Imaging Pearls ❯ 3D and Workflow ❯ Workstations
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- “We aimed to evaluate the feasibility of an iPhone-based remote control system as a real-time remote computed tomography (CT) reading tool for suspected appendicitis using a third-generation (3G) network under suboptimal illumination. One hundred twenty abdominal CT scans were selected; 60 had no signs of appendicitis, whereas the remaining 60 had signs of appendicitis. The 16 raters reviewed the images using the liquid crystal display (LCD) monitor of a picture archiving and communication system (PACS) workstation, as well as using an iPhone connected to the PACS workstation via a remote control system. We graded the probability of the presence of acute appendicitis for each examination using a five-point Likert scale. The overall sensitivity and specificity for the diagnosis of suspected appendicitis using the iPhone and the LCD monitor were high, and they were not significantly different (sensitivity P = 1.00, specificity P = 0.14). The average areas under the receiver operating characteristic curves for all CT readings with the iPhone and LCD monitor were 0.978 (confidence interval 0.965-0.991) and 0.974 (0.960-0.988), respectively, and the two devices did not have significantly different diagnostic performances (P = 0.55). The inter-rater agreement for both devices was very good; the kappa value for the iPhone was 0.809 (0.793-0.826), and that for the LCD monitor was 0.817 (0.801-0.834). Each rater had moderate-to-very good intra-observer agreement between the two devices. We verified the feasibility of an iPhone-based remote control system as a real-time remote CT reading tool for identifying suspected appendicitis using a 3G network and suboptimal illumination.”
A Feasibility Study of Real-Time Remote CT Reading for Suspected Acute Appendicitis Using an iPhone. Kim C et al. J Digit Imaging. 2015 Aug;28(4):399-406 - “One hundred twenty abdominal CT scans were selected; 60 had no signs of appendicitis, whereas the remaining 60 had signs of appendicitis. The 16 raters reviewed the images using the liquid crystal display (LCD) monitor of a picture archiving and communication system (PACS) workstation, as well as using an iPhone connected to the PACS workstation via a remote control system. We graded the probability of the presence of acute appendicitis for each examination using a five-point Likert scale. The overall sensitivity and specificity for the diagnosis of suspected appendicitis using the iPhone and the LCD monitor were high, and they were not significantly different (sensitivity P = 1.00, specificity P = 0.14). The average areas under the receiver operating characteristic curves for all CT readings with the iPhone and LCD monitor were 0.978 (confidence interval 0.965-0.991) and 0.974 (0.960-0.988), respectively, and the two devices did not have significantly different diagnostic performances (P = 0.55). The inter-rater agreement for both devices was very good; the kappa value for the iPhone was 0.809 (0.793-0.826), and that for the LCD monitor was 0.817 (0.801-0.834). Each rater had moderate-to-very good intra-observer agreement between the two devices.”
A Feasibility Study of Real-Time Remote CT Reading for Suspected Acute Appendicitis Using an iPhone. Kim C et al. J Digit Imaging. 2015 Aug;28(4):399-406 - “We aimed to evaluate the feasibility of an iPhone-based remote control system as a real-time remote computed tomography (CT) reading tool for suspected appendicitis using a third-generation (3G) network under suboptimal illumination. The inter-rater agreement for both devices was very good; the kappa value for the iPhone was 0.809 (0.793-0.826), and that for the LCD monitor was 0.817 (0.801-0.834). Each rater had moderate-to-very good intra-observer agreement between the two devices. We verified the feasibility of an iPhone-based remote control system as a real-time remote CT reading tool for identifying suspected appendicitis using a 3G network and suboptimal illumination.”
A Feasibility Study of Real-Time Remote CT Reading for Suspected Acute Appendicitis Using an iPhone. Kim C et al. J Digit Imaging. 2015 Aug;28(4):399-406
- “ While mere numeric values might be different, commercially available software platforms produce comparable CAC scoring results, which suggests a vendor-independence of the method; however, none of the analyzed software platforms appears to provide a distinct advantage for risk stratification, as the variability of CAC scores depending on the reconstruction interval persists across platforms.”
Interplatform Reproducibility of CT Coronary Calcium Scoring Software
Weininger M et al.
Radiology 2012;265:70-77 - “ Vendor independent reproducibiity of coronary artery calcium scores is a prerequisite for reliable comparison of results and has direct impact on cardiovascular risk stratification, risk modification, and therapeutic monitoring.”
Interplatform Reproducibility of CT Coronary Calcium Scoring Software
Weininger M et al.
Radiology 2012;265:70-77 - “ Within our population, Spearman rank correlation between the workstations was highest at 60% of the R-R interval, which supports the clinical use of this time point during the cardiac cycle for image reconstruction at CT CAC scoring.”
Interplatform Reproducibility of CT Coronary Calcium Scoring Software
Weininger M et al.
Radiology 2012;265:70-77 - Workstation Platforms Used in Comparison
- Syngo Calcium Scoring ( Siemens Healthcare)
- Aquarius (TeraRecon Inc)
- Vitrea (Vital Images)
- “ New techniques and tools, already in use in other fields, can be adapte to the health care enviroment to improve medical image analysis, visualization, and navigation through large data sets; three-dimensional image display and incorporation of innovative human machine interfaces will likely be the future.”
Optimizing Analysis, Visualization, and Navigation of Large Image Data Sets: One 5000-Section CT Can Ruin Your Whole Day
Andriole KP et al.
Radiology 2011; 259:346-362 - “ Advanced postprocessing, including three-dimensional image display, multimodality image fusion, quantitative measures, and incorporation of innovative human machine interfaces, will likely be the future.”
Optimizing Analysis, Visualization, and Navigation of Large Image Data Sets: One 5000-Section CT Can Ruin Your Whole Day
Andriole KP et al.
Radiology 2011; 259:346-362 - “ The technology revolution in image acquisition, instrumentation, and methods has resulted in vast ata sets that fat outstrip the human observers’ ability to view, digest, and interpret modern medical images by using traditional methods.”
Optimizing Analysis, Visualization, and Navigation of Large Image Data Sets: One 5000-Section CT Can Ruin Your Whole Day
Andriole KP et al.
Radiology 2011; 259:346-362 - "No matter what the future brings, however, the keys to successfully choosing a workstation are being an informed consumer and having a clear understanding of the application(s) for which the workstation will be used and the environment into which it will be placed."
Choosing a Radiology Workstation: Technical and Clinical Considerations
Krupinski EA, Kallergi M
Radiology 2007; 242:671-682 - "Workstations do not exist in a vacuum, so it is important to consider the entire reading environment and how it affects interpretation accuracy and efficiency."
Choosing a Radiology Workstation: Technical and Clinical Considerations
Krupinski EA, Kallergi M
Radiology 2007; 242:671-682 - "With 3D rendering now available on PACS and on the WEB, the lack of access to 3D software should be less of an issue."
Unsuspected Mesenteric Arterial Abnormality: Comparison of MDCT Axial Sections to Interactive 3D Rendering
Chen JK, Johnson PT, Horton KM, Fishman EK
AJR 2007;189:807-813 - "There can be no doubt that the heavy lifting at the 3D workstation will be performed by technologists. That is not to say that physicians will play no role in the process. Physicians will serve in a supervisory capacity, responsible for setting protocols and troubleshooting individual cases when needed."
Running the Numbers:It’s Time for 3D Postprocessing Services
Falk R
Enterprise Imaging and IT (May 2007)
Diagnostic Imaging (supplement) - "If MSCT and advanced image processing were as easy and intuitive as we’ve been told, we would have no need to discuss workflow management. Our work would flow with no management at all, thank you very much."
Running the Numbers: It’s Time for 3D Postprocessing Services
Falk R
Enterprise Imaging and IT (May 2007)
Diagnostic Imaging (supplement)