Cardiovascular Business - October/November 2007 - (Page 36) haNds ON › by bEtH walsH ThE 3D hEarT Seeing More, More Quickly Advanced visualization has shot from the realm of experimental, futuristic technology to almost routine practice in just a few short years. While the reliance by physicians on 3D varies, clinicians can often determine the presence and extent of heart disease without an invasive procedure. On the horizon, 3D users see further improvements that will reduce radiation exposure and speedier interpretation times. ‘‘O ver the past two to three years, 3D postprocessing has gone from somet hi ng we kind of played with to something that has been incorporated into the general management of patients with cardiovascular conditions,” says David Bush, MD, director of the cardiac catheterization lab at Johns Hopkins Bayview Medical Center in Baltimore, Md. Bush has been using Vitrea workstations and VitalCardia software from Vital Images since 2003. The technology helps him provide a conclusive answer about the extent of coronary disease in patients. For patients who are younger or who otherwise fall outside the typical risk group for coronary disease, they are great candidates for cardiac CT. “The expectation is that they’re not going to have much disease and if you can confirm that, you’ve saved them an invasive test.” “Cardiac CT is relatively new. Not that many cardiologists do it because you are required to have very sophisticated software to read coronary CT angiograms. It puts a lot of demand on software,” says John Lesser, MD, cardiologist at the Minneapolis Heart Institute/Abbott Northwestern Hospital in Minnesota. He has been using Vitrea workstations and VitalCardia software since venturing into cardiac CT in 2003. VitalCardia lets Lesser read studies more quickly and accurately. He finds 3D cardiac imaging particularly helpful when treating peripheral vascular disease and complicated congenital heart disease. Carter Newton, MD, a cardiologist at the University of Arizona in Tucson is another early adopter of 3D imaging. He uses TeraRecon’s Aquarius workstation and AquariusNET server for his monthly CT reading and reporting classes for radiologists and cardiologists. 3D imaging allows for both static and moving images. “The use of static images rendered without motion artifact is extremely useful for high resolution coronary artery analysis,” he says. “That’s really the thing that turns everybody on.” This high resolution structural imagery allows for study of the various elements, including arteries, veins, valves and other various heart structures. “You can actually visualize the heart in a ‘virtual’ anatomic presentation than in an actual surgical dissection,” says Newton. Users also can control how brilliantly the tissues are rendered and emphasize cardiac structures that are the subject of inquiry: ventricular muscle and pulmonary vein connection, for example. Dynamic images let clinicians watch phases of the heart Better than surgical dissection 36 Cardiovascular Business October/November 2007 3D volume heart Ct image from Vital images
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