SIIM 2013:
Three Topics You May Have Missed
Greetings! 

 

With the recent conclusion of SIIM 2013, I want to share (at least) three insights you may not have learned from the meeting and the ensuing media coverage. Despite the slimmed down meeting, there was great energy and excitement on the floor.  We met with dozens of imaging informatics leaders that are poised to make technology decisions to help their organizations transform around increased quality and productivity, and provide better service to referring physicians.  They are also seeking to fundamentally reinvent their technology platforms to move beyond the recent years of stagnancy, and prepare to thrive in a new era of growth through consolidation, merger and acquisition.  Granted, this is not a strategy for all organizations, but first movers in nearly all market segments are zeroing in on this strategy. Deconstructed PACS and server-side processing were frequently heard on the floor and in the breakouts as the 'future of PACS'.

 

Breaking the Rules

 

Similar to prior years, Visage Imaging exhibited at SIIM 2013, but this year we also were an active participant in three portions of the scientific program. I presented during an Applied Learning session, "Who do you turn to for help in developing solutions?" I chose "Breaking the Rules" as the title of my presentation because it has been my observation that so many organizations are restricted by the chronic problems they work around and struggle through.  In my presentation, I presented some of the early findings from the survey I co-authored with SIIM around the topic of "Radiology Has Solved the Problems of Going Digital."  [Note:  I'll write about the complete findings on the SIIM Knowledge Center later this summer]. 

 

Visage 7 - Speed is Everything
Visage 7 - Speed is Everything

 

But what if a new generation of technology changed the rules? What if the limitations and workarounds could be eliminated?  I was onto something, as unbeknownst to me, Dr. Bradley Erickson delivered the Dr. Sam Dwyer Lecture ("Is Innovation the Path to Better, Cheaper PACS?") and was paraphrased by Health Imaging, stating, "Innovation entails a complex and fundamentally disruptive life cycle characterized by breaking the rules." Interesting. He went further, stating, "We need to rethink how PACS is done and how to simplify so it works better. It may be cheaper to build a better PACS." Great insights from Dr. Erickson indeed.

 

Live Demo of Visage 7 Over SIIM's Shared Wi-fi

 

Later, Visage's Tim North participated in, "Advanced Image Analysis: The Vendor Perspective," in the SIIM Innovation Theater.  Per the pre-SIIM request of the moderator, Dr. Gary Wendt, Tim provided both a demonstration and presentation how Visage 7 has developed native advanced visualization and traditional 2D imaging into a server-side processing powered, enterprise imaging platform. Tim impressively demo'd Visage 7 from his MacBook Pro, over the meeting's shared wi-fi connection, to an Internet-accessible demo server located nearly 1,000 miles away in Louisville, KY.  The demo included a variety of 2D (CR, CT, MR, US, MG, etc.) and 3D datasets, with on-the-fly reconstructions; to include display of a 3,940 slice 10-phase cardiac CTA with auto-bone removal of the chest wall and cine of the beating heart across all phases.  Many would agree this was a live demonstration of breaking the rules, as traditional PACS and advanced visualization approaches cannot deliver similar speed, clinical sophistication and accessibility over such a minimal network connection. The other vendor, Vital Images, delivered a slide presentation, without a product demonstration.

 

DBT Forum:  How DBT Kills Your PACS/VNA

 

Visage's last session was Bobby Roe's participation as a panelist on the Digital Breast Tomosynthesis (DBT) Forum, led by David Clunie, "How DBT Kills Your PACS/VNA".  This was one of the most spirited, candid, and well attended working forums in years.  Three topics represented a significant portion of the discussion:

  • Proprietary vs DICOM Standard.  Experts talked openly about the difficulty and variability displaying the Hologic proprietary breast tomosynthesis object versus the DICOM standard breast tomosynthesis object (BTO). Adequate training was also voiced as a challenge. There was also concern expressed that once integrated to PACS, even after the standard BTO is widely available, how will practices access, store and display the proprietary objects that are prevalent with the early deployments of DBT? 
  • Bandwidth.  Gigabit local networks were discussed as a 'best practice' when considering the minimum adequate network speed to support storing and displaying the BTO from the Hologic workstation and/or traditional PACS. If available, experts said 10 Gigabit network connections were preferred.  Necessary workstation improvements in terms of more RAM, faster disk(s) and processors were also discussed.
  • Server-side Processing. Numerous experts commented that the best possible, 'future' technical architecture to support DBT was server-side processing to eliminate the need of pushing the massive DBT studies from server to workstation, and mitigate the need for workstation improvements. 

Bobby advised the participants that Visage 7 supports the display of both the proprietary and standard BTO, powered by server-side processing, over connections as limited as consumer-grade broadband (recommended 6 Mbps or greater). That's a dramatic network difference, and with server-side processing the beefiness of the workstation does not matter.  Also, because DBT is just another supported modality on Visage 7, multi-modality breast imaging protocols and layouts are a core capability. Bobby also pointed out that Visage was instrumental in the early days of DBT (then known as Mercury Computer Systems), reducing the time of DBT reconstruction from 5 hours to 5 minutes. Here's an article describing our groundbreaking efforts with MGH from Dec '06.

 

Server-side processing is state-of-the-art, mature technology enabling leading imaging organizations to take the next leap forward in enterprise imaging.  I hope the above observations have provided some new insights for you.  If you're interested in learning more about Visage 7 or have any questions, please feel free to drop me a note at blevin@visageimaging.com.

 

 

Regards,

 

 

 

Brad Levin

General Manager, North America

Visage Imaging, Inc.

www.visageimaging.com 

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