UNIQUE Image Processing Software - Philips

UNIQUETheImage Processing Softwareart of imaging

Welcome to themaster class of imaHave you ever looked at an X-ray image andthought that the human body is a work of art?Philips welcomes you to experience a master class inimage processing with UNIQUE. We have turnedmodern image processing into an art form.Examining an X-ray image is not unlike analyzingan old master, UNIQUE dissects even the thinnestlayer of paint, showing what really lies beneath thesurface – revealing its secrets.As an experienced practitioner you want an X-rayimage of the highest quality, showing diagnosticallyrelevant information in one single image, displayedas you want it and where you want it. This is exactlywhat UNIQUE delivers.UNIQUE is a sophisticated image processing technology. With over 100 years of imaging experiencewe have developed a solution that displays alldiagnostically relevant information in one singleimage, giving you more confidence in diagnosing.UNIQUE can do even more for you: it displaysimages just the way you want to see them, optimizedfor your diagnosis.2But from Philips you can expect more than just anexcellent image. We look at how you work indifferent departments, from trauma room toradiology, and we understand that flexibility andconsistency are key. Therefore with UNIQUE, itdoes not matter which digital Philips X-ray modalitythe image is taken with, the parameters for allsystems and detectors are the same, and can beviewed and evaluated from any suitable monitor,giving you flexibility and diagnostic confidence.UNIQUE reduces the patient dose and the needfor retakes. The result is a significant increase inworkflow efficiency. Manual procedures, likeapplying wedge filters, multiple processing todisplay all requested areas of the image or adjustingcontrast and brightness, become obsolete.Now from the theory behind the technology, let’sgo to explore the clinical benefits

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Art for childrenUNIQUE in CR and DR“You get more out of UNIQUE:more details, more soft tissueas well as good bone definition,bringing possibilities beyond whatwas achievableuntil now”Dr. Wolf, SwitzerlandLow dose pediatric abdomen, CR technique.Comparable image quality to DR.Low dose pediatric abdomen, DR technique.Comparable image impression to CR.4

University Hospital Bern, SwitzerlandThe University Hospital in Bern, Switzerland, is aleading hospital in the field of pediatric radiologywith particular focus on dosage reduction forpediatric X-ray.Dr. Wolf, Head of Pediatric Radiology, uses fullydigital X-ray systems, which are integrated in the RISand PACS. Both Digital Radiography (DR) andComputed Radiography (CR) systems were installedas part of a PACS implementation that made theoperation of the department completely filmlesswithin less than 3 months. When looking at CRsolutions, Philips met two important criteria: Imagestitching – an absolute must for the spinal and longextremity examinations that are so important forpediatric orthopedists – and the ability to displayboth CR and DR images in a consistent manner. Thisis a significant benefit for the radiologist, as it meansa tremendous reduction of image adaptation that hadto be otherwise done manually by the radiographeror the radiologist.UNIQUE –Improving Diagnostic ConfidenceUNIQUE harmonizes contrast levels, highlights faintdetails and adapts parameters to provide lots of detailand wide image dynamics, while still maintaininga natural, artefact-free appearance. Dr. Wolfcomments, “you get more out of UNIQUE, you getmore details, you get more soft tissue as well as goodbone definition, bringing possibilities beyond whatwas achievable until now”. He cites the example of acontusion of a knee joint. The orthopedists weresatisfied with images using the standard postprocessing, but using UNIQUE, the skin contour,the subcutaneous fat and a finer bone-structure arevisible simultaneously from the same raw data. “It isthe difference between a good and an excellent image,and gives radiologists the chance to achieve the fullpotential of the system, to get more information andimprove diagnostic confidence, based on the specificclinical requirement and the anatomy of region beingexamined”, he says.By applying the same criteria to both CR and DRimages, UNIQUE also ensures that imageconsistency is high. “You get very convincing resultsfrom both systems with UNIQUE”, says Dr. Wolf.Low-dose Research in PediatricsIt might have been expected that the use of digital flatdetectors, which often enables dose reduction whenused in adult radiography, would offer an importantopportunity for further reducing X-ray dose. But, asDr. Wolf explains, they were already using films witha speed class of 800, and had reduced dose to a verylow level. In fact, the dose levels were so low that it isonly recently that digital technology has been able tooffer sufficient sensitivity to make the change todigital beneficial. Watching the market, only thePhilips DR technology met the department’s dosecriteria.Digitalization (PACS) combined with UNIQUEmeant a ‘quantum leap’ in workflow improvement.It also offered substantial benefits for all parties:less scheduling work for the radiographer, greaterdiagnostic confidence for the radiologists and otherspecialists, a dose reduction through lower dosage andfewer retakes, shorter and less stressful examinations for the children, and finally more personal carededicated to them from the time saved throughimproved workflow.5

Art in motionUNIQUE on portable systemsNovato Community Hospital, USAThe Novato Community Hospital, Californiaswitched to digital radiography. As the RadiologyDirector, Dr. Ralph Koenker oversaw theinstallation of CR readers across the hospital, fromthe emergency room and operating room area to theoutpatients center and in the radiology departmentitself.20 % efficiency improvementby going digitalOne of the key problems which digitilization wasable to solve was a bottleneck in the department’sworkflow. Radiology personnel often congregatedaround one particular station for patientexamination, cassette labeling and processing.With the Philips solution, the workflow could bebetter distributed by physically separating thesefunctions. Evaluating the implementationDr. Koenker explains that “going digital has improved our efficiency by about 20 % comparedwith reading regular X-ray images. With that, thephysician’s diagnostic accuracy has also increased,as visualizing lesions is easier on digital imageswhen they are correctly post-processed.”UNIQUE in the ICU environmentA major contributing factor in increasing thedepartment’s efficiency was the utilization ofUNIQUE. The most common X-ray examinationsthat are done in a hospital are portable chest X-rays.Here images often have a wide range of exposurebetween the top and the bottom of the lungs.6Dr. Koenker explains that UNIQUE equalizes thatexposure difference in a very effective way: “I thinkthat one of the big advantages of UNIQUE is thatit allows us to see abnormalities in the lung onportable X-rays with greater conspicuity. We can seelesions in the lung apex as well as lesions which maybe hiding behind the shadow of the heart and that iswhere we found our clinically most significantimprovements.”Another area where the benefits of UNIQUEbecame obvious was on the very periphery of thelungs where all the rib shadows overlie. Again itis easier to see through the rib shadows and detectpleural-based nodules, improving diagnosticrelevance.Dr. Koenker also cites the visibility of catheters andtubes in the ICU setting as another area whereUNIQUE brought significant advantages. Here itis vital to show the position of catheters and tubesaccurately while still being able to see the lungs aswell. This can particularly be a problem with nasalgastric tubes. The tube is in the stomach, which is atthe bottom of the image and the most underexposedpart. Dr. Koenker explains: “This was difficult to seein the days of film and even with standard processedCR. But today we are able much more readily tosee the course of NG tubes and the location of pacemaker wires or other monitoring than before,making UNIQUE the next step in the evolution ofimage processing.”

“UNIQUE had a majorimpact on our diagnosticresults”Dr. Koenker, USAPortable Chest examination, CR techniqueConventional ProcessingPortable Chest examination, CR techniqueUNIQUE processed7

The art of flexibilityUNIQUE andElkerliek Hospital,The NetherlandsThe Radiology Department of Elkerliek Hospital,in the Netherlands, underwent a radical metamorphosis. This involved a PACS installation and thedigitalization of radiology and nuclear medicinemodalities in both the hospital at the Helmondsite, and the outpatient clinic in nearby Deurne.DigitalizationPrimarily, going digital means becoming more efficient. Mr. J.A.M. Op’t Hoog, Head of Radiology,is pleased that the logistical drawbacks associatedwith working with film are now a thing of the past.“The workload in our departments in Helmond andDeurne is permanently increasing. Thanks to thisnew way of working we can now keep up with thisincrease.” Neurologist Dr. P.P. A. Lenssen alsocomments on the advantage of being able tomanipulate images on screen. “From the images onthe screen, which are already fairly large, you canenlarge parts or change the contrast and so spotlightprecisely the part you’re interested in.” Dr. Lenssenalso values the ease with which a patient can watchthe screen while discussing his or her complaint.“They only need to turn in their chair to see thescreen. No more running over to a light box. It isfaster, easier and clearer.”8UNIQUE and PACSAt the core of any diagnosis is the image. Withoutoptimal image quality no other process improvement will truly work. Therefore high and consistentimage quality throughout the entire image chainis key in a fully digital PACS environment. This isespecially true for the replacement of conventionalX-ray film with CR and DR. Only by combiningPACS with UNIQUE was the hospital able to takefull advantage of the digitalization benefits on alllevels.The hospital had already chosen UNIQUE processing when acquiring the Philips DigitalDiagnostin the past, and now added the same for the PhilipsCR system. By providing superb image quality andall the diagnostically relevant information in a singleimage, UNIQUE offers the required information inexactly the desired format, no matter where the datais accessed.In the end, UNIQUE helps to increase diagnosticconfidence and overall throughput.It also helps to reduce the number of retakes andthe X-ray dose for the patient. Without properradiography digitalization and effective post-processing tools the overall efficiency of the PACSproject could be seriously jeopardized. “The resultis an impressively good and constant image qualityin the CR images; a huge leap forwards”, saysradiologist Dr. B.R. De Witte. “Both image contrastand sharpness can be adjusted down to the finestdetail by the user with the help of the parameters.”

PACS“ It is only with UNIQUE that theradiologists have been able tomake use of the much-vauntedlarge dynamic range of digitalimaging technology. As far asI’m concerned, UNIQUE is thecrowning glor y of ourdigitalization project.”Dr. De Witte, The NetherlandsConventional Chest ProcessingUNIQUE processed. Lung Field, Retrocardiac,Mediastinal and Subdiaphragmal clearly visible.9