Experience with a laptop based 3D DICOM reader at MDT meetings in a District General Hospital

Background: Multidisciplinary team (MDT) cancer meetings are frequently too large to be held in radiology departments, although much of the discussion at MDT meetings revolves around the radiologist’s interpretation of the patient’s imaging. Our hospital, like many district general hospitals (DGHs) in the UK, does not have a full PACS system so the radiologist has to show the films either on a viewing box or via an OHP. Aim: To modify a PC based 3D volume rendering application developed by two of us (RSR and RL) for research purposes into a more user friendly application for presenting good quality radiological images, extracted from DICOM files, via a data projector at our weekly MDT meetings. Methods and Results: DICOM files from a selection of patients who had undergone high resolution multidetector row CT scans were burned to CD using the existing CT workstation facilities. The new software runs on a modern laptop computer with a powerful graphics card (128MB Nvidia GeForce FX), and accesses data directly from these CDs. The quality of the images and their refresh rate was judged to be as fast as the hospital’s SG Workstations. The visualisation options include 3D volume view, axial, coronal and sagittal views, maximum intensity projection (MIP), multi-planar reformatting (MPR), and moveable cut planes. Other features include interactive window/level and transfer function, and the ability to save images to bitmap format. Ease of use is an important consideration in the MDT setting and the software has been designed so that all of these features are selected using simple menus. Clinicians and particularly their trainees attending the MDT meetings at which the patients’ radiological images were projected up onto a large screen seem to appreciate their clarity and the ability to both see and think in 3D with the aid of the MPR facility. Conclusions: We have shown (1) that with our software and a suitable laptop computer costing about £2K it is possible to reproduce virtually all of the common functions that can be currently found on a SG Workstation costing 6–10 times as much and (2) linking such a system to a data projector is a relatively inexpensive way of showing radiological images at large MDT meetings