Segmenting Multi-Region CT and MRI Exams
At a large academic medical center, the radiologists read images by specialty — chest reads chest, GI reads GI, etc., — therefore they require software that has the ability to segment images into different unique studies and also to clone images to be included in multiple specialties. Additionally, this software needs to keep pace with the demands of a significant number of patients and scans. The medical center implemented a segmenting software application to address this need in cross-sectional modalities. State of the art at the time of its implementation in 1998, this study segmenting software met all of their requirements: it was user-friendly, efficient, stable and fast.
Over time, the medical center has seen a significant increase of CT and MRI exams. In 1997, the average number of CT images within an exam was typically less than 100. Recently, due to the technological evolution and greater functionality of the scanners, a technologist may have 2,000 to 3,000 images in a given exam, resulting in extended periods of 20 to 25 minutes of time waiting for the images to load onto the legacy segmenting workstation and clear the workstation after sending the new split studies onto the PACS images in that system and move the images from the source PACS to the target new PACS.
Due to the single-threaded architecture of the legacy study segmenting software and its slow time to receive, paint and send a single study, the effect was that, as the size of a study grew, the elapsed time per exam was significantly exceeding the one hour mark. This is the total time it took to clear the study segmenting software to allow processing the next exam on the workstation. Facing the functional limitations and discontinued updates and support on its legacy study segmenting software, changing clinical needs, and advances in scanning technology, the medical center needed to seek new options.
The Mach7 Technologies Solution
Ultimately, the medical center chose to work with software developer (Mach 7 Technologies) on a new state-of-the-art, study segmenting software utility tool. The resulting application, the Keystone Study Split Utility (SSU), is a PACS-neutral, stand-alone modality workstation application that addresses Mass General Imaging’s requirements for simplicity (i.e., accepting multi-image DICOM studies and segmenting them) and improved technologist efficiency.
Due to the single-threaded architecture of the legacy study segmenting software and its slow time to receive, paint and send a single study, the effect was that, as the size of a study grew, the elapsed time per exam was significantly exceeding the one hour mark. This is the total time it took to clear the study segmenting software to allow processing the next exam on the workstation. Facing the functional limitations and discontinued updates and support on its legacy study segmenting software, changing clinical needs, and advances in scanning technology, the medical center needed to seek new options.
Benefits
After data/image acquisition on the modality, the total scanned study is sent to a segmenting workstation, in this case the SSU. Providing user continuity with Mass General’s legacy image workflow system, the new SSU receives the multi-region studies and provides a straightforward work list interface from which studies can be selected for splitting. Once selected, the study loads very quickly into the splitting interface at the Image level or Series level. Results from clinical pilot testing exhibited loading times on the order of 30 to 40 seconds for a 2,000-image study, an improvement of more than 80% compared to the legacy system.
 Massachusetts General Hospital Study Splitting Project
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