Lucas Report – 3DQ Lab 2008

The Stanford 3D medical imaging laboratory is well into the second decade of service to the Stanford Medical community. The 3D laboratory continues to be guided by the mission of developing and applying innovative techniques for efficient analysis and display of medical imaging data through interdisciplinary collaboration. Our clinical goal is to deliver 3D imaging advances as rapidly as possible following validation to the Stanford and worldwide healthcare communities for the swift and accurate diagnosis and treatment of disease. Our educational goal is to disseminate knowledge and duplicate our 3D services at other institutions by providing training for local and international physicians and technologists in the latest developments in 3D imaging.

Progress

Clinical: Over the past year, the 3D laboratory has continued its operations simultaneously in two locations: the first floor of the Lucas Center as well as the third floor of the James H. Clark Center, a building dedicated to interdisciplinary science. Our average monthly 3D volume has increased to approximately 875 examinations, and we have processed over 57,000 examinations, for nearly every clinical department at the Stanford Medical Center, since our inception in 1996. The majority of our referrals come from vascular surgery, cardiothoracic surgery, gastroenterology, cardiology, urology, reconstructive surgery, orthopedics, and neurosurgery.

Education: The 3D lab is attended by a rotation of international visiting scholars, Stanford Radiology fellows, residents, and medical students who acquire skills in 3D interpretation as part of their medical training. Our 3D imaging technologists also train Stanford researchers from engineering and medical departments to acquire 3D images and data for research projects involving a variety of image types from an array of imaging devices, including video microscopy, electron microscopy, and multimodality small animal imagers. In response to the external demand for 3D post processing and management training, the 3D lab hosts visiting radiologists and technologists from other medical centers through our 3D clinical fellowship program. This past year, our visitors included teams from other major university medical centers, such as New York University, Cornell University, and University of Pennsylvania. These tertiary radiology departments are interested in duplicating our 3D workflow model at their institutions.

Infrastructure

3D imaging technologists include: Laura Pierce, 3D lab manager; senior 3D technologists Marc Sofilos and Linda Novello; Keshni Kumar; William Johnsen, and newly hired technologists Nancy Ware and Shannon Walters. Our technologists offer not only expertise in 3D imaging, but also experience in CT and MRI scanning techniques as well. We also employ administrative assistants Lakeesha Winston and Debra Frank, and a database administrator, Kala Raman. The research arm of the lab retains an annual average of 12 engineering graduate students and postdoctoral scholars as well as 2 clinical MD researchers. Both 3D lab locations include a central area table that invites professional collaboration and student desks and carrels for independent research. The lab encompasses a total of 13 advanced 3D workstations for processing clinical cases and for research and development. We also have three servers, which provide remote 3D rendering to the Stanford medical community, and two research and development servers for image and data storage. Two remote PACS workstations allow access to all Stanford medical imaging and reporting. The lab also houses a variety of PCs and printers for software development and support.

We continue our excellent relationships with corporate developers of 3D workstations (e.g., GE Healthcare, TeraRecon, and Vital Images) who place their hardware and software in the 3D lab in anticipation of our feedback. These relationships ensure that we maintain the most advanced multi-dimensional analytical technologies available. Future clinical applications under investigation include automatic pre-processing and pre-loading of patient examinations to improve efficiency; predefined workflow templates; automatic export of quantitative data to patient reports; and improvements to graphical user interfaces for simplicity and ease of use of clinical 3D software.

To facilitate the bridge between innovation and other clinical use of technology, we serve as an imaging core lab for medical device developers. These companies use our expertise to evaluate their current and future products in anticipation of FDA approval. Present industrial projects include the evaluation of data from pulmonary vein ablation procedures (to treat atrial fibrillation), as well as thoracic stent-graft deployment (for the treatment of thoracic aortic aneurysms).

Conclusion

The 3D Medical Imaging Lab continues to function as an international leader in clinical care, teaching, and research in medical imaging analysis. The confluence of talented, medical and engineering expertise as well as the most up-to-date equipment has been a consistent source of innovative developments in diagnostic and treatment planning approaches.