It is becoming increasingly important in modern distributed healthcare enterprises to view and manipulate 3D images. CT and MRI systems are creating ever larger volumes of data. This has increased the need for fast and efficient 3D postprocessing tools, such as multiplanar reconstruction, volume rendering, curved reformatting, and volume measurement.
As use of these 3D tools becomes accepted as the standard way of working, they will need to be made available to radiologists, cardiologists, and neurologists; physicians in the accident and emergency and intensive care units; and interventionalists and surgeons. Image distribution may be required outside the hospital as well. Pure 2D web-based clients will cease to be acceptable. Remote users will want to have the same 3D functionality regardless of where they are working.
Many hospitals currently have a centralized PACS and a number of loosely integrated workstations for 3D review and postprocessing. Data are sent from imaging modalities to the PACS and then forwarded to (or prefetched by) selected workstations. Radiologists and physicians review the images on these workstations. A multitude of key views or processed images are then generated. These are returned to the PACS and/or selected recipients as snapshots and/or cine loops.
This "isolated workstation" paradigm has many problems. Original data are not always available where needed, a significant amount of time is spent sending original and processed data between different workstations and servers, and additional quality control is required to ensure that all diagnostic images generated are archived and transferred correctly. Workstation hardware may be too slow or have insufficient memory to review large 3D studies, while updated versions of software or optional application packages may not be available at every workstation. Referring physicians will be able to review snapshot images, but they will not be able to use these views as bookmarks into the original data.
Hospital IT infrastructure used to provide medical imaging data must meet certain minimum requirements. One frequent problem is bottlenecks in the data flow. Three-D technologies produce thousands of slices per patient and per procedure. Because the complete data set is sent to the workstation, network traffic is inevitably heavy. The infrastructure consequently has to be optimized from start to finish; that is, from the imaging modality through to the user's PC or workstation.
A fully integrated 3D thin-client solution provides full and consistent 3D capabilities throughout the entire hospital enterprise, even on legacy and standard PCs and workstations.
All DICOM data remain on the server—there is no data transfer prior to launching the 3D viewer. All operations are performed directly on the server, and all functions can be accessed instantly from anywhere in the enterprise via thin clients.
