Tuesday, July 27, 2010

Managing Nuclear Medicine Images Gets a Little Easier

"Managing Images Gets a Little Easier" was published by Health Imaging & IT | June 1, 2007 | Inside Molecular Imaging and was written by Jamie Bellavance

The typical PACS doesn’t always cut it when it comes to nuclear medicine.  Mainstream medical imaging technologies have not been designed to handle nuclear medicine’s unique demands, proprietary protocols, or programs, which make them incompatible with radiology PACS.  Hospitals nationwide are finding they have to explore new options when it comes to needs such as display functionality to support nuclear medicine studies. Some nuclear medicine departments have invested in pioneering nuclear medicine solutions or interfaced to radiology department PACS, while others prefer an enterprise-wide, integrated solution.

Nuclear medicine requires specific display capabilities, such as grayscale or color, functional, quantitative and fusion data. Static displays just won’t do for dynamic nuclear medicine studies, planar gated studies, SPECT, PET or PET/CT. PET/CT image review involves viewing of transaxial, coronal and sagittal and maximum intensity projection (MIP) images. For that, physicians need a separate solution to translate data among different file formats.

Nuclear medicine departments across the country have integrated new image management models that facilitate nuclear medicine data flow to benefit department and enterprise workflow.

A solution for all needs
The University of Miami Hospital and Clinics (UMHC) in Miami, Fla., house a total of 120 beds, and conduct approximately 6,000 nuclear medicine procedures each year. UMHC has used Thinking Systems Corp.’s ThinkingPACS for image management in nuclear medicine since 2002. The system includes an MDStation for physicians to perform review of images, quantifications, and image fusion; a QC station for the technologists; and an archive system for archiving all the nuclear medicine images, including SPECT and PET/CT. The ThinkingPACS sends all the images to the radiology RIS-PACS, a GE Healthcare/IDX ImageCast for enterprise-wide access and archival.

UMHC has two ADAC Genesys dual-head SPECT cameras, one Philips Medical Systems Skylight dual-head SPECT camera, and a Philips Gemini PET/CT scanner. ThinkingPACS receives the image data from the SPECT cameras and the PET/CT scanner through proprietary and DICOM connectivity for the purpose of processing, quantification, display and review using the MDStation, and also for archiving.

UMHC chose ThinkingPACS because it is an open architecture, Windows-based system with a robust clinical software package with “the clinical programs, tools, utilities and all necessary functionality that we need in order to perform our work,” says Mike Georgiou, PhD, assistant professor of Radiology and nuclear medicine physicist at UMHC.

The MDStation is used by the nuclear medicine physicians for review of all general nuclear medicine studies (bone, renal, liver/spleen, parathyroid, gastric, lung), SPECT processing and review, quantification for nuclear cardiac studies, and PET/CT fusion for oncology, neurology and cardiology studies. It has all the necessary display/review functions and analysis programs for nuclear medicine studies. For example, the physician has the ability to easily and efficiently manipulate the image data, perform comparisons with current and prior studies, and capture interesting cases for slide presentations, Georgiou says.

The technologists use the QC station to check images that have been acquired, and to ensure that the patient demographic information is accurate. Subsequently, the images are shipped to the university GE/IDX PACS for enterprise-wide access. The QC station also makes CDs.

Currently, UMHC is in the process of purchasing the Thinking Systems “plug-in” solution for its hospital PACS to meet the nuclear medicine needs — including PET and PET/CT — of referring physicians. The plug-in for third-party enterprise PACS, which they hope to install in a few months, will bring the nuclear medicine image programs, functions and tools to the hospital PACS in seamless fashion. The Thinking Systems web server will provide remote access to nuclear medicine images, allowing physicians to read studies from home or any remote location. “Most PACS lack the necessary functionality for nuclear medicine imaging,” Georgiou says. “The Thinking Systems plug-in can provide this functionality and offer a complete PACS solution for nuclear medicine.”

Eliminating manual intervention
Saint Joseph’s Hospital in Marshfield, Wis., stored all nuclear medicine department quality control and patient data on optical disc until December 2004. They knew they needed to change that, says Mike Bull, manager of nuclear medicine, they just needed to figure out how. They also wanted to make sure that their solution would obscure raw data that shouldn’t be seen by physicians.

NumaStore from Numa Inc. was the perfect choice, Bull says. The specialized PACS storage and image management system is designed for nuclear medicine data and studies. It offers secure, long-term storage of patient studies acquired over separate visits and the cataloging of those studies. It also supplies efficient retrieval in a way that facilitates and encourages comparative analysis. These abilities encourage a change in the way nuclear medicine is used, from simply a diagnostic snapshot to a long-term care patient management tool.

NumaStore receives information, or queries the workstation to get all the data, and stores them on the NumaStore server. Then NumaList — a DICOM modality worklist manager — sends only the screen-saved images to the PACS, which is all the referring physicians need to see. NumaList enables importing of vital hospital information system (HIS) and radiology information system (RIS) information into nuclear medicine DICOM headers. Following this, the patient file can be forwarded on to an imaging workstation or PACS. 

For image and data storage, NumaStore eliminated the need for manual invention. Previously, if technologists needed to retrieve data, they had to manually locate the optical disc and load it in the drive. “Now, it’s as easy as querying it back from NumaStore to any of our workstations,” Bull says.  They also don’t misplace as many studies as they did with optical disc. Now that everything’s automated, all studies get pulled or pushed to NumaStore.

An enterprise-wide solution
While some facilities favor a nuclear medicine department solution for image management, an enterprise solution is the choice of others. The radiologists at Diagnostic Radiology Consultants (DRC) wanted an enterprise-wide integrated solution to help read and interpret approximately 200,000 cases per year from the 11 facilities that they service across Chattanooga, Tenn., and northern Georgia. For this job, Specialty Networks, LLC was created as the information technology arm of the radiology practice. Specialty Networks is run by DRC, a private practice group of 10 radiologists who review images in nuclear medicine, MR, CT, and ultrasound for facilities that range from a 300-bed community hospital, to a single CT scanner owned by a urology group.

Three years ago, Specialty Networks was dealing with three PACS and two RIS platforms, all from different vendors, and each with a separate workstation, logon and password. To improve efficiency, they researched a seamless, integrated solution from one vendor that would keep all their databases in sync, using one logon, one keyboard and one mouse.

In 2005, they chose Siemens Medical Solutions syngo Suite to integrate RIS, PACS, post processing and transcription. Syngo Workflow manages the exchange and distribution of patient data and images. Syngo Imaging covers the PACS applications for diagnostic preparation, quality assurance and interpretation. Syngo Voice provides voice recognition and transcription. Specialty Networks also chose Siemens’ partner NextGen Healthcare Information Systems to provide its electronic practice management (EPM) solution. In all, Specialty Networks implemented seven workstations at facilities throughout their network.

With syngo Suite, dedicated workstations for nuclear medicine imaging aren’t necessary, allowing smoother integration while reading other radiology images such as CT and MR. “We weren’t looking for a specific nuclear medicine solution. What we wanted was the solution that brought nuclear medicine into the normal workflow. The last thing you want as a radiologist is a separate workflow for separate types of exams,” says Jim Busch, MD, CEO of Specialty Networks. The nuclear medicine gamma cameras, including the Siemens’ Biograph 16, Symbia T6, Symbia S, and Orbitor gamma camera, as well as a Philips Forte gamma camera, simply plug into syngo Suite, and transfer images to the PACS, Busch says.

The syngo Suite worklist allows radiologists to search for patient images by patient name, medical record number, date, facility, or referring physician. Worklists are organized by priority, need and the radiologist’s physical location, Busch says. For example, while Busch may be located at Tennessee Imaging, half of the exams could be from another facility 50 miles away.

Specialty Networks brought 10 facilities onboard with syngo Suite in about nine months. And the results are impressive: Volume has increased about 15 percent, while workflow efficiency has jumped 27 percent. Report turn-around time also has been cut considerably — dropping to just an hour from 24 hours.

Keeping up with NM
Since radiology PACS often struggle to manage nuclear medicine image needs, vendors have come to the table with specific nuclear medicine solutions that can seamlessly relay data to the department or enterprise-wide hospital PACS. Nuclear medicine departments can now provide fast, accurate image interpretation across proprietary vendor image formats while boosting efficiency and workflow.

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About Thinking Systems Corporation
Thinking Systems is an innovative medical software developer and marketer that brings the power of digital technology to advanced clinical, as well as image management applications, creating highly functional and fully automated imaging environments. With a unique vision of comprehensive enterprise-wide digital image workflow, Thinking Systems’ product portfolio supports the most complete spectrum of imaging modalities available today. Providing truly customized implementations, Thinking Systems translates the power of its versatile product portfolio and expertise into highly effective solutions tailor-made for each installation. Founded in 1996, Thinking Systems’ cutting edge ThinkingPACS and ThinkingRIS have been helping prestigious hospitals and freestanding imaging centers, both large and small, enjoy a fully digital environment. To learn more about Thinking Systems, visit www.thinkingsystems.com.

THINKING SYSTEMS solutions are installed at over twenty sites across Canada and are proudly distributed by Alliance Distribution Network (ADN) Canada. For more information please contact your local ADN Canada sales consultant Toll-Free in Canada at 877-434-5311 or e-mail.  

Note: Any / all product names mentioned in this document may be trademarks or registered trademarks of their respective companies and are hereby acknowledged.

Fletcher Allen Health Care Chooses Thinking Systems’ ThinkingPACS PET-CT, Nuclear Cardiology, Nuclear Medicine, and Other Cardiology Solutions

Solutions To Be Integrated With Existing McKesson PACS

FOR IMMEDIATE RELEASE

St. Petersburg, FL and Burlington, VT (November 22, 2006) – Thinking Systems Corporation, recognized as one of the most innovative medical imaging software developers for its broad product portfolio designed to support the spectrum of modalities, today announced that Fletcher Allen Health Care, a Burlington, VT, teaching and community hospital which operates in partnership with the University of Vermont, has signed an agreement to purchase its latest flagship ThinkingPACS solutions.


Thinking Systems’ solutions, including ModalityBroker, will be integrated with Fletcher Allen Health Care’s existing McKesson Horizon Medical Imaging PACS solution to provide enterprise-wide support of specialty modalities such as PET-CT, nuclear cardiology, and nuclear medicine.  The new installation will also include Thinking Systems’ enhanced PACS features, including hanging protocols, key images, and presentation states, which are DICOM 3.0 2006 conformant.

“We are excited to showcase our flagship ThinkingPACS solutions at one of the most respected healthcare facilities on the East Coast,” said Xiaoyi Wang, President and co-chairman, Thinking Systems Corporation. “This is a significant installation in that it will include new enhancements to provide extended interoperability with Fletcher Allen Health Care’s existing McKesson PACS solution.”

 “We chose Thinking Systems’ ThinkingPACS to complement our McKesson enterprise PACS because after evaluating our options, we determined that Thinking Systems offers outstanding PACS solutions for PET-CT, nuclear cardiology, and nuclear medicine,” said Frank Harris, Vice President of Information Services, Fletcher Allen Health Care. “With the integration of ThinkingPACS into McKesson’s Horizon Medical Imaging solution from the same workstation, our physicians will be able to access images of all modalities with the appropriate clinical tools and compare them side by side. The resulting system based on the cooperation of Thinking Systems and McKesson will not only improve the efficiency of our physicians but also improve the quality of our services.”

About Thinking Systems Corporation
Thinking Systems is an innovative medical software developer and marketer that brings the power of digital technology to advanced clinical, as well as image management applications, creating highly functional and fully automated imaging environments. With a unique vision of comprehensive enterprise-wide digital image workflow, Thinking Systems’ product portfolio supports the most complete spectrum of imaging modalities available today. Providing truly customized implementations, Thinking Systems translates the power of its versatile product portfolio and expertise into highly effective solutions tailor-made for each installation. Founded in 1996, Thinking Systems’ cutting edge ThinkingPACS and ThinkingRIS have been helping prestigious hospitals and freestanding imaging centers, both large and small, enjoy a fully digital environment. To learn more about Thinking Systems, visit www.thinkingsystems.com.

About Fletcher Allen Health Care
Fletcher Allen Health Care, in alliance with the University of Vermont College of Medicine, is Vermont’s only academic health center and is one of 125 in the country. Fletcher Allen also serves as the community hospital for the greater Burlington area. Fletcher Allen has more than 6,000 employees and serves one million people in Vermont and northern New York through more than 40 patient care sites and 100 outreach clinics.

Thinking Systems US Contact:
Xiaoyi Wang, President
+ 1-727-217-0909

Thinking Systems Canada Contact:
+1-877-434-5311

THINKING SYSTEMS solutions are installed at over twenty sites across Canada and are proudly distributed by Alliance Distribution Network (ADN) Canada. For more information please contact your local ADN Canada sales consultant Toll-Free in Canada at 877-434-5311 or e-mail.  Note: Any / all product names mentioned in this document may be trademarks or registered trademarks of their respective companies and are hereby acknowledged.


Thursday, July 08, 2010

DIGIRAD’S NEXT-GENERATION EARTH AND SPACE SCIENCE MISSIONS


An X-Ray Spectrometer using state-of-the-art detector technology will be launched this year on the Clark spacecraft, one of two missions to be flown as part of the Small Spacecraft Technology Initiative. Under SSTI, NASA funded the development of “Clark,” a high technology demonstration satellite to provide 3-m resolution panchromatic and 15-m resolution multispectral images, as well as collect atmospheric constituent and cosmic x-ray data. The 690-Ib. satellite, to be launched in early 1997, will be in a 476 km, circular, sun-synchronous polar orbit.

The primary objective of this mission is to demonstrate new technologies for small spacecraft. In keeping with this philosophy, we use two new types of semiconductor X-ray detectors, both operating near room temperature: avalanche photodiodes and cadmiumzinc-telluride detectors. The main purpose of flying these detectors is to test them in a space environment so that they can be used with confidence on future space missions. Measurements of solar flare and gamma-ray burst X-ray emissions will also be made as well as atmospheric constituent and cosmic x-ray data.  Digirad will measure these emissions.

To assist, Digirad developed a new class of solid-state detector arrays with microelectronics readout circuitry for two-dimensional imaging of x-ray and gamma ray fields in support of next-generation Earth and space science mission requirements.   The approach uses cadmium zinc telluride (CZT), a new room temperature detector material first developed by Digirad. Recent results show that CZT detector arrays can exhibit high detection efficiencies and superior energy resolution from below 1 kev to above 600 kev. CZT detectors are robust and lightweight; and can be patterned in a variety of array structures, with pixel dimensions to well below 100 m.

The innovation of producing CZT imagers suitable for space meets the needs of NASA small missions initiatives. 

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For more information in Canada on Digirad's solid-state technology for advanced Nuclear Imaging, please contact your local ADN Canada sales consultant Toll-Free in Canada at 1-877-434-5311 or via e-mail.  Note: Any / all product names mentioned in this document may be trademarks or registered trademarks of their respective companies and are hereby acknowledged.