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ClearRead CT Solutions

OUR CT SOLUTIONS

ClearRead CT Applications

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A CLEARLY BETTER SOLUTION

Simple Installation and Workflow

Easy Installation


Both ClearRead X-ray and ClearRead CT provide rapid installation based on a combination of use of DICOM standards, flexible and advanced routing capability, DICOM filtering tools that allow specific devices, patient population or exam types to be processed or rejected.

On site installation, once approved for deployment by hospital IT, entails setting up a virtual machine according to ClearRead specifications. Once ClearRead software is installed and deployed on the hospital network based on a VM or physical server, DICOM data is received and selectively processed, according to site established protocols and routed to the PACs archive. Image content can be routed directly from the acquisition device through a parallel push process or routed from the PACS to the ClearRead server.

ClearRead content is read on the institutions existing PACS review station where all standard PACS review station image manipulation tools are available for ClearRead content manipulation.

Installation and configuration of ClearRead software typically take as little as four hours. The simplicity of the ClearRead installation on site is based on Riverain’s image normalization technology that eliminates the need for tuning to specific manufacturers or imaging protocols. Utilization of the existing PACS review station for image interpretation also greatly simplifies deployment at specific sites.

To maintain throughput, ClearRead incorporates highly efficient computational models based on state of the art low level math libraries. Advanced image normalization tools provide the capability to rapidly scale across different acquisition devices, on site or remote. Although high volume centers throughput is typically handled adequately by a single four core, intel processing unit based on a built in queuing and prioritization process, further scalability is easily achieved. For highly demanding throughput with high case volume, ClearRead has a built-in load balancing software capable of leveraging multiple virtual machines (VMs) as necessary. All routing, processing and delivery is automated to ensure ClearRead content is available to clinician without any reading delay.

Workflow


ClearRead CT provides a seamless workflow through use of DICOM standards, advanced routing capability, and DICOM filtering tools that allow specific exams, devices or patient demographics to be selectively processed or rejected.

ClearRead software can be installed on a stand-alone server, delivered by Riverain, or installed on a virtual machine (VM) using institutional server hardware. Once installed and deployed on the hospital network, DICOM data is received and selectively processed, according to site established protocols, and routed to the existing PACs archive. The ClearRead content is read on the institutions existing PACS review station where all standard PACS review station image manipulation tools are available for ClearRead content. Content can be routed directly from the acquisition device through a parallel push process or routed from the PACS to the ClearRead server once the native content is received at the PACS.

To maintain throughput, ClearRead incorporates highly efficient computational models based on state of the art low level math libraries. Advanced image normalization tools provide the capability to rapidlyscale across different acquisition devices, on site or remote. Although high volume centers throughput is typically handled adequately by a single four core, intel processing unit based on a built in queuing and prioritization process, further scalability is easily achieved. For highly demanding throughput with high case volume, ClearRead has a built-in load balancing software capable of leveraging multiple virtual machines (VMs) as necessary.All routing, processing and delivery is automated to ensure ClearRead content is available to clinician without any reading delay.

ClearRead content is read on institutions existing PACS review station, eliminating the need for costly dedicated workstations and disjoint workflows. Desired reading, hanging protocols are easily realized based on flexible tools.

RIVERAIN SOLUTIONS IN ACTION

Case Studies


Duke University Medical Center

Adoption of Inventive, Innovative, ClearRead CT Technology to Provide Patients with the Best Possible Care

Duke University Medical Center is a leading academic institution in thoracic imaging. As one of the first facilities in the country to institute a Lung Cancer Screening Program, Duke University Medical Center is looked to as a thought leader and reference site for institutions initiating similar programs. As an American College of Radiology (ACR) designated center for Lung Cancer Screening, Duke’s Lung Cancer Screening program is recognized for providing safe, effective care for at risk lung cancer patients, while maintaining the highest possible standards.

The shift toward the implementation of lung cancer screening programs began in 2011 with the release of the National Lung Cancer Screening Trial (NLST) results. The study concluded that annual screening with low-dose computed tomography (CT) could detect lung cancer in its earliest stages, reducing lung cancer deaths by 20 percent.

Duke University Medical Center prides itself on providing its patients with the highest quality of care through state of the art technology, programs and the implementation of ground breaking technologies such as Riverain’s ClearRead CT, an aid for detecting lung nodules more efficiently and accurately.

Extending Early Detection Beyond Lung Cancer Screening
According to Dr. Jared Christensen, Division Chief of Cardiothoracic Imaging and Director of Duke’s Lung Cancer Screening Program, one of their biggest challenges in thoracic imaging is searching for lung nodules. For every chest CT exam that is taken, radiologists are obligated to search for lung nodules. Due to the lack of symptoms in early stage lung cancer, the detection of incidental pulmonary nodules serves as a critically important opportunity for early lung cancer detection. In an effort to help their radiologists detect more, more efficiently, Duke University Medical Center has deployed Riverain’s ClearRead CT software throughout their entire health network across all chest CTs, whether taken for screening or not.

“Riverain’s ClearRead CT has been deployed as a part of our routine Chest CT exams, including patients in our Lung Cancer Screening Program,” said Dr. Christensen. “The ClearRead CT technology has helped us to detect lung nodules that may have otherwise been missed. Based upon our early experience, the workflow is faster and more accurate than existing technologies.”

Improved Detection, Decreased Reading Time, Standardized Patient Care
ClearRead CT is the only FDA cleared device to support concurrent reading, allowing for faster reading with proven superior automatic nodule detection performance for all primary nodule types, including: solid, subsolid and ground glass nodules. With the use of ClearRead CT, facilities like Duke are able to achieve a 26% reduction in reading time while improving nodule detection by 29%.

Duke University Medical center has deployed Riverain’s ClearRead CT software throughout their entire healthcare network, providing a standard of care to their entire patient population. The ClearRead technology seamlessly processes CT scans from all 15 of Duke’s CT scanners regardless of manufacturer or acquisition protocols.

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Einstein Medical Center

ClearRead CT Adopted Network Wide to Improve Patient Care

Einstein Medical Center in Philadelphia is a leading academic institution for thoracic imaging. As a leading institution serving it’s Philadelphia patient population, Einstein has a history of quickly adopted innovative technology to improve patient case. Einstein Medical Center was the first U.S. site to adopt ClearRead CT enterprise wide. Einstein Medical Center is an American College of Radiology (ACR) designated center for Lung Cancer Screening, recognizing Einstein’s Lung Cancer Screening program for providing safe, effective care for at risk lung cancer patients.

Einstein Medical Center quickly adopted ClearRead CT and broadly deployed the technology to not only patients participating in Lung Cancer Screening to have the broadest possible patient impact of early detection of lung cancer screening as many lung cancers are detected incidentally on chest CTs performed for reasons outside lung cancer screening.

The ClearRead technology seamlessly processes CT scans from all 13 of the Einstein Medical Centers CT scanners regardless of manufacturer or acquisition protocols.

According to Dr. Terrence Matalon, Chairman of Einstein Medical Center Philidelphia’s Department of Radiology, “The application enables identification of small nodules faster and more reliably, particularly for oncological patients.”

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DISCOVER THE ADVANTAGES OF ClearRead CT
Watch videos below of ClearRead CT in action

“ClearRead CT has changed the way we read chest CT exams. The application enables identification of small nodules faster and more reliably, particularly for oncological patients”Dr. Terrence Matalon Chairman at ALBERT EINSTEIN MEDICAL CENTER

  • Reduces the burden of visual search and assessment by suppressing vascular structure and bookmarking regions of interest
  • Provides the ability to process scans from a wide range of acquisition protocols
  • Provides unprecedented detection and segmentation accuracy for lung nodules
  • Provides detailed characterization of nodules
Q. How does ClearRead CT | Vessel Suppress work?
A. Vessel suppression is a product of modern machine learning. Vessel suppression was built using hundreds of normal scans that spanned many different acquisition protocols, and many thousands of simulated nodules that captured the large variety of different morphologies, texture and attenuation characteristics of real nodules. Vessel suppression works by predicting the local lung air value except where there is nodule tissue. It can be thought of as the ultimate minimum intensity projection, only nodules are left unaltered. Riverain opted for the name “vessel suppression” as the predominant structure in normal lungs is vascular structure. However, vessel suppression also suppresses the bronchial tree and pulmonary fissures: essentially, all normal structures are suppressed.

Q. How does ClearRead CT | Detect work?
A. Detect is built on top of ClearRead CT | Vessel Suppress. Using the vessel suppressed CT series, candidate nodules are detected using nothing more than simple thresholding and morphological post-processing. Through vessel suppression, nodules can be robustly and consistently detected, segmented, and characterized. Not all regions detected through this process are, of course, nodules. False positives, such as residual vascular structure or bronchial wall, or other abnormalities such as scarring, can lead to false marks. Detect attempts to limit the number of false positives to as few as possible. In doing so, some nodules may be inadvertently removed and so the radiologist must remain diligent.

Q. Does ClearRead CT | Vessel Suppress remove nodules?
A. Vessel suppression is designed to operate for nodules that are roughly spherical (not linear or overly flat) and not too small (generally no smaller than 3mm). The vessel suppression algorithm was built using thousands of simulated nodules with a large variety of properties. The algorithm was tested against thousands of actual nodules and was found to perform exceptionally well – not a single nodule was removed. This includes our clinical study, which used data from the NLST study. Vessel suppression has been found, however, to contain false positives. So the clinician must reference the original scan to ensure that what is being revealed by vessel suppression is in fact a true nodule.

Q. Does ClearRead CT | Vessel Suppress work for non-solid nodules?
A. Yes. Vessel suppression is designed to work on solid and non-solid nodules, including those that are pure ground glass. What’s more, vessel suppression can remove superimposed vascular structure from ground glass nodules without removing solid components. This enables reliable characterization of mixed non-solid nodules.

Q. Does ClearRead CT work on low-dose scans?
A. Yes. ClearRead CT contains several modules meant to preprocess the data prior to analysis; this includes a model for removing acquisition noise.

Q. Does ClearRead CT work on contrast scans?
A. Yes. ClearRead CT was designed to work on scans with or without intravenous contrast.

Q. Will ClearRead CT Suite work with my CT manufacturer?
A. Just like our ClearRead chest xray technologies, ClearRead CT is manufacturer neutral and will work across all manufacturers.

  • Reduced lung-cancer mortality with low-dose computed tomographic screening. National Lung Screening Trial Research Team, Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, Gareen IF, Gatsonis C, Marcus PM, Sicks JD. N Engl J Med. 2011 Aug 4;365(5):395-409. doi: 10.1056/NEJMoa1102873. Epub 2011 Jun 29