A review of new information technology products introduced at the 88th annual RSNA meeting.
For information technology (IT) vendors at the 88th Scientific
Assembly and Annual Meeting of the Radiological Society of North
America (RSNA 2002) in Chicago in December, the key themes were
open architecture, instant Web-based access, increased
functionality, and ease of use. Nearly all of the IT products
displayed featured enhancements in at least one, if not all, of
Voxar introduces Voxar 3D
Voxar Ltd. (Edinburgh, Scotland) unveiled Voxar 3D, the newly
re-branded upgrade of its Plug-n-View three-dimensional (3D)
software package. Diane M. Clifford, senior marketing manager at
Voxar, said in an interview with
, "Voxar 3D provides gold-standard maximum intensity projection
(MIP), multiplanar reconstruction (MPR), and 3D color
volume-rendering (Figure) that allow for the rapid display and
analysis of large multidetector computed tomography (CT) and
magnetic resonance (MR) imaging data."
Designed for integration across the hospital DICOM network,
Voxar 3D includes several new feature enhancements, a task-based
user interface, and workflow improvements. With the new software,
misaligned scans, or anatomy that does not align with scan planes,
can be corrected rapidly to a standard orientation prior to
reading. Advanced derived series definition now exceeds the
ease-of-use and capabilities of CT and MR scanner consoles, and
curved MPR is easier and faster to set-up.
"In addition, the 3D color volume-rendered slab brings the
problem-solving benefits of volume rendering to MPR. This makes it
easier to visualize and distinguish closely related vessels and
anatomical structures," noted Clifford. "Targeted 3D volume review
provides an easy link between MPR reading and 3D problem solving."
she continued. "Radiologists can clearly and quickly visualize or
review complex internal structures and pathology without the need
A bone-removal feature allows 3D angiography and boneless MIPs
to be created in seconds, and the "Live Images" feature facilitates
rapid DICOM transfer of postprocessing images from the technologist
to the radiologist for reading.
One of the main benefits of the Voxar system, according to
Clifford, is that it is a "software-only" solution that can be
installed on a hospital's existing hardware. "In the past,
hospitals had to purchase expensive workstations for their 3D
imaging needs," she explained. "For the cost of one or two
workstations, Voxar's software-only solutions allow the opportunity
for '3D everywhere' by enabling image distribution and
postprocessing across multiple machines to meet user demand and
increase efficiency. We see Voxar 3D being used by referring
physicians and surgeons virtually everywhere needed within the
hospital and/or imaging center," she concluded.
Amicas presents the Vision Series
Amicas (Boston, MA), introduced its latest Web-based picture
archiving and communications system (PACS) platform, the Vision
Series, at RSNA 2002.
"The ever-increasing number of studies is affecting departments
across the healthcare enterprise, as well as referring physicians,"
commented Amicas president and CEO Hamid Tabatabaie. "Today's PACS
has to operate much like a FedEx tracking system. Physicians must
know not only where a study is at any given point in time, but also
who has viewed the images, and whether the images have reached
their final destination. Traditional PACS," he continued, "have a
highly departmental focus when it comes to workflow. The Vision
Series provides an ever-expanding list of physicians and other
constituents with real-time access to image studies and
The Vision Series employs a standards-based, hardware-vendor
neutral, Web-based architecture that allows it to operate using an
enterprise's existing network and hardware infrastructure. The
Vision Server provides both images and patient data in a secure,
workflow-driven format that can be customized by each user. The
RealTime Worklist tracks and stores radiology orders, images, and
reports, and provides real-time status to the radiologist and the
"RealTime Worklist is much like the large train schedule at the
railroad station," noted Adrian Gropper, MD, co-founder and chief
medical officer at Amicas. "It is constantly updated with the
latest information, it's open to public viewing for authorized
users, and users in multiple roles use the same schedule."
The Vision Series workstation--the Web-based LightBeam--features
a suite of interpretation tools, including MIP/MPR and one-click
access to prior studies without pre-fetching. The workstation
supports DICOM and JPEG 2000 lossless and lossy compressed images.
The Java-based Web application, LightView, combines browser-based
viewing with an intuitive tool set that can be used for both
primary diagnosis and clinical review. It allows the user to view,
annotate, manipulate, store, and print diagnostic-quality images.
Using JPEG 2000 wavelet compression, images can be transmitted from
the Vision server to the physician's desktop or embedded in the
electronic medical record (EMR).
The company offers several Vision packages designed to meet the
needs of a variety of healthcare settings. The Enterprise package
includes PACS, image distribution, and teleradiology services that
can manage several hundred thousand imaging studies a year. The
Enterprise Enabler is designed for institutions with existing PACS
that wish to implement a scalable technology bridge within their
systems. Radiology Office and Imaging Office are scalable solutions
designed to bring on-demand image access and integrated workflow
capabilities to smaller hospitals, imaging centers, and individual
"We are able to offer both an incremental adoption approach that
allows institutions to progressively implement the features they
need when they need them, and an end-to-end PACS from the start,"
said senior vice president John Ariatti.
Cerner showcases ProVision Web
Cerner Corporation (Kansas City, MO) introduced its new
Web-enabled image management solution, Cerner ProVision Web, at
RSNA 2002. The enterprise-wide system integrates all images--from
radiology, cardiology, oncology, or other departments--directly and
permanently into the EMR while supporting user authentication and
"Cerner ProVision Web is built within the same Cerner Millennium
system as the PowerChart EMR, enabling clinicians to view images
and reports at the point of care, when they are needed most
urgently," said Heman Goel, vice president of radiology and imaging
solutions. "For example, a physician in the emergency room uses
FirstNet to view the EMR. One click of the image icon will launch
Cerner ProVision Web and give the physician access to the patient's
The browser-based system allows for distribution of images
across the entire enterprise, including to referring physicians and
on-call radiologists, regardless of location. JPEG 2000 compression
capability and progressive wavelet decompression technology
minimize bandwidth requirements, which reduce network traffic and
facilitate faster transmission. The system's ability to use
existing computers throughout the hospital and the clinicians'
homes eliminates the need for additional hardware purchases.
One of the most important features," concluded Goel, "is that
any hospital or radiology facility can reap the benefits of an
image management system. You don't have to have Cerner's PACS to
implement it. Cerner ProVision Web can be used to enable images for
Cerner PowerChart users, sites with a third-party PACS, or as a
stand-alone configuration with no PACS."
Misys adds voice-integration technology to RIS
Misys Healthcare Systems (Tucson, AZ) showcased the latest
version of its radiology information system (RIS) that integrates
voice-recognition technology and Web-based information access
The TalkStation Radiology voice-integration technology combines
speech recognition, digital dictation, and distribution features
with image management, internet access, and procedure history. It
allows the user to dictate, edit, code, and sign reports with voice
recognition support, open architecture, and digital dictation and
The Misys WebView permits access to patient results data over a
corporate intranet and allows the user to review related reports,
sign or reject reports, and edit and tag text within documents.
"The current shortage of radiology professionals, reduced
reimbursements, and cost containment issues in healthcare are
driving our clients to achieve maximum productivity and efficiency
in the healthcare enterprise," noted Andrew Lawson, chief operating
officer at Misys. "Our integrated solution is designed to provide a
broad choice of third-party PACS solutions and eliminate the need
to re-enter data and minimize paper and film use. Data and images
are available as part of the radiologist workflow, anywhere at any
time, electronically within the healthcare enterprise."