How Cobalt Imaging is Empowering Patients with Vue Motion & MyVue

Cobalt Health is a medical charity that was started about 50 years ago to support mainly oncology services. As a part of the charity, the Cobalt Imaging Centre is responsible for delivering high-quality medical imaging services and diagnoses.

The charity worked with Carestream to implement Vue Motion and MyVue. With Vue Motion, Cobalt enjoyed that the medical images were easily accessible from anywhere within the country, highlighting how there are no more discs with saved images being sent around, and that the experience of viewing and sharing images is safer, cheaper, and more efficient.

Additionally, while Vue Motion has allowed for the access of medical images for the physicians from many different localities, the MyVue portal has provided that same access to the patients. This has helped with patient education, and solidifying the diagnosis for them because they can now see and understand what the physician does.

Key Updates Made to the RSNA 2014 Mobile App

Last year we did a brief tour of the key features in the RSNA 2013 mobile app you should be aware of. Many features used in 2013 are still present in 2014, but there have been a few updates made that enhance and improve the design and experience of the app.

When first logging in, you will find an impressive redesign, with the focus on imagery making for a clean, intuitive user experience.


On the main menu, one of the biggest updates made this year was in the “Maps” section.


When clicking on “Maps,” you are taken to a layout of the main halls in McCormick Place.


As you zoom in, you will find a clean layout for each floor in the halls. You can easily find vendors you wish to visit or classrooms in which sessions are being held. This is quite an impressive upgrade that is easy to use and extremely helpful in navigating the enormous space that is McCormick Place.


RSNA has also updated its “Social” section a bit.


When clicking on “Social,” you are then taken to a list of RSNA’s social media accounts.


When clicking on a network, you are taken directly to that profile where you can easily follow the account to stay up-to-date on the latest news and happenings taking place at RSNA.


RSNA has done an excellent job improving the user experience for creating an attendee’s schedule at the meeting.  The following images show what happens when clicking on the “Meetings” and “Exhibitors” sections under the main menu.


You click the star next to the session that you wish to attend to add it to your schedule.


The same goes for “Exhibitor” lists: click the star next to the company you wish to visit and it will be added to your schedule to create a checklist.




To access your schedule, you go to “My Meeting.”


There the schedule is broken down into two sections: “My Agenda” for sessions…


…and “My Exhibitors” for the vendors you wish to visit.


There you have it as far as some of the major design and layout changes to the mobile app. It is a valuable tool, and one that can surely come in handy when working to maneuver around RSNA with almost 60,000 other attendees and vendors.

Wishing you an exciting and educational RSNA 2014! See you in Chicago!

PulvinoRich Pulvino is a digital media specialist for Carestream. He will be in the Carestream booth, South Hall – A, #4735, capturing videos and photos of the meeting, as well as blogging throughout the week about key trends observed at RSNA 2014.


Four Presentations Worth Seeing at RSNA 2014

RSNA 2014 logo

In addition to demonstrating our latest medical imaging and healthcare IT solutions in South Hall Booth #4735 at RSNA 2014, we are also proud that a few of our scientists will be presenting with researchers from prestigious medical schools on a number of topics.

The four presentations are listed below and cover such topics as extremity imaging using CBCT equipment, tomosynthesis for chest imaging, multi-media radiology reporting, and multi-spectral X-ray.

  1. Scientists from the Johns Hopkins University School of Medicine and Carestream will present a paper titled, “3D Imaging of the Foot and Ankle Using a Dedicated Extremity Cone-Beam CT Scanner,” on Sunday, Nov. 30, from 11:35-11:45 am (Room S403B). The paper reports that CBCT images of the foot and ankle can provide functional information and precise morphological analysis in cross-sectional imaging not achieved by radiographs.
  2. The University of North Carolina at Chapel Hill, Department of Physics and Astronomy, and Carestream will present a scientific paper entitled “Physiologically Gated Stationary Chest Tomosynthesis System using CNT X-ray Source Array,” on Monday, Dec. 1, from 11:50 am-12 pm (Room S504CD). Results from this paper indicate that imaging quality can be greatly improved with physiological gated s-DCT, which can improve the imaging outcome for patients who cannot easily hold their breath.
  3. Emory University and Carestream will present a scientific poster entitled “Traditional Text vs. Image and Interactive Data Embedded Multi-Media Enhanced Radiology Reporting: Referring Physicians’ Perceptions about Value,” on Wednesday, Dec. 3, from 12:15-12:45 pm inLearning Center, Hall D. This session will discuss interactive additions in radiology reports that provide additional clinical information designed to enhance the value of the report for physicians and potential to increase referrals.
  4. The University Health Network in Toronto and Carestream will present a scientific paper entitled “Tissue Characterization using Multispectral X-ray: Description of a Novel Metric for Categorization of Pleural Effusions” on Thursday, Dec. 4, from 10:50-11 am (Room S404CD). This paper reports initial results of a multi-spectral portable DR system, which may have the potential for discriminating between pleural effusions types (i.e. bloody vs. non-bloody effusion).

There will certainly be a number of sessions and papers worth exploring as attendees prepare for their busy week at RSNA 2014. It is sure to be an exciting week for the RSNA organization, and for the entire medical imaging profession.

Diagnostic Reading #4: Five Must-Read Articles from the Past Week

This week’s Diagnostic Readings include a look at the history of the RSNA conference, healthcare technology updates, industry accomplishments and more. Check out our weekly series, “Diagnostic Reading,” for news and updates in healthcare IT and radiology.rsna_afiche

1) Constant Change Characterizes RSNA’s First 100 Years

As we prepare for the 100th annual RSNA conference on November 30, take a look at the development that the field has made since the first RSNA conference. This article examines current market trends and discusses how radiology has grown over the past century.

2) Health IT Enabled Quality Improvement: A Vision for Better Health and Health Care

According to the ONC, this paper “describes ONC’s vision for advancing the use of health IT to support transformational improvement in health care quality and value.  It invites health IT stakeholders – clinicians, consumers, hospitals, public health, technology developers, payers, researchers, policymakers and many others – to join ONC in shaping the future with a renewed focus on health and care quality as the ‘why’ that aligns with the ‘what’ of interoperable health information systems.”

3) DeSalvo Discusses Future of Health IT, Growing Pains

Karen DeSalvo, Acting Assistant Secretary for Health to the Obama administration, gives an overview of the adoption of health IT. She discusses the primary challenges that the healthcare industry is facing when it comes to technology. Furthermore, DeSalvo is encouraged that electronic health records can be implemented and facilitate the meaningful use process.

4) Emory Healthcare Shares Imaging Processes for Ebola Patients

Emory University Hospital was responsible for curing all four Ebola patients that went to their facility this fall. One of the most important factors in this success was the use of radiology. This article summary explains the importance of portable computed radiology to obtain chest x-rays from patients with dangerous infections such as Ebola.

5) Quality and Contract Negotiations: Putting a Price on Quality

Healthcare is facing a time where quality of patient care is as important as any other aspect healthcare. This article discusses how radiologists are not judged by the same criteria as primary care physicians (availability of parking, waiting time, etc.). Quality in radiology is judged by the ‘fast and accurate diagnostic imaging results and superior patient outcomes’—standards that are difficult to quantify. Read how the radiology field can add quality to the care of each patient that is encountered.

Top Trends to Expect at RSNA 2014

PrintThis year marks the 100th annual RSNA conference, with the theme “A Century of Transforming Medicine.” Over the last century, we have achieved the unthinkable. Never would we have thought that we can capture a 3D image with such clarity and accuracy, or that we could transfer high-quality digital radiology images instantly through powerful wireless technology. After continuous progressive advancement in medical imaging technology, radiology has become one of the most integral parts of the healthcare continuum. Radiology will constantly evolve and improve, and here we list a few of the top trends you can expect to hear about at RSNA 2014:

Adoption of Big Data

Big Data is a highly sophisticated topic to discuss. Simply put, it is a collection of billions of bytes of data that is collected, mined and analyzed. Software is then used to create reports and prediction algorithms based on findings from the data. Dr. Daniel Rubin, an assistant professor of radiology & medicine at Stanford University, said that in the future big data will be utilized to pull information harvested from historical data in patients’ archives in order to guide clinicians in the decision-making process by pursuing ‘evidence-based’ care. He added that imaging will be a crucial component in the future if we are to embrace the adoption of big data.

New Premium CT-Scanners & MRI Systems

With the ever-advancing technology in the medical imaging profession, companies are racing against each other to build the most advanced and reliable CT-Scanner and/or MRI Systems. In a research article by Greg Freihrerr, the assertion is the market will demand much faster CT-Scans but with more accuracy and more flexibility that allows the CT-Scan to perform exams amidst clinical difficulties. More importantly, the market will demand a significant decrease in radiation dose.

Decreasing Dose

This subject continues to be an important topic of conversation and debate. Many companies are driven to and strive for lowering dose in their medical imaging systems. In relation to X-ray systems however, when analyzing how to lower dose, companies do not necessarily have to redesign these technologies. Dan Harvey wrote in Radiology Today that “DR detector enhancements have led to improve dose efficiency.” Detectors convert X-ray into signals, which are then translated into an image. The more efficient the detector is, the lower the dose needed for an X-ray exam. Improving the DR detectors not only lead to decreasing dose, but also ultimately improving the images captured as well.

Improving productivity

In Radiology Today, Amit Dedhia and Shujah Das Gupta believed that healthcare costs are constantly rising, pushing radiology to become more “outcome-based and value-driven.” Many companies have developed products and software that help increase the productivity of radiologists. The idea is to improve the efficiency of work flow and increase productivity, but at the same time making the experience more patient-centric. For instance, Carestream has developed software to remove the ribs from a chest X-ray image in order for radiologists to see soft tissue more clearly and help them better visualize lung nodules and other pathology. This can add value for radiologists and can be a helpful diagnostic tool for clinicians in determining the best treatment for each individual patient. Dedhia and Gupta wrote that by using analytics, radiologists can pull actionable insights from a large pool of data. By doing that, workflow becomes much more efficient as machines can make better and accurate assessment based on patterns derived from the data.

Many challenges stand between a greater improvement in image quality, dose reduction, and lowering costs. With these trends in mind, we can see that radiology is moving towards value-based customer-centric system. Radiology will advance beyond what it is today towards the future.

What top trends do you expect in RSNA 2014?

Carestream CMONorman Yung is the CMO of Carestream Health. He will be attending RSNA 2014, come and meet him at our booth at McCormick Place in Chicago,  South Hall Booth #4735.


Infographic: The Evolution of Radiology Reporting

Cristine Kao, Healthcare IT, Carestream

Cristine Kao, Global Marketing Manager, Healthcare Information Solutions, Carestream

We have come a long way since the days of handwritten radiology reports. What was once difficult to read and understand has evolved into a narrative history of a patient’s medical imaging experiences.

Radiology has now reached its pinnacle with multimedia reporting. An interactive, complete report full of graphs, charts, high-res images, hyperlinks, and videos can provide the radiologists with a patient’s complete history.

We live in an era where visuals are needed to tell the story and complement the written report. By combining these features in multimedia reporting, radiologists can ensure that they truly understand their patients and that the information is easily accessible at a moment’s notice.

The infographic below takes you through the history of radiology reporting, and how it has gotten to where it is today, along with the pros and cons of each evolutionary stage.

Additionally, at RSNA 2014, scientists from Emory University and Carestream will present a scientific poster entitled “Traditional Text vs. Image and Interactive Data Embedded Multimedia Enhanced Radiology Reporting: Referring Physicians’ Perceptions about Value,” on Wednesday, Dec. 3, from 12:15-12:45 pm in Learning Center, Hall D.

Evolution of Radiology Infographic

Radiology and Macro Healthcare Trends Part III: Quality Care

On-site or cloud-based teleradiology can provide effective patient care.

An on-site or cloud-based teleradiology system can connect radiologists to reports, images, and patient history to provide efficient and effective care.

Part II of this series explored how radiology can impact cost effectiveness at healthcare facilities.  In this final post, we will look at delivering quality care in our new healthcare environment.

New regulations, controlled costs for facilities and patients, and technological innovations have given healthcare providers the ability to more easily provide patients a high-quality level of care. Particularly in radiology, we see significant advances in the products and software that support the capture and delivery of images.

Patients expect that the care they receive will be of the highest quality.  To contribute to this, radiologists should think about the following:

  • Streamlining Communication
    • Making sure that getting to images and results is easy for technologists, doctors and patients. One way to do this is leverage new technology that provides a platform from which this is possible.  Doctor and patient portals are becoming more and more popular – and standard functionality – across many types of healthcare facilities.
  • Playing a Role in Patient Communication
    • Instead of seeing radiology outside of the healthcare continuum, facilities and radiology professionals can work to see how imaging has a direct impact on the quality of patient care. This understanding must be facility-wide so that radiologists have the support they need to become part of the continuum and to be educated on how to communicate with patients.

Technological advances such as reporting platforms that offer native voice recognition, RIS or PACS integration, and advanced reporting, support internal and patient communication.  Having a strong, integrated reporting system contributes to reducing delays in processing and produces better, more contextual reporting.

One area in which streamlining communication and patient communication is having a greater impact is in the area of telemedicine.

Telemedicine, and to be more specific, teleradiology, has not entirely come to fruition because of laws and payment systems that are more encouraging for face-to-face doctor-patient visits. In the U.S., doctors are licensed by states, but the rules follow where the patients live, so doctors must also be registered in their patients’ states too. In the European Union, doctors are licensed by country and have the free reign to practice throughout the union, no matter where their patient lives.

While the U.S. may seem more conservative with telemedicine laws, telemedicine practiced within a state has its advantages. It can be difficult for those living in rural areas to have access to quality care. With a broadband connection, telemedicine can provide rural populations with high-quality care that many in more populous areas have access to. This is certainly the case in China, where it is spending billions on healthcare reform with an emphasis on teleradiology.

What do you think? Are you seeing radiology become an integrated, vital component of quality healthcare? Are there other trends to keep an eye on? 

Carestream CMONorman Yung is the CMO for Carestream. His series about macro trends in healthcare is being published in three parts. Part I was posted in September and Part II was published in October.


Diagnostic Reading #3: Five Must-Read Articles from the Past Week


On-site or cloud-based teleradiology can provide effective patient care.

An on-site or cloud-based teleradiology system can connect radiologists to reports, images, and patient history to provide efficient and effective care.

This week’s Diagnostic Readings include updates on meaningful use, analysis of telemedicine growth, tips about dose management and more. Check out our weekly series, “Diagnostic Reading,” for news and updates in healthcare IT and radiology.

1) Survey Indicates Telemedicine Adoption Growth among Healthcare Executives

This post presents the results of a survey taken by 57 healthcare executives. The findings explore the extent to which health care systems are adopting telemedicine and electronic health records (EHR). The author explores the the channels of telemedicine that are the most popular among this sample group.

2) Enterprise Imaging—Walking the tightrope: Optimizing radiation dose management 

Since the 1980s, the annual per-capita radiation dose from medical exposure has risen from 0.53 mSv to 3.1 mSv. This article from the November edition of Applied Radiology explores the challenges and solutions of moderating dose. The author discusses how the balance of radiation dose management can be optimized.

3) AMA Urges CMS to Drop Meaningful Use Penalties

This article addresses the existing meaningful use criteria and the difficulties that some medical centers may encounter. This piece discusses that reasons outside of a physician’s control may be the reason for their lack of interoperability. Due to these difficulties, the American Medical Association has asked the Centers for Medicare & Medicaid Services to “suspend all penalties to physicians and healthcare facilities for failure to meet meaningful use criteria.”

4)  It’s Time for Radiology to Take Peer Review Seriously

This post discusses the importance of knowing your diagnostic accuracy rate in radiography. The author writes about comparing accuracy rates to bench marks and national standards. These ideas could lead to more accurate readings and more industry-wide credibility.

5) To Improve Mammography Reading Accuracy, Follow Through with Workups

This article discusses the correlation between reading high volumes of mammography readings and accuracy rates. The study conducted at the Group Health Research Institute in Seattle found that radiologists with higher numbers of annual workups had higher screening sensitivity and cancer-detection.

Webinar: The Future on Displays


Click the image to go to the sign-up page for the webinar, “The Future on Displays.”

On Tuesday, November 18, I will be presenting a webinar titled, “The Future of Displays.” The goal of this presentation is to provide attendees with an idea of what they can expect to see in the evolution of medical-grade monitors they work with on a routine basis, and how they differ from conventional displays.

Multi-modality hybrid diagnostic displays are essentially the future of image viewing in radiology. The image quality and versatility these monitors offer for facilities have been able to improve efficiency and allow for remote access to images from a central point, which also allows the execution of remote calibration and performance monitoring.

After the webinar, it is my goal that attendees can take away the following information:

1) Why medical monitors are needed over conventional monitors. This is especially true for telemedicine. We must ensure that radiologists conducting the readings have the same set up and same calibration as the technologies at the physical imaging center, so that they are both viewing the same image.

2) Screen elements that have an impact on image quality. Luminance, sharpness, brightness, contrast, gamma, uniformity, grayscale, and panel technology are elements that will be discussed. These image technologies, in addition to panel size customization, are what contribute to high-quality images on a medical monitor.

3) Quality control is vital for medical-grade monitors and certain standards must be followed. Standards define the condition, how monitor should be checked and controlled, and that this should be done every quarter. There are many countries that buy medical equipment and do not understand why one image looks different between two different screens. I will cover the different quality control standards facilities need to adhere to in order to ensure high image quality, as well as how these standards change among different regions and modalities.

4) Thorough understanding of the required type of display. Everyone understands the workflow, but when it comes to the image quality for different modalities—ultrasound, mammography, MRI, CT—how should the colors/greyscale be displayed? What happens when the monitor is not calibrated?

You can click the following link to the sign up for the webinar, “The Future on Displays.” It will be taking place on Tuesday, November 18, at 10 AM EST.

Juergen HeckelIng. Juergen Heckel currently serves as EIZO’s worldwide VP of Medical Business Sales and Marketing. With over 13 years in the medical industry, he has worked with a large network of key hospital decision- makers and radiologists – making him an authority on market trends and needs regarding display solutions.

Radiology in the First World War

World War I Radiology

Radiology a hundred years ago was still a heroic endeavor not just for the patients but also for the personnel. Concepts such as protection against the danger of ionizing radiation were largely unknown or ignored.

The horrors of war stimulated a remarkable period of technological development in the then embryonic field of medical imaging.

At the eleventh hour of the eleventh day of the eleventh month in 1918 the armistice was declared to bring to the end one of the most murderous of all conflicts, with an estimated grand total of some 37 million soldiers reported as killed, wounded or missing. The armistice ceremonies, still celebrated in most countries with appropriate solemnity on the 11th of November are always very poignant, but this year, exactly one hundred years after the onset of the First World War they are particularly so.

In the face of the overwhelmingly bleak immensity of the casualty statistics, it is very difficult to unearth any positive aspects but, as so often happens, the sheer force and immediacy of military imperatives actually resulted in positive developments which far outlasted the war itself. Such a situation occurred in the First World War where the overwhelming need for better and more immediate care of the huge numbers of wounded soldiers brought about a step-change in radiology. There was of course a ruthless logic to the need for improved treatment of military wounded in the First World War — the quicker a soldier could be treated, the higher the chance that he would survive and be able to be sent back to the front again.

It was difficult and time-consuming to evacuate the thousands of wounded soldiers from the trenches to traditional military hospitals located far behind the lines. The solution was to develop mobile radiology units which could get closer to the battlefields. The French in particular were active in this aspect, which required considerable ingenuity to overcome problems such as those caused by the then fragility of the radiology equipment. Image visualization techniques have changed in the hundred years since the First World War.

It was difficult and time-consuming to evacuate the thousands of wounded soldiers from the trenches to traditional military hospitals located far behind the lines. The solution was to develop mobile radiology units which could get closer to the battlefields. The French in particular were active in this aspect, which required considerable ingenuity to overcome problems such as those caused by the then fragility of the radiology equipment. Image visualization techniques have changed in the hundred years since the First World War.

Firstly, let’s put things in context. As every modern radiologist knows the birth of radiology occurred in 1895 — so not even twenty years before the First World War — with the discovery in 1895 by WC Röntgen of X-rays and their then  mysterious power of being able to visualize the interior of living tissue and organs. By the standard of the time, the news of the invention spread very rapidly thanks to the use of the latest newfangled invention the telegraph (of course at a snail’s pace as compared to modern communication methods of phone internet, Facebook and Twitter, etc.). Interestingly, the military was one of the first to realize the potential of the new X-ray technique. Thus only one year after Röntgen’s ground-breaking discovery, there were already reports of the use of radiology by military surgeons in the Kaiser Wilhelm Academy in Berlin.

Thus, by the time of the onset of the First World War, the potential of radiology for the examination of soldier’s wounds was well recognized by the military authorities. The principal application was brutally simple. With a wounded soldier of a hundred years ago, no one would bother looking for suspicious probably cancerous soft tissue lesions. Instead the primary objective of radiology was to identify the location of metallic foreign bodies such as shrapnel, projectiles etc. lodged within the soldier’s body so that the surgeon could extricate them as quickly as possible.  Such metallic foreign bodies are a potential source of infection. The early radiology systems were actually quite good for this purpose — apart from the obvious disadvantage that a radiograph is a two-dimensional projection of a three dimensional volume. Recognizing this, several ingenious solutions were proposed, including the wartime invention by the Frenchman A. Bocage of a rudimentary tomographic system, using the principle of two images of the same patient but taken from different angles, with of course no computer to reassemble the images. The CT scanner as we know it nowadays was still many years off.

The sheer number of casualties was the stimulus for remarkable technological development. By the end of the war, there even existed air-borne mobile radiology units. Here a converted bomber carries in its under-wing pods a complete radiology station which could be rapidly set up in an inflatable tent also carried in the plane.

The sheer number of casualties was the stimulus for remarkable technological development. By the end of the war, there even existed air-borne mobile radiology units. Here a converted bomber carries in its under-wing pods a complete radiology station which could be rapidly set up in an inflatable tent also carried in the plane.

In fact as the sheer numbers of wounded soldiers increased dramatically in the early war years, the problems were not so much the basic technique itself, but rather the organization and structure of the military medical services responsible for radiology. The standard model was to have fully equipped military hospitals located far behind the lines. However the difficulty and time taken to evacuate so many wounded soldiers from the front lines to the hospitals meant that by the time they arrived their situation had deteriorated so seriously that medically there was almost nothing to be done.

Hence a huge effort was expended into making mobile radiology systems to be able to positioned wherever were the biggest needs. There were however huge problems to be overcome in the development of early mobile radiology units, principally due to the fragility of the early radiology equipment and the need for a supply of electrical power. The abandonment of the traditional horse-drawn cart in favour of the then new technology of automobiles had the advantage of being able to rig up special dynamos run off the motor engine. The French in particular were very active during the first world war in the development of motor driven mobile radiology units. Even Marie Curie and her daughter Irène were actively involved.

The speed at which solutions were introduced to previous problems was quite remarkable and indicative of the urgency of the situation. For example, one problem of mobile radiology units was that under the conditions of war the glass photographic plates used at the time frequently broke. This explains how avidly the invention by Eastman of cellulose-based films coated with photographic emulsions was seized by military radiologists. Likewise the invention of the hot cathode X-ray tube finally solved the short life time of the cold tube. By the end of the war the inventive process reached its peak with the introduction of a Franco-American project of an air-borne radiology unit, where a converted Voisin bomber carried all the equipment necessary to set up a radiology surgical room quickly installed under an inflatable tent.

Despite these advances, one mustn’t become misty – eyed or nostalgic about radiology of the time. Compared to today’s equipment and performance, radiology during the First World War was still a heroic and relatively primitive undertaking. In particular the concept of protection against the dangerous side effects of radiation was effectively non-existent.

Of course the remarkable developments occurring in radiology during the First World War go nowhere near to justifying the carnage which was the underlying impetus for the developments. At best it is a meagre consolation that, in the midst of the colossal human tragedy, a little spark of benefit was found in an embryonic technology that has since grown into today’s indispensable profession.

Alan BarclayAlan Barclay, PhD., is the editor of Diagnostic Imaging Europe.