Team tracks timely CT workflow in acute stroke patients

Timely CT scans are a crucial component of a stroke patient’s immediate treatment plan, and researchers at the University of Wisconsin-Madison have devised a method for tracking efficiency in institutions nationwide.

In a case study published by the Journal of the American College of Radiology, first author Christina L. Brunnquell, PhD, and colleagues evaluated the efficiency of their own programs in Wisconsin, tracking nearly 500 stroke examinations to measure image acquisition, processing and transfer efficiency.

“Timely diagnosis and therapy is essential in stroke response, because time-efficient CT imaging in acute stroke can significantly contribute to preserved neural circuitry and improved patient outcomes,” Brunnquell and co-authors wrote. “In addition to rapid imaging, accessibility of imaging series to interpreting radiologists before examination completion is vital for rapid decision-making and patient management.”

Existing commercial image analytics currently don’t have the capacity to assess such in-depth workflow, the authors wrote, which can result in “potentially inaccurate and time-consuming pen-and-paper methods” of evaluating quantitative data.

The researchers’ hospital was no exception, they said. Despite technologist training, protocol and policy changes and the implementation of software solutions, Brunnquell et al. wrote objective assessment of the radiology team’s process was lacking prior to this study.

The authors used data from 494 comprehensive acute stroke exams over the course of a year and a half, according to the research. For each image in each series—all of which were performed at the same hospital—the researchers extracted timing information from DICOM tags and PACS time stamps. Data corresponded to the time of the series creation, image acquisition and image reconstruction.

CT protocol is standard at Brunnquell and colleagues’ institution; it utilizes the standard CT workflow steps of image acquisition, reconstruction, processing and transfer. The researchers said their analysis indicated high-efficiency workflow and PACS availability, which can aid clinicians in diagnosing and evaluating possible ischemia or hemorrhage in stroke patients.

“This approach can be easily adopted at any institution for objective efficiency monitoring because it uses easily accessible data that are automatically recorded with every image slice,” Brunnquell et al. wrote. “Time-efficient CT imaging in acute stroke is essential for improving patient outcomes and has been emphasized in national guidelines for acute stroke care. For our institution, these results provide important insight into what clinical factors significantly impact efficiency and indicate new areas for quality improvement.”