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Influence of Enhanced Visualization Processing (EVP) of Chest Images on Workflow

Influence of Enhanced Visualization Processing (EVP) of Chest Images on Workflow.

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Influence of Enhanced Visualization Processing (EVP) of Chest Images on Workflow

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  1. Influence of Enhanced Visualization Processing (EVP) of Chest Images on Workflow

  2. PROJECT PARTICIPANTSElizabeth Krupinski, PhD 1Martin Radvany, MD 2Alan Levy, MD 2Daniel Ballenger, MD 2Jonathan Tucker, PhD 2Anna Chacko, MD 2Richard VanMetter, PhD 31 University of Arizona Tucson, AZ2 Brook Army Medical Center San Antonio, TX3 Kodak Health Imaging Rochester, NY

  3. EVP • Increase latitude without reducing contrast needed for diagnostic details? • Acquire CR images traditional way • Process with Kodak CR system • Default processing with nonlinear edge enhancement

  4. EVP • Automatic tone scaling algorithm PTONE (perceptual tone scale) • Image analysis • Tone scale generation • Tone scale application • Utilizes Perceptual Linearization • EVP applied after analysis & generation, before application

  5. EVP • Divides image low & high-frequency component images • Contrast low-frequency reduced, increasing the latitude • Contrast high-frequency enhanced,preserving diagnostic detail • Images recombined & PTONE applied

  6. Preference Study • Van Metter & Foos SPIE 1999 • 70 images, 10 radiologist • Side-by-side comparison • EVP satisfactory or better than control images (92.6% vs 55.6%) • More control images unsatisfactory (4.0% vs 0.6%)

  7. Current Hypothesis • EVP will improve workflow • Reduce use image processing • Reduce time using processing • Reduce overall viewing time

  8. Materials & Methods • BAMC summer 2000 • Kodak CR 400 System with EVP • Fuji CR system without EVP • Portable chest images - 4 ICUs • 1 ICU each day for Kodak => mix of both each day • R & L lead markers on Kodak • Send through PACS

  9. Reading Procedure • Did not alter normal reading routine • Used window/level etc. • Used zoom • Reports dictated • Proceeded own pace

  10. Observation • Digital video security camera • VCR • Date & time stamp • Radiologists turned on • Showed ID badge to camera

  11. Panasonic WV-BP330 - 768 x 494 pixels - 30 frames/sec - SNR = 50 dB - Minimum illumination 0.08 lx at F1.4 with automatic gain on Sony VCR & Monitor

  12. Data Analysis • 66 Kodak & 75 Fuji cases • 4 radiologists • 1 = 23 Kodak, 25 Fuji • 2 = 21 Kodak, 25 Fuji • 3 = 17 Kodak, 22 Fuji • 4 = 5 Kodak, 3 Fuji • Videotapes reviewed: viewing time & frequency use of image processing

  13. Viewing Time F = 6.271, p = 0.0135 all readers F = 13.58, p = 0.0003 # 4 out

  14. Zoom & Processing • Zoom • 64% Kodak cases & 69% Fuji cases • X2 = 0.51, df = 1, p > 0.05 • Window/level etc. • 35% Kodak cases & 41% Fuji cases • X2 = 0.49, df = 1, p > 0.05 • No significant differences in usage frequency

  15. Zoom Time Zoom : F = 9.26, p = 0.0028 Modality : F = 9.19, p = 0.0029

  16. Processing Time Processing : F = 17.61, p < 0.0001 Modality : F = 18.73, p < 0.0001

  17. Conclusions • Workflowsignificantly improved with EVP ~ 13 sec on average / case • Savings of 22 minutes / 100 cases • Does not reducefrequency of image processing use • Time associated with use is reduced significantly

  18. Caveats • Not a diagnostic accuracy study • ROC study could address this • Used only chest images from the ICU • Image & diagnostic task may influence EVP impact on workflow

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