Health Imaging & IT - April 2008 - (Page 25)

more, Md., uses the Somatom Definition dual-source 64-slice CT scanner from Siemens Medical Solutions. Multidetector CT scanning demands better workflow, he says, because “when you go to new scanners, your possible applications change.” For example, coronary CT, virtual colonoscopy and CT angiography all increase. protocols and automation The other new consideration is the speed of studies. With 10- to 15-second scans and reconstruction done almost in real time, “the speed of imaging patients is not determined by the scanner, but by workflow.” That includes, Fishman says, the design of proper protocols and taking advantage of background automation. About 10 percent of Fishman’s volume is 3D imaging. “For a cost-effective environment, you need to make sure the equipment is used well,” he says. That includes learning the software to analyze those datasets, such as fly-throughs for virtual colonoscopies and tools specific to cardiac imaging studies. Fishman also recommends purchasing a scanner that is easy to use and easy to train new people to use. With the right scanner, “complicated applications really aren’t that complicated to do.” Another step Fishman took was meeting with referring physicians to teach them what he could do with the multidetector scanner. He makes prints of all his 3D studies and delivers them to referring doctors. Thinking in 3d Frederick Barnett, MD, director of radiology services at Metroplex Hospital in Killeen, Texas, and director of cardiac CT angiography services at Doctors Hospital at Renaissance in Edinburgh, Texas, has been using the Aquilion 64-slice CT system from Toshiba America Medical Systems for more than two years. A move to more invasive cardiology services meant that “it made sense to get a scanner that would let us do noninvasive coronary artery disease screening.” Barnett went from a single-slice, helical Healthimaging.com trast, previous stents or bypass procedures scanner to the Aquilion. That forced him to and previous arrhythmias. The nurse also start thinking in 3D mode—“an entirely works with patients to start heart rate-lowdifferent concept.” ering medication the night before the scan. Automation is an important part of that “This attention to detail really makes for a different concept. Once the scanner genergood study,” Hines says. “It’s why we don’t ates the data, the computer takes the raw have run-of-the-mill studies and can sepadata, reconstructs it into axial scans and rate ourselves from hospitals and radiolofrom those axial images, performs reformats. gists who really don’t pay attention to the All this is done within minutes. “In the past, detail the way we do.” you would have a specific protocol for everything. This makes it much easier. There are very few acquisition [ gE Healthcare’s vCt console. ] protocols now.” Barnett also says that once display protocols are set up and plugged into the computer, the task is done. Archival plans are another protocol facilities must consider, he says. “You can’t put all that raw data on PACS. It will overwhelm the system in no time.” To manage and work with the large datasets, Barnett says he installed new, robust 3D work“This attention to detail really makes stations, particularly for cardiac for a good study. It’s why we don’t CT. “The computer can do a lot of work, but we still have to have run-of-the-mill studies and can manipulate and interrogate the separate ourselves from hospitals data to make a diagnosis. Withand radiologists who really don’t pay out robust workstations, it would take forever.” He also upgraded attention to the detail the way we do.” the PACS. “That allowed us to Jerome Hines, Md, cardiologist and president of illinois Heart and vascular store and retrieve data in a faster, more efficient way.” Only the data actually used to make the diagnosis more applications on the way goes to the PACS. Making workflow changes and considering Jerome Hines, MD, cardiologist and efficiency is important for anyone using mulpresident of Illinois Heart and Vascular, a tidetector CT since applications and study 27-physician cardiology practice with sevand image volume are only going to increase eral locations in and around Chicago, has in the future. Fishman expects to see much been using the 64-slice LightSpeed VCT more in the way of very specific applications, scanner from GE Healthcare for three years. such as analysis of lung tissue, more computHines is one of three cardiologists at the er-assisted imaging and routine use of CAD practice who reads CT scans. in virtual colonoscopy and lung scans. These Preparing the practice for multidetector advances will be the result, he says, not of CT became a task of organization and perimprovements to the scanner, but improvesonnel. For example, patient preparation ments in post-processing. And that is where includes a checklist inquiring about recent current users are applying the majority of creatinine levels, past experience with contheir workflow enhancements. april 2008 | Health Imaging & IT 25 http://Healthimaging.com

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Health Imaging & IT - April 2008 Contents On the Web The Enterprise News Update Cracking Down: CT Radiation Dose 3D Rendering: Options Galore Thinking Thin-Client Modality Review Ergonomics & Design Special Section: Storage Strategies Imaging Tools Technology Outlook People & Technology Technology Review IT Trends Reader's Resource Stat Sheet

Health Imaging & IT - April 2008

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