3D Mouse to Help Radiologists "Feel" Images is Among Technological Promises
 Erik Vidholm, Ph.D., headed the research team that developed software tools that utilize the 3D mouse that allows researchers to analyze and "feel" virtual organs to determine their size—a technology called haptics. Dr. Vidholm works with the haptic pen at the specially constructed work station that can show stereographics. |
 Adaptation of a computer model to an image of a liver. With the aid of the adapted model it is possible to measure the volume of the liver, for instance, or calculate changes in shape and migrations. Images courtesy of Uppsala University. |
Radiologists could one day have access to technology that allows them to analyze images and "feel" the resulting organs with a 3D mouse.
Although the 3D mouse is still in the research and development stage, other new technologies are available now, including one that allows radiologists to connect to an iPAD interface to make image annotations stored in a searchable repository.
"iPAD: A Tool for Creating Semantic Annotations in Radiology Images," is among the scientific papers scheduled for presentation at RSNA 2009. Also featured will be, "Imaging Suite Workflow Orchestration Dashboard" and "Medical iPhone Applications: A Systematic Review of Present Applications and a Look at Future Directions with a Focus on Radiology."
Such devices have different applications, but all share one common denominator—they are designed to help radiologists do their jobs better, faster and more efficiently.
"Feeling" Virtual Organs Could Aid in Cancer Diagnosis
The software tools that utilize a 3D mouse allowing researchers to analyze and "feel" virtual organs to determine their size were developed by a research team headed by Erik Vidholm, Ph.D., who said the technology could lead to easier diagnosis and treatment plans for patients with cancer. Called haptics, the technique interfaces with the user via the sense of touch through force, vibrations and/or motion.
Dr. Vidholm worked on the project as a doctoral candidate at the Center for Image Analysis at Uppsala University in Sweden.
"We started the project in order to find out if a 3D device had the potential to reduce the amount of time radiologists and physicians spend manually contouring organs in medical image datasets," he said. "We have developed a number of semi-automatic tools for contouring where 3D interaction with haptics is a central part.
"One example is deformable model segmentation, by which we use surface meshes that can adapt to image data," Dr. Vidholm continued. "By using the device, the user can push and pull the surface in 3D in order to guide it during the adaptation process."
The device is designed as a stylus that the user holds and manipulates like a regular pen. Forces are generated to the user from a number of fast step-motors in the device.
"We calculate the forces based on a combination of how the user moves the stylus and the characteristics of the medical image data at the stylus position," Dr. Vidholm said. "This way we can, for instance, simulate hard and soft tissue."
No longer involved in the project, Dr. Vidholm said research and development continues on the device, which he hopes to see on the market in about five years.
iPAD Helps Physicians "Describe" Lesions
The iPAD tool was designed to overcome a significant problem in imaging—medically important content such as anatomy, radiology findings and quantitative features, are not recorded in a way that machines can easily access this information.
"iPAD provides a way for radiologists to more efficiently and more completely describe the lesions they see in images," said creator Daniel Rubin, M.D., M.S., an assistant professor in the Department of Radiology at Stanford University, who will outline the advantages of this technology at RSNA 2009.
iPAD is a plug-in to the popular OsiriX image viewing workstation and implements the annotation and image markup (AIM) standard of the National Cancer Institute's Cancer Biomedical Informatics Grid (caBIG) project.
Using iPAD, a radiologist can draw an annotation indicating a lesion on an image. Behind the scenes, iPAD records this information in the AIM format, which can then be stored in a database or serialized to DICOM-SR, making it more widely available to fellow radiologists.
"This allows us to perform functions like retrieving all images of lesions with particular characteristics," Dr. Rubin said. "There is a close relationship between structured reporting and what iPAD is capable of doing. iPAD essentially provides a reporting template for radiologists to fill out to describe the characteristics of the abnormalities they see in images."
iPhone Study Reveals Breadth, Utility and Price of Applications
The iPhone study to be presented at RSNA 2009 examined the benefits to radiologists of certain iPhone applications geared toward the medical community, including viewing applications to help provide timely consultations and increase response time to referring clinicians.
 Daniel Rubin, M.D., M.S. Stanford University |
 Krishna Juluru, M.D. Cornell University |
The impetus for the study came from several RSNA annual meeting presentations in recent years that demonstrated novel iPhone technologies for medicine. Krishna Juluru, M.D., and colleagues at Weill Medical College of Cornell University in New York and the University of Pennsylvania School of Medicine in Philadelphia decided to examine the full breadth of medical applications available, including the average cost.
His group split the medical applications category into seven subcategories: viewing applications, communications, business, education, clinical utility, medical reference and non-radiology.
Researchers found 303 applications in the medical applications category, four of which were not included in the study because they were in foreign languages. Another 135 that researchers deemed to not have much relevance to radiology were placed in the last subcategory.
The study revealed many useful applications in the other six subcategories, including some that would be valuable to both physicians in private practice and those working in an academic setting. Applications of highest interest were those enabling viewing of radiographic datasets.
"The viewing applications would be very useful to both groups," said Dr. Juluru. "If you're a private practitioner running a small group, clinicians may call you for quick consults at times you do not have direct access to your PACS workstation. These iPhone viewing applications can help provide timely consultations and increase response time to referring clinicians."
Applications in the medical reference subcategory were the most expensive, averaging $41 per application. The next highest average was the business category at $20.50, which included such applications as a coding and billing guide. Clinical utility applications, such as a drug guide, were the least expensive, at an average of $2.37.
Researchers discovered that iPhone applications are not only about viewing imaging data, but they can also provide decision support, increase operational efficiency, promote patient safety and improve productivity.
The next step is to learn the limitations for these medical applications, Dr. Juluru said.
"Do they provide the level of diagnostic detail for accurate interpretation, or should they really be used for a general review to provide a preliminary read or confirm a finding, before a final read?" he asked. "That's a study that's just waiting to happen."