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Digital Cameras: A Rapid and Inexpensive Means of Transferring Angiographic Images to Referring Clinicians
994
a
Letter to the Editor
July-August 1999 JVIR
pinching the end of the jacket. After approximately half of the jacket and stent-graft was advanced through the valve of the introducer sheath, the jacket was carefully held in place, with use of forceps, as the remainder of the stent-graft was advanced completely into the sheath (Fig 2). The jacket was then removed and discarded. We have found this simple modif5cation to be very helpful and have used it to deploy a stent-graft in a human subject. By using the jacket, one can avoid taping the end of the stent-graft to advance the stent-graft assembly into an introducer sheath and avoid the use of a second, larger sheath. Reference 1. Kato N, Sze D, Semba C, Razavi M, Kee S, Dake M. Custom-
made stent-graRof polytetrafluoroethylene-covered Wallstents: techniques and applications. JVIR 1999; 10:9-16.
Digital Cameras: A Rapid and Inexpensive Means of Transferring Angiographic Images to Referring Clinicians From: Reed A. Omary, MD, MS Riad Salem, MD, MBA Gary Wendt, MD, MBA John C. McDermott, MD Department of Radiology University of Wisconsin-Madison Hospitals & Clinics E31311 Clinical Science Center 600 Highland Avenue Madison, WI 53792 Editor: The transfer of radiographic images from the angiography suite to referring clinicians can be difficult in the absence of a dedicated picture archiving computer system (PACS). At our institution, because the vascular surgery clinic is located a t a n off-site facility, there are inherent delays in transferring radiographic images to vascular surgeons while the patient is still on the angiography table. We describe a low-cost means of transferring images from the angiography suite to referring clinicians using a hand-held digital camera and the Internet. Within our institution, the referring vascular surgeons will usually request a diagnostic arteriogram and desire to view the results before any subsequent endovascular intervention. This pattern usually does not present any problems when the vascular surgeons are present within the hospital. However, it is often inconvenient for them to view the images when they are seeing patients a t their off-site clinics. We solved this problem by using a hand-held digital camera to take pictures of the critical images. The digital camera can be used to take images directly off the angiographic monitor or the hard-copy film. Many varieties of digital cameras are available, at a range of prices. We have used the Mavica MVC-FD81 (Sony, Tokyo, Japan) because of the combination of low price
Figure. (a) Abdominal midstream aortogram in a 75-
year-old hypertensive man demonstrates bilateral severe renal artery ostial stenosis. (b) Completion aortogram following bilateral renal artery angioplasty and endovascular stent placement shows successful treatment of the bilateral renal artery stenosis. Images were obtained directly from the angiographic monitor using a hand-held digital camera (1,024 X 768 pixel resolution).
(about $800 retail), features, and ease of use. Images are directly stored onto a 3.5-inch floppy disk, which is inserted in the camera. The floppy disk can then be easily placed into the disk drive of any personal computer (PC or Macintosh), permitting access to the stored images. We then send the images to the vascular surgeons on our office desktop computers via electronic mail. The vascular surgeons review the transferred image files on their personal computers located in their clinic. Our vascular surgeons have uniformly appreciated this service because it allows them to participate in the potential management options of their patients while located at an off-site facility.
Letter to the Editor
995
Volume 10 Number 7
Images are stored in JPEG (Joint Photographic Experts Group) format, with resolution of either 1,024 x 768 or 640 x 480 pixels. The number of images that may be stored on a standard 1.44 Mb floppy disk varies depending on the image quality and resolution selected by the camera user. The camera's manual states that 25-40 images may be stored in low-resolution standard mode and six to eight images may be stored in high-resolution fine mode. We recommend that users experiment to decide what resolution and mode settings they find most useful. The camera has a long-lasting lithium battery, elinimating the need for any attached power cords. The floppy disk permits easy transfer of images from the camera to nearly any personal computer, without the extra step of a digitizer. Images may then be directly
loaded into Powerpoint (MicrosoR, Redmond, WA) for use as slides, stored on the personal computer's hard disk drive, placed on a recordable CD-ROM, or transferred over the Internet to another physician via electronic mail. When taking pictures, we make sure not to include the patient's name on the image. This ensures the patient's privacy while images are transferred over the Internet. The Figure demonstrates a set of sample images obtained during a diagnostic renal arteriogram and after the subsequent treatment of bilateral renal artery ostial stenoses with angioplasty and endovascular stents. We hope that this information is useful for other interventional radiologists who are having difficulties transferring angiographic images.
a
Letter to the Editor
July-August 1999 JVIR
pinching the end of the jacket. After approximately half of the jacket and stent-graft was advanced through the valve of the introducer sheath, the jacket was carefully held in place, with use of forceps, as the remainder of the stent-graft was advanced completely into the sheath (Fig 2). The jacket was then removed and discarded. We have found this simple modif5cation to be very helpful and have used it to deploy a stent-graft in a human subject. By using the jacket, one can avoid taping the end of the stent-graft to advance the stent-graft assembly into an introducer sheath and avoid the use of a second, larger sheath. Reference 1. Kato N, Sze D, Semba C, Razavi M, Kee S, Dake M. Custom-
made stent-graRof polytetrafluoroethylene-covered Wallstents: techniques and applications. JVIR 1999; 10:9-16.
Digital Cameras: A Rapid and Inexpensive Means of Transferring Angiographic Images to Referring Clinicians From: Reed A. Omary, MD, MS Riad Salem, MD, MBA Gary Wendt, MD, MBA John C. McDermott, MD Department of Radiology University of Wisconsin-Madison Hospitals & Clinics E31311 Clinical Science Center 600 Highland Avenue Madison, WI 53792 Editor: The transfer of radiographic images from the angiography suite to referring clinicians can be difficult in the absence of a dedicated picture archiving computer system (PACS). At our institution, because the vascular surgery clinic is located a t a n off-site facility, there are inherent delays in transferring radiographic images to vascular surgeons while the patient is still on the angiography table. We describe a low-cost means of transferring images from the angiography suite to referring clinicians using a hand-held digital camera and the Internet. Within our institution, the referring vascular surgeons will usually request a diagnostic arteriogram and desire to view the results before any subsequent endovascular intervention. This pattern usually does not present any problems when the vascular surgeons are present within the hospital. However, it is often inconvenient for them to view the images when they are seeing patients a t their off-site clinics. We solved this problem by using a hand-held digital camera to take pictures of the critical images. The digital camera can be used to take images directly off the angiographic monitor or the hard-copy film. Many varieties of digital cameras are available, at a range of prices. We have used the Mavica MVC-FD81 (Sony, Tokyo, Japan) because of the combination of low price
Figure. (a) Abdominal midstream aortogram in a 75-
year-old hypertensive man demonstrates bilateral severe renal artery ostial stenosis. (b) Completion aortogram following bilateral renal artery angioplasty and endovascular stent placement shows successful treatment of the bilateral renal artery stenosis. Images were obtained directly from the angiographic monitor using a hand-held digital camera (1,024 X 768 pixel resolution).
(about $800 retail), features, and ease of use. Images are directly stored onto a 3.5-inch floppy disk, which is inserted in the camera. The floppy disk can then be easily placed into the disk drive of any personal computer (PC or Macintosh), permitting access to the stored images. We then send the images to the vascular surgeons on our office desktop computers via electronic mail. The vascular surgeons review the transferred image files on their personal computers located in their clinic. Our vascular surgeons have uniformly appreciated this service because it allows them to participate in the potential management options of their patients while located at an off-site facility.
Letter to the Editor
995
Volume 10 Number 7
Images are stored in JPEG (Joint Photographic Experts Group) format, with resolution of either 1,024 x 768 or 640 x 480 pixels. The number of images that may be stored on a standard 1.44 Mb floppy disk varies depending on the image quality and resolution selected by the camera user. The camera's manual states that 25-40 images may be stored in low-resolution standard mode and six to eight images may be stored in high-resolution fine mode. We recommend that users experiment to decide what resolution and mode settings they find most useful. The camera has a long-lasting lithium battery, elinimating the need for any attached power cords. The floppy disk permits easy transfer of images from the camera to nearly any personal computer, without the extra step of a digitizer. Images may then be directly
loaded into Powerpoint (MicrosoR, Redmond, WA) for use as slides, stored on the personal computer's hard disk drive, placed on a recordable CD-ROM, or transferred over the Internet to another physician via electronic mail. When taking pictures, we make sure not to include the patient's name on the image. This ensures the patient's privacy while images are transferred over the Internet. The Figure demonstrates a set of sample images obtained during a diagnostic renal arteriogram and after the subsequent treatment of bilateral renal artery ostial stenoses with angioplasty and endovascular stents. We hope that this information is useful for other interventional radiologists who are having difficulties transferring angiographic images.