house a total of 120 beds, and conduct approximately 6,000 nuclear medicine procedures each year. UMHC has used Thinking Systems Corp.’s ThinkingPACS for image management in nuclear medicine since 2002. The system includes an MDStation for physicians to perform review of images, quantifications, and image fusion; a QC station for the technologists; and an archive system for archiving all the nuclear medicine images, including SPECT and PET/CT. The ThinkingPACS sends all the images to the radiology RIS-PACS, a GE Healthcare/IDX ImageCast for enterprise-wide access and archival.
UMHC has two ADAC Genesys dual-head SPECT cameras, one Philips Medical Systems Skylight dual-head SPECT camera, and a Philips Gemini PET/CT scanner. ThinkingPACS receives the image data from the SPECT cameras and the PET/CT scanner through proprietary and DICOM connectivity for the purpose of processing, quantification, display and review using the MDStation, and also for archiving.
UMHC chose ThinkingPACS because it is an open architecture, Windows-based system with a robust clinical software package with “the clinical programs, tools, utilities and all necessary functionality that we need in order to perform our work,” says Mike Georgiou, PhD, assistant professor of Radiology and nuclear medicine physicist at UMHC.
The MDStation is used by the nuclear medicine physicians for review of all general nuclear medicine studies (bone, renal, liver/spleen, parathyroid, gastric, lung), SPECT processing and review, quantification for nuclear cardiac studies, and PET/CT fusion for oncology, neurology and cardiology studies. It has all the necessary display/review functions and analysis programs for nuclear medicine studies. For example, the physician has the ability to easily and efficiently manipulate the image data, perform comparisons with current and prior studies, and capture interesting cases for slide presentations, Georgiou says.
The technologists use the QC station to check images that have been acquired, and to ensure that the patient demographic information is accurate. Subsequently, the images are shipped to the university GE/IDX PACS for enterprise-wide access. The QC station also makes CDs.
Currently, UMHC is in the process of purchasing the Thinking Systems “plug-in” solution for its hospital PACS to meet the nuclear medicine needs — including PET and PET/CT — of referring physicians. The plug-in for third-party enterprise PACS, which they hope to install in a few months, will bring the nuclear medicine image programs, functions and tools to the hospital PACS in seamless fashion. The Thinking Systems web server will provide remote access to nuclear medicine images, allowing physicians to read studies from home or any remote location. “Most PACS lack the necessary functionality for nuclear medicine imaging,” Georgiou says. “The Thinking Systems plug-in can provide this functionality and offer a complete PACS solution for nuclear medicine.”
Eliminating manual intervention
Saint Joseph’s Hospital in Marshfield, Wis., stored all nuclear medicine department quality control and patient data on optical disc until December 2004.