MR option puts offsite experts in driver’s seat

With software from Siemens Medical Solutions and a high-speed network connection, experts can advise staff at remote locations how to run their MR scanners. In a pinch, these experts could even take over the examination, inputting patient setup and sequences, as well as making midexam adjustments based on images displayed in real-time.

An alpha version of the Expert-i software has been in testing for about a year at the University of California, Los Angeles. This work-in-progress, called syngo Expert-i, turns networked PCs in the UCLA Cardiovascular Research Laboratory into virtual MR consoles, showing full-screen views with the option of remotely controlling the MR. Siemens plans to release Expert-i in 2006 as an option on its syngo software.

The goal behind the currently experimental product is to allow expert collaborations on challenging examinations. These may be local or cross-country, as occurred on the floor of the RSNA meeting, where Siemens showcased collaborations between UCLA and Northwestern University.

Visitors to the Siemens booth witnessed Expert-i in action twice daily in demonstrations featuring real-time scans performed at Northwestern but run from a PC at UCLA. Siemens framed its Expert-i technology as "a second opinion in seconds." But the technology might also be fitted into a regular routine that involves handling the practical aspects that go with expanding clinical applications.

A site planning to implement cardiac MR, for example, might work with a site experienced in these applications, such as UCLA's Cardiovascular Research Laboratory, where Expert-i is now operating. Expert-i would support the training of staff in these applications, while providing a safety net, if and when operators run into trouble.

"The immediate initial testing is within a hospital network, but we are running it here in Chicago to UCLA, so you can let your imagination run as to how we could use this," Jeffrey M. Bundy, Ph.D., Siemens director of MR R&D told DI SCAN on the RSNA exhibit floor.

Sprawling provider enterprises - such as teaching institutions like UCLA - often spread MR scanners across sites miles apart, making it virtually impossible to provide expert guidance at each. Expert-i currently provides this guidance at UCLA.

PCs loaded with Expert-i are assigned the appropriate password and plugged into a local network for experts in UCLA's Cardiovascular Research Laboratory to see what is happening remotely.

The software displays on a PC monitor the full-screen view of what is shown on the console. With this, remote experts can advise local staff by phone how to take corrective action. Or they can take control of the distant scanner, using their mouse clicks to operate the console user interface. This flexibility can be used to streamline workflow, as experts need not be physically present to handle problems. This makes better use of staff resources, according to Siemens.

The software is a logical next step for the company. It had previously launched its Phoenix technology, which allows users to download and execute on their scanners clinical protocols developed by experts. Siemens' new software builds on this idea by providing access to the experts themselves.

Expert-i promises enhanced productivity, as problems are handled more quickly and efficiently while the patient is are in the scanner, thereby minimizing the need for call backs. The software might also serve as a training tool, as it provides staff the opportunity to try new techniques with the assurance that help is literally standing by.

A subtle twist on this potential turns Expert-i into a sales tool. The software could be framed as providing an extra measure of comfort to prospective customers considering the purchase of a system for applications beyond their grasp. One such area is cardiac MR, which may be the reason Siemens chose the UCLA Cardiovascular Research Laboratory as the testing ground for Expert-i.

While acknowledging that cardiac MR is an area of interest, Bundy described the potential of Expert-i as much broader and its use in the imaging community as largely undefined.

"We are in the early days of looking at how Expert-i might be applied," Bundy said. "The initial scope may be smaller, within a (local) network, but certainly we have had a lot of discussions about how to bring this to a broader scale."