I3 develops universal distribution network

Recognizing the need to facilitate the distribution of images to any operating system platform, Los Angeles-based Intuitive Imaging Informatics (I3) has switched from its core Unix-based systems to a Java-based application that runs on Windows, Macintosh, Solaris, or Linux. As a result, the company's new ImageQube Web Client provides an easy and economical method of distributing patient information to referring physicians, consultants, or even to patients in their homes, said I3 president J. Martin Pfaff, Ph.D.

"For years, our company's strength has been our Unix-based systems, which are very reliable with very little downtime," he said. "On the other hand, there's a great need these days to integrate other technologies - radiology information systems and common desktop systems, such as the PC and even Mac - in reviewing images, doing diagnostic interpretations, completing reports and summaries. ImageQube allows us to bring all the diagnostic capabilities that used to be Unix-based onto any platform."

The highly scalable ImageQube is targeted in particular at 100 to 200-bed hospitals, Pfaff said. A site can begin with the ImageQube, which not only delivers images to referring physicians and other outside users but also provides in-house diagnostic capability at a limited level. As it moves to more advanced capabilities, such as PET fusion imaging, the hospital can build a high-end I3 PACS workstation onto it.

"This allows a hospital to scale up to advanced imaging capabilities rather than make a huge investment right off the bat," Pfaff said.

I3 has been doing such build-outs for several years. At the Angeles Clinic and Research Institute, a multifacility oncology organization based in Santa Monica, CA, I3 installed both its Rational Imaging PACS and the ImageQube (I3's web-based PACS) in 2005, along with the firm's Intelli-NAS online storage and archive system. Onsite, the Rational Imaging PACS has integrated with modalities and devices from Siemens, GE, Lunar, and Codonics, as well as with existing workstations, providing robust image distribution across facilities.

New upgrades to Rational Imaging PACS have included maximum intensity projection imaging and a new user interface supporting high-resolution 3D reconstructions of CT and MR image data, thereby allowing I3's multimodality workstations to handle even more diagnostic functionality. The Angeles Clinic is also a beta site for I3's development of PET fusion functionality within its PACS, featuring user-selectable color maps, real-time PET transparency manipulation, automated multiplanar reconstruction for orthogonal views, and integrated MIP for 3D rotational displays.

ImageQube's advantage is its distributed architecture. Many PACS companies have taken a central server type of approach featuring large storage systems that are most effective when distributing images within a single hospital. This approach is not practical when transmitting diagnostic information across multiple hospitals and outpatient facilities, particularly given the loads that are produced by advanced imaging technologies such as multislice CT, Pfaff said. The distributed nature of ImageQube gets around this problem.

"We have an architecture that's unlike most any other, which allows us to archive at each facility, distribute the capabilities of the system locally to the facility, and yet provide for physicians one common work list," he said. "There is a lot of synchronization between our PACS and the ImageQube in maintaining workflow flags, STAT flags, and assignments. An administrator can assign cases to radiologists who are offsite so they know exactly what they need to read. Those types of things you don't find within disparate systems very often."