Three-D interpretation tools have rapidly found their way into the image review process but seamless integration with workstations remains a barrier to widespread adoption, according to a study presented at the RSNA meeting on Sunday.

The study, based on results of an e-mail survey, included 103 responses from physicians in a variety of settings, including private and academic practice, said Dr. Krishna Juluru, a radiologist at Johns Hopkins and a fellow at the University of Maryland in Baltimore. Although initially targeted to radiologists, the respondents also included cardiologists, who provided pretty much the same answers as radiologists.

The findings included:

• Among radiologists, 96.2% are using common reconstruction techniques such as multiplanar reformats and coronal reformats. Among cardiologists, 92.3% are using these techniques.

• Although many facilities use technologists to create reconstructions, 79.2% of radiologists and 69.2% of cardiologists are doing so themselves as part of the interpretation process.

Despite the advantages of 3D visualization techniques, barriers to implementation remain. These include unfamiliarity with workstation interfaces; convenience of access to stand-alone workstations; and the need to send studies from PACS to stand-alone workstations.

To increase radiologist adoption of 3D visualization techniques, a shorter learning curve is needed and 3D visualization tools need to be incorporated seamlessly with PACS workstations, Juluru said.

Radiologists could also benefit from widely accessible and systematic training techniques. Radiologists differ in how much they rely on their respective 3D labs. Some radiologists prefer to perform their own 3D visualization for complex structures that require multiple views and measurements. If provided with integrated PACS-3D workstations, most radiologists believe that they would use more 3D views to illustrate findings to referring physicians during consultations.

"These groups are learning to use 3D as part of the interpretation process and they are finding it valuable," Juluru said. "Coronal reformats and MPRs are no longer part of advanced application tools. PACS need to be able to provide these tools without the user going to another application."

"The days of 3D workstations are numbered," he added. "These tools really need to be incorporated into our routine interpretation process."