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<meta name="DC.Title" content="PACS Integration of Semiautomated Imaging Software Improves Day-to-Day MS Disease Activity Detection" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6195" />
<meta name="DC.Date" content="2019-10-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The standard for evaluating interval radiologic activity in MS, side-by-side MR imaging comparison, is restricted by its time-consuming nature and limited sensitivity. VisTarsier, a semiautomated software for comparing volumetric FLAIR sequences, has shown better disease-activity detection than conventional comparison in retrospective studies. Our objective was to determine whether implementing this software in day-to-day practice would show similar efficacy.

MATERIALS AND METHODS: VisTarsier created an additional coregistered image series for reporting a color-coded disease-activity change map for every new MS MR imaging brain study that contained volumetric FLAIR sequences. All other MS studies, including those generated during software-maintenance periods, were interpreted with side-by-side comparison only. The number of new lesions reported with software assistance was compared with those observed with traditional assessment in a generalized linear mixed model. Questionnaires were sent to participating radiologists to evaluate the perceived day-to-day impact of the software.

RESULTS: Nine hundred six study pairs from 538 patients during 2 years were included. The semiautomated software was used in 841 study pairs, while the remaining 65 used conventional comparison only. Twenty percent of software-aided studies reported having new lesions versus 9% with standard comparison only. The use of this software was associated with an odds ratio of 4.15 for detection of new or enlarging lesions ( P = .040), and 86.9% of respondents from the survey found that the software saved at least 2–5 minutes per scan report.

CONCLUSIONS: VisTarsier can be implemented in real-world clinical settings with good acceptance and preservation of accuracy demonstrated in a retrospective environment.

AIC
:   akaike information criterion
CSSC
:   conventional side-by-side comparison
EDSS
:   Expanded Disability Status Scale
VT
:   VisTarsier" />
<meta name="DC.Contributor" content="A. Dahan" />
<meta name="DC.Contributor" content="R. Pereira" />
<meta name="DC.Contributor" content="C.B. Malpas" />
<meta name="DC.Contributor" content="T. Kalincik" />
<meta name="DC.Contributor" content="F. Gaillard" />
<meta name="article:published_time" content="2019-10-01" />
<meta name="article:section" content="Adult Brain" />
<meta name="citation_title" content="PACS Integration of Semiautomated Imaging Software Improves Day-to-Day MS Disease Activity Detection" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;The standard for evaluating interval radiologic activity in MS, side-by-side MR imaging comparison, is restricted by its time-consuming nature and limited sensitivity. VisTarsier, a semiautomated software for comparing volumetric FLAIR sequences, has shown better disease-activity detection than conventional comparison in retrospective studies. Our objective was to determine whether implementing this software in day-to-day practice would show similar efficacy.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;VisTarsier created an additional coregistered image series for reporting a color-coded disease-activity change map for every new MS MR imaging brain study that contained volumetric FLAIR sequences. All other MS studies, including those generated during software-maintenance periods, were interpreted with side-by-side comparison only. The number of new lesions reported with software assistance was compared with those observed with traditional assessment in a generalized linear mixed model. Questionnaires were sent to participating radiologists to evaluate the perceived day-to-day impact of the software.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Nine hundred six study pairs from 538 patients during 2 years were included. The semiautomated software was used in 841 study pairs, while the remaining 65 used conventional comparison only. Twenty percent of software-aided studies reported having new lesions versus 9% with standard comparison only. The use of this software was associated with an odds ratio of 4.15 for detection of new or enlarging lesions (&lt;i&gt;P&lt;/i&gt; = .040), and 86.9% of respondents from the survey found that the software saved at least 2–5 minutes per scan report.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;VisTarsier can be implemented in real-world clinical settings with good acceptance and preservation of accuracy demonstrated in a retrospective environment.&lt;/p&gt;" />
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<meta name="twitter:title" content="PACS Integration of Semiautomated Imaging Software Improves Day-to-Day MS Disease Activity Detection" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The standard for evaluating interval radiologic activity in MS, side-by-side MR imaging comparison, is restricted by its time-consuming nature and limited sensitivity. VisTarsier, a semiautomated software for comparing volumetric FLAIR sequences, has shown better disease-activity detection than conventional comparison in retrospective studies. Our objective was to determine whether implementing this software in day-to-day practice would show similar efficacy.

MATERIALS AND METHODS: VisTarsier created an additional coregistered image series for reporting a color-coded disease-activity change map for every new MS MR imaging brain study that contained volumetric FLAIR sequences. All other MS studies, including those generated during software-maintenance periods, were interpreted with side-by-side comparison only. The number of new lesions reported with software assistance was compared with those observed with traditional assessment in a generalized linear mixed model. Questionnaires were sent to participating radiologists to evaluate the perceived day-to-day impact of the software.

RESULTS: Nine hundred six study pairs from 538 patients during 2 years were included. The semiautomated software was used in 841 study pairs, while the remaining 65 used conventional comparison only. Twenty percent of software-aided studies reported having new lesions versus 9% with standard comparison only. The use of this software was associated with an odds ratio of 4.15 for detection of new or enlarging lesions ( P = .040), and 86.9% of respondents from the survey found that the software saved at least 2–5 minutes per scan report.

CONCLUSIONS: VisTarsier can be implemented in real-world clinical settings with good acceptance and preservation of accuracy demonstrated in a retrospective environment.

AIC
:   akaike information criterion
CSSC
:   conventional side-by-side comparison
EDSS
:   Expanded Disability Status Scale
VT
:   VisTarsier" />
<meta name="og-title" property="og:title" content="PACS Integration of Semiautomated Imaging Software Improves Day-to-Day MS Disease Activity Detection" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/40/10/1624" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The standard for evaluating interval radiologic activity in MS, side-by-side MR imaging comparison, is restricted by its time-consuming nature and limited sensitivity. VisTarsier, a semiautomated software for comparing volumetric FLAIR sequences, has shown better disease-activity detection than conventional comparison in retrospective studies. Our objective was to determine whether implementing this software in day-to-day practice would show similar efficacy.

MATERIALS AND METHODS: VisTarsier created an additional coregistered image series for reporting a color-coded disease-activity change map for every new MS MR imaging brain study that contained volumetric FLAIR sequences. All other MS studies, including those generated during software-maintenance periods, were interpreted with side-by-side comparison only. The number of new lesions reported with software assistance was compared with those observed with traditional assessment in a generalized linear mixed model. Questionnaires were sent to participating radiologists to evaluate the perceived day-to-day impact of the software.

RESULTS: Nine hundred six study pairs from 538 patients during 2 years were included. The semiautomated software was used in 841 study pairs, while the remaining 65 used conventional comparison only. Twenty percent of software-aided studies reported having new lesions versus 9% with standard comparison only. The use of this software was associated with an odds ratio of 4.15 for detection of new or enlarging lesions ( P = .040), and 86.9% of respondents from the survey found that the software saved at least 2–5 minutes per scan report.

CONCLUSIONS: VisTarsier can be implemented in real-world clinical settings with good acceptance and preservation of accuracy demonstrated in a retrospective environment.

AIC
:   akaike information criterion
CSSC
:   conventional side-by-side comparison
EDSS
:   Expanded Disability Status Scale
VT
:   VisTarsier" />
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      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Adult Brain</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">PACS Integration of Semiautomated Imaging Software Improves Day-to-Day MS Disease Activity Detection</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A. Dahan</span>, <span class="highwire-citation-author" data-delta="1">R. Pereira</span>, <span class="highwire-citation-author" data-delta="2">C.B. Malpas</span>, <span class="highwire-citation-author" data-delta="3">T. Kalincik</span> and <span class="highwire-citation-author" data-delta="4">F. Gaillard</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2019,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1624-1629; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6195 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-70716--81438960311" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A. Dahan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (A.D.), Austin Hospital, Heidelberg, Australia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BDahan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Dahan%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BDahan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-3205-425X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Dahan</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">R. Pereira </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Radiology (R.P., F.G.)</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Radiology (R.P.), University of Queensland, Brisbane, Queensland, Australia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2BPereira%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Pereira%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AR.%2BPereira%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7965-2065" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Pereira</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">C.B. Malpas </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Neurology (T.K., C.M.), Royal Melbourne Hospital, Parkville, Victoria, Australia</div><div class='author-affiliation'><span class='nlm-sup'>e</span>Clinical Outcomes Research Unit (CORe) (C.M., T.K.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.B.%2BMalpas%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Malpas%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.B.%2BMalpas%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-0534-3718" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.B. Malpas</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">T. Kalincik </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Neurology (T.K., C.M.), Royal Melbourne Hospital, Parkville, Victoria, Australia</div><div class='author-affiliation'><span class='nlm-sup'>e</span>Clinical Outcomes Research Unit (CORe) (C.M., T.K.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.%2BKalincik%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kalincik%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.%2BKalincik%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-3778-1376" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T. Kalincik</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">F. Gaillard </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Radiology (R.P., F.G.)</div><div class='author-affiliation'><span class='nlm-sup'>f</span>Departments of Medicine and Radiology (F.G.), University of Melbourne, Melbourne, Australia.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.%2BGaillard%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gaillard%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AF.%2BGaillard%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-2382-872X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F. Gaillard</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><span class="name">A. Dahan</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-2"><span class="name">R. Pereira</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">b</a><span class="xref-sep">,</span><a id="xref-aff-4-1" class="xref-aff" href="#aff-4">d</a>, </li><li class="contributor" id="contrib-3"><span class="name">C.B. Malpas</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">c</a><span class="xref-sep">,</span><a id="xref-aff-5-1" class="xref-aff" href="#aff-5">e</a>, </li><li class="contributor" id="contrib-4"><span class="name">T. Kalincik</span><a id="xref-aff-3-2" class="xref-aff" href="#aff-3">c</a><span class="xref-sep">,</span><a id="xref-aff-5-2" class="xref-aff" href="#aff-5">e</a> and </li><li class="last" id="contrib-5"><span class="name">F. Gaillard</span><a id="xref-aff-2-2" class="xref-aff" href="#aff-2">b</a><span class="xref-sep">,</span><a id="xref-aff-6-1" class="xref-aff" href="#aff-6">f</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address><sup>a</sup>From the Department of Radiology (A.D.), Austin Hospital, Heidelberg, Australia</address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address><sup>b</sup>Departments of Radiology (R.P., F.G.)</address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address><sup>c</sup>Neurology (T.K., C.M.), Royal Melbourne Hospital, Parkville, Victoria, Australia</address></li><li class="aff"><a id="aff-4" name="aff-4"></a><address><sup>d</sup>Department of Radiology (R.P.), University of Queensland, Brisbane, Queensland, Australia</address></li><li class="aff"><a id="aff-5" name="aff-5"></a><address><sup>e</sup>Clinical Outcomes Research Unit (CORe) (C.M., T.K.)</address></li><li class="aff"><a id="aff-6" name="aff-6"></a><address><sup>f</sup>Departments of Medicine and Radiology (F.G.), University of Melbourne, Melbourne, Australia.</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1">Please address correspondence to Ariel Dahan, MD, <span class="addr-line">MSc, Radiology Department, Lance Townsend Bldg, Austin Hospital, 145 Studley Rd, Heidelberg 3084, Australia</span>; e-mail: <span class="em-link"><span class="em-addr">ariel.dahan{at}austin.org.au</span></span></li></ol></div></div><a href="http://ajnr-stage2.stage.highwire.org/content/40/10/1624.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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