Geneva University Hospital. Filling the Image Analysis
Needs of 15 Clinical Departments.
A Revolution in Diagnostic Workflow
The arrival of the Mac systems with the intuitive Mac OS X operating system and the powerful OsiriX GUI opened the floodgates of 3D image analysis and revolutionized workflow in the clinical departments. They quickly became a crucial everyday component of clinical conferences, surgical planning, and tumor board meetings.
“The orthopedists were very excited,” says Ratib. “As soon as the head of the department got a Mac Pro on his desk, everybody wanted one.”
Dr. Robin Peter, an orthopedic surgeon and associate professor, explains this enthusiasm.
“In the past, we were able to get digital images onto our screens and review them with the simple imaging tools the hospital provided. If we wanted to do 3D reconstruction, we had to go to the Radiology department’s workstations. You usually needed the help of a technician – if one is available – because the application is complicated to use on those workstations. Even if you bought one of these workstations, which cost up to $40,000, the software would be obsolete in two years. And you would still need the help of a technician.”
Today Peter has an iMac on his desk running OsiriX, which he finds sophisticated and easy to use. He pulls images off the hospital PACS up to ten times a day and does 2D and 3D manipulations to plan treatment. Because he works with very complex structures, image reconstruction is an enormous help. The insight it provides enables him to avoid having to strip attachments from the bones, making surgeries much less invasive.
“Soon after we got our Mac systems and OsiriX,” says Peter, “they brought in a 32-year-old woman who had been skiing in the Alps. She had a complex acetabulum fracture of the pelvis. We did a reconstruction with OsiriX and discovered a small piece of bone, broken off and hiding behind the fracture. We changed our approach. We would never have been able to put these fragments back into position without the 3D view that OsiriX gave us.“
Clinicians in other departments also began pulling DICOM images from the hospital PACS and rendering them for 3D analysis. They were also able to pull up images that had been processed by radiologists on other imaging workstations. With OsiriX they easily opened and displayed DICOM CDs and DVDs created on outside scanners – the end of a longtime pain point. Tumor boards began to rely on the Mac and OsiriX for radiology reviews, viewing ultrasound, angiogram, echocardiogram, CT, PET-CT, or MRI images, and fusing images when needed, to make clinical decisions in patient management.
“The physicians in Neurosurgery really liked the ease of use of both the Mac and OsiriX,” says Ratib. “The head of Neurosurgery has his own Mac running OsiriX, and so do most of the surgeons. The head of Neurology saw it and bought one for his own office. And the Cardiovascular department likes this solution because they can look at images from all modalities on a single Mac.”
The Road Ahead: Extending the Mac/OsiriX Presence
Professionals at the hospital are finding other ways to put the Mac/OsiriX combination to work. The hospital is currently remodeling its operating rooms, and surgeons have requested the addition of Mac systems running OsiriX. The Anatomy Department is using three Mac systems and OsiriX to create curriculum, using data from the Visible Human project and other sources with higher resolution scans of the human body. The many pre-med students with their personal MacBook can now use it to learn general 3D anatomy.
“If we teach anatomy on the Mac through OsiriX, we win twice,” says Ratib. “We win because they learn anatomy through 3D volumetric rendering, which is the way anatomy should be learned. But they also learn to use a radiology tool that they will use later in their clinical practice. The head of Anatomy is very excited about it.”
Meanwhile, the OsiriX user base just keeps growing. The first version was released in 2004; today OsiriX is in active use on 37,000 Mac workstations around the world.
