Multi-Touch, Automation, and Open Interfaces Developed for Advanced Visualization Technology

A new platform developed for advanced visualization is a comprehensive, client-server, enterprise solution that incorporates such features as multi-touch, automation, and open interfaces.

TeraRecon, Inc. (San Mateo, CA, USA), a developer of advanced visualization and decision support, highlighted aspects of its Aquarius iNtuition advanced visualization system at the 2009 Society for Imaging Informatics in Medicine (SIIM) annual meeting in Charlotte, NC, USA, June 4-7, 2009.

Research and development of algorithms such as segmentation and computer-aided detection (CAD) can proceed to a certain extent in a laboratory setting, where algorithms are developed and tested on sample cases in a controlled environment. However, to obtain real-world experience with such algorithms, it is necessary to deploy them into the real diagnostic interpretation workflow, which can often be challenging since most vendors of diagnostic interpretation systems do not support such integration of external algorithms.

TeraRecon's Aquarius iNtuition includes the AquariusAPS server, which hosts a wide variety of automatic image processing algorithms that can be applied in a rules-based manner on any imaging data acquired by an institution's scanners. AquariusAPS also supports an open application-programming interface (API) for "plugging in” third-party algorithms, so that they may be applied to an institution's imaging data (even historically), and the results then observed in the context of the normal Aquarius iNtuition diagnostic user interface. The algorithm reported on by Mayo Clinic (Rochester, MN, USA) is being integrated into the AquariusAPS server (for internal use only) by a Mayo Clinic team using this API, as an example of such an integration.

Presentations at SIIM 2009 highlighted the advantages of exporting findings and measurements using a standardized XML format, which can be read into a database and later searched to find similar cases or findings, to aid diagnosis, or for research purposes. The Aquarius iNtuition 4.4 software includes advanced support for customizing measurement protocols, and for exporting the results of applying such measurement protocols, using standardized XML, CSV (for use in Microsoft Excel and other software), or Text formats. This tool allows a clinical institution to standardize its interpretation protocol, a three-dimensional (3D) lab to standardize its measurement sets for various procedures, or a research facility to define standardized measurements that must be made by readers in a clinical trial, all with the output formatted in a standardized way that can be automatically exported into other software or analysis tools.

At SIIM 2009, Jason N. Itri, M.D., Ph.D., and William W. Boonn M.D., from the Hospital of the University of Pennsylvania ((Philadelphia, USA), presented a study that found that using such automated processing generates substantial time savings, and that "the substantial time savings is expected to improve workflow and productivity.”

The study was performed using the system featuring AquariusAPS with "AutoBatch,” an automated processing server that performs coronal, sagittal, and axial reformats using maximum intensity projection (MIP), multiplanar reformatting (MPR), or other algorithms immediately upon scan completion, according to various user-defined rules and parameters, with automatic forwarding of the results to picture archiving and communication systems (PACS). The AquariusAPS server used in this study showed that trauma-related computed tomography (CT) examinations of the cervical spine, chest, abdomen, and pelvis significantly improved diagnostic interpretation efficiencies.

At SIIM 2009, another presentation highlighted the use of an alternative user interface based on multi-touch technology. TeraRecon's Aquarius iNtuition is integrated with a multi-touch user interface, and iNtuition now supports the iPhone and iPod Touch multi-touch user interface.

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