Lucas Report – 3DQ Lab 2011

The Stanford Radiology 3D and Quantitative 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 to the Stanford and surrounding communities as rapidly as possible for the swift and accurate diagnosis, tracking, and treatment of disease; our educational goal is to disseminate knowledge to replicate our 3D services at other institutions; we continue to facilitate cutting edge research through our collaborations with faculty in Radiology and other Departments. In early 2011 we changed our name to “Stanford Radiology 3D and Quantitative Imaging Lab (the 3DQ Lab).” This was done to reflect the Lab’s increasing involvement in quantitative imaging, as our resources are being sought out and have expanded our scope beyond the traditional “images as pictures” paradigm.

 

Progress

Clinical: Over the past year, the 3DQ 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 3DQ volume has held steady at approximately 950 examinations, and we have processed over 89,000 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. 3DQ clinical procedures now offered by the Lab include Volumetric rendering of liver volumes to aid in tumor quantification(fig 1), Volume rendered view of vascular structures to assess stent placement (fig 2), and musculoskeletal exams to aid in surgical planning (fig 3).

Education: This year the 3DQ Laboratory has been attended by international visiting scholars from Japan, China, and Kazakhstan as well as Stanford Radiology fellows, residents, and medical students who acquire skills in 3D processing and interpretation as part of their medical training. Stanford researchers from engineering and medical departments have also been trained in processing and 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.

Research: The research arm of the lab hosts an annual average of 8 graduate students and post-doctoral scholars from several departments of the university, as well as 2 clinical MD researchers. This year, projects included investigations by visiting physicians from Japan of the utility and limitations of cardiac CT angiography, and use of eye gaze-tracking to understand and improve the detection of pulmonary nodules in volumetric CT scans.

Finally, reflective of the envisioned growth in quantitative imaging, Dr. Daniel L. Rubin, MD, MS, has joined the 3DQ Lab to lead our research and translational efforts in this area; we have already begun to offer core lab services for clinical trials that use imaging as surrogate biomarkers.

 

Infrastructure

The last 12 months have been a time of transition for the Lab as 2 of its pioneers have departed to continue their careers at Duke University. Lab Co-Director Dr. Geoffrey D. Rubin left to assume the position of Chairman of Radiology at Duke University, and Lab Manager Laura Pierce left to manage the nascent 3D Lab at Duke. Current Stanford 3DQ Lab personnel include: Charles Stanley, 3DQ Laboratory Manager, senior 3DQ technologists Linda Horst and Marc Sofilos; 3DQ technologists Kristen Bogart, Caryn Damits, Keshni Kumar, Rhea Lang, Nancy Ware, and Shannon Walters. Support staff includes administrative assistants Debra Frank and Lakeesha Winston, and database administrator Kala Raman.

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 3DQ Laboratory also houses equipment on a central area table, surrounded by student carrels. The lab equipment consists of 12 advanced 3D workstations, two research and development servers for image and data storage, and three TeraRecon servers, which also provide remote 3D rendering to other parts of the Stanford medical community.

Three remote PACS workstations allow access to all Stanford medical imaging and reporting. This past year the 3DQ Lab acquired servers from GE Healthcare and Vital Images; this is reflective of the entire industry moving away from standalone workstations to server/thin client models. These servers are currently being integrated into the lab workflow and will further enable us to expedite the processing and sharing of data throughout the lab. These upgrades will also allow for flexible workspaces utilizing generic PC workstations while accessing all 3D applications from these centrally located servers. During this evolution, we continue our excellent relationships with corporate developers of 3D workstations/servers (e.g., GE Healthcare, TeraRecon, and Vital Images) who site their hardware and software in the 3DQ lab in anticipation of our feedback. These relationships continue to ensure that we maintain the most advanced multi-dimensional analytical technologies available. The lab continues to support the use of the MEDIS QMass® and QFlow® analysis software, which allow for enterprise collaboration when measuring cardiac output and analyzing muscle mass.

 

Conclusion

During this time of transition with regards to mission and resources, the 3DQ Medical Imaging Laboratory continues to function as an international leader in clinical care, teaching, and research in medical imaging analysis and quantitation. The confluence of talented medical and engineering expertise with the most up-to-date equipment has been a consistent source of innovation in diagnostic, monitoring, and treatment planning approaches.