Stanford MDCT: open thread

I’m home from San Francisco safe and sound, and though I didn’t leave my heart there, I did leave another two days of MDCT excitement — editorial duties on the homefront called. But that doesn’t mean you should stop reading. Instead, jump in and participate! Leave a comment below about your favorite aspect of the show so far. What’s the most interesting thing you’ve learned? Your ideas shape our future coverage, so comment early and comment often! And don’t forget to join us again in June for coverage of SIIM (beginning June 4) and RBMA (beginning June 7).

–Cat

Workstation face-off liveblog

Here it is, the entry you’ve been waiting for — the workstation face-off liveblog! For those new to blog readership, here’s how liveblogging works: I’ll update this entry continuously throughout the face-off, with my newest updates appearing at the top. Keep refreshing to stay on top of all the action!

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The ins and outs of implementing a 3D lab

If I had a nickel for every time I’ve contemplated opening up a 3D lab, I’d be a rich woman.

Okay, that’s a lie. But more and more imaging centers are considering taking their 3D interpretations off the scanner, out of the hands of the radiologists and into a separate 3D lab staffed by specialized techs. Techs like Laura Pierce, one of this afternoon’s presenters, who’s been doing 3D since the mid-nineties and, as such, is well aware of the ins and outs of implementing a 3D lab.

“You probably want a 3D lab, but you’ve run into some barriers,” Pierce said. She proceeded to outline a few of the most common barriers to implementing a 3D lab — as well as a few insider tips for overcoming those obstacles.

RadLex: coming into focus

I was delighted that Sandy Napel, PhD, gave a shout-out to RadLex in his talk “Beyond Visualization and Quantitation: Data Mining for Radiology Decision Support.”

Scanning thin, reading thick . . .

. . . and storing how, exactly?

That was the question that kicked off this afternoon’s session on workflow and image processing. Jeffrey Mendel, MD, began his presentation by observing that to believe the New York Times and the Wall Street Journal, imaging is currently awash in exciting, amazing new technology. “But somehow that great new technology that I see on the cover of the times never seems to make it to me,” he said.

Why? Well, 3D image reconstruction and analysis are all well and good, but issues remain when it comes to storage of all those thin slices. Where should all the thin slices go? The answer probably changes depending on who you ask. As Mendel delineated, clinicians are not a homogenous group: some are report-centric, others image-centric, and any storage strategy you implement should accommodate both.

Lunch date with 320-slice CT

I just had lunch with 320-slice CT. Well, not exactly, but the fine folks at Toshiba sponsored a delicious lunch accompanied by a presentation on the use of the technology in a community hospital. Dr. Jeffrey Dardinger of St. Elizabeth’s Medical Center in Kentucky presented on how his hospital has been using their Aquilion ONE system in the year or so since installation.

CTC: is the tide turning?

In the hours leading up to lunch, the talk here at Stanford MDCT turned to CT colonography, the hotly contested (well, by CMS, anyway) technique for virtually scanning the colon for cancer. C. Dan Johnson, MD, kicked off the CTC presentations with a look at the five requisites for performing high-quality CTC:

• Patient preparation
• Colon insufflation
• Scanning technique
• Training of radiologist
• Interpretation

Abe Dachman, MD, of the University of Chicago Medical Center, took the podium to elaborate on colon insufflation, sharing a few “tricks of the trade” with the assembled crowd. Here’s one that I thought was particularly smart: spray lidocaine onto the balloon lubricant to reduce bowel pain. And, though Dachman prefers mechanical insufflation, he recommended that everyone keep equipment on hand for manual insufflation, just in case. Finally, he suggested that on low-volume days physicians supervise techs to help reinforce training.

This afternoon: workstation face-off liveblog!

By the way, be sure to tune in from 3:15 to 5 today, when I’ll be liveblogging the Workstation Face-Off with a running thread. See you then!

–Cat

What’s new in CTU

It’s a cool, sunny morning here in San Francisco, and the Stanford MDCT conference continues with Session V, looking at hepatobiliary and genitourinary imaging with CT. Knowing what urologists need and expect from their colleagues in radiology is particularly important as imaging continues to disseminate into other subspecialties, which is why I enjoyed Dr. Elliot Fishman’s examination of the pitfalls of MDCT imaging of renal masses.

Imaging gently: kids and CT

The last sessions of the day today looked at pediatrics and CT. The discussion began, appropriately, with a few presentations on dosing and radiation in pediatric patients — a hot topic in recent years with the advent of the ACR’s Image Gently campaign, a push to spread the word about “child-sizing” pediatric imaging dose.

Frandics Chan, MD, PhD, presented on the topic “Radiation in Pediatric Cardiac CTA: Myth and Reality.” His view of the issue at hand was sobering. “Does radiation at the diagnostic dose of CT cause cancer?” he asked the audience. “We don’t know, but the likelihood is probably high.”

Chan went on to urge conference-goers to “get over the hump” and assume that CT does cause cancer, saying the only real question now is how much cancer does it cause?