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Softcopy diagnostic with 15MsP
super-high resolution displays
Kanazawa University Hospital
Kanazawa University Hospital introduced softcopy diagnostic environment
in 2005, the filmless diagnosis has reliably reduced workload.
Additionally, in July 2008, Kanazawa University Hospital installed 15MsP
super-high resolution workstations for mammography equipped with the ISD
Mr. Yamamoto (RT) and Dr. Kawashima (MED) answered our questions on the
Radiological Technologist Chief
Hiroko Kawashima -
Doctor of Medical Science, majoring Radiology
Development of medical treatment is a key role of university hospitals.
Please tell us about the current FPD mammography
Dr. Kawashima (MED)
With early FPD digital images, contrast of the mammary gland was painfully
low and lesions were not enhanced adequately enough for them to be viewed
clearly. The monitor manufacturer made numerous improvements, and now, we
are satisfied with the image quality.
tell us how you have decided to deploy the super-high resolution digital
mammography workstation into your facility.
Mr. Yamamoto (RT)
The development and improvement such as new treatment methods and new medical
devices are important roles for university hospitals. The budget is limited,
but as Dr. Kawashima said, working closely with the manufacturer is very
important for further improvement.
I am very familiar with the 15MsP mammography imaging system developed
by Dr. Ichikawa in our university and I am also familiar with the manufacturer,
TOTOKU. I also knew its mechanism and its image improvement effects through
the academic thesis and the exhibition. Subsequently we introduced it to
our University Hospital for the purpose of image quality improvement.
Was there any concern in introducing the ISD technology since
it was the world's first technology of its kind?
Not really. As Dr. Kawashima already evaluated the image quality of the
15MsP system and I wanted to install the system to improve image quality
for our Radiologists.
from 5MP to 15MsP
Cooperation between the manufacturers was integral for our success."
You have installed the 15MsP super-high
resolution mammography workstation from Climb Medical Systems Inc., and it
was integrated with your current image management system from a different
manufacturer. Please tell us about the current conditions.
We completed the digitalization of our department after the construction
of our new central building. Subsequently, we deployed a filmless environment
quickly and efficiently with help from other departments. Overall, it was
a positive change that we executed fairly flawlessly. Softcopy diagnostics
has introduced substantial improvements to our hospital as we predicted.
Most of the old devices for film diagnosis environment have been removed,
and now, we have enough space to work comfortably. We really don’t want to
go back to the old environment.
Was there any concern with deploying the super-high resolution
Initially, we were using 5MP workstations that were manufactured by the
same OEM as our Picture Archiving and Communications Systems (PACS). We
were concerned that by installing the new Totoku Display System, we would
have compatibility issues between the new displays and our existing PACS.
That wasn’t the case at all. The new 15MsP display system perfectly integrated
with our existing PACS.
As Dr. Kawashima said, we have introduced Climb Medicals’ workstation only
for mammography, and was attached to our current system which was manufactured
by a different OEM. The DICOM standard made integration easy. However,
when you have multiple vendors involved it has the potential to be difficult,
and it wasn’t.
As a result, the change was made successfully without any major setbacks
and the system continues to operate properly.
Please tell us about your current mammography system using the
The image taken by the digital mammography system is transferred to the
image server to be stored. To interpret the stored image, the image is
called up on the 15MsP diagnostic workstation. Then the diagnostic report
is transferred to our information server through the report server. Also,
radiographers use the old 5MP workstation to check the image. Both the
workstation and the image management station receive the same image.
of super high-resolution display
We fully expected the image quality would be improved with the 15MsP ."
|This 15MsP display equipped with
the ISD technology achieves three-times the resolution of today’s most
Please share with us what you saw and experienced with the 15MsP
Although I didn’t see significant difference between the 15MsP and the
conventional 5M displays as the resolution difference between respective
displays represents, the image quality was dramatically improved
with the 15MsP. I believe the 15MsP display will make it easier
to find micro-calcifications without panning and zooming. This is a value
to me since it saves time. It is my professional opinion that there is
still a significant difference between the 15MsP and 5M displays
because the 15MsP display has the advantage of fully utilizing information
included in the digital image that the 5MP display does not.
of super high-resolution display
In addition to the digital advantages, disadvantages against films are
special AR coating of the 15MsP display offers improved properties
focus, and contrast, achieving film-like black.
It has taken a very long time for digital imaging to catch up with the
quality of film. Totoku’s ISD technology has brought us that much closer
for confident softcopy reads. As previously mentioned, image quality can
reach optimal levels when not only the display, but also the entire PACS
system is also upgraded.
I agree Dr. Kawashima. In addition to the overall efficiency that digitalization
brought us, the image quality is now nearly comparable to film.
Thank you very much. We, as a manufacturer, are very glad
to hear that. Considering the increase in image data, what is your opinion
about the display speed of the 15MsP display?
Display speed has significantly improved. For example, it took much longer
for the old workstations to display two different images on one screen
at the same time. However, because of hardware and software improvement
the display speed is much faster on the 15MsP display. Subsequently,
it takes less time to interpret images. The amount of time it frees up
is immeasurable and positive for increased workflow.
of super high-resolution displays
" Panning and zooming to find micro-calcifications can be intense
and stressful. Totoku’s 15MsP display alleviates that stress. ”
are you interpreting the image?
Basically, I use two displays, dividing the two screens lengthwise
to display four images. When I first open an image, I prefer to display
it a bit smaller than fit-screen. Prior to having the 15MsP, I had to
display the image at the same pixel size to detect small micro calcifications.
Now with my new 15MsP, most of the micro-calcifications can be detected
on the initial screen. Furthermore, in instances where the modality captured
a poor images, we can still detect the micro-calcifications without zooming.
speaking, would you say that our 15MsP system has exceeded your expectations?
Yes, I think so. Actually, I have no complaints.
Do you use the Zoom function at all with the 15MsP?
I zoom up the image later after all, but it is good that we are free
from the stress that we have to magnify the image to find micro calcifications.
I don’t use the zoom function of viewer software application as I always
lose where I’m viewing. In order to see the detailed image, I magnify
the entire image and slide it to look at the entire image. This is much
faster and makes fewer errors by virtue of oversight in my opinion.
You mean that you display MLO/CC images on divided four screens
using two displays, and then use the pan function to look at
the image displayed on the divided screen. We think that it is perfect
for the 15MsP display because it has less image degradation.
Oh, I see. That's right.
" It is important to pursue the further
improvement and introduce the new technology. I hope manufacturers can
work more closely in a standardized
As I said before, at first, we were unable to obtain the high quality image
when we just introduced FPD. However, as we work with the manufacturer,
improvements have been made. Of course, we believe there is always room
for improvement. It is important to continue development of new technology.
Digitalization has been deployed in most of the major facilities with success.
Seamless integration among hardware and software systems is critical for
that success. It is my hope that manufacturers work together to remove
the barriers and strive for standardization.
you very much for your time.
The central hospital of Hokuriku Medical District has 150 years of history
and tradition that started when the Kaga Domain established the Vaccination
Center in Kanazawa Hidoso in 1862. It’s based on a basic philosophy of
fostering medical care for people with a rich sense of humanity as well
as providing the finest medical care.
1,485 staff members (71 teachers of graduate school of medicine doubling
as university hospital and others)
385 doctors, 173 medical engineers, 775 nurses, 136 administrative staff,
832 beds, 31 diagnostic and treatment departments