Health Imaging & IT - October 2007 - (Page 45) By Lisa Fratt Battle Strategies Sixty-four slice CT is a tremendous clinical boon for cardiac imaging, opening the door to non-invasive images of the heart, enabling physicians to diagnose cardiac disease at earlier stages and providing the data needed to allow some patients to bypass invasive cardiac procedures. Despite its clinical advantages, 64-slice CT is not without challenges. Managing the image volume beast sits near the top of the list. Winning the Multidetector CT Data War of images generated by its GE Healthcare VCT XT scanner. The practice deployed 64-slice cardiac imaging in August 2005 and completes 70 to 100 studies monthly. Typical studies include retrospective gating and functional motion analysis and generate 1,000 to 4,000 images each. Although the 64-slice scanner produces a hefty amount of data, only a fraction of the original images are stored on PACS. Images designated for PACS storage include a single axial dataset of approximately 200 images, scout images and calcium scores, which comprise between two and 40 images. The next layer of data includes reconstructions for functional evaluation; typically cardiologists review 20 phases or axial datasets. These images are stored on PACS and backed up onto optical disk. Finally, the hospital adds an extra layer of security to its storage plan. To meet the complementary goals of answering questions—such as left ventricular ejection fraction—at later dates and ensuring complete regulatory compliance and maintaining all reviewed studies for seven years, the practice burns the entire exam to a DVD. “Each DVD costs 30 to 40 cents; this approach is probably more cost-effective than PACS storage for small practices,” opines Min. Still, the DVD option is not without its downsides. “It does take longer and can use more staff resources than outright PACS storage,” states Min, who admits the practice could shave time off the process by requiring techs to burn and label studies at the time of acquisition. s A heart imaged in real-time 3D on the GE Lightspeed VCT 64-slice scanner. ixty-four slice systems churn out massive amounts of data with scanners regular producing 4,000 images or up to 20 gigabytes of raw data per scan. The data load is enough to tax even the most meatiest storage systems, which forces sites to wrangle with some tough questions, including: • Which images should be saved on PACS? • What other media can be used to store multidetector CT data? • What is the best way to balance the regulatory and economic needs of the practice or facility? HealthImaging.com What is the ideal system to move and share images? This month, a few cutting-edge sites outline their 64-slice CT data management plans to help steer their colleagues toward an optimal solution. • click and burn “The New York Presbyterian Hospital [New York City] is ultra-meticulous,” confirms James Min, MD, director, cardiac CT laboratory at Weill Cornell Medical College of The New York Presbyterian Hospital. New York Presbyterian employs a three-pronged approach toward storage triple redundancy CVCTA Education in San Francisco employs a triple redundant approach to handling data generated by its Toshiba America Medical Systems Aquilion 64slice CT scanner. The cardiac CT education center performs about 15 to 20 scans daily including eight cardiac scans and Health Imaging & IT | O C T O B E R 2 0 07 45 http://HealthImaging.com
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