Health in 3D

Once slow and cumbersome, 3D imaging is now taking radiography to another level - and its applications are growing. KATHLEEN ARMSTRONG reports

3D imaging has come a long way since it was first developed for use in healthcare. Slow and in low resolution, it often increased the time taken to attain results instead of speeding them up. But how things have changed.

A cardiac reading that used to take an average of 22 minutes is now down to around four minutes

“3D imaging typically used a lot of processing power", says Peter Harrison, director of sales and solutions at Siemens Healthcare. "That processing power used to be very much more expensive than it is today and was typically located in a dedicated workstation. Now the processing typically takes place on a server. This means that users can access the images via a variety of connected devices that do not themselves need a lot of processing power."

Now images are delivered in high definition, can be rotated and geared to particular procedures – and they are much quicker bringing real benefits to the surgeon. “At one of our customer sites, cardiac readings that used to take an average of 22 minutes are now down to around four minutes," Harrison explains.

Siemens’ latest 3D advanced visualisation product family is syngo.via, which Harrison says has taken 3D further by delivering accessibility improvements and also enhancing workflow.

When 3D images are taken of the heart, for example, the software acknowledges that the cardiologist or radiologist will want to see past the ribcage and remove the blood pool, so it prepares the image without the unnecessary obstructions. In addition, syngo.via can automatically label the blood vessels and make key measurements, preparing the case for reading by the radiologist. These automatic case preparation steps can be user-specific or disease-specific.

Another automated feature is the ‘one-step stenosis’ in which syngo.via automatically identifies and measures vessel narrowing plus measurements before and after the stenosis - details that are particularly important for the implantation of stents, for example. “In cardiology, where rapid diagnosis is needed, this type of technology provides accurate and rapid diagnosis, enabling early intervention,” Harrison adds.

In cardiology, where rapid diagnosis is needed, this type of technology is key

IBM is working with the Mayo Clinic in the US to use 3D imaging to analyse the brain in a more sophisticated way. Together they are working to create an advanced algorithm that will increase the chance of spotting brain aneurysms by 70-90%.

“3D images are at a point we could not have envisioned 20 years ago,” says Martin Kohn, associate director of healthcare analytics at IBM Research, whose technology is also being applied in patient education, using a 3D avatar of the human body.

IBM Research is also using the technology to better understand how groups of patients are similar or dissimilar. For example, it says, medical information from Asian males over the age of 65 with both diabetes and hypertension can be plotted against other similar groups of patients to see specifically what treatments are most effective and how their diseases progress over time.

“By displaying this in 3D, the data can be turned and more easily examined to see relationships with other patients or other diseases, and to get a better understanding of how to improve the treatment process,” a company spokesman says.

Imaging 2.0 is the first medical networking platform which allows the radiologist to integrate information from various sources to make a confident diagnosis and discuss it with all the clinical partners on the case, putting the radiologist at the centre of clinical decision-making

Philips Healthcare is another company to take 3D technology a few steps further with the development of Imaging 2.0, an intelligence-based portal that enables consultants, radiologists and surgeons to collaborate in real time. Using web 2.0 technology, which supports blogs and other conversation-type tools on the internet, Imaging 2.0 enables consultation both within and between hospitals. Philips technologies with which it integrates include the Philips Ingenia digital broadband MR system, designed specifically for oncology imaging; the Philips Ingenuity CT, a 4th-generation dose management system; and the Philips IntelliSpace Portal, a multi-modality multi-vendor workstation.

The technology was first unveiled at the annual conference of the Radiological Society of North America in November 2010 and recently had its UK launch at the UK Radiology Congress on 6 June. It has already been installed in a number of hospitals in England, including Frimley Park, Guys and St Thomas’, Queens Medical Centre in Nottingham and Poole General Hospital.

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“Imaging 2.0 is the first medical networking platform which allows the radiologist to integrate information from various sources – for example, CT, MRI and PET scans – to make a confident diagnosis and discuss it with all the clinical partners on the case, putting the radiologist at the centre of clinical decision-making. The result is more efficient workflow, cost efficiencies, and greater patient focus,” says Mike Haydon, Philips’ head of imaging for the UK and Ireland.

“The quality of 3D images is at a high level now,” Haydon adds. “It can remove skin and de-layer a person, and you could still recognise the patient, the image is so good.”

In June, GE Healthcare announced the development of GE Breast Tomosynthesis, which it predicts will eventually replace 2D mammography. The technology uses a low dose short X-ray sweep around a compressed breast to construct a 3D image of the entire breast. “This technique is designed to help avoid tissue overlap, which can hide small cancers and can be a limiting factor in standard 2D mammography today,” said a spokesman.

The quality of 3D images is at a high level now. It can remove skin and de-layer a person, and you could still recognise the patient, the image is so good

Demand for 3D imaging is growing, according to Mike Haydon and Peter Harrison. This was supported by a recent report from Global Industry Analysts, which predicts that the global medical imaging market will be worth $3.5 - £2.1billion – by 2015. The key factors for this, it says, are the ageing population, increases in the incidence of critical diseases, technological advancements in 3D imaging, and the broadening of its application into areas such as obstetrics, gynaecology, cardiology and dentistry. The rising adoption of 3D medical imaging in developing markets such as Asia will also contribute to its growth.

Sales of imaging technologies may have slowed down during the economic downturn. However, as the applications of the technology improve and expand, there is no doubt their use will become more widespread and commonplace.

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