Imaging Pearls ❯ 3D and Workflow ❯ Workflow in Time
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- Since the advent of whole-body CT scanning in 1974, many studies have been made in its application to all parts of the body. One of the most fruitful areas has been CT of the spinal cord. The only limitation appears to be the technique used; there is no substitute for a good technique. We shall first review standard CT techniques, then mention special techniques for spinal cord work, and finally discuss the future.
CT techniques. Ledley RS Eur Neurol. 1982;21(3):204-9.
- "3D imaging has matured to become routinely applied in clinical practice. However, despite progress and refinements in organ or structure segmentation, there is a long way to go to obtain fully automatic segmentation of any organ. Although 3D images of bony structures can be obtained by a single mouse click, 3D images of other organs are still time demanding and often require manual adjustments for exact delineation of organs and pathological structures."
Three-dimensional imaging: Past, present and future.
Fishman EK, Bluemke DA, Soyer P
Diagn Interv Imaging. 2016 Mar;97(3):283-5 - "With advances in computer hardware especially with advanced graphics processing unit development, the capabilities of low cost post-processing will continue to evolve and 3D imaging has a promising future."
Three-dimensional imaging: Past, present and future.
Fishman EK, Bluemke DA, Soyer P
Diagn Interv Imaging. 2016 Mar;97(3):283-5 - "Volume rendering requires a more complex computer algorithm. It analyzes the content of each voxel within a data set, assigns a specific color and transparency based on its underlying attenuation, and subsequently presents the data in a 3D display."
Three-dimensional imaging: Past, present and future.
Fishman EK, Bluemke DA, Soyer P
Diagn Interv Imaging. 2016 Mar;97(3):283-5
- “Target identification in the coronal plane is extremely similar to the axial plane on abdominopelvic CT in this study and offers a substantial time benefit. A perceptual limit to visual processing of CT images may contribute to this similarity. Greater use of coronal reformats in day-to-day practice could substantially improve radiologist workflow.”
Visual search in abdominopelvic CT interpretation: accuracy and time efficiency between coronal MPR and axial images. Mcmenamin D et al. Acad Radiol. 2015 Feb;22(2):164-8 - “Coronal images took 40% less time to view overall. No significant difference was found in reader accuracy or reader confidence between the two planes. Interrater agreement was observed as fair, across a very large number of raters.”
Visual search in abdominopelvic CT interpretation: accuracy and time efficiency between coronal MPR and axial images. Mcmenamin D et al. Acad Radiol. 2015 Feb;22(2):164-8
- “ Radiologists in collaboration with oncologists, surgeons and pathologists should adopt a multidisciplinary therapeutic approach that includes use of imaging and clinicopathologic data for optimize, focused care of patients with GEP-NETs.”
Update on the Management of Gastroenteropancreatic Neuroendocrine Tumors with Emphasis on the Role of Imaging
Kim KW et al.
AJR 2013; 201:811-824 - “ As newer therapeutic agents and approaches become available, it may be necessary to further modify existing anatomy-based response assessment methodologies, verify promising functional imaging methods in large prospective trials, and investigate new quantitative imaging technologies.”
Response Criteria in Oncologic Imaging: Review of Traditional and New Criteria
Tirkes T et al.
RadioGraphics 2013; 33:1323-1341
- “ Failure to provide patient centered care was the most common complaint; most of these complaints could be attributed to systems issues. There was a higher incidence of complaints related to interventional procedures than diagnostic examinations. Delays and providers interactions with patients were identified as key areas for improvement.”
Patient Satisfaction in Radiology: Qualitative Analysis of Written Complaints Over a 10-Year Period in an Academic Medical Center
Salazar G et al.
J Am Coll Radiol 2013;10:513-517 - “ The majority of complaints concerning operational systems issues were secondary to delays, including unanticipated waiting for a radiologic examination to be performed (invasive or noninvasive), waiting for an appointment for a radiologic examination, or waiting for test results. Long waiting times plays a major role in patients’ dissatisfaction in radiology.”
Patient Satisfaction in Radiology: Qualitative Analysis of Written Complaints Over a 10-Year Period in an Academic Medical Center
Salazar G et al.
J Am Coll Radiol 2013;10:513-517
- “Now that hardware and software have improved to the point that his every gesture reveals what he wants, the radiologist can twist and turn the image till it gives up its secret, revealing to him and to his colleagues the true nature and extent of disease.”
Should Post-Processing Be Performed by the Radiologist?
Mezrich R, Juluru K, Nagy P
J Digit Imaging (2011) 24:378-381 - “ And so the radiologist must choose the plane and isolate the anatomy, he wants to explore and demonstrate-much like Michelangelo chipped away till he uncovered what he saw. Now that hardware and software have improved to the point that his every gesture reveals what he wants, the radiologist can twist and turn the image till it gives up its secret, revealing to him and to his colleagues the true nature and extent of disease.”
Should Post-Processing Be Performed by the Radiologist?
Mezrich R, Juluru K, Nagy P
J Digit Imaging (2011) 24:378-381 - "With regard to the presence of intraabdominal pathologic findings, coronal reformations from isotrophic voxels are similar to transverse scans in terms of interpretation time and reader agreement."
Abdominal Pain: Coronal Reformations from Isotrophic Voxels with 16-Section CT- reader Lesion Detection and Interpretation Time
Jaffe TA et al
Radiology 2007; 242:175-181 - "In conclusion, scanning with 1.25 mm collimation seems adequate for a routine abdominal angiography examination with 16-detector CT, and scanning with 0.625 mm collimation facilitates improved delineation of fine vessels, although noise levels may increase with 0.625 mm collimation compared with 1.25 mm collimation."
Abdomen: Angiography with 16-Detector CT: Comparison of Image Quality and Radiation Dose between Studies with 0.625 mm and those with 1.25 mm Collimation
Miyoshi T et al.
Radiology 2008; 249:142-150 - "The average time to generate simple MIPs at the console was 3.4 minutes (range 1.7-4.4 minutes), and 22.3 minutes (range 15-30 minutes) to create images at the 3D workstation."
Semiautomated MIP Images Created Directly on 16 Section Multidtector CT Console for Evaluation of Living Renal Donors
Singh AK et al.
Radiology 2007; 244:583-590