Clinical Application: Softcopy review

Overview
The AccuView Workstation is a powerful and flexible system for the management and
post-processing of data from CT, MR and other imaging modalities.
AccuView supports a wide range of applications from Softcopy Review to 3D Volume
Rendering, and has been refined and field-tested over recent years in co-operation with
physicians around the world. Systems are installed in such institutions as the Mayo
Clinic and Foundation, Walter Reed Army Hospital and Stanford University Medical
Center, as well as in diverse environments from busy hospitals to stand-alone imaging
centers. As a result AccuView has evolved with a natural balance between advanced
post-processing and efficiency in everyday workflow.
AccuView's modular design allows configuration of systems to suit specific roles and
budgets, while providing a simple and cost-effective upgrade path. DICOM services
are provided for seamless networking with other medical imaging devices, and
AccuView is fully compatible with our eStation3D web server for browser-based
distribution of reports and images via internal networks and the Internet.
Circle of Willis
3D Visualization of vessels and aneurysm
Study courtesy of Ospedale di Busto Arsizio, Italy
Clinical Application: 3D
Visualization
For 3D applications, the AccuView workstation provides the comprehensive visualization and
reporting tools essential for rapid, efficient everyday clinical workflow. Developed in close
consultation with expert physicians, simplicity, ease-of-use and speed are emphasized throughout.
Full-color visualization is provided by AccuVRT, our advanced Shear-Warp Factorization
volume rendering module. AccuVRT features support for up to six different materials, each with
independent color and transparency. A powerful set of standard presets is provided, any one of
which can be applied with a single mouse click. Your own settings can be conveniently stored
as presets which can be accessed from on-screen lists or programmed directly onto toolbar buttons.
Interactive zoom and rotation of the 3D image are possible, and movie sequences can easily be
constructed and stored to DICOM or standard AVI/MPEG formats. Generation of standard
sequences can be initiated with a single mouse click on a toolbar button.
Abdominal Aorta and Spine
3D Visualization
Automated conversion to full-color Volume Rendered 3D dataset
Flight-path planning
Interactive sliding-slab MIP for reconstruction in oblique planes
Curved multi-planar reconstruction
Automated reporting tools
Ease-of-use, speed and efficiency
Colon
3D visualization of lumen
Study courtesy of University of California, San Francisco
Through the use of the AccuAviator plugin, AccuView can generate a sequence of 3D
visualizations along a user-defined path through the dataset. This technique can be used
to visualize the lumen of a blood vessel, bronchus, trachea, spinal column or colon.
The workstation features a suite of flight path planning tools in support of this pioneering
application.
A powerful tool to aid rapid 3D diagnosis is the fully interactive sliding-slab MIP
implemented in the AccuProjector module. This provides for detailed, interactive analysis
of particular vessels and anatomy in appropriately-sized oblique slabs. Sliding-slab MIP
is far more effective than conventional MPR because it can capture in a single projection
anatomy which is shaped such that a single MPR oblique cut cannot capture it in its entirety.
The projection algorithm can be switched on the fly between MIP, MinIP, Volume Rendering
and Radiographic Projection for the selected region of interest. The region of interest can be
dynamically resized, rotated or moved at will. 3D curved multi-planar reconstruction
completes the 3D analysis package.
MIP of intra-cranial vessels,
volume rendered carotids.
Studies courtesy of
Ospedale Villa Sofia,
Palermo, Italy
Reports are constructed dynamically using time-saving shortcuts, leading to a Microsoft
Word document ready for e-mailing, faxing, printing or archiving. The software follows
the physician's instruction for the placement and annotation of selected images, then
presents the draft for final editing and approval. The report generator is compatible with
our eStation3D web server line, allowing reports and original datasets to be automatically
combined and published on a facility's web site.
This suite of features works in harmony to provide the physician with all the requisite
tools for speedy yet comprehensive analysis and postprocessing of volume studies from
CT, MR and other modalities.
Clinical Application:
Calcium Scoring
· Fast, efficient Calcium Scoring ensures utmost throughput
Point and click
scoring interface
AccuView's AccuScore module provides fast, efficient Calcium Scoring to ensure that the
utmost throughput is realized. The software employs fully 3D point-and-click scoring to
minimize user interaction and simplify the routine scoring procedure. Analysis and
reporting can be completed in minutes. Both the conventional Agatston Score and the
Calcium Volume Score are reported, using fully validated algorithms.
· Configurable report generator and database package
Automated
Reporting
The workstation features a comprehensive, user-configurable report generation and database
package. The standard configuration includes a sample report, which can be modified or
replaced with a facility's own design. All fields from the database are available for inclusion
in the report along with the Calcium Score, and the software can be configured to generate
a percentile ranking for the patient's score relative to a stored database of their peers. The
accompanying questionnaire tracks a broad spectrum of patient demographics and risk factors
including: lipid profile, family history, exercise, stress, medication, pre-existing medical
conditions, symptoms and previous procedures. Other information such as how the patient
was referred for the test is also recorded and available for later summary and statistical analysis.
· Advanced tools for progression and research studies
Lesion-by-lesion, side-by-side comparison for follow-up or repeat scanning is supported, as
well as tools providing full control of the scoring algorithm, automated threshold calculation
and background subtraction. Isotropic Interpolation of the dataset is employed for the Volume
Score. Readout of lesion mean and/or peak is provided, as well as tools for selection and
annotation of images for the report or for educational and presentation purposes. All aspects
of a scoring session for a particular study are recorded automatically and restored the next
time that study is loaded.
3D Visualization
Clinical Application:
Visceral and subcutaneous
fat quantification
Quantitative Analysis
AccuView's AccuAnalyzer plugin provides powerful, yet fundamental tools for performing
quantitative analysis of medical imaging data. Regions of interest can be drawn within a dataset,
and then the constituent voxels can be color-coded by HU range (up to 4 ranges can be defined),
and quantified by volume. Auto-contour tools are provided to simplify ROI definition, for
example a complete lung can be selected with a single mouse-click. Export of the histogram is
possible to a plain-text format file which can easily be imported into other commercial software
modules for further analysis or interpretation. AccuAnalyzer enables swift analysis of clinical
data, often enabling a volume calculation that would normally take several minutes to be
performed in just a few clicks of the mouse.
AccuView is constantly being enhanced to provide support for the full range of clinical
applications, present and future. Advanced fundamental analysis tools that are currently
available on the workstation are being refined and applied in collaboration with physicians to
develop support for additional advanced clinical applications, such as Time vs. Density, Time
vs. Volume and Visceral Fat Quantification procedures.
Clinical Application:
Softcopy review
The advanced post-processing capabilities discussed so far are optional upgrades to the basic
AccuView configuration, which can stand alone as a fully-capable softcopy review station
for general use. Support is provided for DICOM modalities such as CT, MR, Nuclear
Medicine, Angiography and Ultrasound. Optimal image quality and performance have been
developed in close consultation with busy radiologists who read hundreds of images daily on
our workstations. Specific tools which make the difference between smooth workflow and
frustration have been implemented and refined under the guidance of radiology
professionals.
· Reading lists and synchronized side-by-side display
Multiple series can be selected from the AccuView patient list, and opened as a "reading list"
which can be stepped through at the press of a button. In a similar fashion, the multiple studies
can be opened simultaneously for side-by-side review, with synchronization available by image
number, image position, or image time. This means that even series scanned with different slice
thicknesses can be synchronized to the same relative position in the body. Duplicate views of
the same series can also be opened at will, allowing simultaneous review of multiple window/
level settings.
· Measurement and manipulation, plus realtime interactive MPR
AccuView supports realtime continuous zoom, pan and window/level control, as well as
providing programmable window/level presets which can be immediately accessed at
any time. Measurement tools are provided for distance and area, with useful statistical
readouts on each of multiple regions of interest.
In fully interactive realtime, AccuView can reconstruct volume datasets to sagittal, axial
and coronal orientations, or an arbitrary oblique cut. Thickness can be applied to the
oblique with a selectable projection algorithm applied through the resulting slab,
facilitating focused study of structures of a particular size. AccuView has been highly
optimized to ensure natural and effortless interaction with the dataset.
This suite of tools is smoothly integrated with standard Microsoft Office tools for
reporting, providing a powerful platform for efficient and detailed softcopy review.
Optimized Workflow
· Designed for all environments from imaging centers to hospitals
AccuView has been designed to operate equally well in a range of environments from busy
imaging centers to multi-modality hospital imaging facilities. Flexibility and simplicity are
key elements of the software design. The user interface is clear and simple to learn, while
providing powerful time-saving shortcuts for more experienced users.
· Streamlined workflow enables maximum patient throughput
In support of imaging center workflow, patient demographics and other information can be
entered directly at the workstation or remotely at the front desk through network access to
the common patient database. Patient information can be entered in advance of the scan
and then later combined with the scan results for instant report generation. Such streamlined
workflow enables maximum patient throughput for a busy imaging center.
· Archiving Services
Archiving services are provided to inexpensive CDR media, or optionally to higher capacity
MOD media with off-the-shelf management of archived studies. All images are archived using
DICOM, so that any DICOM-compliant device which supports the chosen media format can
access them in future.
· Configurable auto-filming services
Auto-filming services are provided, enabling entire studies to be filmed rapidly, with fully
configurable output format, information overlay and window selection. Direct connection
(3M and Kodak protocols) to laser imagers is supported, as well as network connection via
the industry-standard DICOM protocol.
· Web servers for secure distribution of reports and images
If the appropriate network connectivity is available at a particular site, our eStation3D Web
server can be installed to provide easy distribution of images and reports with security and
compression over local networks and the Internet.
· Distribution via CD of scan data, reports and 3D studies
A standard feature of every AccuImage workstation is the ability to generate a CD containing
DICOM scan data, post-processed studies (for example, 3D reconstructions) and reports. This
CD includes freely distributable viewing software, which will auto-run on a standard PC when
the CD is inserted. Using such CDs, scans and reports can be distributed easily and costeffectively.
Product Configurations
AccuView is available in a basic workstation configuration, which can be enhanced
with various advanced post-processing modules as required.
Basic Workstation
Softcopy review
Slab MIP, MPR and simple Volume Rendering
Dataset editing and resampling tools
Standard DICOM services: Send, Receive, Query/Retrieve
Optional archiving support to CDR and/or MOD
Hardcopy output to standard Windows printers
Single or dual 21" monitors, high-brightness an option
Intel Pentium III platform, Windows NT operating system.
Additional modules
AccuVRT - Full-color volume rendering
AccuAviator - Flight path planning and movie sequencing
AccuScore - Coronary Calcium Scoring
AccuAnalyzer - Histogram analysis package
AccuFilm - Laser Imager support
Advanced configurations are realized by simply combining the required additional
modules with the basic workstation. Hardware is provided as appropriate depending
on the configuration. A typical 3D workstation features dual Intel Pentium III
processors running at 933MHz, 1GB of system memory, a 40GB hard drive, one or
two 21" monitors and a high-quality color printer for hardcopy output.
Software-only modules
The standalone software modules AccuNet and AccuQuery are available for purchase
from the AccuImage web site, www.accuimage.com, and can be used in conjuction
with our Free DICOM viewer to provide a desktop or notebook PC with the ability
to receive DICOM images and display them.
Service provision and upgrade paths
The modular nature of the AccuView suite lends itself readily to a straightforward upgrade
path. Additional software modules can be purchased individually to enhance an existing
installation, and cost-effective hardware upgrades are possible through our choice of a
non-proprietary hardware platform for the product.
A typical workstation purchase includes shipping and installation costs, with on-site Clinical
Applications training provided by our expert personnel. One year of service and support is
usually included as standard, including telephone support, remote network support, and
on-site or return-to-base corrective maintenance as appropriate. Service provision is
implemented via our international network of contracted service providers and distributors,
and our service plan includes software upgrades and bug fixes during the service period.
For further information, contact your AccuImage representative
AccuImage Diagnostics Corp.
400 Oyster Point Boulevard, Suite 114
South San Francisco, CA. 94080
Phone: (650) 875-0192
Fax: (650) 875-0194
email: info@accuimage.com
www.accuimage.com
Selected installations:
USA
Stanford University Medical Center, CA
Mayo Clinic and Foundation, Rochester, MN
University of California at San Francisco, CA
Walter Reed Army Hospital, Washington DC
Department of Thoracic Radiology, UCLA, CA
Central DuPage Hospital, Glen Ellyn, IL
Hackensack University Medical Center, NJ
St Francis Hospital, Roslyn NY
University of Pittsburgh Medical Center, PA
Scott and White Memorial Hospital, Temple TX
Veteran Affairs Medical Center, San Francisco CA
Veteran Affairs Medical Center, Fresno CA
Alameda County Medical Center, Oakland CA
International
Alfried Krupp Krankenhaus, Essen, Germany
Landeskrankenhaus, Universitätsklinik für Radiologie, Graz, Austria
Röntgeninstitut Dusseldorf, Düsseldorf, Germany
Hospital Israelita Albert Einstein, Sao Paulo, Brazil
Nanjing General Hospital, Nanjing, China
Guangzhou University Hospital, Guangzhou, China
National Cardiovascular Center, Suita, Osaka, Japan
SCRC, Ohsato-gun, Japan
Matsubara Tokushukai Hospital, Matsubara-shi, Osaka, Japan
Chibanishi General Hospital, Matsudo-shi, Chiba, Japan
Hiroshima University Medical Center, Hiroshima, Japan
Fukuokoa Tokushukai Hospital, Kasuga-shi, Fukuoka, Japan
Miyazaki Medical College, Miyazaki-gun, Miyazaki, Japan
Kyungpook National University Hospital, Taegu, Korea
400 Oyster Point Boulevard, Suite 114, South San Francisco, CA 94080. Tel:650-875-0192 Fax:650-875-0194 info@accuimage.com