Efficacy of a new post processing workflow for CTA head and neck

Transcription

1 Efficacy of a new post processing workflow for CTA head and neck Poster No.: C-1760 Congress: ECR 2013 Type: Authors: Keywords: DOI: Scientific Exhibit N. Ardley 1, K. Buchan 2, K. K. Lau 3 ; 1 Clayton, Victoria/AU, 2 Mont Albert, Victoria/AU, 3 Melbourne/AU Arteries / Aorta, Computer applications, Vascular, CT- Angiography, CT, Computer Applications-3D, Diagnostic procedure, Efficacy studies, Aneurysms, Arteriosclerosis, Embolism / Thrombosis /ecr2013/C-1760 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 11

2 Purpose CT angiography (CTA) of the head and neck is an accepted diagnostic test for assessing the integrity of vascular structures in this region [1,2]. CTA invariably includes some form of Post processing (PP) workup of the acquired data. For a complex anatomical region like the head and neck, which inherently has intricate structures in close proximity to one another, the PP is traditionally time consuming because of the need to isolate vessels from surrounding bone. An example of an image which is produced is demonstrated in Figure 1. A new PP workflow has been developed which utilises robust technology to automatically utilise image data and generate PP images with minimal initial technologist manipulation. This aim of this study was to assess the efficiency of this new PP workflow on workup times in the setting of CTA head and neck examinations. Images for this section: Page 2 of 11

3 Fig. 1: Example of 3D Image of the Head and Neck vessels Page 3 of 11

4 Methods and Materials Patients: This study included 90 consecutive patients who presented for the CTA of head and neck from June 2011 through to March Technique: The initial 45 examinations were worked up using a traditional PP workflow (see Figure 2) on a CT workstation, whilst the latter 45 examinations were worked up using a new PP workflow (see Figure 3) within a server based thin client environment (IntelliSpace Portal 5, Philips Healthcare, Cleveland, USA). Each sample included the generation of 3D images (volume rendered and maximum intensity projections) and bilateral curved multiplanar reformatted images of the carotid and vertebral arteries. The new PP workflow differed from the traditional workflow, in that it automatically recognised the incoming CTA data on arrival at the server, and proceeded to initiate an automated process of bone removal, extraction of the 6 main vessels (bilateral internal and external carotid and vertebral arteries) with automatically placed centerlines and labels for each vessel. Analysis: The PP time in both samples was quantified by obtaining time stamps from the DICOM tags in the CTA source and reconstructed data. PP time was defined as the time period from when the CTA scan ended to the time when the last CTA image arrived on the Picture Archiving Communication System (PACS). All these times were electronically recorded on the CT scanner, workstation and PACS. Comparative analysis was made between both methods of PP for the CTA workup time. Images for this section: Page 4 of 11

5 Fig. 2: Traditional Post Processing Workflow Page 5 of 11

6 Fig. 3: New Post Processing Workflow Page 6 of 11

7 Results The results obtained from the data collection can be seen in Table 1. The average time period calculated for the traditional method of CTA PP workflow was minutes. The average time period for the new method of CTA PP workflow was minutes. The new CTA PP workflow demonstrated an improvement of minutes. Table 1: Average Post Processing Times per Method Workflow Traditional PP Method Mean PP time (range) mins (12-149) Standard Deviation Confidence Interval New PP Method mins (4-91) The new PP workflow resulted in a 50% average reduction in post processing time as compared to the traditional CTA PP workflow (see Figure 4). This results in much faster image review on the PACS. There was improved image quality using the new PP method in the clarity of vessel in the 3D images especially through the region of the carotid siphon. This is demonstrated in Figure 5, however this statement is subjective as there was no scope within this research project to investigate the image quality differences between the two methods of PP. Images for this section: Page 7 of 11

8 Fig. 4: Time Comparison - Traditional vs. New PP Method Page 8 of 11

9 Fig. 5: Comparison of 3D Volume Rendered Images: Note the clarity of the vessels through the carotid siphon in the new PP method image (right). Also this image is clear of residual noise which may superimpose anatomy Page 9 of 11

10 Conclusion The new CTA PP workflow demonstrated greater efficiency in producing a standardized series of CTA PP images for the head and neck. The new PP workflow technique expedites the availability of images on PACS for prompt reporting and thus unquestionably improves patients' clinical outcomes. References 1. Marquerring HA, Nederkoorn PJ, Bleeker L, van den Berg R, Majoie CB Intracranial carotid artery disease in patients with recent neurological symptoms: high prevalence on CTA. Neuroradiology. October [ONLINE] Springer: article/ %2fs ?null 2. Maekawa M, Awaya S, Teramoto A Efficacy of three dimensional CT angiography (3D-CTA) for a first diagnosis of occlusive cerebrovascular disorders. No Shinkei Geka. July 27(7): Personal Information Nicholas Ardley, BRadMedImag (HONS) CT Supervisor Monash Medical Centre Southern Health Melbourne, Australia Kevin Buchan, DCR(R), GDVET Clinical Science CT Business Unit Philips Healthcare Page 10 of 11

11 Dr Kenneth K Lau MBBS, FRANZCR Director of CT Southern Health Melbourne Australia Page 11 of 11