Operations Management

Establishing and Running a Three-dimensional and Advanced Imaging Laboratory

Published Online:Oct 10 2018https://doi.org/10.1148/rg.2018180058

Abstract

A dedicated three-dimensional and advanced imaging laboratory is an important resource for postprocessing both clinical and research imaging examinations for an imaging practice that performs a large number of studies requiring this postprocessing; careful planning and regular monitoring of laboratory operations are necessary to ensure that stakeholders’ needs and expectations of output quality are met.

Multidetector CT technology has advanced during the past 2 decades from single-digit numbers of sections to 320-section CT scanners. The ability to perform three-dimensional (3D) postprocessing of acquired data has accompanied this technical progress. Multiple considerations are involved in developing and deploying a 3D and advanced imaging laboratory to provide postprocessing for both CT and MRI examinations. Establishing and running a 3D laboratory requires administrators to buy into the process and also requires regular input from radiologists and other stakeholders. Technologists with prior 3D experience are rare, and extensive immersive training is typically required. Laboratory space and equipment must be maintained and updated regularly to continue to meet stakeholders’ needs. Postprocessing protocols must be established and reviewed periodically. Quality control is also necessary to ensure that postprocessing outputs adhere to the protocols. Laboratory technologists can also provide postprocessing support for research examinations and can lend their technical expertise to research projects. Regular review of laboratory productivity is essential to ensure longevity and availability of necessary resources (human, environmental, and technical). As the technologies for the imaging equipment, the picture archiving and communication system, and postprocessing continue to advance, the role of the 3D laboratory will also evolve to include other services. This evolution will affect ongoing training of technologists, as well as the requirements when new technologists are hired. The 3D laboratory is often positioned to take on novel technology and augment radiologists’ workflow as new modalities and techniques enter the clinical workflow.

^©RSNA, 2018

References

1. Dalrymple NC, Prasad SR, Freckleton MW, Chintapalli KN. Introduction to the language of three-dimensional imaging with multidetector CT. RadioGraphics 2005;25(5): 1409–1428.
Google Scholar
2. Perandini S, Faccioli N, Zaccarella A, Re T, Mucelli RP. The diagnostic contribution of CT volumetric rendering techniques in routine practice. Indian J Radiol Imaging 2010;20(2):92–97.
Medline Google Scholar
3. Yitta S, Hecht EM, Slywotzky CM, Bennett GL. Added value of multiplanar reformation in the multidetector CT evaluation of the female pelvis: a pictorial review. RadioGraphics 2009;29(7):1987–2003.
Google Scholar
4. Higashino T, Ohno Y, Takenaka D, et al. Thin-section multiplanar reformats from multidetector-row CT data: utility for assessment of regional tumor extent in non-small cell lung cancer. Eur J Radiol 2005;56(1):48–55.
Medline Google Scholar
5. Hong C, Bruening R, Schoepf UJ, Bae KT, Reiser MF. Multiplanar reformat display technique in abdominal multidetector row CT imaging. Clin Imaging 2003;27(2): 119–123.
Medline Google Scholar
6. Kocaoglu M, Bulakbasi N, Soylu K, Demirbag S, Tayfun C, Somuncu I. Thin-section axial multidetector computed tomography and multiplanar reformatted imaging of children with suspected foreign-body aspiration: is virtual bronchoscopy overemphasized? Acta Radiol 2006;47(7): 746–751.
Medline Google Scholar
7. Prokop M, Shin HO, Schanz A, Schaefer-Prokop CM. Use of maximum intensity projections in CT angiography: a basic review. RadioGraphics 1997;17(2):433–451.
Google Scholar
8. Fishman EK, Ney DR, Heath DG, Corl FM, Horton KM, Johnson PT. Volume rendering versus maximum intensity projection in CT angiography: what works best, when, and why. RadioGraphics 2006;26(3):905–922.
Google Scholar
9. Sørensen TS, Beerbaum P, Körperich H, Pedersen EM. Three-dimensional, isotropic MRI: a unified approach to quantification and visualization in congenital heart disease. Int J Cardiovasc Imaging 2005;21(2-3):283–292.
Medline Google Scholar
10. Tongdee R, Narra VR, Oliveira EP, Chapman W, Elsayes KM, Brown JJ. Utility of 3D magnetic resonance imaging in preoperative evaluation of hepatobiliary diseases. HPB 2006;8(4):311–317.
Medline Google Scholar
11. Li X, Liu X, Du X, Ye Z. Diagnostic performance of three-dimensional MR maximum intensity projection for the assessment of synovitis of the hand and wrist in rheumatoid arthritis: a pilot study. Eur J Radiol 2014;83(5):797–800.
Medline Google Scholar
12. Kawel N, Seifert B, Luetolf M, Boehm T. Effect of slab thickness on the CT detection of pulmonary nodules: use of sliding thin-slab maximum intensity projection and volume rendering. AJR Am J Roentgenol 2009;192(5): 1324–1329.
Medline Google Scholar
13. Gruden JF, Ouanounou S, Tigges S, Norris SD, Klausner TS. Incremental benefit of maximum-intensity-projection images on observer detection of small pulmonary nodules revealed by multidetector CT. AJR Am J Roentgenol 2002; 179(1):149–157.
Medline Google Scholar
14. Hata N, Wada T, Chiba T, Tsutsumi Y, Okada Y, Dohi T. Three-dimensional volume rendering of fetal MR images for the diagnosis of congenital cystic adenomatoid malformation. Acad Radiol 2003;10(3):309–312.
Medline Google Scholar
15. Sofia C, Magno C, Silipigni S, et al. Value of three-dimensional volume rendering images in the assessment of the centrality index for preoperative planning in patients with renal masses. Clin Radiol 2017;72(1):33–40.
Medline Google Scholar
16. Levin DC, Rao VM, Parker L. Trends in the utilization of outpatient advanced imaging after the Deficit Reduction Act. J Am Coll Radiol 2012;9(1):27–32.
Medline Google Scholar
17. Agarwal R, Bergey M, Sonnad S, Butowsky H, Bhargavan M, Bleshman MH. Inpatient CT and MRI utilization: trends in the academic hospital setting. J Am Coll Radiol 2010;7 (12):949–955.
Medline Google Scholar
18. Boland GW. Enhancing CT productivity: strategies for increasing capacity. AJR Am J Roentgenol 2008;191(1):3–10.
Medline Google Scholar
19. Mezrich R, Juluru K, Nagy P. Should post-processing be performed by the radiologist? J Digit Imaging 2011;24(3): 378–381.
Medline Google Scholar
20. Bücking TM, Hill ER, Robertson JL, Maneas E, Plumb AA, Nikitichev DI. From medical imaging data to 3D printed anatomical models. PLoS One 2017;12(5):e0178540. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0178540. Published May 31, 2017.
Medline Google Scholar
21. Mitsouras D, Liacouras P, Imanzadeh A, et al. Medical 3D printing for the radiologist. RadioGraphics 2015;35(7): 1965–1988.
Google Scholar
22. Eid M, De Cecco CN, Nance JW Jr, et al. Cinematic rendering in CT: a novel, lifelike 3D visualization technique. AJR Am J Roentgenol 2017;209(2):370–379.
Medline Google Scholar
23. Dappa E, Higashigaito K, Fornaro J, Leschka S, Wildermuth S, Alkadhi H. Cinematic rendering: an alternative to volume rendering for 3D computed tomography imaging. Insights Imaging 2016;7(6):849–856.
Medline Google Scholar
24. Ebert LC, Schweitzer W, Gascho D, et al. Forensic 3D visualization of CT data using cinematic volume rendering: a preliminary study. AJR Am J Roentgenol 2017;208(2):233–240.
Medline Google Scholar
25. Cook TS. Computed tomography angiography of the lower extremities. Radiol Clin North Am 2016;54(1):115–130.
Medline Google Scholar

Article History

Received: Mar 6 2018
Revision requested: Apr 26 2018
Revision received: May 24 2018
Accepted: May 31 2018
Published online: Oct 10 2018
Published in print: Oct 2018

Vol. 38, No. 6

Abbreviations

Abbreviations:
CPT	Current Procedural Terminology
DICOM	Digital Imaging and Communications in Medicine
MIP	maximum intensity projection
PACS	picture archiving and communication system
3D	three-dimensional

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