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· DR Pride!
· Workstation Optimizes Mammography and PACS
· A Valuable Option: Merging Mammography and PACS
DR Pride!
With an old slogan like “The few, the proud, the Marines,” they must be choosy. Swissray International Inc, East Brunswick, NJ, recently sold a number of its flat-panel DR systems to several Veterans Affairs medical centers and the Marine Corps Recruiting Depot in San Diego.
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| Swissray’s flatpanel DR Systems are in demand at VA centers and with a Marine Corps recruiting Depot. |
The purchase orders were all from Swissray’s Formula series product line, which features a multifunctional C-Arm design with the x-ray tube always centered to the FP-5000 Si flat-panel detector. Depending on the user’s preference, the system is available with either fixed or variable SID.
“Swissray’s DR systems are the fastest on the market,” said John Monahan, senior vice president of strategic accounts. “They meet the demanding needs of busy hospitals and clinics in the most automated and ergonomic method available. We offer the best image quality at the lowest dose, and for these reasons we have found success among those technologists and administrators entrusted with meeting the needs of our military veterans’ and active soldiers’ imaging needs.”
In addition to the Marine Corps Recruiting Depot, the systems were sold to the VAMC Kansas City; the VAMC Columbus, Ohio; and the VAMC Wilkes Barre, Pa.
When asked for a possible reason behind the military’s selection of Swissray’s solution over the company’s competitors, Monahan responded, “I believe that we have been selected by government agencies, such as the VA and the Navy, due to our quality. The fiduciary responsibility of the administrators and officers within the Department of Defense and the Department of Veterans Affairs is to select only the highest quality available. They do an extremely thorough job in their evaluation process. It is under such close scrutiny that Swissray rises above the rest and meets the highest quality standards of these agencies.”
Equipped with the company’s exclusive Automated Positioning System, the Formula systems were designed to streamline the radiography workflow process by automating all positions and image-acquisition requirements.
Via a DICOM worklist, an expert control desk allows patient information to be directly transferred from the RIS/HIS, with desired exposure and image parameters. The technology’s advanced robotics position the system for the selected examination by using a remote control, and an integrated video camera monitors the patient to ensure correct positioning. Users can choose from more than 1,200 preprogrammed positions.
The flat-panel detector offered by the Formula features a 3.5 lp/mm spatial resolution, 143-micron pixels, a 17-inch square format for large field requirements, carbon fiber casing that lowers radiation dose requirements, a five field measuring chamber, a 3P built-in infrared sensor that detects obstacles, and a floating-frame shock absorber for maximum panel protection.
Workstation Optimizes Mammography and PACS
Fujifilm Medical Systems USA Inc, Stamford, Conn, has introduced the Breast Imaging Diagnostic Workstation (BIDW) for facilities that have implemented full field digital mammography (FFDM). The Web-based solution is designed to optimize the mammography environment while still providing the enterprise features expected from a PACS.
The system is a response to the market need for more clinically and operationally advanced systems to support breast imaging. “As more and more facilities adopt digital mammography, there is an increased need for PACS that provide the specialized features and advanced technologies that are so vital to the
interpretation of full field digital mammography exams,” says Jim Morgan, director of marketing, network systems, for Fujifilm.
Unique mammography features include MQSA overlays, CAD SR support, and Fuji’s patented dual-side reading technology. All FFDM studies are automatically sent after image acquisition to the BIDW, where the image display is available in seconds and prior studies can be accessed for comparison.
Because the system delivers the full functionality of Fuji’s Synapse PACS, the workstation is not limited to breast imaging. “Users get a view of the total patient record from our system. The user can see the exams that have been prefetched over to the mammography workstation, but they also see other prior data from a third-party PACS without having to ask for it,” Morgan says.
A complement to Fujifilm’s Computed Radiography for Mammography (FCRm), the solution also is designed to integrate with other vendors’ PACS systems. It also can connect to EMR portals, HIS, RIS, and more than a dozen dictation systems. The flexibility makes it ideal in mixed-vendor environments.
It also is compatible with various hardware systems. Morgan explains he can deliver a system with hardware that matches the facility’s (Dell, IBM, HP, etc), or he can deliver the software alone to run on existing hardware. “It’s a more cost-effective way to get a mammography department up and fully functioning today while other things happen in the background,” Morgan says, citing savings in maintenance and support.
Scalability comes at no cost. Users license the software and are not charged a per-user fee. Additional workstations, including remote sites such as at a clinic, are easily networked.
Fuji believed it was uniquely qualified to produce the BIDW because the system draws upon the developmental efforts of both its PACS and mammography offerings. According to Morgan, many mammography workstation vendors sell stand-alone workstations and do not produce PACS, while PACS vendors that do not offer a digital mammography modality are adding mammography functionality to their PACS. “We combined our knowledge of the mammography modality and PACS and made an always Web-based mammography workstation solution with enterprise PACS features,” Morgan says.
Fuji’s FCRM is equally flexible. The system also is capable of capturing general radiography images in addition to mammography. Advanced image-processing features intended to improve image quality and diagnostic accuracy include multi-objective frequency processing and pattern enhancement for mammography. Large patients and volumes are both manageable: a large field of view (24 x 30 cm) accommodates any patient that could be imaged with film, and the FCRm reader can serve up to three rooms.
With the introduction of the BIDW and in combination with the Synapse PACS, the company has positioned itself to offer a total acquisition-to-archive solution. Seamless systems can offer advantages in terms of workflow, maintenance, and ultimately, patient care.
A Valuable Option: Merging Mammography and PACS
If a radiologist needs to spend an extra minute or so to access mammography images, that may not seem like a huge inconvenience. But multiply that by 90,000 mammograms annually, and it becomes not only a waste of time for radiology but also a huge expense for the institution. “You don’t want to throw away minutes and hours because it costs hundreds of thousands of dollars,” says Ramin Abrahim, MD, a partner radiologist at Washington Radiology Associates, Fairfax, Va.
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Instead of paying radiologist salaries to access studies, Washington Radiology Associates used technicians whose sole responsibility was to pull studies. Although less expensive than radiologists, their salaries were still a significant cost for the facility—about $200,000 annually, Abrahim estimates. That changed with a switch to an integrated system.
The institution has implemented Merge Mammo 7.10, a multimodality, vendor-neutral digital mammography workstation from Merge Healthcare, Milwaukee. The system is integrated with Merge’s Fusion PACS MX 3.0 to enable radiologists to launch the mammogram platform from the PACS workstation. Washington Radiology Associate radiologists can now view the mammogram and related studies, such as sonograms and breast MRIs, using flexible “pull” technology; they can review electronic documents; they can report using either a dedicated mammogram reporting or speech recognition software; and they can do it all without taxing the hardware. They do not need to deal with two separate worklists, transmitting mammography studies to different workstations, or a system crash.
“Although it’s been possible to get mammo tracking, electronic document management, and speech recognition software on the same computer, these setups have been unstable and very cumbersome to use,” Abrahim says. The facility experienced one or two crashes per day (requiring 5 to 6 minutes to reboot) when the previous system was overloaded with running the multiple programs and downloading data.
Implementation of the Merge integrated system has eliminated crashes as well as streamlined workflow. “The new integrated version allows very efficient navigation between the different software that enables complete digital reading, with the Fusion 3.0 being the central manager of data. Many clicks are saved by automation, and efficiency goes up too,” Abrahim says.
The PACS worklists begin to automatically download the current exam along with any priors. Radiologists can view one study while another downloads in the background. “It’s eliminated the need to have FTEs who pulled studies,” Abrahim says.
The functionality does not come at the expense of quality: Merge Mammo 7.10 offers new features to enhance images. Customizable line measurements allow users to set line thickness (to increase visibility and accuracy); the OptimumView tool features a customizable zoom factor that enables examination of paired images at increased resolution (to improve visualization of subtle anatomic features); and support for a fanning view lets users specify spatial orientation on each monitor separately (to provide a chest wall-to-wall view of mammography images). The system supports 12-bit printing and automatic VGA monitor support of ultrasound images.
The Fusion PACS also has debuted advances. Study caching improves on-demand loading, enabling clinicians to select multiple studies for local download in the background and in the order they designate. Greater flexibility in hanging protocol criteria and selection includes support for viewing protocols with multiple views. Extended keyboard shortcuts can be created for frequently used PACS tools, saving keystrokes and time.
Accessing the mammography program is as simple as one of these keystrokes—or actually, the push of a specific button. If the physician clicks the option, the PACS system will bring up the patient demographics in the mammography system.
Abrahim believes this advance represents a step toward an all-inclusive PACS. “This type of environment uses only one workstation with the capability of having all best-of-breed subspecialty software plugged into it,” Abrahim says.
For now, though, mammography is enough. The radiologists at Washington Radiology Associates have significantly streamlined workflow. “We are now running our practice without any delays,” Abrahim says. Patients don’t wait, results are completed on time, and cost-efficiencies have resulted in significant savings.
“Although it’s been possible to get mammo tracking, electronic document management, and speech recognition software on the same computer, these setups have been unstable and very cumbersome to use,” Abrahim says. The facility experienced one or two crashes per day (requiring 5 to 6 minutes to reboot) when the previous system was overloaded with running the multiple programs and downloading data.
Implementation of the Merge integrated system has eliminated crashes as well as streamlined workflow. “The new integrated version allows very efficient navigation between the different software that enables complete digital reading, with the Fusion 3.0 being the central manager of data. Many clicks are saved by automation, and efficiency goes up too,” Abrahim says.
The PACS worklists begin to automatically download the current exam along with any priors. Radiologists can view one study while another downloads in the background. “It’s eliminated the need to have FTEs who pulled studies,” Abrahim says.
The functionality does not come at the expense of quality: Merge Mammo 7.10 offers new features to enhance images. Customizable line measurements allow users to set line thickness (to increase visibility and accuracy); the OptimumView tool features a customizable zoom factor that enables examination of paired images at increased resolution (to improve visualization of subtle anatomic features); and support for a fanning view lets users specify spatial orientation on each monitor separately (to provide a chest wall-to-wall view of mammography images). The system supports 12-bit printing and automatic VGA monitor support of ultrasound images.
The Fusion PACS also has debuted advances. Study caching improves on-demand loading, enabling clinicians to select multiple studies for local download in the background and in the order they designate. Greater flexibility in hanging protocol criteria and selection includes support for viewing protocols with multiple views. Extended keyboard shortcuts can be created for frequently used PACS tools, saving keystrokes and time.
Accessing the mammography program is as simple as one of these keystrokes—or actually, the push of a specific button. If the physician clicks the option, the PACS system will bring up the patient demographics in the mammography system.
Abrahim believes this advance represents a step toward an all-inclusive PACS. “This type of environment uses only one workstation with the capability of having all best-of-breed subspecialty software plugged into it,” Abrahim says.
For now, though, mammography is enough. The radiologists at Washington Radiology Associates have significantly streamlined workflow. “We are now running our practice without any delays,” Abrahim says. Patients don’t wait, results are completed on time, and cost-efficiencies have resulted in significant savings.
