Vital Images, Inc. (Minnetonka, MN) recently announced the release of the latest version of its enterprise-wide advanced visualization and analysis product solutions, Vitrea 4.0 and ViTALConnect 4.1.

This release is designed to provide advanced visualization and analysis capabilities to workstation clients, remote clients, and Web-based clients. The new versions enhance the system's cardiovascular, neurovascular, and gastrointestinal (GI) applications and increase its Web-based cardiovascular analysis and distribution capabilities. Todd Johnson, Director of Product Marketing at Vital Images, recently spoke with Applied Radiology about this latest solution.

Applied Radiology: How is this release different from previous versions?

Todd Johnson: One of the major differences is that we are releasing Vitrea 4.0 with ViTALConnect 4.1. This is a true "solution release" in that these 2 components work together as a complete Vital Solution. This is a combined release of all of our solution components, including our workstation, our PACS-integrated solution, and our Web-solution. Our goal is to enable users to analyze complete data from anywhere in the enterprise and to communicate the results anywhere.

AR: What changes have been made to the Vitrea software?

TJ: We have enhanced some of the workflow capabilities within the cardiac, stroke, and virtual colonoscopy workflows. We added automation to increase the ease of use and the efficiency with which these workflows can be performed. Also, with Vitrea, we rebuilt the reporting capabilities to provide automatic templates for each of the workflows and, within those templates, we added automatic population of results. For example, the results from the cardiac workflow are automatically populated into the cardiac reporting template. So the enhancements have been made on both ends. We have provided automation of the analysis within the cardiac, stroke, and colon workflows, as well as automation of the results to our report templates.

AR: Which changes have been made to the neurovascular workflow?

TJ: We have made some enhancements to our stroke protocol that are designed to give us even richer results. We've also added motion correction. If the patient happens to move his or her head during a stroke procedure, the system provides motion correction to allow for the dynamic analysis of the perfusion of the brain within our computed tomography stroke package. We have added templates for looking at regions of interest in the brain for brain perfusion, and we've added the ability to report those results into a stroke template.

AR: What about the GI workflow?

TJ: On the colonography side, we've really increased the ability to fly through the colon and click on structures of interest. We provide key information about those structures to help the radiologist analyze whether or not what they are seeing are polyps. It provides a simple click access to information about structures within the 3D colon to allow the user to determine whether or not there is a potential polyp. It then sends this information to the report template.

AR: Does Vitrea include a computer-aided detection (CAD) system for colonography?

TJ: Our ColonCAD is not yet approved for sale in the United States. In Europe, however, we have released a version integrated with ColonCAD. With this software, during the colon fly-through, the user can turn on markers that indicate where the CAD had found potential polyps. The user can then further investigate these suspicious areas.

AR: What about cardiac workflow?

TJ: We've added full automation of the extraction of the coronary tree. As the user loads the data, the software automatically extracts all the coronary vessels and identifies them. So the user's first actions are to page through the detected coronaries to perform the analysis. The user can then go into analysis of the stenosis if any exists. It's an automated package now. We also have some new viewer layouts that present the data in a much easier, simpler manner than before. Again, the automatic reporting of the results into the template is also a big benefit.

The last cardio piece is our new automated electrophysiological (EP) planning application, ViTAL EP. This program automatically segments out the pulmonary veins and creates a 3D anatomic model of the heart for superimposed EP mapping. This allows the user to go through the image quickly and take the proper measurements needed for an EP examination.

AR: What changes have been made to ViTALConnect?

TJ: In ViTALConnect 4.1, we have added new vessel analysis capabilities. We've taken a lot of the power to analyze vessels that had been available on our Vitrea workstations, including our Vital Vessel Probe, and have enabled them on the Web through ViTALConnect. We have added the ability to perform sophisticated manipulation of oblique multiplanar reconstructions (MPRs) and other workflow efficiencies. All of these enhancements allow users to securely investigate very complex structures over the Web, so they can utilize this power from the reading room, from their office, and even from their homes.

With this new release, the only capabilities relegated to the workstation are some truly advanced capabilities of automation. There are a few things that the user still can't do in ViTALConnect, but they are highly targeted workflows that, at the point at which the scan is performed, the user would know if a workstation is needed to complete the study. All of the real core capabilities in Vitrea, such as curved MPRs, seamless volumetric viewing in minimum intensity projection (MIP), and volume rendering-are now available on the Web through ViTALConnect.

AR: How does this change the experience for the radiologist?

TJ: ViTALConnect 4.1 allows the traditional Vitrea user to have familiar workstation capabilities available anywhere. A user can, at any time, log into the system and get access to all the data. The capabilities of ViTALConnect 4.1 allow any computer anywhere to become a workstation. We've always had enterprise capabilities within Vitrea to run on multiple locations, but ViTALConnect 4.1 offers a greater extension of the ability to analyze this data from anywhere.

But this new release invites a new set of users, such as referring physicians, who previously didn't have access to a workstation to be able to use these capabilities. ViTALConnect has always allowed multiple users to log on at the same time and collaborate over the Web. But the new release enhances the ability of radiologists and referring physicians to analyze data together over the Web.

The radiologists are empowered and enabled to do heavy analysis of the imaging data. The referring physicians (such as surgeons, oncologists, or orthopedists) want evidence of the information presented in the radiologist's report. We want to provide easy access to really interactive evidence that can be used for surgical planning and communication to the patients.

AR: Where do you see this technology moving in the future?

TJ: Our goal is to continue to provide tools for radiologists to increase their efficiency in analyzing very large and increasingly complex data sets. The new scanners-64-slice or later-will generate new types of data, a lot more data, and greater capabilities to use that data. So we want to stay at the forefront of being able to analyze this very complex data. We also need to continue to allow radiologists to communicate more effectively with referring physicians. We need to make the radiologist more effective in analyzing data and we need to stress the ability of radiologists to communicate with their customers. We need to give their customers the ability to also analyze the data to gain a greater understanding of the findings and evidence that the radiologist has pointed out in the report.