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
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
about this latest solution.
How is this release different from previous versions?
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
What changes have been made to the Vitrea software?
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.
Which changes have been made to the neurovascular workflow?
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
What about the GI workflow?
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
Does Vitrea include a computer-aided detection (CAD) system for
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
What about cardiac workflow?
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.
What changes have been made to ViTALConnect?
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.
How does this change the experience for the radiologist?
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
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.
Where do you see this technology moving in the future?
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.