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ABILITY TO SEE CLEARLY

ClearRead Xray Solutions

OUR XRAY SOLUTIONS

ClearRead Xray Applications

A CLEARLY BETTER SOLUTION

Simple Installation and Workflow

Easy Installation

ClearRead Xray provides 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 Xray 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


University of Colorado

Enterprise deployment of ClearRead Bone Suppression and Confirm

UCHealth expanded their use of Riverain’s ClearRead Bone Suppression and ClearRead Confirm software to all five of their flagship hospitals in October, 2016 after five years of clinical use at the maincampus hospital, Anschutz Medical Campus in Aurora.

UCHealth is a nationally recognized system of five hospitals and more than 100 clinics including University of Colorado Hospital, Poudre Valley Hospital, Medical Center of the Rockies, Memorial Hospital Central and Memorial Hospital North.

ClearRead Bone Suppression forms a soft tissue image by subtracting the ribs and clavicles from the standard chest x-ray, allowing radiologists to more effectively detect lung disease. Powered by cutting edge machine learning, it is the only software product to perform robust, pixel level bone suppression throughout the entire body.

The ClearRead Confirm optimizes the visual quality of chest x-rays, including improving the conspicuity of lines and tubes on portable images, allowing radiologists to read up to 19% faster.

The software immediately enhances any adult chest X-ray image after capture from upright or portable imaging machines, without the need for additional imaging equipment. It seamlessly integrates into any digital radiology department, offering universal connectivity with existing PACS, and can be used to improve the visibility and detection rates of focal densities, including nodules. Affordable Solution Compared to Dual Energy ClearRead Bone Suppress is a strictly software solution, so it can easily be applied to every X-ray device in the facility for one fixed cost, whereas dual energy subtraction is hardware-based and can only be applied on designated X-ray devices.

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Riverside Medical Center

Riverside Medical Center Utilizes Riverain’s ClearRead Bone Suppress Software in Conjunction with Their Program for Earlier Detection of Lung Disease.

The Riverside Low Dose CT (Computed Tomography) Lung Cancer Screening program is geared toward patients that would be labeled high risk. The high risk patients then meet with a lung cancer screening navigator to discuss possible options and screening methods. The standard route is to have a CT scan and if everything comes back normal schedule two additional annual follow-up CT scans. Since the current program is geared toward the high risk population, Riverside has adopted Riverain’s ClearRead Bone Suppress technology as a way to reach and scan patients in lower risk categories allowing for further additional findings and earlier treatment of their patient population.

"Our staff loves it, they think it’s a great tool," said Curiel. "The techs, radiologists and referring physicians are definitely positive." When asked to describe the lung cancer program and what they see as the role of ClearRead Bone Suppress, Curiel stated, "Our plan is to get more information out of the initial chest X-rays so we can detect nodules earlier and begin tracking them and providing treatment at earlier stages and in turn provide a better quality of life for our patients."

"Past bone suppression techniques have been tied to a single device, making it impractical to utilize in a widespread program like ours," said Kathleen Curiel, Director of Radiology Services at Riverside Medical Center. The Riverain software could be deployed at all 7 of our sites, on all of our devices, allowing us to create a soft tissue image for all patients with a chest X-ray, 18 and up." With seamless deployment and wide spread utilization, it didn’t take long for the staff at Riverside Medical Center to see the diagnostic potential and get acclimated to using the software in their day-to-day processes.

ClearRead Bone Suppress processes the standard chest X-ray image and produces a secondary soft tissue image without requiring additional procedures or radiation dose. The soft tissue image is automatically placed in the patient file, allowing the radiologists to see more and make more confident decisions. Riverside Medical Center, has implemented a lung cancer screening program, designed to detect, track and diagnose lung nodules to find cancer in its earlier stages. In conjunction with their CT outreach program, Riverside implemented ClearRead Bone Suppress software as a valuable tool in their lung cancer program, making greater use of the most commonly performed radiological exam, the Chest X-ray.

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CLEARREAD XRAY

BONE SUPPRESSION

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DETECT

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CONFIRM

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COMPARE

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“Certainly in our practice we absolutely have had proven cancers where, when we were reading the study, we did not see them until we looked at the bone-suppressed image.”Dr. Peter Sachs University Of Colorado Hospital
and Anschutz Medical Campus

For radiologists:

  • More confident, accurate image interpretation
  • Easy, one-click access to enhanced images
  • Images automatically added to patient files

For administrators:

  • Immediate display on existing PACS viewer—no need for extra time or equipment
  • Uses existing chest X-ray – no additional procedure or dose to the patient
  • Hospital-wide solution automatically enhances every X-ray image
  • FDA-cleared solution benefits patients across multiple departments settings
  • Benefits patients in multiple hospital settings including radiology, ICU/CCU, and ER

For patients:

  • Enables detection of 1 in 6 nodules previously missed
  • Uses existing chest X-rays, so no additional procedures/doses required
Q. Is ClearRead Xray on a dedicated review station?
A. No, the ClearRead Xray images are stored as part of the original patient study and is available for review on the existing PACS review station with the original study.

Q. Will it work with my PACS?
A. ClearRead Xray is fully DICOM compliant and works with any PACS. It has been installed in different environments containing all prominent PACS vendors’ systems.

Bone Suppression Clinical Studies

  • Bone Suppression Increases the Visibility of Invasive Pulmonary Aspergillosis in Chest Radiographs. S. Schalekamp, B. van Ginneken, I. Van Den Berk, I. Hartmann, M. Snoeren, A. Odink,W. Van Lankeren, S. Pegge, L. Schijf, N. Karssemeijer, C. Schaefer-Prokop; Published: October 03, 2014 DOI: 10.1371/journal.pone.0108551.
  • Chest radiography: new technological developments and their applications. S. Schalekamp, B. van Ginneken, N. Karssemeijer and C.M. Schaefer-Prokop; Seminars in Respiratory & Critical Care Medicine 2014;35:3-16.
  • Bone suppressed images improve pulmonary fungal infection detection in chest radiographs. S. Schalekamp, I.A.H. van den Berk, I.J.C. Hartmann, M.M. Snoeren, A.E. Odink, S.A.H. Pegge, L.J. Schijf, N. Karssemeijer, C.M. Schaefer-Prokop, European Congress of Radiology, March 2014.
  • Improved Detection of Focal Pneumonia by Chest Radiolgraphy with Bone Suppression Imaging. Feng L, Engelmann R, Pesce L, Armato III S, MacMahon H. European Society of Radiology, May 2012.
  • Lung Nodules: Improved Detection with Software that Suppresses the Rib and Clavicle on Chest Radiographs. Freedman, et.al, Radiology; July 2011, Volume 260 Number 1, RADLAX 260(1) 1-308.
  • Bone suppression imaging improves observer performance for the detection of lung nodules in chest radiographs. ESTI, 2012. Schalekamp, Steven, et. al.
  • Small lung cancers: improved detection by use of bone suppression imaging–comparison with dual-energy subtraction chest radiography. Li F, Engelmann R, L Pesce L, Doi K, Metz CE, MacMahon H, Radiology. 2011 Dec;261(3):937-49. Epub 2011 Sep 23.
  • Improved detection of subtle lung nodules by use of chest radiographs with bone suppression imaging: receiver operating characteristic analysis with and without localization. Li F, Hara T, Shiraishi J, Engelmann R, MacMahon H, Doi K., AJR Am J Roentgenol. 2011 May;196(5):W535-41.
  • Improved Conspicuity of Small Lung Nodules on Bone Suppression Chest Images. Li F, Hara T, Englemann, R, et al., RSNA, 2009; p793.
  • Improved Detection of Pneumonia by Chest Radiographs with Bone Suppression Imaging. Li F, Engelmann R, and MacMahon H, RSNA, 2010.

Detect Clinical Studies

  • Computer aided detection improves detection of pulmonary nodules in chest radiographs beyond the support by bone suppressed images. S. Schalekamp, B. van Ginneken, E. Koedam, M.M. Snoeren, A.M. Tiehuis, R. Wittenberg, N. Karssemeijer and C.M. Schaefer-Prokop; Radiology, March 2014.
  • Double reading improves detection of small lung tumours in chest radiographs: can a computer aided detection system replace the second reader? S. Schalekamp, C.M. Schaefer-Prokop, N. Karssemeijer, B. van Ginneken; European Congress of Radiology, March 2014.
  • Performance of a Next Generation Computer-aided Detection Algorithm for the Detection of Overlooked Lung Cancers on Chest Radiographs. RSNA 2013. Gilkeson, Robert C., Frolkis, Calen.
  • Comparison of Dual-Energy Subtraction and Electronic Bone Suppression Combined With Computer-Aided Detection on Chest Radiographs: Effect on Human Observers’ Performance in Nodule Detection. Szucs-Farkas, Zsolt, et. al., AJR:200, May 2013.
  • Use of Bone Suppression in Computer-Aided Detection for Chest Radiographs: Analysis of a new Scheme with High Sensitivity and Greatly Improved Specificity. Heber Macmahon MD, RSNA Meeting presentation. November 2011 CODE SSJ05-06.
  • Use of CAD to Evaluate Lung Cancer on Chest Radiography. Chen J and White C (2008). Journal of Thoracic Imaging. 23:93-96.

Compare Clinical Studies

  • Riverain Medical DeltaView FDA 510(k) Reader Study Results. 2011

Confirm Clinical Studies

  • Riverain Technologies ClearRead +Confirm FDA 510(k) Reader Study Results. 2012