CVS (Cardiovascular Surgery)
For CVS, our process involves direct interaction with the nurses, administrative staff, and physician assistants who send us image requests. These requests are processed ahead of patient clinic appointments to ensure the requesting clinicians have the most up-to-date information for the patient’s clinic appointment . In many cases, patients are scanned just before their clinic appointment, on the same day, so we coordinate the completion of results within 1-2 hours. This allows patients and their providers to make treatment decisions during their appointments.
Measurements are entered into an online portal and graphed against previous data points. The tables are printed and reviewed on clinic day, and we provide in-clinic assistance for any real-time measurement queries. Physicians have their own access to our online portal and can place orders through EPIC.
Learn more about our aortic surveillance program here.
Figure A: An example of CVS measurements as they appear in the 3DQ Lab’s web portal; which is accessible to all CVS team members.
Neurosurgery
In neurosurgery, our technologists play an important role both in the clinic and the operating room (OR). Surgeons request digital models of patient anatomy and pathology to review with patients during their clinic appointments. If they decide to move forward with surgery, the models are then used for guidance in the OR.
The 3DQ Lab technologists are responsible for preparing the models and manipulating the software to display the requested anatomy. In the clinic, they assist surgeons by piloting the software to show the patient specific views and anatomy. In the OR, they integrate the model with the neurosurgical navigation system for real-time surgical guidance. Techs remain available throughout the surgery to make changes to the model as needed, ensuring the model displays exactly what the surgeon needs to see, when they need to see it.
Figure B: A surgeon is reviewing a model created by the 3D Lab. This process can be useful for familiarizing oneself with the patient’s anatomy, aiding in the formulation and communication of surgical approaches before surgery.
Prostate Biopsy
Our prostate biopsy process starts with a request for biopsy imaging through an Epic order. We contour the prostate and lesions in specialized biopsy planning software, following the radiologist’s annotations and report. This imaging is then labeled, verified, and sent to PACS.
We use a custom-built web portal to manage biopsy requests and radiologist review of contours. Upon radiologist approval, we upload files for the biopsy system to a secure shared folder.
Learn more about prostate biopsy here.
Figure C: An example of contours created on an axial MR, which the urologist will use as a guide during biopsy.
TAVR (Transcatheter Aortic Valve Replacement)
All measurements we make for TAVR planning are entered into our web portal. These include measurements of the iliac, subclavian, and carotid arteries for evaluation of access, as well as calculated angiography angles that help guide C-arm positioning for clear visualization of the aortic valve and radiation reduction. This data is summarized into tables that help the TAVR team quickly reference the information during treatment planning meetings and during the actual procedure.
These tables are shown alongside relevant images on a customized page of our web portal, which is accessible from the Cath Lab. This page is displayed on one of the monitors in the Cath Lab, avoiding the need to switch to PACS to display images. During TAVR meetings, now conducted over Zoom, techs present our imaging and measurements and provide any on-the-fly imaging needs.
The Cath Lab, where TAVR procedures occur, is a specialized OR equipped with a C-arm. Initially, 3DQ Lab techs brought a laptop into the Cath Lab and projected the custom-built web page to one of the Cath Lab monitors from it. We have since worked with hospital IT to allow computers in the Cath Lab to access our web portal, making this process smoother. We also convert the tables into DICOM images and send them to PACS for easy accessibility outside of the Cath Lab and firewall limitations.
Learn more about TAVR here.
Figure D: Example imaging and measurements that are uploaded to our web portal and used in the Cath Lab for reference.
TRAC (Tumor Response Assessment Criteria)
Our TRAC program leverages specialized software and integrations between different software to manage requests, manage workflow, and communicate results. Radiologists involved in the TRAC workflow can be automatically prompted by the software to check their worklist in the software when results are ready for their approval. Once approved, reports are downloaded and sent to EPIC and PACS. Reports can also be sent to the requesting Principal Investigator (PI) and Clinical Research Coordinator (CRC). This approach ensures data accuracy, efficient workflow, and timely delivery of critical imaging results, ultimately enhancing patient care and streamlining communication between various medical professionals.
Learn more about TRAC here.
Figure E: Example TRAC report that is used by healthcare professionals to understand the trajectory of a patient’s cancer response to various immunotherapy treatments.
