Health Imaging & IT - October 2007 - (Page 46) special section: Inside Cardiac Imaging seamless storage But 64-slice CT need not be a storage beast. Take for example South Jersey Radiology Associates, a seven-site practice headquartered in Voorhees, N.J., that operates the CT continuum from four-slice systems to Siemens Medical Solutions Sensation 64 and Definition Dual Source scanners. The practice runs a full schedule on its scanners and completes 40 to 45 CTs daily on each of its mega scanners: the Definition and Sensation 64. Both scanners yield datasets of similar sizes. A typical chest CT from the Definition produces 206 images and consumes 37 megabytes of PACS storage; a chest CT from the 64-slice scanner generates 208 images, which requires 39 megabytes of storage CVCTA Education in San Francisco archives about 750 MB of data per study from its Toshiba Aquilion 64-slice CT scanner three to four peripheral vascular studies. A typical cardiac scan produces about 20 gigabytes of raw data, an amount that would overwhelm most storage solutions. The center completes approximately 15 reconstructions on cardiac scans or 1.2 gigabytes of data. “We save functional data, one or two thin-slice reconstructions and 10 thick-slice reconstructions for coronary studies on PACS. We wind up archiving about 750 megabytes of data per study,” says Tony DeFrance, MD, medical director. Techs also burn a DVD with the same 750 megabytes of data directly from the scanner. “Patients and doctors appreciate the advantages of access to a hard copy,” reports DeFrance. The final layer of CVCTA’s approach is driven by its teaching operations and consists of a 10 terabyte server that allows the site to easily distribute studies to multiple workstations as CVCTA trains physicians new to cardiac CT. The other component of 64-slice scanning is image review. Sites need to determine who is reading studies and where. “Sites need good bandwidth, usually T1 or T2 lines to move studies around,” says DeFrance. 46 O C T O B E R 2 0 07 | Health Imaging & IT space. Despite the file sizes, multidetector CT has been fairly seamless from a storage perspective, says PACS Administrator Kim Baldwin. The practice does employ a triage approach to data storage. For standard exams like chest, abdomen and pelvis studies, South Jersey Radiology sends 5 millimeter (mm) axial reconstructions and 3 mm coronal reconstructions to PACS. Studies requiring 3D manipulations such as coronary CT angiographies require a different approach. “We save the thin slice [data] on Siemens syngo WebSpace. Radiologists can interact with the slices without eating up PACS storage,” explains William Muhr, MD, radiologist. Any images created by the radiologists are then saved to PACS. Like most cardiac CT sites, the practice does not hold on to raw data for the long-term, relying on the Siemens Leonardo workstation as a shortterm, temporary storage archive. DATA STORAGE STRATEGIES S » » » » ixty-four slice CT can bring tremendous benefits to a practice; a well-conceived archiving plan goes a long way toward a healthy deployment. Pioneers share their wisdom. Determine the most cost-effective storage option by soliciting input from PACS vendors about their offerings and do the math comparing PACS storage against other media, says Min. Often the most advantageous approach places small datasets on PACS and stores the remainder on DvD. Another advantage of the click-and-burn approach? If the entire dataset is stored on PACS, it can be unwieldy to query and retrieve the dataset. Assess the network infrastructure and make sure it is robust enough to handle multidetector traffic, says Baldwin. South Jersey Radiology upgraded to a 45 megabit connection and gigabit switches prior to deploying its dual-source scanner. Invest in tech training. Techs need to understand storage parameters and what to send where. 256-slice CT systems and larger datasets are around the corner. “Sites need scalable systems and PACS servers that can adapt to larger and larger volumes of data. It’s critical to ensure that the PACS vendor offers an appropriate upgrade path,” DeFrance says. HealthImaging.com http://HealthImaging.com
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