3D-enabled workstations yield immediate results in emergency room

Integrating 3D reformatting software into PACS workstations has allowed radiologists at Boston College Medical Center to take advantage of the power of 3D imaging in the emergency department.

The likelihood of generating timely 3D reformations of CT studies in a Level 1 trauma center is often limited because necessary postprocessing workstations are usually located in the CT suite, away from the emergency radiology reading area. This inhibits the availability of these workstations for acute trauma examinations.

"The concept of integrating 3D postprocessing capabilities into PACS obviates many of the shortcomings that limit use of 3D imaging in acute trauma settings," said Dr. Jorge Soto, an associate professor of radiology at BCMC.

Soto and colleagues evaluated the impact of PACS-based software on requests for 3D reconstructions of multislice CT in their emergency radiology department. Results of the study appear in the April issue of Emergency Radiology.

"Implementation of PACS-integrated software significantly increases utilization of 3D reconstruction across a wide variety of indications," he said.

While it's difficult to know how the immediate availability of 3D images in emergency departments will affect the management of acute trauma patients, the technology has many applications in trauma settings, according to Soto.

"The technique has proven very helpful in detecting and characterizing spinal, pelvic, maxillofacial, and extremity fractures, as well as detecting acute vascular injuries with CT angiography," Soto said.

Although 3D reconstruction applications in emergency radiology have broadened in scope, many institutions have developed dedicated laboratories for image processing and 3D reformations, often operated by specialists.

This has led to a perception by some radiologists that use of 3D imaging in everyday practice is too time-consuming, complicated, and expensive, Soto said.

"Since transmission of images to dedicated workstations is no longer necessary, the timeliness of the information provided by 3D reconstructions is appealing to radiologists and clinicians making patient management decisions," he said.

Postprocessing options are also more available with 3D-enabled PACS workstations.

At BCMC, all workstations used for interpretation of trauma CT are equipped with 3D postprocessing software, which allows simultaneous use of the 3D software by multiple users.

Another advantage of this arrangement is the interactive display of image data.

"In practice, this adds a new dimension to the ability to report findings to clinicians at the time of primary interpretation of CT scans," Soto said.