1. Digital Echocardiographic studies are easy to archive
in an organized hierarchical system
Videotape cassettes contain 2-h recordings of multiple consecutive
studies, making the search of an individual study time-consuming.
In contrast, digital echo studies are organized in a digital
archive, which permits instantaneous search and retrieval.
2. Digital Echocardiographic study images and report
features are easy to query
This archival system also allows query by dates, name, medical
records, specific diagnosis and individual demographics, a
powerful research tool. Exam review is improved by higher/stable
image quality, random access to images/views in a study, and
rapid comparison with prior studies.
3. Easy editing
Videotape studies contain redundant information and frequently
segments of suboptimal image recordings, thus requiring 15-20
min for review. Conversely, digital studies can be edited easily,
off-axis and poor quality images deleted, allowing extra time
for more in-depth review of the important findings. Clerical
errors can be easily corrected (incorrect patient’s identifiers,
etc..) and when necessary patient identifiers can be removed
in accordance with HIPPAA regulations.
4. Easy side-by-side comparison
Navigation from specific point-to-point is difficult in videotaped
studies, and requires repeated rewinding and replays. Since
finding a given view can take long time, the reader needs to
rely primarily in images retained in memory. Digital echocardiography
permits quick point-to point navigation by clicking in the
desired image thumbnails.
5. Easy retrieval of older studies
Review of older studies on a patient is often important, but
requires significant time and effort and is rarely done in
a busy laboratory. Videotape libraries may be far, tapes are
often misplaced or missing and then tapes need to be scanned
until the study of interest is found. In digital echo, an older
study can be found with a click of a bottom and retrieved within
seconds to few minutes. Several studies can be reviewed easily
and even compared side-by-side. This is particularly important
when comparing subtle abnormalities such as change in size
of a pericardial effusion, wall motion abnormalities, etc.
6. Easy off-line analysis
Quantification is simpler with DICOM calibration information
allowing direct measurements that in turn promotes generation
of elect ronic reports and databases.
Digital echocardiography also facilitates meaningful telemedicine
consultation and research applications. With the development
of a large database, users can search records for unique combinations
of findings or measured parameters easily, not only deriving
quantitative information but also the raw data and images for
subsequent review and extended analysis.
6. Remote diagnosis
Remote diagnosis and consultation via telemedicine is a great
potential advantage of digital echocardiography. Studies performed
at a primary care hospital, ambulance or emergency department
can be sent to a tertiary referral center for interpretation.
The accuracy of digital compared with videotape echo studies
has been previously demonstrated.
The feasibility of tele-consultation has been demonstrated from
remote communities to a tertiary facility. In this series,
83% of studies provided accurate diagnostic information, with
most inaccuracies caused by the selection and transmission
of a reduced number of images containing incomplete information.
Although no significant morbidity was attributed to inconclusive
transmission, this study highlights the importance of appropriate
selection of diagnostic and complete digital studies.
8. Simultaneous viewers
Several readers are capable of reviewing the same study simultaneously
from multiple locations, such as during case conferences, sending
selected views to referring physicians and patients on a disk
or via e-mail.
References
Thomas JD. Digital storage
and retrieval: the future in echocardiography. Heart 1997;
78(suppl 1):19-22.
Mohler ER, Ryan T, Segar
DS, et al. Comparison of digital with videotape echocardiography
in patients with chest pain in the emergency department. J
Am Soc Echocardiogr 1996; 9:501-508.
Sobezyk WL, Solinger
RE, Rees AH, et al. Trans-telephonic echocardiography: successful
use in a tertiary pediatric referral center. J Pediatr 1993;122:S84-S88.
| ASE
Documents and Guidelines Dedicated to Digital Echo |
| |
Digital
Signal and Image Processing in Echocardiography |
| |
Digital
echocardiographic laboratory: Where do we stand? |
| |
| ASE
Educational Resources on Digital Echo |
| |
Going
Digital: A Real-World Experience
Excerpts from an article by James D. Thomas, MD, FACC, Neil L. Greenberg,
PhD, and Mario J. Garcia, MD, FACC from the The Cardiovascular Imaging
Center, Department of Cardiology,Cleveland Clinic Foundation, Cleveland,
Ohio. This article will appear in JASE in early 2003. |
| |
|
| Digital
Echo Archives |
| |
May
2000 President's Message: Aequanimitas: Lessons From
Sir William Osler |
Download the following resources:
The Digital Echocardiographic
Laboratory: Clinical Benefits
and Improved Efficiency at the
Michigan Congenital Heart Center - Applications in Cardiac
Imaging
Achi Ludomirsky, MD - Download PDF of Article
Dr. Ludomirsky is a Professor of Pediatrics and the Director
of Echocardiography,
Michigan Congenital Heart Center, University of Michigan. Ann
Arbor, MI. This article contains a great description and interesting
pictures.
Understanding the Need for and
Use of Digital Echocardiography
Geoffrey A. Rose, MD, FASE - Download PDF of Article
Dr. Rose is the director of the Cardiac Ultrasound Laboratory
Sanger Clinic/Carolinas Medical Center Charlotte, NC. This
is a great introductory paper on the digital lab.