Celebrating 10 Years of the HIMSS-SIIM Enterprise Imaging Community and Enterprise Imaging Informatics.

In response to the growing recognition of enterprise imaging as a critical component of healthcare's digital transformation, in 2014, the Healthcare Information and Management Systems Society (HIMSS) and the Society for Imaging Informatics in Medicine (SIIM) signed a Memorandum of Understanding to form the HIMSS-SIIM Enterprise Imaging Community (HSEIC). At the time of the agreement, the two organizations decided to collaborate to lead enterprise imaging development, advancement, and adoption. This paper celebrates the past 10 years of the HSEIC's thought leadership, industry partnerships, and impact while also looking ahead to identify enterprise imaging challenges to solve in the next decade.

Visible Light Imaging: Clinical Aspects with an Emphasis on Medical Photography-a HIMSS-SIIM Enterprise Imaging Community Whitepaper.

Photodocumentation is a subset of visible light imaging and is an important growing segment of enterprise imaging. Medical videography is another subset of visible light imaging that shares many of the challenges of photodocumentation. Medical photographs are used to document clinical conditions, support diagnosis, guide, and document procedures and to enable collaboration among colleagues.

The Importance of Body Part Labeling to Enable Enterprise Imaging: A HIMSS-SIIM Enterprise Imaging Community Collaborative White Paper.

In order for enterprise imaging to be successful across a multitude of specialties, systems, and sites, standards are essential to categorize and classify imaging data. The HIMSS-SIIM Enterprise Imaging Community believes that the Digital Imaging Communications in Medicine (DICOM) Anatomic Region Sequence, or its equivalent in other data standards, is a vital data element for this role, when populated with standard coded values. We believe that labeling images with standard Anatomic Region Sequence codes will enhance the user's ability to consume data, facilitate interoperability, and allow greater control of privacy.

The Enterprise Imaging Value Proposition.

As resources in the healthcare environment continue to wane, leaders are seeking ways to continue to provide quality care bounded by the constraints of a reduced budget. This manuscript synthesizes the experience from a number of institutions to provide the healthcare leadership with an understanding of the value of an enterprise imaging program. The value of such a program extends across the entire health system.

Fundamentals of Enterprise Photodocumentation: Connecting the Clinical and Technical-a Review of Key Concepts.

Photodocumentation is an invaluable tool in many specialties, including dermatology, facial plastic and reconstructive surgery, and wound management. As digital cameras and camera-enabled smartphones have become omnipresent in our society, they have brought photodocumentation to all corners of healthcare organizations including the emergency department as well as family medicine and pediatrics. Simultaneously, enterprise imaging programs have evolved enabling access to all medical images for all providers throughout these organizations.

The Evolution of Enterprise Imaging and the Role of the Radiologist in the New World.

Objective: The concept of enterprise imaging is part of the next frontier in the evolution of health care technology. Incorporating all medical images into a single location integrated with electronic medical records supports care coordination and the ideal of a comprehensive longitudinal medical record.

Conclusion: Radiologists have tremendous value to offer in support of the new concept of enterprise imaging, which extends outside the radiology department to encompass all image producers in a health care enterprise.

Lumbar disc replacement.

Lumbar disc replacement is a developing primary surgical treatment for patients with degenerative disc disease. The goals of disc arthroplasty are to remove the native nucleus pulposus and to preserve motion at that disc level. Devices being developed include artificial replacement of the nucleus pulposus and artificial replacement of the entire disc.

Imaging of the acetabular labrum.

The acetabular labrum is a critical structure within the hip joint. It is a significant cause of pain, and it plays an integral role in the development of osteoarthritis. This article reviews the normal anatomy, imaging techniques, and normal MR appearance of the labrum.

Femur: MR imaging-guided radio-frequency ablation in a porcine model-feasibility study.

Purpose: To determine the feasibility of magnetic resonance (MR) imaging-guided and -monitored radio-frequency (RF) ablation of bone.

Materials And Methods: Seven femurs were treated in five pigs with use of a 0.2-T open MR imager.

Sternoclavicular joint ganglion cysts in young children.

Ganglion cysts originating from the sternoclavicular joint in children have not been previously reported. In this study, 5 children who presented with a small mass over the anterior aspect of the sternoclavicular joint were evaluated and treated. Only 1 patient was symptomatic.

Association of bladder exstrophy with congenital pathology of the hip and lumbosacral spine: a long-term follow-up study of 13 patients.

The authors evaluated, clinically and radiographically, 13 of 28 patients with bladder exstrophy treated at their institution between 1964 and 1982. All had been treated with bilateral iliac osteotomies and pelvic rami reapproximation to assist in urologic repair. At skeletal maturity, the diastasis had partially recurred and the patients had short stature and were living normal lives.

Treatment of collagen induced arthritis by proteolytic enzymes: immunomodulatory and disease modifying effects.

Objective: To investigate the efficacy of a novel therapy (proteases) in an animal model of rheumatoid arthritis, and to investigate the mechanisms of arthritogenesis.

Methods: We induced progressive arthritis in male DBA/1 mice by immunization and boosting with Type II collagen; groups of mice were treated orally twice daily with either ibuprofen or proteases, or were left untreated. After 2 weeks, joints were scored for clinical, radiographic, and histologic changes.

MR arthrography for evaluation of the acetabular labrum.

MR arthrography of the hip has provided new insights into the lesions underlying mechanical hip pain. Until now evaluation of these structures, especially the acetabular labrum, has been limited. With the joint distention provided by MR arthrography, labral detachments and intrasubstance tears can be identified and differentiated from the many varied appearances of the asymptomatic labrum.

Evaluation of the postoperative spine: reducing hardware artifacts during magnetic resonance imaging.

The magnetic susceptibility artifact created by the hardware that is a mainstay of today's surgical techniques can complicate magnetic resonance (MR) imaging of the postoperative spine. This article reviews the physical principles that underlie production of the magnetic susceptibility artifact, as well as the imaging parameters that can be altered to reduce artifact and improve visualization of the areas of concern. Those imaging parameters that most greatly affect artifact production are the strength of the ambient magnetic field, the type of sequence chosen, echo time, the strength and orientation of the frequency encoding gradient, the resolution along the frequency encoding axis as determined by field of view (FOV) and the number of pixels in the frequency encoding direction, the orientation of the hardware to the main magnetic field, the section thickness, and the orientation of the imaging plane.

From the RSNA Refresher Courses. Radiological Society of North America. Chronic adult hip pain: MR arthrography of the hip.

This article describes the technique for performance and interpretation of magnetic resonance arthrography of the hip. A description of normal anatomy of the hip is presented, and the appearance of the abnormal labrum is discussed. Labral detachments and tears are the most common clinically significant abnormalities to be identified.

Morphologic considerations of C2 isthmus dimensions for the placement of transarticular screws.

Study Design: This study examines the C2 vertebrae using both direct anatomic and computed tomographic measurements.

Objective: To define the relation of the C2 vertebrae bony elements to the vertebral artery and the spinal canal, to determine individuals at risk for vertebral artery injury during C1-C2 transarticular screw placement.

Summary Of Background Data: Recent literature assessing the safety of upper cervical spine transarticular screws has concentrated on technique, including the optimal point of entry and path projection of the screw.

MR imaging of the traumatized lumbar spine.

MR imaging is the imaging modality of choice for evaluation of the traumatized lumbar spine, providing critical information for determination of appropriate therapy. It is superior to other modalities for evaluating the supporting ligaments, disc, spinal cord, and the cauda equina. Major fracture patterns are readily discernable.

Augmentation of spinal arthrodesis with autologous bone marrow in a rabbit posterolateral spine fusion model.

Study Design: Posterolateral spinal fusion with autologous bone marrow aspirate in addition to autograft iliac crest bone graft in a rabbit model.

Objective: To demonstrate that the addition of autologous bone marrow can have positive effects on bone formation and spinal fusion.

Summary Of Background Data: Bone marrow has been shown to contain osteoprogenitor cells.

CT-guided fine needle aspiration and needle core biopsy of skeletal lesions. Complementary diagnostic techniques.

Objective: To compare the diagnostic sensitivity and specificity of fine needle aspiration (FNA) to those of needle core biopsy (NCB) and to attempt to determine if a complementary role exists for the two modalities.

Study Design: Skeletal lesions in 144 patients were evaluated with concomitant FNA and NCB over a 21-year period. FNAs and NCBs were divided as diagnostic of neoplasm, normal or inflammatory (i.

Interactive MR imaging-guided biopsy and aspiration with a modified clinical C-arm system.

Objective: This investigation was performed to test the hypotheses that interactive guidance of MR image acquisition during needle-directed procedures using a clinical 0.2-T C-arm open MR imaging system integrated with a frameless optically linked stereotaxy system is feasible, and that procedure times can be sufficiently short to be well tolerated by the patient.

Subjects And Methods: One hundred six MR-guided procedures were performed in 86 patients (ranging in age from 5 months to 88 years) using a clinical C-arm imaging system supplemented with an in-room RF-shielded liquid crystal display monitor, a frameless stereotaxy system, rapid gradient-echo sequences for needle guidance, and MR-compatible monitoring and surgical lighting equipment.

Cortical metastatic lesions of the appendicular skeleton from tumors of known primary origin.

Background And Objectives: Metastatic disease represents the most common neoplastic process involving bone. Recently, a small subset of cortical based metastatic lesions has been identified. We attempted to delineate the incidence, origin, location, and possible significance of these lesions within an orthopaedic patient population.

Remember true FISP? A high SNR, near 1-second imaging method for T2-like contrast in interventional MRI at .2 T.

Clinical requirements for interventional MRI (I-MRI) monitoring of needle placement or thermal ablation demand rapid (near-real-time) image acquisition rates, high spatial resolution, and T2 weighting. Experimental analysis performed earlier suggests that many sequences used for either rapid scanning or T2 weighting at high fields fail to meet both the speed (conventional spin echo [SE], turbo SE) or contrast (ie, fast low-angle shot [FLASH], fast imaging with steady state precession [FISP]) requirements when used at .2 T.