Radiologists seek more control over 3D postprocessing

At a time when many radiologists are still trying to determine the best way to integrate 3D postprocessing into their workflow, it's no surprise that they want the best of both worlds. Most radiologists want to perform their own image processing in addition to using the services of a dedicated 3D imaging lab, according to research presented Sunday at the RSNA meeting.

In an overview of the issues involved with 3D postprocessing and workflow integration, Dennis Lau, an engineer with GE Healthcare, outlined four paradigms:

• 3D workstation. Images must be transferred to the standalone workstation, which requires multiple logins, and workstation availability is often limited.

• A dedicated 3D imaging lab. Three-D capability for incidental findings may not exist; findings are limited to views created; and postprocessed image availability can delay interpretation

• Modalities generate 3D reformatted images. This approach may involve wait times for technologists, image processing consumes scanner time and increases storage, and the option only provides reformats.

• Integrated PACS/3D workstation. With this option, there is no extra image transfer, no wait time for technologists or a 3D lab, and storage is reduced. The impact on radiologists is not known, Lau said.

For the survey, conducted in collaboration with GE Healthcare, Stanford researchers sought to determine the effects of 3D imaging on workflow and radiologist experience. There were 15 responses to the survey.

The survey indicated that use of 3D imaging improved interpretation efficiency for most respondents, especially when using coronal/sagittal reformations. They also found that for curved planar reformation and volume rendering, sufficient expertise is necessary to reduce interpretation time.

Independent of reader expertise, respondents reported using coronal/sagittal reformations more frequently than any other 3D postprocessing technique.

Survey results indicated that between 1% and 10% of respondents felt the need for additional images to be postprocessed, above and beyond what they already received from a 3D imaging lab.

"A lot of the radiologists were performing their own postprocessing and not just counting on 3D labs," said Denny Lau, an engineer with GE Healthcare.

Performing their own postprocessing allowed radiologists to conduct just-in-time decision making, increased availability of image processing tools, and allowed users to further explore imaging data as needed, Lau said.

Most survey respondents reported that integrated 3D/PACS can be useful in explaining findings to referring physicians.

The next step for researchers, according to Lau, is to extend such a survey beyond Stanford and to look at 3D image use in community hospitals and clinics.