Dr. Peter Metherall is a registered Clinical Scientist and Chartered Engineer at Sheffield Teaching Hospitals NHS Foundation Trust, UK. As the Scientific Lead of the Sheffield 3D Imaging Lab, he is improving the clinical utility of Advanced Visualization and Quantitative Imaging for routine clinical imaging investigations and research applications.
Why did the Sheffield Teaching Hospitals NHS Foundation Trust decide to set up a 3D Imaging Lab?
“I first became aware of the 3D Imaging Lab approach to image processing at the RSNA annual meeting in Chicago back in 2007. This appeared to be an ideal way of providing advanced visualization services, and would improve the consistency and reproducibility of results. Using dedicated image processing staff leads to improved efficiency, higher operator expertise and better familiarization with the software. The imaging department in Sheffield already had access to lots of image processing software but much of it was seldom or inconsistently used. By implementing a 3D Lab we would be able to better utilize the 3d medical imaging software and also be in a good position to embrace new technology and become involved in the development of novel image processing techniques, research and educational opportunities. We were also very keen to increase the use of quantitative imaging to try to reduce the subjective nature of image interpretation in certain tests.”
Can you describe how the 3D Imaging Lab was implemented? What were the different steps?
“The first step was to gain support of the hospital and get the agreement that that it would be part of the imaging department’s future strategy. At the same time I was fortunate to obtain some funding to visit a number of well-established 3D Labs in the USA at Stanford University, Massachusetts General Hospital and the University of Michigan. The information gained from these visits was invaluable and aided our initial implementation enormously. After discussing the concept with a number of keen radiologists, we started with a couple of targeted quick wins; one existing cardiac MR application was currently being performed by radiologists and the other was applying a new analysis technique to improve the accuracy of tumor measurements. From this, the 3D Lab has gradually evolved and has enabled the imaging department to increase the capacity of a number of different tests and also increase the variety of applications that the 3D Lab processes.”
What are the considerations for setting up a centralized lab?
“First of all, you need to get agreement from the imaging department management team. Then, it is important to realize that 3D imaging requirements can vary between radiologists and referring clinicians and that they can also vary between different radiology specialisms (e.g. Cardiac, Neuro and Orthopaedics). You need to engage with all the radiologists to identify their different needs, and which modalities will provide the data to the Lab. As for the existing software in the department, it’s important to analyze how it could be used more efficiently. Then there is the task of obtaining funding for the staff: radiographers, technologists and scientists or engineers. And their roles need to be determined as well; should the staff spend all their time in the lab, or should it be split between scanning and post processing? Staff selection is important and applications training will be required for the staff working in the 3D Lab. Finally, it is key to receive good support from your IT department and it is also very advantageous to have a software developer working within the Lab. Identify any required funding for new software, and ensure that rigorous quality control processes are in place.”
Which challenges have you faced?
“Funding has been the most difficult challenge, but this is mostly related to way the internal funding works in the National Health Service in the UK. Another challenge is acquiring software that is good enough. The 3D Lab always wants the very best software tools so it’s important to make sure you have a good service contract to get the latest updates; or better still, establish good relationships with software vendors to test and influence future developments. One example of this is how the standard Radiology Information System didn’t provide the required functionality to capture the quantitative results we were generating, so we developed our own 3D Lab database to manage the workflow and all the quantitative data being generated.”
Which departments are currently benefitting from 3D imaging?
“We work with many different departments and these include Radiology, Cardiology, Oncology, Vascular Surgery, General Surgery, ENT, Orthopaedics, Anaplastology, Maxillofacial Surgery, Urology and Renal.”
What is the main benefit for these departments in using your 3D reconstructions?
“There are many benefits of using 3D reconstructions and quantitative imaging. Higher standardization, consistency and reproducibility of the generated results are clearly significant benefits but communication is a very important advantage. By transforming the cross-sectional images into a format where the anatomy and pathology can more easily be interpreted is of benefit not only for the Radiologists, but also for the referring clinicians and most importantly, the patient. Consent will be much easier if the patient can better understand what is wrong and what a planned intervention is hoping to achieve.”
Tell us about your typical workflow when your lab works with different departments and hospitals?
“The workflow can vary depending on the type of study being processed but all of the work is identified automatically by querying the hospitals Radiology Information System for new studies. This provides a very effective method of generating a worklist and also helps the 3D Lab to be completely paper-free. Studies are picked up from the database by the 3D Lab Radiographers and images are downloaded from PACS to the appropriate software. The 3D Lab always uses the best tool for the job, and sometimes this means using more than one software application. Input from a computer scientist or engineer can be very useful here to develop seamless workflows. Once the study has been processed the results are passed onto a radiologist for verification, and for quantitative results to be incorporated into their report. The 3D Results are then made available to the referring clinician.”
|About Dr. Peter Metherall: Dr. Peter Metherall is a registered Clinical Scientist and Chartered Engineer at Sheffield Teaching Hospitals NHS Foundation Trust and is the lead scientist of the 3D Imaging Lab. He is responsible for the imaging computer systems and has developed image visualization software which has now been licensed commercially. He has received two Chief Scientific Officer awards for innovation in 2005 and 2008. He is currently leading the implementation of the Sheffield 3D Imaging Lab; a new initiative to improve the clinical utility of Advanced Visualization and Quantitative Imaging for routine clinical imaging investigations and research applications.|