1. Garry Choy, MD; Supriya Gupta, MD; Onofrio A. Catalano, MD; Michael P. Wejkszner, RTR; Ronald S. Arellano, MD; Debra A. Gervais, MD; Peter R. Mueller, MD; Dushyant Sahani, MD
Designing an Interventional CT Suite to Meet the Current Demands and Future Expectations
MASSACHUSETTS GENERAL HOSPITAL • Department of Radiology • HARVARD MEDICAL SCHOOL
The purpose of this exhibit is to discuss the evolution
of the Interventional CT Suite.
We will discuss the emerging trends in image-
guided procedure for oncologic and non-oncologic
applications.
We will also review the latest new technologies that
improve image-guided procedures and technologies
to improve workflow.
POST-PROCEDURE
• Electronic dashboard to facilitate and track follow-up,
any necessary consults, lab results, and transfer
• Automated test ordering such as pathology, chemistry
and microbiology for specimens that have been obtained
• IT-based result tracking and alerts to close clinical
work-up loop and enhancement of follow-up
• Quality and safety
• New tools during CT guided procedures
• Fusion Systems, flat panel systems, and novel
configurations for image-guidance
• Better visualization during procedures
• Workflow improvement and optimization
SUMMARY
The major teaching points of this exhibit are:
• Continued innovations in procedural-based radiology improve accuracy, ease of performing procedure, and quality of patient care
• Interventional radiology suites of the future are already here
• Next generation interventional radiology technologies are actively being developed by academic institutions and vendors
• Time out / RFID Improved“Time out”process via IT
• Integrated overhead display with vital sign
monitoring and PACS with fusion and multi-
planar reconstruction capability
• Real-time cumulative radiation dose monitoring
• Robotic guidance
• Voice-based commands of overhead display or
headsets to better facilitate with technologists
and other staff involved
• Advanced applications tailored to each procedure
such as RFA and volume kill
• New room configurations that faciliate near-
simultaneous multi-modality image-guided
proceduresThe volume in CT guided interventions at our own institution has been steadily increasing
TRENDS IN INTERVENTIONAL CT
PRE-PROCEDURE
• Computerized Order Entry
• Electronic dashboard to enhance scheduling,
utilization, communication, and quality/safety.
The electronic dashboard is omnipresent, it can be
displayed at attending’s desktop, on a large screen in
procedure area, mobile [iPhone], or procedure room
prior to procedure.
• Evaluate patient and complete use of EMR for
pre-procedure labs, allergies, and other relevant
clinical information
• Automated screening for safety/adverse reaction/allergies
• Prefetching of patient’s studies from PACS for pre-
proceduring planning and intra-procedure guidance
• Patient name on overhead display on CT
INTRA-PROCEDURE
Electronic dashboards
enhance scheduling,
utilization management,
communciation, quality,
and safety. For example,
dashboards can be displayed
in numerous patient care
settings: mobile devices,
procedure area, interventional
suite, and physician's
computers.
Electronic dashboards
enhance scheduling,
utilization management,
communciation, quality,
and safety. For example,
dashboards can be displayed
in numerous patient care
settings: mobile devices,
procedure area, interventional
suite, and physician's
computers.
improve patient safety
Image above demonstrates how IT will be utilized to improve patient safety.
CT scanner and overhead display screens are playing significant roles in
identifying the patient, facilitating a "TIME OUT," and ensuring that allergy
information is readily available.
improve patient safety
Image above demonstrates how IT will be utilized to improve patient safety.
CT scanner and overhead display screens are playing significant roles in
identifying the patient, facilitating a "TIME OUT," and ensuring that allergy
information is readily available. Multi-Modality IMAGE GUIDANCE
Illustration of intra-procedure heads-up display enabling interventional
radiologist to utilize fall information from multiple modalities (CT,
Ultrasound, PET) and multiplanar reformations (MPR). Targeting of lesions
will be improved by real time use of all available imaging.
Multi-Modality IMAGE GUIDANCE
Illustration of intra-procedure heads-up display enabling interventional
radiologist to utilize fall information from multiple modalities (CT,
Ultrasound, PET) and multiplanar reformations (MPR). Targeting of lesions
will be improved by real time use of all available imaging.
Mobile
Applications
For a busy
interventionalist
on the run, mobile-
based scheduling
dashboards
can improve
throughput in a
busy practice.
Mobile
Applications
For a busy
interventionalist
on the run, mobile-
based scheduling
dashboards
can improve
throughput in a
busy practice.
AutomatedPost-Proceduretasks
Post procedure, work-flow will also be
facilitated by information technology.
For example, post-procedure
checklists and automated lab ordering
systems can be deployed.
AutomatedPost-Proceduretasks
Post procedure, work-flow will also be
facilitated by information technology.
For example, post-procedure
checklists and automated lab ordering
systems can be deployed.
Critical results alert
Important finding alert
systems via mobile devices
can also be employed to
notify the interventionalist
of critical lab results.
Critical results alert
Important finding alert
systems via mobile devices
can also be employed to
notify the interventionalist
of critical lab results.
Radiation Dose
Monitoring and Alert
Image Fusion
Interventional CT Suite of the Future
PURPOSE/AIM