Updated: Aug 26, 1998
This is the most recent structured information on this project. Complementary data can be found on previous documents
CARDI-ASSIST Improving cardiac telediagnostic and surgery by enabling technology and 3-D ultrasound imaging

Overview

• Improving the quality of 3D ultrasound images
• Integrating an enabling system to impart an in-depth understanding of cardiac diseases through interactive 3D graphics and animation
• Using 3D ultrasound images together with a corresponding model and a variety of annotations and references as a communication medium between health care professionals (cardiologists, surgeons).

The system will be implemented on three platforms: a new-generation ultrasound scanner, an add-on device for existing scanners and a stand-alone training platform. These will be evaluated in a number of European hospitals.

Purpose and objectives

• Creation of a hardware/ software platform for 3D ultrasound training, diagnosis and consultation (integrated with ultrasound scanner or on standalone PC)
• Basic technical developments needed for this platform (noise reduction, TiDAS toolkit, knowledge-based guidance)
• Clinical and commercial viability of 3D ultrasound.

On a basic technical level, three developments are necessary. New algorithms for processing the ultrasound RF signals in cardiac images reduce the acoustic noise by 6dB, improving contour detection. The TiDAS toolkit will enable a normal cardiologist to build an intuitive 3D visualisation of a pathology out of a set of 8 basic pathologies in less than 5 minutes.

Finally, the project will determine the feasibility of a watch dog that analyses the cumulative results during diagnosis and compares them with a database of existing findings in order to detect anomalies and to suggest further verification steps.

The hardware/software platform consists of two software modules on three different system platforms. Prototypes of these systems will be available after 25 months, a first demonstrator will be ready after 13 months. The EchoCom enabling system supports the communication of case-related findings. It will be established via 3D patient data calibrated with virtual models over ISDN lines, allows synchronous and asynchronous communication within or between cardiological departments and supports pointing and other annotational actions.

The enabling system and the associated tools will be integrated into the Vingmed System V platform, the TomTec P90 system and a standalone training platform. The new functionality will enhance usability (as measured by usability tests). Comparative performance test will show that the dignostic quality increases in comparison to traditional training methods and that communication performance increases. The viability of 3D ultrasound depends on a community consensus on its medical and commercial perspective. In the medical area, diagnostic patterns will be determined for echocardiography and be reflected in the systems. The commercial perspective requires convincing business cases that address decision makers, outlining advantages and costs of the new technology.

Results

The clinical benefits of 3D/4D echocardiography are:

• Better delineation of pathology through visual-isation of any desired imaging plane
• Accurate assessment of volumes, function and geometry
• Improved reproducibility for follow-up studies
• Better description of complex anatomy by dynamic 3D display
• More comprehensive surgical planning

In telemedicine, the specialist (advisor) guides the investigator. The benefit of a tool for guidance as described in this proposal is indisputable. 3D echocardio-graphy will enable better communication between cardiologists and surgeons, which are frequently at different sites (even small distances count).

Medical ultrasound imaging requires skilled instrument operators and skilled image interpreters. Training of echocardiographers takes 9 to 12 months. There is a general need for tools which will improve the quality of education and training. 3D and 4D (3D + time) imaging will demonstrate its clinical utility in the next three to five years. This permits image projections which are unfamiliar to the medical community. The virtual reconstruction of anatomical image projections will significantly aid the interpretation of real images.

List of deliverables

List of participants

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