Dave Fornell, DAIC Editor

Dave Fornell, Editor DAIC

Blog | Dave Fornell, DAIC Editor | August 30, 2013

Going Beyond 3-D in Cardiovascular Ultrasound: The Next Step to Improve Reproducibility, Speed

By Dave Fornell, DAIC Editor
 
There are two main issues facing clinical practice today, including lower reimbursements and the need to see more patients, which combined calls for technology that can improve efficiency and increased patient throughput. In addition, there are inherent issues with traditional 2-D ultrasound imaging technology, including that the quality of image acquisition relies on the skill and experience of the operator. Also, 2-D images are flat slices, so measurements are dependent on the transducer angle, section of the anatomy chosen to take a measurement, and again on user experience and skill level. Combined, this leads to issues with reproducibility. 
 
There have been several technological advancements to help address these issues, the biggest of which is 3-D echo. While 3-D echo adoption started out slow because it was time-consuming to use, today’s systems offer much improved speed and automation. It used to take 30 minutes to an hour to create cardiac images manually. But, as faster computer processing became available and vendors streamlined workflow and automated steps, today it takes less than 30 seconds to create the same cardiac views.
 
The use of 3-D echo can help improve the accuracy and reproducibility of cardiac quantification. The technology has the advantage of removing the inter-operator variability by imaging whole volume datasets of the heart, so specific images or organ views can be extracted and reconstructed in any position, similar to CT or MRI datasets. Also, because a volumetric dataset is captured, exam times can be shortened, instead of spending time trying to get just the right angle for a 2-D slice view. Cardiac quantification can also be improved by measuring the entire heart or ventricle, rather than just slices of it. New software also automates this quantification.
 
At the American Society of Echocardiography’s (ASE) 24th Annual Scientific Sessions held in June, it was evident there is growing adoption of 3-D echo. The main trends in 3-D focused on increased automation to streamline and the collection of more quantitative data from images. 
 
Among the new technologies discussed was what I consider the next step in 3-D echo ­— the use of artificial intelligence to immediately identify the anatomy being imaged and then extract the views required for automated quantification and clinical diagnosis. While the technology is cool from the sci-fi standpoint, there are many who will wonder why we need this and stand by the belief that only a highly skilled echocardiographer should be doing this job. I would agree, but in light of increasing numbers of patients entering the system under healthcare reform and as the baby boomers continue to age, this type of automation may help speed exams to timeframes never before possible.
 
Philips Healthcare has developed smart anatomical imaging software, which it released commercially Aug. 30 with the introduction of its new Epiq premium ultrasound system. It addition to being able to identify cardiac anatomy on its own with out human interface, the system can identify anatomy throughout the body for use in OB/GYN and general imaging. This might help in leveling the playing field between experienced echo and ultrasound technologists and novice ultrasound system users. The need for this type of technology is becoming greater as the number of patients in the U.S. healthcare system expands, while at the same time as the proliferation of point-of-care ultrasound systems is rapidly expanding into all areas of medicine.
 
I suspect this type of smart anatomical imaging will be among the top highlights of new medical imaging advances at the Radiological Society of North America (RSNA) meeting in December. 
 

Related Content

cybersecurity, healthcare industry, SecurityScorecard report, social engineering, cyberattacks
News | Information Technology| October 31, 2016
SecurityScorecard, a security rating and continuous risk monitoring platform, released its 2016 Healthcare Industry...
RFID inventory control in the cath lab, inventory management, cardinal

An example of RFID cabinets in a cath lab. As items are pulled from the cabinet, the inventory control system automatically determines what items were take out and adds them to the patient case. The system can also help locate recalled or expired items, and automatically track on-hand inventory to avoid manual counts.

Feature | Inventory Management| October 28, 2016 | Jean-Claude Saghbini
The healthcare industry’s transition to value-based care leaves no room for waste, and yet we know that inefficiency
Sponsored Content | Videos | Inventory Management| October 28, 2016
With quality of care and cost efficiency at the top of your mind, there is no room in your hospital for waste from hi
Philips, TCT 2016, image guidance technologies, iFR, HeartNavigator
News | Cath Lab| October 26, 2016
Philips recently announced its latest image guidance solutions to be featured at the 2016 Transcatheter Cardiovascular...
pediatric echocardiograms, cardiovascular ultrasound, therapy dog impact, animal-assisted therapy, Human Animal Bond Research Initiative, HABRI
News | Cardiovascular Ultrasound| October 25, 2016
The Human Animal Bond Research Initiative (HABRI) announced it has awarded a $44,000 grant to Duke University School of...
medicare bundled cardiac payments, CMS cardiology payments
Feature | Business| October 24, 2016 | By John W. Meyer, MPH, FACHE
(Editor’s note: This is the second part of a two-part series on the proposed Medicare five-year demonstration for
Analogic Corp., bk3500 ultrasound system, cardiac imaging software, ACEP 2016, RSNA 2016
News | Cardiovascular Ultrasound| October 18, 2016
Analogic Corp. announced last week that it will introduce its new premium cardiac imaging software for the bk3500...
Philips, Lumify smart-device ultrasound, S4-1 cardiac transducer, RSNA 2016
Technology | Cardiovascular Ultrasound| October 14, 2016
Philips announced at The American College of Emergency Physicians' (ACEP) annual meeting that it has received 510(k)...
GE Healthcare, Optison ultrasound contrast agent, FDA labeling change, cardiac shunts, intra-arterial injection
Technology | Contrast Media| October 04, 2016
GE Healthcare announced that the U.S. Food and Drug Administration (FDA) has approved a label change for the ultrasound...
Sci-image, Scimage, CVIS, CIIMS, Cpacs c-pacs, cardiovascular information system

Today's cardiovascular information systems need to incorporate all facets of the cardiology department, including subspecialties, to allow a complete picture of a patient's record. These data also need to be able to be shared with enterprise data systems, such as the electronic medical record (EMR). This image is from ScImage, illustrating the various aspects that integrate to make up a complete CVIS. 

 

Feature | September 29, 2016 | Val Kapitula, RT(R), PMP, CIIP
 
Overlay Init