Lucas Report – 3DQ Lab 2010

The Stanford 3D Medical Imaging Laboratory is guided by the mission of developing and applying innovative techniques for efficient analysis and display of medical imaging data through interdisciplinary collaboration. Since 1996, our clinical goal has been to deliver 3D imaging advances as rapidly as possible 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; and we continue to facilitate cutting edge research through our collaborations with faculty in Radiology sand other Departments. To facilitate the bridge between innovation and other clinical use of technology, we also offer services as an imaging core lab for medical device developers.

Progress

Clinical: Over the past year, the 3D Laboratory has continued its operations simultaneously in the Lucas Center as well as the James H. Clark Center, a building dedicated to interdisciplinary science. Our average monthly 3D volume has increased to approximately 950 examinations, and we have processed over 78,000 examinations overall since our inception. The majority of our referrals continue to come from vascular surgery, cardiothoracic surgery, gastroenterology, cardiology, urology, reconstructive surgery, orthopedics, neurology and neurosurgery. 3D clinical procedures now offered by the Lab include CT Virtual Colonoscopy for both diagnostic and screening evaluation of polyps (fig 1), CT Temporal Bones for visualization of tiny structures in the inner ear (fig 2), and MR Heart for quantification of muscle mass, ejection fractions, and flow velocity (fig 3).

Education: This year the 3D Laboratory has been attended by international visiting scholars from Japan, as well as Stanford Radiology fellows, residents, and medical students who acquire skills in 3D interpretation as part of their medical training. Stanford researchers from engineering and medical departments have also been trained in acquiring 3D images and data for research projects, including measurements of craniofacial deformities for reconstructive surgery, pulmonary vasculature volumes for 3D model fluid flow simulations for vascular surgery, and 3D modeling for multimodality small animal imagers. The 3D Laboratory has also hosted several visiting radiology managers and technologists from domestic and international medical centers through our 3D clinical fellowship program.

Infrastructure

3D imaging specialists include: Laura Pierce, 3D Laboratory manager; senior 3D technologists Marc Sofilos and Linda Novello; 3D technologists Keshni Kumar; William Johnsen, Nancy Ware and Shannon Walters. Technologists John William Weidinger and Kristen Bogart provide per diem 3D services to maintain up-to-date workflow (image 1). Our technologists offer not only expertise in 3D imaging, but also experience in CT and MRI scanning techniques as well. Support staff includes administrative assistants Lakeesha Winston and Debra Frank, and database administrator, Kala Raman. The research arm of the lab retains an annual average of 12 engineering graduate students and post-doctoral scholars as well as 2 clinical MD researchers. In the Clark Center, a central area table invites professional collaboration, and student desks with moveable workspaces provide areas for independent research. The Lucas Center 3D Laboratory also houses equipment on a central area table, surrounded by student carrels. The lab equipment comprises a total of 13 advanced 3D workstations, three TeraRecon servers, which also provide remote 3D rendering to the Stanford medical community, and two research and development servers for image and data storage. Three remote PACS workstations allow access to all Stanford medical imaging and reporting.

We continue our excellent relationships with corporate developers of 3D workstations (e.g., GE Healthcare, TeraRecon, and Vital Images) who site 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. To expedite workflow and allow for flexible workspaces, we are upgrading the infrastructure of the 3D Laboratory to access all 3D software applications on centrally located vendor-supplied servers, to allow for processing and sharing of image data throughout our enterprise on generic PC workstations. We have already begun this transition by utilizing the TeraRecon Intuition® server from multiple locations for real-time interactive 3D rendering, and the MEDIS QMass® and QFlow® analysis software which allows for enterprise collaboration when measuring cardiac output and analyzing muscle mass.

Conclusion

The 3D Medical Imaging Laboratory 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.