Mullinix J, Rankin J, Stoner C, Dharaiya E, Yanof J.
Maximizing workflow efficiency in radiology and collaborating departments is of great importance. Measureable workflow improvements can be achieved with enterprise-wide thin-client/server solutions including advanced processing and reporting capabilities.
Collaborating on image response evaluation spans departments (radiology, oncology), imaging modalities, PACS, and thin client/server solutions. We reviewed advanced post-processing applications and networking features that can increase interdepartmental efficiency in treatment response evaluation:
- sending baseline and follow-up images to a server
- preparing for longitudinal tumor measurements
- performing measurements (e.g.,diameter)
- calculating response criteria for categorization.
We evaluated workflow efficiency by estimating time savings (per data set) with the Multi-modality Tumor Tracking Application (MMTT) of the IntelliSpace Portal (ISP, Philips Healthcare) relative to alternate methods: Sending images to server: Protocols set-up to automatically send image data to the ISP server saved between 5-10 minutes in comparison with PACS retrieval. Preparing for measurements: After lesion selection and identification in the baseline study, the MMTT application's advanced tools for automatic registration of multiple data sets prior to temporal comparison saved between 7-12 minutes. Performing measurements: Use of semi-automated MMTT tools to measure follow-up lesions saved about 4-12 minutes relative to PACS. Calculating and reporting response criteria: The evaluation criteria, e.g., RECIST 1.1, is automatically calculated. Alternate methods using a spreadsheet are more time consuming and prone to error. The oncology staff and the study monitor can access results via bookmarks and reports placed by the radiologist on the ISP client.
The major time savings resulted from automatic registration of longitudinal datasets, response criteria calculation, and reporting via the thin-client review. Features such as automatic image sending and customizable analysis workflow were also of significance. These features and tools facilitate collaboration as the image data is processed toward shared quantitative results.