System provides 3D image access via teleradiology

Abdominal pain assessment can be, well, gut wrenching. The root cause, seen in axial images, may appear as nothing more than a tiny circle, the outline of an appendix gone bad.

Most on-call radiologists, making those assessments from a PC at home, do their best with the CT axials they get by phone, cable, or T1 line. But Dr. Lawrence Tanenbaum, a radiologist at Edison Imaging Associates in Edison, NJ, gets more. At home and in his office at the JFK Medical Center, where he serves as section chief of CT and MR, he reprocesses those data in different planes.

"In sagittal or coronal images, I am looking for a big tube," he said. "And that's a lot easier to recognize."

Multislice CT has prompted radiologists to leap into 3D, reprocessing data into different planes or volumes. But this tool has been slow to leave the medical center or clinic, saddling remote interpreters with antiquated methods. ViTALConnect changes that.

The software-based teleradiology solution allows advanced visualization from PCs and notebook computers connected to the Internet. With ViTALConnect, physicians away from the radiology department can analyze and review multidimensional images with a mouse click. A collaboration mode lets multiple physicians in different locations confer while they interact with the same images in real-time.

These interactions, either singly or as a group, are still more limited than those that can be performed on a dedicated workstation in the medical center, Tanenbaum said. Volume renderings are less "spectacular," and CT angiograms are "relatively rudimentary." But they serve the purpose.

"The server not only gives me sagittal, coronal, and axial views of the CT angiogram, but a 3D rendering as well-all with a click of one button," he said. "There is no compromise there."

ViTALConnect is designed for situations when access is more important than performance, according to Jay D. Miller, president and CEO of Vital Images, which started shipping the product in September. It enables not only radiologists but surgeons, referring physicians, and interventionalists to download 3D images with ease, allowing them to assess patient status, plan procedures, and communicate with radiologists.

Miller predicted that, eventually, workstation and network capabilities will merge, putting the full power of advanced visualization at the fingertips of remote users. Until then, Vital Images need not make any apologies for its new product, according to Tanenbaum.

"It is unparalleled," he said. "It allows live interactive volumetric assessment from remote nodes."

ViTALConnect is being marketed to radiologists, specifically the PACS/informatics sector, through Vital Images' regular marketing and sales channels. The new product sells for about $100,000 and includes a PC-based server, network and PC hardware and software, and multiple licenses for their use.

"It's totally Web-based, and there's no proprietary hardware required," Miller said.

The core technology came from a company called HInnovation, which Vital Images acquired in January. The new parent "vitalized" the product, boosting some of the functionality and adapting the user interface to match Vital Images' full-featured Vitrea workstation.

Tanenbaum, who routinely uses Vitrea in the JFK Medical Center radiology department, said ViTALConnect is the missing link between the way he works during the day and how he wants to work in his office and at home.

"It has become clear that for many, if not all disease states, interrogation of data in the axial plane is suboptimal," he said. "Through the ViTALConnect server, we can manipulate primary data in multiple planes."