No abstract

Mobile image intensifier systems (C-arms) are used frequently in orthopedic and reconstructive surgery, especially in trauma and emergency settings, but image quality and radiation exposure levels may vary widely, depending on the extent of the C-arm operator's knowledge and experience. Current training programs consist mainly of theoretical instruction in C-arm operation, the physical foundations of radiography, and radiation avoidance, and are largely lacking in hands-on application. A computer-based simulation program such as that tested by the authors may be one way to improve the effectiveness of C-arm training. In computer simulations of various scenarios commonly encountered in the operating room, trainees using the virtX program interact with three-dimensional models to test their knowledge base and improve their skill levels. Radiographs showing the simulated patient anatomy and surgical implants are "reconstructed" from data computed on the basis of the trainee's positioning of models of a C-arm, patient, and table, and are displayed in real time on the desktop monitor. Trainee performance is signaled in real time by color graphics in several control panels and, on completion of the exercise, is compared in detail with the performance of an expert operator. Testing of this computer-based training program in continuing medical education courses for operating room personnel showed an improvement in the overall understanding of underlying principles of intraoperative radiography performed with a C-arm, with resultant higher image quality, lower overall radiation exposure, and greater time efficiency. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.313105125/-/DC1.

Abstract

Volumetric imaging (computed tomography and magnetic resonance imaging) provides increased diagnostic detail but is associated with the problem of navigation through large amounts of data. In an attempt to overcome this problem, a novel 3D navigation tool has been designed and developed that is based on an alternative input device. A 3D mouse allows for simultaneous definition of position and orientation of orthogonal or oblique multiplanar reformatted images or slabs, which are presented within a virtual 3D scene together with the volume-rendered data set and additionally as 2D images. Slabs are visualized with maximum intensity projection, average intensity projection, or standard volume rendering technique. A prototype has been implemented based on PC technology that has been tested by several radiologists. It has shown to be easily understandable and usable after a very short learning phase. Our solution may help to fully exploit the diagnostic potential of volumetric imaging by allowing for a more efficient reading process compared to currently deployed solutions based on conventional mouse and keyboard.