Dedicated labs lend consistency to image quality and results

Stanford University processes an estimated 650 imaging cases a month through its onsite 3D lab, but neither high volumes nor large practices are needed to justify such a lab.

"Three-D labs are not just for academic centers, and you don't have to be a 35-radiologist practice to have one," said Dr. Jay Cinnamon, a private-practice radiologist with Quantum Radiology Northwest in Marietta, GA. "Three-D labs make work more efficient, provide quality assurance, and afford the potential to introduce and use new applications."

A 3D lab can be an alcove or a dedicated office space. At its most basic level, it is simply a centralized area for postprocessing with one or more specially trained staffers.

Technologists in 3D labs perform time-consuming tasks such as curved planar reformations and segmentation of large data sets. That frees up radiologists to interrogate those data sets, homing in on regions of interest in the preprocessed images. Such a protocol-driven system allows for consistency in image quality, results, archiving, and communication, according to Dr. Geoffrey Rubin, chief of cardiovascular imaging at Stanford University.

Even in an era of 3D automated tools for tasks such as bone removal, there is still a role for trained technologists to clean up and refine images.

"When it comes to the full spectrum of 3D, from creating a 3D lab report to manual creation of curved planar reformats, bone removal, standardized views, MIPs, and measurements, the lab is invaluable," Rubin said at the Symposium on Multidetector-Row CT in San Francisco this summer.

At Brigham and Women's Hospital, the 3D lab provides support for a wide range of routine applications, including 3D views for CT angiography and urography, MR angiography, and a smaller volume of cases such as orthopedic CT and neurologic applications, said Dr. Matthew Barish, director of the 3D and image processing lab.

Smaller practices can and should reap these benefits, too, Cinnamon said. Efficiency is the primary reason. Reconstructing a CTA exam from beginning to end, including vessel and tissue review, can average 45 minutes without preprocessing.

"With our 3D lab, I am down to 10 minutes for a neurovascular CTA report because the lion's share of the work is being done by our supertechs in the 3D lab," he said during a presentation at the MDCT meeting.

In addition, the 3D lab provides built-in quality assurance in a practice that includes six neurologists whose computer skills vary widely. A 3D lab levels the playing field, leading to better quality and consistency, Cinnamon said.

The lab has allowed the group to explore new clinical applications in 3D CT, providing a more efficient and effective roll-out.

"It's a profit center," he said. "It makes money for our practice and helps us deliver high-quality care to our patients. That's a win-win."