Clinical Collaboration Platform Grown from the Enterprise VNA

We have discussed the evolution of the vendor-neutral archive at length on Everything Rad, and that conversation will not dissipate any time soon.

Healthcare facilities are dealing with petabytes upon exabytes of data, and not only do they need technological resources to store this data, but they also need a system that can properly categorize the data, and provide access to it across different -ologies.

The animation below shows how VNA owners can build upon their systems to create the Clinical Collaboration Platform. The platform is able to capture data from various sources without changing departmental workflow.

A patient-centric repository is created that stores all of the medical imaging data whatever the format or modality, and distributes the images via the appropriate clinical viewer.

University College Hospital & Diagnostic Imaging Needs of Nigeria

We spoke with Dr. Biodun Adeyinka, consultant radiologist at University College Hospital in Ibadan, Nigeria at RSNA 2014 about what brought him and his colleagues to the meeting. He explained that while Nigeria is a wealthy country, he and his colleagues need to make a strong case for purchasing equipment. They came to RSNA to learn about the latest and greatest pieces of equipment and plan to bring this information back home to help with purchasing decisions.

NHS Ayrshire and Arran Works to Improve Radiation Dose with Radimetrics

NHS Ayrshire and Arran serves 400,000 people at 10 hospitals across East, North, and South Ayrshire in Scotland. Two years ago, the organization worked to integrate Bayer HealthCare’s Radimetrics with its Carestream Vue PACS. The integration was completed in weeks, and the facility immediately found how well the two work together.

With Radimetrics, NHS Ayrshire and Arran became able to track radiation dose and room utilization as a way to collect data and act swiftly if issues are to arise. The big questions that the facility can now answer include, “Are we minimizing radiation dose for our patients?” and “Are we making the best use of our resources?”

As the video above explains, the organization was able to bring protocols together, standardize them, and oversee the management of dose. With this newfound efficiency, NHS Ayrshire and Arran can now easily spot discrepancies in the data, and seamlessly update patient information.

As volume of exams and complexity exams goes up, the organization needs to justify its decisions. As an example, it can view dashboards to determine room utilization, which allows for specific acquisition on how a room is being used, with Radimetrics, that information is now at their fingertips.

[Video] Replacing Analog to Allow for DRX-1 Detector Sharing

Karen Swanson, R.T. (R) (M), Director of Medical Imaging, at Platte Valley Medical Center in Brighton, CO, shares her feedback about wireless detector sharing at her facility and the CARESTREAM DRX-Revolution.

The medical center replaced three analog portables with two DRX-Revolution Mobile X-Ray Systems. They share the DRX-1 detector between the portables and the RF room – making the best use of the most expensive piece of the system at peak times.

A Mobile Imaging Efficiency Showdown: CR vs. DR

When it comes to medical imaging it is no secret that every second counts. The modern healthcare environment can be incredibly fast-paced and medical imaging professionals demand, and deserve, the best when it comes to time-saving technologies.

We wanted to compare the efficiency of DR compared to CR using the DRX-1, and with the support of Queen Elizabeth Hospital in Birmingham, UK we were able to record a speed test. In the video, wireless DR is almost twice as fast as standard CR mobile imaging–an impressive performance that could make a big difference in terms of productivity and patient care.

[Webinar] Image Quality: Does it Matter, and How Should We Define It?

Dr. Ralph Schaetzing, Manager, Strategic Standards & Regulatory Affairs, Carestream

Dr. Ralph Schaetzing, Manager, Strategic Standards & Regulatory Affairs, Carestream

Where is image quality? In the capture device? In the image processing? In the display system? In the brain of the viewer? Is it everywhere, or nowhere in particular?

These questions were answered recently in a webinar titled “Does Image Quality Matter?” by taking a closer look at the imaging chain.

Any imaging chain (also a medical one) contains five distinct functions:

  1. Capture (the creation of the image),
  2. Process (which itself consists of three sub-functions: preprocessing of the captured image, optimization for interpretation/viewing, and processing for the output device),
  3. Display (assuming a human is the viewer),
  4. Storage
  5. Distribution.

The answers depends on which image quality we mean: the objective image quality we can measure, the subjective image quality perceived by the viewer, or, particularly important in medical imaging, viewer performance using the image for some interpretation task.

In modern imaging systems, these three “flavors” of image quality are weakly, if at all correlated, which makes the prediction of one kind of image quality from another rather tricky, but also interesting.

The entire webinar has been embedded below. By the end, the questions asked at the outset should be answered, though the path to get to those answers may surprise you.

Studies Have Proved the Benefits of Digital Breast Tomosynthesis: Now How Do We Change Referral Habits?

Dr. Harmindar Gill, Medical Director, Premier Women’s Radiology (Bonita Springs, Fla.)

Dr. Harmindar Gill, Medical Director, Premier Women’s Radiology (Bonita Springs, Fla.)

As a female radiologist, I have created a practice dedicated to women’s imaging that includes digital breast tomosynthesis (DBT), breast and body ultrasound, whole body bone density screening and other services. I also read breast MR images that are captured at another facility.

According to the American Cancer Society, 1 in 8 women will develop breast cancer during her lifetime—just over a decade ago the rate was 1 in 11 women. Genetics cannot account for this increase since 85 percent of breast cancer victims have no family history of the disease. There are a variety of factors that may be contributing to increased risk, including estrogen in our foods, post-menopausal hormone therapy and childbearing later in life. The good news is that the ACS reports death rates from breast cancer in the U.S. have dropped 34% since 1990.

I am an avid proponent of DBT because I believe it can assist in the effort to further reduce deaths from breast cancer. In my personal experience, I have found small lesions that I did not detect on other breast imaging exams and it also decreased the need to recall patients for additional testing. The ability for DBT to increase cancer detection rates and decrease recall rates has now been well documented through studies conducted across the country. In 2013 breast tomosynthesis captured attention and acceptance throughout the radiology community, as illustrated by the dozens of scientific presentations and poster sessions focused on DBT at RSNA 2013.

One RSNA 2013 presentation reported results from a study in which every patient since October 2011 was screened for breast cancer using DBT at Hospital of the University of Pennsylvania (HUP) in Philadelphia. The study’s lead author was Emily F. Conant, M.D., chief of breast imaging at HUP. Dr. Conant and five colleagues compared imaging results from 15,633 women who underwent DBT at HUP beginning in 2011 to those of 10,753 patients imaged with digital mammography the prior year. Six radiologists trained in DBT interpretation reviewed the images. The researchers found that compared to digital mammography:

  • Average recall rate using DBT decreased from 10.40 percent to 8.78 percent
  • Overall cancer detection rate increased from 3.51 to 5.25 (per 1,000 patients)
  • Overall positive predictive value for the group—the proportion of positive screening mammograms from which cancer was diagnosed—increased from 4.1 percent to 6.0 percent with DBT.

A prominent earlier study published in the June 2013 issue of the American Journal of Roentgenology documented the benefits of DBT by Dr. Stephen L. Rose and his colleagues at TOPS Comprehensive Breast Center of Houston, Texas. This study compared recall rates, biopsy rates, and cancer detection rates for six radiologists who interpreted 13,856 screening mammography studies without tomosynthesis and 9,499 studies with tomosynthesis.

For the group as a whole, the use of tomosynthesis resulted in:

  • Increase in invasive cancer detection rate from 2.8 to 4.3 per 1,000 screening examinations
  • Increased cancer detection rates from 4.0 to 5.4 per 1,000 screenings
  • A reduction in recall rates from 8.7% to 5.5%
  • Reduction in biopsy rates from 15.2 to 13.5 per 1,000 screenings.

As a result of my personal experience and the scientific studies now available, I advocate use of DBT for all screening mammograms—especially for patients with dense breasts, patients with BRCA gene mutation and those who have been previously diagnosed with breast cancer—because its three-dimensional imaging offers significantly enhanced visualization of breast tissue.

Now that we recognize the advantages offered by DBT, the challenge is to make tomosynthesis a mainstream screening protocol. It’s not enough for radiologists to recognize the value of tomosynthesis—physicians and gynecologists need to be educated about the benefits of this technology since these doctors account for a majority of the referrals for annual screenings and follow up exams.

Hear more about Dr. Gill’s practice and the importance of DBT below from RSNA 2013.

ACR’s Teleradiology White Paper and What it Means for the Industry

The ACR white paper about best practices in teleradiology that was published in 2013 has been a popular discussion topic over the past several months. David Willcutts, CEO of ONRAD, a radiology services provider based in California that offers flexible, custom radiology service solutions that can include teleradiology, on-site coverage, subspecialty reports and turnkey quality assurance programs, spoke with us about the teleradiology white paper and what he sees as being the most important points.

Willcutts explained that the focus is on important issues related to radiology as a whole, and that these are not exactly unique to teleradiology. A company such as ONRAD has trained radiologists on staff, and it is vital for them to maintain and manage items such as having the right licensure, efficient around time, complying regulations, etc. He stated that as the radiology industry evolves, the two monickers are going to blend and the only way to support clients is to focus on being the best radiologists possible.

In the end, it is all about one core issue – how do radiologists best take care of the patients? The interview with Willcutts can be viewed in its entirety below.