Three options that make the most of your staff time.

While the advent of 3D imaging has opened up a whole new world of possibilities to the medical imaging profession, processing and storing the staggering amount of data involved can be a huge burden on a department’s resources. Many community hospitals are looking for cost-effective solutions to help manage 3D reconstruction so that staff can devote more time to what they do best—taking care of patients. Here are three options that can lighten your department’s workload without sacrificing quality.

1. Think “Thin”

Reconstructing 3D images was once a long and tedious process for radiology technologists at Saint Francis Medical Center in Cape Girardeau, Mo. But since the 258-bed hospital purchased the AquariusNet server and thin-client application from TeraRecon, San Mateo, Calif, that burden has been lifted from the technologists’ shoulders.

Today, 3D images from CT angiography and MR angiography are processed and stored on a central server. Radiologists and referring physicians can then access the results on demand from any networked PC, while the DICOM data remains on the server.

The thin-client application, which is integrated with the hospital’s PACS system, makes the process more user-friendly for technologists and less frustrating for radiologists, who are now able to manipulate the resulting images in the reading room.

“It’s a lot more automated now,” said Eric Banda, MHS, RDMS, director of radiology for Saint Francis Medical Center. “Before, it was a slow process, and then the finished product was not that satisfactory. The doctors in the reading room were hardly looking at those images.”

Depending on the type of study, reconstructed 3D images are now available 5 to 10 minutes after the images are taken. Not only are the results ready faster, but the quality has also improved.

“There is better consistency because the software is doing a lot of things for us in the same way across the board,” Banda said.

It also means better use of staff time. In the old days, some technologists would leave the time-consuming 3D-reconstruction work until the end of the day—which was a problem, Banda says, because “that’s when mistakes happen.” But the faster thin-client server has eliminated this issue. Now, staff can practically complete the reconstruction work between patients. To facilitate this, Banda doubles up his techs on each machine so they can alternate between taking and reconstructing images.

“As one tech is scanning a patient, the other tech can be doing reconstruction,” he said. “It’s just more efficient.”

The TeraRecon system also assists in stent planning. In the case of a positive abdominal aneurysm, for example, the system maps the 3D images and pairs them up with a specific stent brand. “It saves us the work of guessing which stent is going to fit best for the patient,” Banda said. “And then on the practical side, we’re not having to keep inventory on the shelf because we know exactly what we’ll need for that specific case.”

While Banda notes that every hospital has different needs when it comes to a 3D postprocessing solution, he says that the high-end AquariusNet server was worth the capital investment for his department. “It is cost-effective, definitely, because it’s cutting my technologists’ reconstruction time,” he said. “And it makes us feel good that the reconstructed images actually are being looked at by the radiologists. Psychologically, that’s big for my staff.”

2. Go Portable

Advanced video game technology is the surprising secret ingredient to the new 3D-imaging software from FiatLux Imaging, Redmond, Wash. Using DirectX game programming protocols to provide detailed images, FiatLux Visualize allows health care providers to access and manipulate 3D CTs and MRs on any PC, laptop, or tablet PC with a standard graphics card.

With a price tag of under $2,000, FiatLux Visualize could be an attractive option for smaller community or rural hospitals that do not have the capital to invest in dedicated 3D processing workstations.

“It’s a good way for facilities without the financial resources to have a PACS system to store their images, show their patients the images, and share images between providers,” said James Mounts, (RT), (R), (MR), an MR technologist at Skagit Valley Hospital, Mount Vernon, Wash, who has tested the product.

Health care providers can use the software to view cases in 2D, 3D, MIP, and MPR formats. The interface features reformatting and imaging tools, and users can access the original images, multiplanar reformats, volume rendering, and a database view.

The software allows health care providers to access and manipulate 3D images in the office, at home, or anywhere else they take their computers. “The portability of the system is one of the draws,” Mounts said. “You can even take it to the patient’s bedside and explain to the family what is going on.”

3. Get Outside the Box

One tried and true method for hospitals with limited staff resources is to outsource 3D-image reconstruction. Although Missouri Baptist Sullivan Hospital, Sullivan, Mo, is under the large umbrella of BJC HealthCare, the 46-bed hospital functions as a small, rural health care facility. For Travis Little, RT(R), ARDMS(AB), RVT, radiology manager for Missouri Baptist Sullivan Hospital, outsourcing to 3DR Laboratories, Louisville, Ky, saves valuable staff time.

“Some of these images can take up to 45 minutes to reconstruct,” Little said. “And that’s time that your tech could be spending with a patient instead of sitting in front of a computer cleaning up images.”

Now the techs send their 3D images to 3DR Laboratories, where the trained technologists perform the reconstruction based on protocols set by the hospital’s radiologists. The turnaround time is typically 1 to 2 hours.

“The radiologists are very satisfied with the images,” Little said. “They’re much better than in the past when we did them ourselves.” He notes that the radiologists also appreciate that the reconstructions have the same quality across the board, which was hard to achieve in-house.

Little adds that using this service gives the hospital access to better postprocessing technology. For example, 3DR Laboratories has integrated the Visage CS Thin Client/Server and Visage PACS Server from Visage Imaging, Carlsbad, Calif, into its product portfolio.

Outsourcing also means that Little does not have to invest in costly reconstruction training programs for his techs. “Sending people out for a week or a few days of training can be a real cost, especially when you’re looking at airlines, hotels, the classes themselves, and the lost productivity at the facility when you send that person away,” he said. “And you can’t just send one, because if that person is gone, someone else has to be there to clean up those images.”

If Little were to invest in this training, he would have to send all four of his CT techs—but it would be almost impossible to match the uniform quality of the reconstructed images the department currently receives. “You’re still not going to get the same level that you’re receiving back from the 3DR,” he said. “The images are just so much more than we were capable of doing.”

For Missouri Baptist Sullivan Hospital, Little says that outsourcing has worked smoothly from day one, and he recommends this option to other rural hospitals. “Some [hospitals] are reluctant because they don’t want to pay that fee per exam,” he said. “However, if they measure the productivity time that their staff is spending cleaning up these images, and the cost of the station that the tech would use to clean up these images, it’s significant savings in the long run.”

Ann H. Carlson is a contributing writer for Axis Imaging News.