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Inobitec DICOM Viewer Pro: Body Cancer Imaging for Radiologists — Transcript

by Inobitec Company · 5,986 words · 919 segments · language en · Watch on YouTube

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0:00Okay.
0:03Uh let me know in the chat please
0:07if you see us well and if you hear us
0:10well.
0:13Yeah sound is okay. Thanks a lot. Okay.
0:16So now we can start. We're glad to
0:18welcome you at our regular live session
0:20and today we will explore the important
0:22software features for radiology with an
0:25emphasis on body cancer imaging. The
0:28previous sessions on biomodeling and
0:30surgical uh surgical planning in
0:32virtually reality were intended to
0:34highlight the innovative features of
0:36innov.
0:39But today we want to return to the
0:41basics and discuss the common software
0:44features which can help a radiology
0:46professional to improve their workflow.
0:50I'm glad to welcome Bren of Llukach, a
0:52radiologist and cancer imaging
0:54consultant with a great deal of
0:56knowledge and experience with a wide
0:57range of imaging software. Hello Brenav.
1:01Hello Jagger. Uh dear colleagues and
1:03friends, I would like to greet you all
1:05on my behalf. Uh and thank you all for
1:08joining our live stream. I would also uh
1:11like to thank Diego for inviting me to
1:13share my experience with the innovable
1:24piece of software which is not just a
1:26simple DICOM viewer but a comprehensive
1:29medical imaging suite. I have been using
1:32it for almost three years now and uh I I
1:36will be happy to share my experience
1:38with it.
1:40Uh thanks a lot for your kind feedback
1:42Renis. We really uh appreciate such a
1:45positive review.
1:47Uh and my first question to you will be
1:49the following. How do you think a
1:51radiologist can benefit from working
1:54with the appropriate software today?
1:57I think the benefits of using adequate
1:59software are twofold. uh firstly to save
2:03time while struggling with the
2:05everinccreasing workload and make
2:08dealing with it easier and secondly to
2:11provide the clinicians with clear and
2:13understandable depictions of the
2:15pathology whether in 2D 3D or 4D.
2:19Uh that's really nice and uh before we
2:22start the demo I shall say a couple of
2:24words about the program we use today for
2:26demonstration.
2:28uh Inobitech Dome Viewer Pro is a
2:31multi-platform
2:32uh solution um designed for the advanced
2:36medical diagnostics and image processing
2:39uh and it was developed to help the
2:41quality treatment planning as well.
2:43There's a wide range of basic and
2:45extended tools some of which we are
2:47going to apply today. If you feel
2:50interested to try the program yourself,
2:52you can find the link to the uh to
2:54download the program trial in the chat.
2:57And uh another thing I wanted to mention
3:00is that today we would like to make this
3:03session uh as interactive as possible.
3:06That's why your questions, remarks and
3:08comments will be highly appreciated. I
3:11will try to pick out some questions from
3:12the chat during the demo and we will try
3:15to discuss it. If you face high activity
3:17in the chat, we will even make a special
3:19break for Q&A session. So, uh, now I
3:22shall turn it over to Bernice and let
3:24him share his demo cases. So, you're
3:26welcome, Brunis.
3:28Thank you. Uh, I'd like to briefly note
3:31that my work is almost exclusively
3:33related to cancer imaging.
3:35uh assessing patients with advanced
3:37malignant disease whether it is initial
3:39evaluation of an already uh uh extensive
3:43disease evaluation of the treatment
3:45response and follow-up or detection of a
3:48relapse. Therefore, this presentation
3:51reflects my personal use case scenarios
3:53and features of the software that I use
3:56most on a daily basis and I find most
4:00helpful but uh which may or may not be
4:03of relevance to you. I most sincerely
4:06hope that uh you will find at least
4:09something of of what we show today
4:11useful and worth a try.
4:14That's why I shall try to keep the
4:16unidirectional part of the stream as
4:17short as possible as Jgo has already
4:19noted and to make it interactive in the
4:22Q&A section. Uh before we start, I must
4:26apologize to all of you in advance. uh
4:28because I'm a rather reclusive
4:30radiologist with a severe case of stage
4:33fright and at one hand and at the other
4:37uh uh I uh while practicing for the this
4:40live stream I realized uh that I find it
4:44difficult to speak and manipulate images
4:46at the same time. So if at any time
4:49during the stream I begin to stutter or
4:51become unpleasantly quiet, please
4:53forgive me. It's not your internet
4:55connection, it's just me.
4:57It's okay Brenlaf. I I think you will uh
5:00you will be great.
5:02Uh okay. So uh when we open uh the the
5:06DICOM viewer uh we are greeted uh with
5:09the local storage or local database view
5:12where all our exams are listed. And from
5:16there uh we can open the the t the 2D
5:20viewer
5:22which will allow us to to scroll through
5:25any series or studies that we may have.
5:28We can bring them in from the from the
5:30uh striped uh thumbnail view from the
5:33side. Uh we shall we shall go through
5:36that a little bit later. So we can
5:38quickly go through a study.
5:40Here we have a a case of an advanced
5:43already disseminated lung cancer as you
5:46may see.
5:48And then we shall move to the MPR views
5:52which uh we we open in in multiple tabs
5:57to evaluate it further.
5:59As you can see
6:02we can also extend it to the full screen
6:04view. As you can see it is right lower
6:08lobe mass
6:13already already affecting
6:24right killer lymph nodes subcorinal
6:27lymph nodes
6:30now I'm going to briefly switch to the
6:33brain
6:36window to show you.
6:43Okay.
6:48Right hemisphere
6:50metastasis. Then switch back
6:53to the med medicinal window to go
6:57through the rest of the
6:59of the study.
7:04Interestingly, there is a lesion
7:07in the pancreatic body which is also a
7:10metastasis.
7:14We can quickly make a curved MPR to show
7:18it.
7:49It took you just five seconds to build
7:52this kind of reconstruction. Looks very
7:54nice.
7:54Yes. Yes. Uh
8:00And as you can see, we can we can remove
8:02the curved line in order to show to show
8:04the pathology clearly or and uh I find I
8:08find the the curved reconstruction
8:10option very very helpful and and very
8:13very customizable.
8:16So I really do do like using it and uh
8:22we can we can switch it off quickly and
8:26then go back to evaluating uh
8:30the study further.
8:34An interesting finding of of a
8:38metastasis in the great momentum
8:44which would
8:46indicate that that the the tumor we are
8:49we are assessing now is is most likely a
8:52small cell lung cancer.
8:55And also what is what is rather
8:58interesting for lung cancer
9:05a small metastasis I'm I'm now I'm now
9:08switching to to the
9:123DMPR pointer a small metastasis in the
9:15measurectal fat
9:17which is which is not a frequent finding
9:20in lung cancer.
9:23So uh this case show us actually uh the
9:28the basic options of 2D image viewer and
9:31and MPR reconstruction views which I
9:34yeah really on a on on a on a daily
9:37basis as my I'd like to say bread and
9:40butter.
9:42the basic view really of uh yeah you're
9:45right that the basic view of a single
9:47study appears to be excellent though uh
9:50it sounds like an easy task for almost
9:52any imaging software doesn't it? So
9:55could you please give us an uh any
9:56example when you need to compare two or
9:59more different studies of the patient?
10:01Yes, that's that's
10:04practically my my most used case
10:07scenario. And I'm going this case um uh
10:12of of an oligometastic relapse of
10:14ovarian cancer five years into the
10:17treatment and one year after the
10:18previous relapse uh to show uh how the
10:21viewer can can um u very easily compare
10:26two studies and five uh find small and
10:29inconspicuous pathology.
10:32So we're going to open our first study
10:34in the MPR
10:39And then the second study
10:42also in the MPR.
10:48So it is a case of a
10:52rather small volume relapse
10:58in an autocable lymph node. So this is
11:02uh February February 19th, 2021 exam
11:08and we are going to compare it to
11:14okay
11:21to May 17th 2022
11:24exam. So a a little more than one year
11:30and we can clearly see that this
11:33particular AO2 cable lymph node has
11:36enlarged
11:40and is clearly metastatic
11:42and we can easily demonstrate it in all
11:45three views,
11:47all three planes.
11:57mark it, do the measurements, whatever
12:00whatever we need to do to
12:04to present it. So,
12:08and as you can see, what I what I find
12:11very helpful is that uh windows in the
12:14NPR view can be zoomed independently.
12:19So
12:21we can show we can show the lesions very
12:24zoomed in in one view and show their
12:27exact position in an unzoomed image in
12:30the other views. So I find this one to
12:32be very helpful as well.
12:37Well that looks quite interesting but uh
12:40what about the comparison of the paired
12:42organs? And uh another question, do you
12:44use any uh shortcuts when you're
12:47changing the color tables and uh how do
12:50you use them?
12:51Yes. Yes. Well, uh the viewer the viewer
12:54actually has uh in its in its in its
12:57settings uh section uh the ability to uh
13:03customize the hotkeys that that we as
13:07you can see that that we use u uh
13:09frequently. So uh any user can basically
13:13uh adjust the the hot keys any way uh
13:17hit it find suited
13:21and so I'm using I'm using uh shift f3
13:25hotkeys for example to bring inverse
13:27logarithmic color lookup table and shift
13:29f12 to to use uh the flow lookup table
13:34and I'm going to demonstrate um uh how
13:37and when they may be of help. So the
13:40next case I'm going to show is uh
13:42intended to demonstrate the value of the
13:44viewer in comparing paired organs
13:48uh which implies opening two or more NPR
13:51views of the same series of the same
13:53study at the same time. A feature which
13:56some other software solutions on the
13:58market do not have. And uh I shall also
14:01try to uh to show how inverse
14:03logarithmic and flow color lookup tables
14:06uh can emphasize postcontrast
14:08opacification of lesions and uh allow us
14:11to perform a limited but very often
14:13useful evaluation of pathology for which
14:16CT is not the modality of choice like
14:19breast like in breast imaging. So I'm
14:22going to open the same
14:25uh
14:28MPR study uh of the same uh Venus series
14:33whole body image of
14:36breasts.
14:41As you can see, this menu allows us to
14:43put uh to put the images exactly where
14:47we want them. And I'm going to to make
14:50um
14:52a maximum intensity projection
14:57of the breast tissue.
15:10CT is not of course the modality of
15:12choice for evaluating breasts, but it
15:15can really be of assistance in in in
15:18some situations and in some cases. So,
15:21I'm going to do
15:24a quick MPR render
15:28of the right breast and then the exact
15:32same thing on the left breast.
15:47Okay,
15:48I will use the center lines to
15:53to show the borders within the
15:55quadrants.
16:10And then I'm going to use the inverse
16:13logarithmic color lookup table
16:18to show
16:21the multicentric cancer of the upper
16:24quadrants.
16:25and the lower medium quadrant of the
16:27left breast and also a small focus in
16:30the
16:31lower outer quadrant of the breast. And
16:34when we switch to
16:38flow color lookup table, we can clearly
16:42see the difference in contrast of
16:44pacification pattern of of the breasts.
16:47So I I find this to be really helpful
16:49really
17:01Okay, that's about that one.
17:08That looks really impressive, Breny. Uh,
17:10I've just came up uh with the idea to
17:13ask you about the comparison of
17:14different modalities. Sometimes the
17:16radiologists need this option to have a
17:18better picture of a certain lesion.
17:20Could you show us how the program meets
17:22this challenge please?
17:24Uh yes. Uh well uh the one of the of the
17:29strong points of the DIC innovative
17:31diccom viewer is its ability to combine
17:34different modalities and to show uh
17:37different series of different studies in
17:40split screen mode or in full screen mode
17:43at the same time. So here we have a case
17:46of of um actually of a solitary u
17:50metastasis of adenocarcinoma of the
17:54pancreas. So we have
17:57a previous exam
18:00that is MRI.
18:08Okay. And now we have a a T2 weighted
18:12sequence and
18:26just a second please.
18:36And we have
18:39a follow-up city exam.
18:44Oh, sorry.
18:46I I've already marked this one for for
18:50what we are going to show later. But we
18:53have a small human
18:56and right lobe of the liver
19:00which can be seen here. But there is
19:03another
19:04denovo leion
19:09right sephilate to to the previous one.
19:12So if we if we go to the MPR view,
19:30let me just
19:36make it look nicer for a second.
19:41Okay. So now we have two lesions here
19:47and as you can see the view
19:50automatically splits the view when we
19:51add studies
19:53and only one lesion on the previous
19:57exam. So this one is a human gioma
20:03and the second one is adenovo metastasis
20:06and we are going to use this case later
20:09to to present other interesting features
20:11of the viewer. Also uh as as as you may
20:15note, we can we can actually open as
20:18many
20:20studies as we need or want and then
20:26and then bring them to the front or send
20:29them back
20:31as we need. So I find this to be
20:34extremely useful. And um I I I have to
20:37note that um uh you can see that I'm
20:40using this monitor in a split screen
20:42view. Uh so basically I have two virtual
20:45displays on one monitor. Um we are
20:48showing showing only this monitor
20:50because uh if uh if uh we wanted to show
20:54you multiple monitors, you can you can
20:56basically split screen on any number of
20:58monitors you have and that allows you to
21:01place multiple studies
21:04uh on on as many monitors you have. But
21:06we are not showing this option now
21:08because it would be too small and
21:10cramped.
21:13But it I find it to be uh very very
21:17helpful. So basically any number of
21:20studies on any number of monitors you
21:22have
21:24uh it's um we we all we quite often we
21:29have uh requests uh to about the uh
21:33capability of the viewer to open
21:36mamography.
21:38uh but we have to tell uh the customers
21:40that we don't uh actually have the
21:43dedicated hanging protocol uh in the
21:45program but can you please show uh to
21:48the audience uh how the viewer can uh
21:51handle these type of cases?
21:53Yes. Yes, of course. Uh the the split
21:55screen view allows you to open
21:57mographies without a dedicated hanging
22:00protocol. You just simply click the
22:03studies uh in the order you want them to
22:05open and the viewer will do everything
22:07else for you automatically. So here we
22:11have
22:12of course a standard
22:15native mamography and a nice depiction
22:17of of a speculated mass in the in the
22:21upper outer quadrant of the of the left
22:23left breast and and a benign appearing
22:26one in the upper outer quadrant of of
22:29the right breast. And as you may see,
22:31I'm constantly adding studies and
22:34everything that we have uh had opened
22:37previously remains exactly where we left
22:40it. So if uh for example someone asks
22:44you just to take to take a brief look at
22:47something and you are in the middle of
22:49doing something else, you don't have to
22:52to close what you are working at at the
22:54moment. you can just add studies and uh
22:58basically the only limitation that you
23:00have is your hardware and we are going
23:03to discuss that a little bit later.
23:08Thanks a lot for your uh demonstration
23:10of the mimography case and now it seems
23:13that we've uh covered most of the basic
23:15features of 2D image view. Now um I
23:19shall check the chat uh for the
23:21questions and decide whether we can we
23:23will make the separate Q&A session or
23:26not. Uh give me a moment please.
23:29Okay.
23:33Don't have any questions except the
23:35praises. 140 fps looks nice in NPR. Very
23:38smooth.
23:40Alex Johnson tells us.
23:43Uh yes. Yes. the the viewer is actually
23:46well optimized for for multiple
23:49platforms. Uh we can discuss that uh in
23:52in more detail later if if the audience
23:55is is interested in it.
23:57Uh oh yes, I must I must make a remark.
24:00Uh we are doing this uh stream in 1080p
24:04uh in in order for it to to be smooth.
24:08uh uh I I use 4K resolutions uh on a
24:12daily basis and I use uh three 4K
24:15monitors uh for for my work.
24:19So So the the FPS count is excellent in
24:224K as well.
24:25Uh I shall also use this break uh
24:29between first and the second part to
24:31announce that uh in the middle of July
24:35we are traveling to ECR uh with the
24:38stand and we are going to exhibit our
24:41software there. So if uh if you like you
24:44can come and meet us live and ask us
24:47questions and uh we can make we can
24:50perform a live demo for you. uh we will
24:53be there since 13th until 18th of July
24:56in the Vienna Congress Center in
25:00Austria. So everybody uh who wishes to
25:04see the software live and who wishes to
25:07ask us the questions welcome uh we will
25:10be glad to to see you there. Uh I think
25:14it's time to move to the second part of
25:17our session and uh
25:20um we can uh try to demonstrate the
25:24advanced features and modules of the
25:26software and as far as I know usually
25:28the oncology cases require uh the
25:32specific imaging modality called BETCT.
25:36Could you please show us how this
25:38software helps you to assess this type
25:41of studies?
25:43Yes, the viewer has a powerful pet city
25:45module uh which automatically opens a
25:48pet city study in a four window view uh
25:52which uh implies the pet the native city
25:55the fusion of the two and the 3D
25:56reconstruction and it's also capable of
25:59opening two or more pet city studies at
26:01the same time for comparison and to
26:04combine them with other modalities and
26:07uh this is u this module is uh the only
26:11one which is not intuitive um
26:14immediately intuitive as I I'd say
26:17because what we need to do first is to o
26:21open the series fusion view
26:25and to fuse uh the low do city with the
26:29pet city.
26:31Then uh go back to the
26:36just a second please go back to the to
26:38the storage view and then open the fused
26:41analysis in the pet safety module.
26:47Okay.
26:51Let me just try with another one.
27:09Okay,
27:16this one. Never mind. So, we can we can
27:19open uh pet city studies uh and
27:27We can see them in pet view, native
27:30city, the fused view,
27:36and the 3D reconstructed view. And they
27:39they're all open automatically.
27:42And what I what I find to be very useful
27:46is is the point pointer tool uh which
27:49allow us to
27:53to quickly identify uh the the spots of
27:58the um increased FDG update. And another
28:03very welcome feature is that the SUV
28:06values are shown uh automatically
28:11while we scroll the mouse through the
28:13study. Okay, let me just try once more
28:20to get another pet city study open.
28:25So I'm going to
28:31actually the additional modules and the
28:33advanced features uh is uh where the
28:36viewer starts to do the magic. Uh
28:39yes. Yes.
28:40It allows to perform the advanced
28:42analysis just with a couple of clicks of
28:45your mouse.
28:47Yes. Yes. I I'm I'm not quite sure why
28:50why it won't open my my second study
28:52now. Let me just check it. No,
28:55you can select you can select two series
28:58at the same time.
28:59Here it is. Here it is.
29:01Okay. So, it's it's the the the same
29:03patient um one almost one year apart
29:10and now uh what what we can see now.
29:14So, you mean the difference uh in the
29:16scanning time is one year, right?
29:18Yes. Yes. Uh so one was done on November
29:2024th, 2021 and the second and the first
29:23one was done on on August 12th, 2020 and
29:28as you can see there is
29:35a denovo liver metastasis
29:38and as you can see the FDG uptake is
29:43above eight. Of course we can do
29:53just the FDG uptake measurement.
29:57We can do it in volume as well or we can
30:01combine the measurement of the FDG
30:04uptake with with measurement of density
30:07and we can bring out
30:10any of the individual views in enlarged
30:14if we need to. So I I find I find this
30:18module to be really fantastic actually.
30:21Do you use any any other mod additional
30:23modules of the viewer you know on your
30:25daily basis?
30:27Yes, I I use uh vessel analysis module
30:31uh to evaluate blood vessels uh and I
30:34use 3D segmentation module. So first we
30:37are going to have a really brief look on
30:39the on the vessel analysis module and
30:42then we are going to shed some light on
30:44the on the 3D segmentation which which
30:47uh I am I'm really uh fascinated by I
30:51must say. So let me just go briefly. So
30:55uh uh um for now the viewer uses uh the
30:59subtraction method to to uh to show uh
31:05the the vessel structures and as as you
31:09mentioned I think you're going to do
31:11some improvements on that one on on the
31:14on the subtraction.
31:17Oh yeah but uh we will we will keep it a
31:21secret for a while. Ah okay.
31:23We will announce it announce the uh the
31:26changes a little bit later.
31:28Okay, great.
31:31So
31:33I'm now moving to the full screen view
31:35of the of the vessel analysis module.
31:38I'm going to
31:43select the native study.
31:48Oh, wait just a second. Please,
31:53I'll have to close some of my previous
31:55views.
32:06No,
32:07sorry.
32:09This one has
32:18I have some some other studies opened in
32:20the background
32:22which are I believe um
32:27I'll wait just a second please.
32:30Let me just show some of the some of the
32:35already opened one and try again.
32:46No.
32:50Uh could we move could could we move to
32:52the 3D reconstruction module and then
32:54we'll come back because uh uh it seems
32:56that I've I've exceeded my the use of
32:59memory and and I will I will Yes. And I
33:02you're finally you finally reached the
33:04limit of your machine.
33:06And yes, it seems so. But I will show
33:08you why. So uh let me move to the to the
33:113D segmentation module which which I uh
33:15I have prepared I had prepared in the
33:17background.
33:18Okay. Okay. No problem. You can you can
33:20switch to the 3D uh to to the
33:23segmentation.
33:24Yes. Yes. I I've I've uh overstretched
33:27it now. So let me just close these.
33:31Okay.
33:32Uh I think you uh to remove this uh you
33:36need just to reboot the program. Yeah.
33:38Yes. Yes. Yes. Yes. Yeah. I've I've had
33:41I've had many of them open at the same
33:43time. So um
33:46that's nice that we can we can show we
33:48can also show how to um get rid of the
33:53uh memory over limit. Uh that you can
33:56just reboot the program. I've I've
33:58overstretched I've overstretched my my
34:00memory use. But let us now allow show
34:04the vessel analysis module.
34:06Okay.
34:07You're you're being too enthusiastic
34:09about it.
34:10Yes. Yes. Um well now now it's going now
34:14it's moving smoothly
34:16as as you may see I have I have selected
34:19the uh the arterial uh phase of the exam
34:24and the native one to subtract the
34:26bones.
34:37Okay. And the magic is happening.
34:40Yes. And as you can see, we we have we
34:42have a beautiful a beautiful vessel
34:46analysis structure. Oh, I must note uh
34:48that I am using huge city data sets as
34:52as you may see this is a whole body city
34:54data set done in 768 by 768 u axial
34:59image resolution and8 mm slices. So u my
35:04data sets are huge and hence the uh the
35:08uh memory overload issue because I've
35:11had open more than 15 studies in the
35:13background. So, it's not going to happen
35:16um on a regular basis because I'm really
35:19pushing the viewer to its to its very
35:20limits. And as you can see, this is this
35:23is a lovely um
35:26uh a lovely module. Now, I'm cutting all
35:29everything else except the object to get
35:32really beautiful view.
35:38And now we are going to to show uh how
35:41how the viewer actually finds um in this
35:45case
35:48in this case this is uh
35:51uh
35:54uh left uh uh hypotic bile duct cancer
36:00that has stenosed the the left hypotic
36:03artery. But now we are going to to show
36:05how the module actually works uh for for
36:08evaluating arteries. So we are going to
36:10use the two module the twopoint uh the
36:13twopoint uh option to to get a stretched
36:17view to get a stretch view of the artery
36:20and then we are going to
36:24to use the analysis
36:26and to show that it's been stenosed
36:36in this segment. Yeah, that looks
36:39so really really really excellent
36:42module.
36:44Okay, now
36:44it looks pretty instructive.
36:46Yes. Now, now we are going to to switch
36:49to the to the MPR
36:51or or and and to the uh 3D segmentation.
36:56The 3D segmentation module has advanced
36:58tools for automatic watershed
37:00segmentation, semi-automatic region
37:02growing segmentation and medial
37:04delineation of regions of interest. and
37:07it provides the possibility to show
37:09almost any pathology in 3D. Um, its
37:12size, exact positioning within an organ
37:14and its relationship with other
37:16structures of interest. So, I'm going to
37:18try to to show it to you now. So, I'm
37:22just going to briefly go back to the to
37:26this case.
37:34And in order to save time, I'm going to
37:37to open the all uh the the projects that
37:40I've saved of the segmented uh uh
37:44structures.
37:48Okay. Now I'm going to switch to the 3D
37:51view. And as as you may see
37:58I've uh segmented yes the portal vein
38:01the hpatic vessels the liver bones aorta
38:06and in yellow color is the metastasis
38:09and in green color are two small
38:11hemiomas in the liver. So we can
38:19we can practically uh segment anything
38:22and of course uh we can use the
38:24segmentation tool to remove
38:29uh the structures that we have se
38:31segmented in order
38:33to present
38:35only what we want.
38:37Yeah, that really helps in the
38:39pre-operative planning, right?
38:41Yes. Yes, it does. And as as as you may
38:44note the viewer uh automatically
38:46calculates the volumes of uh every
38:49segmented structure. So if we uh if we
38:53want to to assess the for example the
38:56remnant liver volume uh before the
38:59surgery the viewer can do it very
39:01easily. So uh this is really really a
39:04module that I that I use most of the
39:06time and find it very very helpful. Of
39:09course, I'm now going to, for example,
39:11remove the liver and and leave just the
39:13vessels
39:16and
39:19and the veins.
39:20Yeah. Use use
39:22as as you may see uh uh this uh uh this
39:27uh exam was was not done perfectly. So,
39:31the the contrast of pacification of
39:33blood vessels was not ideal. But the
39:36viewer has the option actually to to
39:40compensate
39:45to compensate for for for the uh to to
39:48to I think a very good extent to
39:51compensate for for the what's lacking in
39:54the quality of the exam itself. And as
39:56you can see it can demonstrate
39:58demonstrate the structures in 3D
40:00beautifully. And um also another module
40:04that I would like to show and that I
40:07really find very helpful is is uh the
40:11series fusion module that that that
40:13we've briefly addressed while while uh
40:15doing the pet CT. So uh what I'm going
40:18to do now
40:20is I'm going to open um a CT study
40:30of a small tumor of the left common
40:32hypatic bile duct of the of the left
40:35hypatic bile duct
40:38and I'm going to fuse it
40:47with the with the um
40:51MRCP in order to show the blood vessels
40:54and bile ducts and their relationship to
40:56the tumor.
40:58So, let me just quickly open the the
41:01MRCP.
41:03Okay, here it is.
41:06So, and then I'm going to
41:11open the MPR view.
41:15And then I'm going to try to to open the
41:18projects that I've I've pre-saved.
41:47Okay. And when we open the 3D view, uh,
41:50we are going to have, um, actually wait
41:54just a second, please.
41:58So, we are going to have the view of
42:00the,
42:04we are going to have the view of the
42:06blood vessels.
42:10and of the dilated by bile ducts in in
42:13the same view.
42:23Okay, I'm opening them. And as you can
42:28see now, we can we can switch between
42:30the few studies and and we can we can
42:34open basically all the all the
42:36structures that we've segmented.
42:41Yeah, that looks really impressive.
42:43Yes. And now now because uh we can we
42:47cannot depict the bile ducts in the in
42:49the CT study uh we can combine u uh as
42:53you can see MRCP with CT to to show both
42:58the bile ducts and the blood vessels uh
43:01in in the same study and the same in the
43:03same image. So I find this to be really
43:06really useful as well.
43:10Great. So yes and
43:15and as as you can see what what I've
43:18done here actually is that I've uh
43:21separately segmented the bile ducts for
43:24um let me just remove the blood vessels
43:28just for for a second. Um
43:36okay I I've I've I've kept only the bile
43:39ducts now as and as you can see it is a
43:43a rather small tumor of the left hypatic
43:46duct
43:48with dilation of of the bile ducts for
43:51for the for the left lobe and
43:55I've segmented them separately so we can
43:59switch them on and off uh as we need
44:02them. So,
44:07okay. Now, I'm removing the bile ducts
44:09for segments two and three and leaving
44:12just the the common hypotic duct and and
44:18the right and left hypotic ducts and
44:19bring them back of course
44:23if we need them.
44:25Okay, so that would be that case and of
44:30course switch on and off all other
44:32structures if we need them.
44:36Okay, so that that would be it for for
44:39the for the advanced module and I
44:41apologize for for the little glitch we
44:43had with the with the vessel analysis
44:45module. That's just my my memory
44:47overload.
44:49It's okay. It happens sometimes uh even
44:52with the uh with the machines which are
44:56pretty uh pretty good for this type of
45:00uh for this type of work. But uh most
45:05the most of the of our customers they
45:08use uh the regular laptops to operate
45:12the same type of modules and they uh
45:16they do quite okay with that.
45:20I think I think you always shall mention
45:24the capability of your hardware when you
45:28uh exceed the limits uh because it is
45:32eating the uh the memory very very very
45:37very much.
45:39Well uh as as I've said I'm I'm using
45:42extremely large studies. So I'm I'm
45:44always using whole body studies uh done
45:46in natively and anterior portal venus
45:49and and delayed phases and I'm using 768
45:53by 768 um um axial uh image resolution
45:58for the CT and it really eats up a lot
46:01of memory but um uh as you may see the
46:05viewer uh deals with it
46:08very smoothly and very easily and I've
46:10been testing the viewer for a long time
46:12now and I've been testing uh I I must
46:15mention that the viewer is being
46:16developed for for all three major uh uh
46:20operating system platforms um available
46:23today for for Windows for Mac OS and for
46:26Linux for different Linux distros and I
46:30found that even um relatively modest uh
46:35laptops with six core CPUs and let's say
46:38uh GTX 1660Ti
46:41laptop GPUs can handle 95% of the
46:44workload easily especially the CT
46:48studies are done in 512 by by 512 aial
46:52image resolution uh I I haven't found
46:56any problems so far in in handling those
46:58studies uh if uh we move to CT studies
47:03uh with uh 768x 768 axial resolution or
47:07or 10 uh uh 1024x 1024 axial resolution
47:11solution the the um amount of data is
47:16simply u overwhelming and uh then uh the
47:21user will need GPUs will 12 or more GB
47:24of RAM. So, I'm currently using a GPU
47:27with 16 GB of RAM, but for most
47:30applications, I um I repeat the the
47:33hardware requirements are are really
47:35modest and the viewer is very well
47:37optimized and GPUs with six gigs of RAM
47:41uh will be more than enough. And I just
47:45didn't mention uh whether you meant
47:47whether you told us about uh the the
47:51fact that you're running the the
47:54software at all different available
47:56platforms like you're running it at
47:58Linux, Windows and Maros.
48:02Yes. Yes. I'm I'm running and testing
48:04software on all three platforms. Uh for
48:07this presentation, we are we are using
48:09Windows and I must note that I'm using
48:12Windows 11. uh which is known to be
48:15unstable at times. So uh the memory
48:18overload issue that I that we've show
48:20that we've seen uh could be also uh uh
48:26in in in part the the Windows 11 memory
48:30handling error. So it may not it may not
48:33be related to the viewer itself. So, I'm
48:36I'm really using um u I'm really pushing
48:39my hardware to the limit, but could also
48:42be a Windows 11 issue.
48:45Yeah, I uh from our side uh I just uh
48:50I can tell you that we're happy to have
48:52you uh as our user uh because uh you're
48:57pushing uh our software to the limits.
48:59you're testing it on different platforms
49:01and we're really glad that such a
49:04professional uh has the ability to um
49:08work with the viewer on a daily bas
49:11basis and give us uh different kind of
49:14comments, remarks and reports. Uh thank
49:17thank you uh again for uh attending
49:20attending this webinar and helping us um
49:24to demonstrate the capabilities of the
49:27program and I think um uh we will be
49:31happy to see you next time uh and to
49:34call you to um to make sure we can see
49:38another cases uh of the viewer. As long
49:42as the program is progressing, we're
49:45trying to uh give out the new releases
49:49uh every three months uh practically
49:52four times a year. uh adding some new
49:55functionality and uh polishing the
49:58current functionality and we try to meet
50:01the requirements of the uh upto-date
50:05radiologists and uh other medical
50:07professionals who work with the with the
50:12medical images on a daily basis. So I uh
50:15would like to say thank you Ranislaf and
50:18thank you thank you for everybody who is
50:20attending the stream
50:22and I think uh you liked everything
50:26you've seen here and if you have any
50:28other questions um you can ask us
50:32directly um using the contacts in this
50:36description of the video and please
50:39subscribe to our YouTube channel. Uh we
50:41always try to post uh new videos here.
50:46Thank you, Brunes. It was really nice
50:47having you here today. Thank you, Jiego.
50:50Thank you for having me.
50:55[Music]

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