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Through My Goggles at RSNA 2015

Echopixel’s Tru 3D is not the first 3D viewer I’ve seen in RSNA’s exhibit halls over the years. Whether the device was displaying volume renderings on a 2D screen or some holographic display, most discussions I’ve had with radiologists about such systems have followed this paraphrased path: Those 3D renderings look great, but they don’t really save me time; I do my work in 2D.

Surgery planning and education tools are obvious exceptions—and the presentation on 3D printing to make a model to help surgeons separate conjoined twins was amazing—but diagnostic work is dominated by radiologists interpreting traditional 2D CT and MR images.

The Tru 3D 1.0 viewer is 510(k) cleared and several clinical applications are in development, according to the company. Other clinical applications being studied include surgical planning and Transjugular Intrahepatic Portosystemic Shunt, widely known as TIPS.

Who knows whether Echopixel’s system will pan out to be a broad use or niche application, but Tru 3D required, in my view, a shorter leap from, “that looks cool,” to “someone might be able to use that for …” than most I’ve seen demonstrated. It wasn’t a big mental stretch to see it someday finding its way into the day-to-day practice of diagnostic radiology.

Judy Yee, MD, a professor and vice chair of radiology and biomedical imaging at the University of California, at San Francisco and radiology chief at the San Francisco VA Medical Center, put it this way when describing her experience using Tru 3D to evaluate CT colonography (CTC) exams. “I realized that using the primary 3D imaging technique actually took longer, so I went back to primary 2D readings,” Yee said, in an Exchopixel monograph. “Depending on the case, if there was suboptimal colon distension or cleansing, the traditional 3D fly-through could take 20 to 25 minutes compared with 12 to 15 minutes with the 2D images.”

Yee’s comments echo my discussions with radiologists on the matter. Until she experimented with the Tru 3D platform, volume renderings were more likely to slow CTC work down than speed it up. In investigating the True 3D platform, she found that the time it her takes to read a CTC with True 3D is similar to that of a primary 2D read, with the possibility of decreasing reading time by an additional five minutes.

“True 3D allows the user to instantly view larger portions of the colon at one glance in a time-efficient manner,” Yee said in the monograph. “I found True 3D to be less fatiguing and it keeps the reader engaged and interactive.”

I don’t know whether True 3D will pan out to be a widely used tool or not, but it was an intriguing display at RSNA.