This year marked the 12th annual International Society for Computed Tomography’s (ISCT) Workstation Face-off at Multidtector-row CT (MDCT) 2014. Doctors representing four vendors (Siemens, Phillips, TeraRecon and Carestream) worked on four different cases with the vendor’s workstation to put each system to the test in terms of speed and accuracy of diagnosis. Once again, Carestream was the only vendor that used a PACS workstation to complete all the cases, while the other vendors used highly specialized, dedicated 3D workstations.
All cases were complex and required advanced and fast image processing, measurement and reporting capabilities. The cases included:
- Following a lesion in the abdominal wall across four time points based on two PET-CT and two CT studies;
- Segmenting two lesions in the liver and segmenting the whole liver into nine segments according to the Bismuth classification;
- Providing a set of measurements from a CT scan to plan a transcatheter aortic valve replacement; and
- Highlighting multiple rib fractures of a severely injured man following a motor vehicle accident.
Dr. Michalle Soudack, Head of Pediatric Radiology at the Safra Children’s Hospital in Israel, was our experienced representative on the Carestream Vue PACS system. As always, she demonstrated the various applications in a clear, concise and precise manner, all within the allotted time.
Three areas that stood out in this year’s face-off:
- Polling. These were not scientific, official polls, but questions were posed to the audience and they could text in their answers. The questions and results are below and these findings, while not conclusive, are interesting in terms of the audience makeup at MDCT 2014. For instance, the first poll question, 11 respondents say they have never been asked to measure liver volume and, surprisingly, 10 respondents answered “Yes” to the fourth poll question. This is a promising sign that collaboration and cooperation are gaining ground in the medical imaging space.
- The case results. These differed widely among the vendors in the second case, where the competitors were asked to measure the whole liver volume and the tumor burden per liver segment.
While the judges did not provide an official answer on which vendor was the most accurate, they did comment that validating the reproducibility and accuracy of automatic measurement results is an important factor in assessing workstation segmentation performance.
3. New product and application. During the presentation of the fourth case, Dr. Soudack was able to provide a look at two of Carestream’s newest technologies for radiology IT.
a. The first was a work-in-progress called radial view. Dr. Soudack worked through a case focused on rib fractures and showed a new view that more clearly depicts the fractures, as can be seen below:
Radial View is a special form of MIP (Maximum Intensity Projection) showing the ribs spread out as if they were looked upon from inside the body.
b. The second and more important new technology demonstrated by Dr. Soudack was a complete workflow highlighting Vue Reporting as a key tool for communicating findings and promoting collaboration between all radiology stakeholders. Vue Reporting brings radiology reporting into the rich, multimedia and interactive world. This new technology allows radiologists to couple findings and images into a single interactive report, as well as to inject into the report measurements and calculations created during image interpretation, thus helping to minimize chances for errors. Dr. Soudack demonstrated features such as live hyperlinks that enable instant access to live images and complete patient portfolios from the web, including validated mobile devices such as iPad and iPhone (for which Carestream has FDA clearance).
As always, the workstation face-off was a thrill to watch because we were not only able to see expert radiologists maneuver throughout the different platforms, but we were able to see how the workstation technologies and applications are evolving. These advances are being made with the purpose of helping create a more efficient and error-free work environment for the radiologist, which can in turn provide better care to patients. The unique design of Carestream Vue PACS, with its unified backend and data model, strives to expand this environment to ALL radiology stakeholders, addressing the needs of referring physicians, administrators, and patients as well.
Where do you see PACS workstations in the future? Are there applications you hope to see added to your system down the road?