WorkstationOne. - a diagnostic breast imaging workstation. User Training Presentation. doc #24 (v2.0) Let MammoOne Assist You in Digital Mammography

Transcription

1 WorkstationOne - a diagnostic breast imaging workstation User Training Presentation

2 WorkstationOne Unique streamlined workflow for efficient digital mammography reading Let MammoOne Let MammoOne Assist You Assist in Digital You in Mammography Digital Mammography 2

3 Device Description The WorkstationOne is a vendor-neutral diagnostic breast imaging workstation which consists of a software system that obtains breast imaging screening or diagnosis exams from PACS or Modalities; displays and manipulates the images for radiologists to perform interpretation task for breast cancer screening and diagnosis. The workstation can also interface with a reporting system to generate an interpretation report. Optionally, the workstation supports media exchange and film printing.

4 Principles of Operation The aim of the design of the workstation is to maximize the radiologists efficiency as well as accuracy in order to enhance the level of the patient care: Follows IHE integration profiles, specifically, the MAMMO profile (Mammography Image Profile) to support enterprise workflow; Pre-fetches images based on an interpretation worklist in order to manage high throughout; Uses DICOM communication to move the source images, the CAD SR reports and the GSPS graphic annotations; Automates the mammography specific interpretation workflow to improve reading efficiency; Manages mammography specific hanging protocol Displays and manipulates the images, and Generates the recall and screening reports.

5 Multi-modality Display MG (digital mammography), either lossless compressed or non-compressed DICOM images. CAD SR (structure report) as an overlay over the image GSPS graphic annotation as an overlay over the image Digitized prior mammogram film images Breast US (ultrasound) images Breast MR (magnetic resonance) images Associated documents, such as, referring doctor s letter, notes and previous Recall or screening SC reports

6 Protocol Automation Automation of the mammography specific protocol includes: Automated image orientation and chestwall alignment for the mammography Automated size calculation so multiple images can be displayed at the same relative physical size Automated hanging protocol (standard 4-view, extra view, implant etc.) Single key/button for navigating the mammographic viewing protocol Single key/button for navigating the mammography screening hanging protocol sequence

7 Image Functionality The workstation provides the following functions to be performed automatically or operated by the users: Image layout Image manipulation Image quantification Graphic or text annotations Markup and assessment

8 User View - Worklist

9 User View Reading Workflow Overall viewing Quality check Systematic viewing All pixel viewing Finding review and report

10 User View - Navigation The reading protocol is stepped through using the button with the forward icon: When configured this way and there is more than one prior study, all the prior studies can be navigated using the circular loop icon: A user can navigate one step backwards in the protocol using the button with the backward arrow icon:

11 Reading Workflow - Overall Viewing The workstation displays the standard four views of a mammogram from both the current and prior exams based on the configured hanging protocol. Whenever a prior exam is displayed simultaneously with the current exam, the images in the current exam are framed by a bold bounding box in order to ensure that the radiologist makes his diagnosis on the current exam (see the following figure).

12 Overall Viewing Example

13 Reading Workflow Image QC If the QC Check protocol step is configured on, the user is prompted to review the current study for any missing images or images of insufficient image quality. There are a number of layout selections for displaying the images from the current study. A popup dialog can be configured to display a QC dialog as a reminder checklist to the user.

14 Reading Workflow - Current/Prior The user is able to step through comparison of the current and multiple prior CC and MLO views individually, or views on each side of breast, based on the user s preferences. For example, the user can view the right current and prior CC and MLO views side by side, followed by the left current and prior CC and MLO views side by side, as shown in the following figures.

15 Current/Prior Comparison Example

16 Reading Workflow - Systematic Viewing The systematic perception viewing approach is based on the expert viewing methodology that has been developed for viewing films. The idea of the systematic viewing is to use three types of masks to enhance perception of subtle radiographic abnormalities: a horizontal mask, a vertical mask, and an oblique mask. By use of these masks, special attention can be given to asymmetric densities in regions with a high probability of malignant lesions.

17 Systematic Perception Viewing Example

18 Reading Workflow - All Pixels Viewing The purpose of the all pixels viewing step is to provide the ability to view all the actual pixels in the images, with optimal reading speed. A grid is shown over the images, and the user can easily scroll through the grid boxes (magnified so that each pixel in the underlying image is shown - see the following figure as an example).

19 All Pixels Viewing Example

20 Finding Interpretation and Report This step in the reading protocol displays a summary of any user markups made during the previous steps. A markup can be assessed by selecting the Assess Markup menu The markup can be removed or kept by the user. If available, CAD marks can be toggled on / off by selecting the CAD ON or CAD OFF button. A recall report can be generated using the Recall Form button, which results in the display of a recall summary report (see an example following).

21

22 Reading Workflow Open Next Study Once the review of a study is complete, the user can navigate to the next study by selecting the forward icon.

23 Viewing Multiple Priors If multiple prior studies are available for viewing, they can be viewed sequentially in the protocol. In the Overview step, the first screen shows the current study and the most recent prior study. The next screen shows the current study and the second most recent prior study. When configured (uncheck Step through more than 1 prior study in the configuration), all the prior studies can be navigated using the circular loop icon, and the step forward icon only shows the most recent prior study. The same workflow approach is provided in the Compare step.

24 Viewing Diagnostic Studies The system provides 8 diagnostic layouts to automatically arrange up to 4 studies (1 current study plus 3 prior studies) on a same display screen for side-by-side comparison of the changes to a possible abnormality. An additional 12 diagnostic layouts are provided for the user to manually arrange a larger number of studies with up to 24 diagnostic images on a same display screen. Viewing diagnostic studies is integrated with the screening viewing protocol.

25 Viewing Diagnostic Studies

26 Viewing Documents Documents (such as previous reports or referring physicians letters) stored as DICOM Secondary Capture (SC) can be viewed on the screen displaying the worklist. When documents are available, the Doc folder icon is high-lighted, and the documents can be accessed by selecting that icon.

27 Viewing Documents

28 Viewing Ultrasound Images

29 Viewing MR Images

30 User Interaction Tools Two sets of tools are provided for users to interact with the images: Tool buttons Drop-down tool menu Key-code shortcuts are provided for these tools

31 User Settings The site and user preferences can be set to optimize the use of the workstation (accessed by clicking the middle round button in the upper left hand corner of the navigation screen). The configuration option include: Worklist View Sequence Diagnostic Hanging Protocols User Controls Key Codes Connectivity

32 Hardware Requirements WorkstationOne is a software system that can be installed on an off-the-shelf general purpose computer with one or two gray-scale high-resolution monitors and one color monitor. In the United States, WorkstationOne must be used with monitors cleared by the FDA for the review of mammographic images. The high-resolution monitors are used to display digital mammography images and associated overlays for the purpose of primary interpretation by radiologists. The color monitor is used for selecting studies, displaying color images, navigating the workflow, and other user interface elements.

33 WorkstationOne at Las Vegas Conference Let MammoOne Let MammoOne Assist You Assist in Digital You in Mammography Digital Mammography 33