Time efficiency of a new server-based post-processing solution (syngo.viatm) for post-processing and reporting of cardiac CT

Transcription

1 Time efficiency of a new server-based post-processing solution (syngo.viatm) for post-processing and reporting of cardiac CT Poster No.: C-0636 Congress: ECR 2012 Type: Scientific Paper Authors: T. De Zordo 1, N. Mukke 2, C. Biermann 3, P. Sögner 4, W. Jaschke 1, G. Feuchtner 1 ; 1 Innsbruck/AT, 2 Corunna/DE, 3 Tübingen/DE, 4 Götzens/AT Keywords: DOI: Cardiac, CT-Angiography, Diagnostic procedure, Cardiac Assist Devices /ecr2012/C-0636 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 11

2 Purpose Readout of cardiac CT exams requires advanced 3-D postprocessing. Conventional off-line 3-D workstations are widespread used, but are limited by "non-flexibility" (=cannot be integrated into PACS) and a "single-user" approach. A new advanced 3-D postprocessing solution (syngo.via TM) is serverbased, can be integrated into any PACS workstation and shared by "multiusers". Consequently, advanced 3-D postprocessing can be performed on any PACS workstation. This advanced tool performes most 3-D post-processing steps automatically, hence the manual work is reduced. beyond, multiple users can work "interactively". To compare postprocessing and reporting time for cardiac CTs using the newly introduced server based 3-D solution (syngo.via) with a conventional 3D multi-modality workplace (MMWP). Methods and Materials Twenty consecutive patients (mean age, 55.3 years; range, 26-85; 13 male, 7 female) were examined with 128-slice dual source CT for a variety of clinical indications for cardiac CT according to ACCF/SCCT/ACR/AHA/ASE/ ASNC/NASCI/SCAI/SCMR 2010 guidelines (Taylor et al, Circulation 2010) coronary artery disease=9, bypass follow-up= 6, pre-operative TAVI planning =3, chronic Total Occlusion (CTO) assessment for intervention=1, congenital heart disease=1. Figure 1 and 2 show the integration of the server into the PACS environment. Datasets were blinded and analyzed by 2 different softwares (conventional 3D workstation (MMWP) and a thin-client server based solution (syngo.via), Page 2 of 11

3 both Siemens, Forchheim, Germany), and randomized to avoid bias. The assessement work-flow process is shown at Figure 3. The MMWP software postprocessing time of the technician (tech time) and the reporting time (doc time) of an experienced radiologist were recorded (total time=tech time + doc time). Syngo.via for combined automatic postprocessing and reporting time (total time) was recorded. Usability was assessed subjectively on a 5 point scale. T-test was used to test statistical significance. Images for this section: Fig. 1 Page 3 of 11

4 Fig. 2 Fig. 3 Page 4 of 11

5 Results When using MMWP software a mean tech time of 369 sec (range, sec) and a mean doc time of 212 sec (range, sec) were noted, resulting in a mean total time of 581 sec (range, sec) (Figure 4). By using syngo.via, a significantly lower mean total reporting time of 131 sec (range, sec) (p<0.001) was recorded. A mean total readout time reduction of 77.4% (450sec; range, sec) was found. (Figure 5) For evaluation of coronary artery disease, 79.4% of timesaving were observed, for bypass follow-up 79.4%, for TAVI planning 70.9%, for CTO 90.8%, and for congenital disease 64.4%. (Figure 4) Coronary CT workflow: Figure 6 shows a case of a 64 YOF with chest pain, in which total readout time was 58 seconds. (shown on 1st left screen- interactive MPR) Figure 7 shows curved multiplanar reformations (MPR), which are generated automatically without manual manipulations (which are Shown of 2nd- right screen). Another patient is shown with a high-grade stenosis. QCA can be done. Both interactive MRP (Figure 6) and curved MPR (Figure 7) are shown on one PACS workstation with 2 screens side by side TAVI -(transcutaneous aortic valve implantation) workflow: Figure 8 shows automated aortoilical vessel post-processing including sizing and Figure 9 dedicated cardiac measurements (C-arm LAO/CC prediction) for planning of the TAVI procedure. Usability Better usability was found for syngo.via software. Data preparation, usability, and reporting cases was easier when using syngo.via (Figure 10). Page 5 of 11

6 Images for this section: Fig. 5 Page 6 of 11

7 Fig. 4 Page 7 of 11

8 Fig. 6: Example of the syngo.via interface showing myocardial bridging in an 64 year old female patient with atypical chest pain. Automated multiplanar reconstructions are facilitating diagnostic confidence. Fig. 7: Automated center line views of coronary arteries are shown on a second screen by syngo.via. This 55 years old male patient with angina pectoris showed a 50-70% stenosis of the right coronary artery. Page 8 of 11

9 Fig. 8: Automated aortoilical vessel post-processing including sizing for TAVI planning. Fig. 9: Dedicated cardiac measurements (C-arm LAO/CC prediction) for planning of the TAVI procedure. Page 9 of 11

10 Fig. 10 Page 10 of 11

11 Conclusion Syngo.via software reduces both total post-processing and total reporting time in cardiac computed tomography. References ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography : A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance Cardiac Computed Tomography Writing Group, Allen J. Taylor, Manuel Cerqueira, John McB. Hodgson, Daniel Mark, James Min, Patrick O'Gara and Geoffrey D. Rubin Circulation 2010, 122:e525-e555: originally published online October 25, 2010 doi: /CIR.0b013e3181fcae66 Personal Information Tobias De Zordo, Department of Radiology, Medical University Innsbruck Anichstr. 35, 6020 Innsbruck, Austria. tobias@de-zordo.net Gudrun Feuchtner, Department of Radiology, Medical University Innsbruck Anichstr. 35, 6020 Innsbruck, Austria. gudrun.feuchtner@i-med.ac.at Page 11 of 11