The impact of implementing lesion tracking

As we spoke to Dr. Stephen Seiler, who has been a user of Sectra’s radiology solution for just over a year at UT Southwestern Medical Center, we learnt he has been actively exploring its features and functionalities, including the lesion tracking tool. He primarily works with mammograms and ultrasounds, and occasionally reads complex MRI studies, where it is highly useful with a structured follow-up of lesions over time. In the interview he said:

“I think when you have a very complex exam with numerous images and series, having that information pop up and knowing almost instantaneously what was shown on a previous exam, how it was measured, and how it has changed—that’s where I find the lesion tracking tool particularly helpful”.

Out of the discussion we can conclude that with tailored and easy-to-use functionality with a built-in workflow, a radiologist can get a fast and accurate overview of current and prior measurements. This helps clarify and evaluate lesion progression or regression effectively, and in the end leads to more informed treatment decisions and follow-ups.

To briefly explain the functionality of Sectra Lesion tracking, the software uses image registration to facilitate comparison, and navigate to the correct anatomical region, ensuring that measurements across studies are consistent and reliable. As Dr. Seiler has experienced:

“And if you click on the image, it will take you there. So, I find that that’s, from a navigation standpoint, really nice”.

In addition, Radiologists can seamlessly compare current and prior studies, either through thumbnails or by reviewing the complete image series, particularly for the most recent examinations.

Another important feature is the quick access to prior measurements and navigation to the corresponding location in the current study. It can significantly speed up the process of following up lesions and save significant time per case. Dr. Seiler highlights the importance of such efficiency, particularly in high-volume settings like the Cancer Center at UTSW, where numerous cases must be assessed and followed up quickly and accurately each week. He points out:

“In any given year, my institution has about 1,000 breast cancer cases that we either diagnose internally or are referred to us externally. So, an average of about two to three neoadjuvant chemotherapy follow-ups a day”.

Doing some simple calculations, this shows tools like Sectra Lesion tracking that streamline lesion management would be highly valuable to any organization. Both timewise and moneywise.

We continued the discussion now talking to Dr. Ng, and we came into the topic about keeping track of lesion progression using manual measurement is time-consuming and risky. Another benefit with lesion tracking tools is that they can have support for adding the exact measurement without any manual step other than a right-click and choose to add measurement to report. Think of the difference this would make to the security of the solution.

We also concluded that manual steps require radiologists to dedicate significant time to adding findings to the report and double checking that these measurements have been entered correctly. Such manual tasks result in slow workflows and may jeopardize the accuracy of the information provided to referrers. As Dr. Ng explains:

“In the past, everyone just ‘free-texted,’ but now it’s good to list out and be really organized when talking about the lesions.” He continues, “Usually in our report, what we need is series and image numbers so the clinicians can navigate to that lesion easily when they’re looking at the images to know what we’re talking about.”

Given the importance of reporting in a radiologist’s workflow, it is essential that reports are generated in a structured, comprehensive, and concise manner. However, manually entered lesion information, as well as over-detailed reports, can directly impact productivity, increasing the risk of inconsistencies or errors that could potentially affect patient outcomes.

On the reporting topic, the receiver of the report expects the findings to be communicated clearly and for the data to be easily interpreted. However, in the case of complex examinations, this does not always happen. Inaccurate or incomplete reports on the lesions can hinder effective communication between radiologists and referring physicians, making it difficult for them to read the report, interpret the findings and move along with accurate clinical decisions.

Tools like Sectra Lesion tracking addresses these challenges by allowing radiologists to insert lesion details into the report with a single click of a mouse button. The measurement is automatically transferred as key information into the report template, reducing manual steps and eliminating the risk of human error. Dr. Ng highlights the benefits, stating:

“The measurements are there, and series and image numbers are there. So, I don’t ‘fat finger’ or make typos on measurements and the location of the lesions.”

Referrers—e.g. general practitioners, emergency rooms, surgeons etc.—receive the report and are the primary point of contact for patients. Having a clear and well-structured report helps them to communicate with the patient and walk them through the treatment. This ensures they can communicate information accurately and plan the right follow-up treatment and take other necessary actions.

In addition to the reporting functionality, marking, categorizing and comparing lesions is another field where a lesion tracking solution adds a great deal of support. Its capability of accurately reporting those findings and presenting them in a visual report presentation greatly helps the recipient in understanding the report. When the referrer can use interactive visual aids, such as annotated images and graphical representations of lesion progression and regression, it helps with immediate insight into the patient’s condition. This ensures transparency with a simplified breakdown of measurements that streamline communication.

“They (author’s note: referrers) love that I’m using lesion tracking. In the past (during an MDT), I showed one exam and then the prior on the other partition. Now I show the current exam and how the lesion is looking, and I just scroll through the thumbnails to see how it looked in the prior exam, in one view. You can basically have an assessment of how the patient is responding, or not. So, they really love it.”

In most diagnostic imaging applications, radiologists are trying to maintain a comprehensive view of all lesions across different periods of time. Such a fragmented overview of the lesions can affect or even hinder the follow-up of progression or regression and make it more complex and prone to error. By having an overview that visually presents the history and status of the patient’s lesions in one view, the radiologists can monitor the trajectory. This directly assists the radiologist to efficiently report on the current case and may also indirectly help patient treatment progress.

Dr Ng said, “I use it to track every single lesion to ensure they are stable in size across time. When you are tracking lesions over ten different priors, each being three months apart, you’re more likely to see that gradual increase over time”.

Preparing for MDT meetings often involves manually organizing imaging data, reports, and study data, which can lead to inefficiencies and potential oversights. However, it is still a very important but time-consuming step in the decision-making process leading up to a treatment plan for the patient.

It can take as much or even more time to prepare for such a meeting than to read and report the case. Dr. Ng describes MDT preparation as a time-consuming and precise task:

“Preparing for an MDT presentation takes a significant amount of time, often as long as reading the case itself. For oncology cases, it might take around 20–30 minutes per case, especially in a tertiary hospital where patients often have complex or metastatic disease. Overall, preparing for an entire MDT can easily take up to four hours, as it involves reviewing prior studies and ensuring everything is ready for discussion”.

To solve these challenges, he sees tools, and in this case Sectra Lesion tracking, as a valuable assistant in reducing preparation time, minimizing errors, and automating manual tasks. This improves both accuracy and efficiency when presenting findings. Dr. Ng said:

“However, having a complete report and tools like [Sectra] lesion tracking significantly cuts down this preparation time, saving five minutes per case. Since we typically present up to ten cases during an MDT, this saves almost an hour just for the preparation alone”.

A diagnostic application with tools for lesion overview facilitates MDT preparation by showing annotated thumbnails and summarized lesion information and improves the quality of presentations and discussions. Dr. Ng says:

“I use lesion tracking a lot with multidisciplinary conferences, because given that many lesions, I want to go through and cover all of them. It is enhancing a lesion here, and I can quickly—instead of pulling the priors, which takes time—just show them the thumbnails. The thumbnails already show the information that I want to show, which is the measurements and what the lesion looks like.”

Without these capabilities, which most legacy systems lack, lesion tracking workflows are inefficient. He continues:

“In the past, in a different PACS system, I would write down the series and images number and try to navigate to that during the MDT itself. So, by using  lesion tracking, I don’t even have to do that anymore. It’s much easier to navigate through different lesions and present cases efficiently”.

And on the topic of saving time with smart tools, Dr. Ng concludes:

“For the typical hour-long MDT, I’m usually finishing it in 45 to 50 minutes now, thanks to (Sectra) lesion tracking”.

The efforts of one person can reflect and impact on the entire workflow within the organization. If there is no standard practice and workflows are inconsistent, a whole department can become inefficient. When it comes to healthcare organizations specifically, this could impact the decision-making process and consequently patient care and outcomes.

The implementation of standard and consistent processes is vital for a radiology department to work quickly and efficiently. When it comes to the task of evaluating lesion progression or regression, this is no different. Sectra Lesion Tracking enables transparency, making it easy to see how colleagues measured lesions in prior examinations, as Dr. Seiler explains:

“I find it particularly helpful that it shows how the lesion was measured previously. And being able to replicate that. It is helpful to know if the measurement was done on an MPR (author’s note: multiplanar reconstruction) image”.

This ensures that when radiologists compare prior cases with current studies and decide on the next course of action, they can make confident and accurate decisions. The work that one puts in on the current study will benefit the next radiologist in subsequent studies.

Lesion tracking can have a positive impact on the entire radiology department’s workflow and present even more long-term benefits. When adopted as a standard practice:

• Radiologists experience consistent workflows.
• Radiologists benefit from their colleagues’ work on prior examinations.
• Multidisciplinary teams gain easier access to structured data.
• Collaboration improves, benefiting both clinicians and patients.

The value achieved with the solution can be amplified when it is used as a group. It can facilitate the reading and analysis of studies while also automating and creating structured and clear reports. The results used in a group context can enhance communication, optimize resources and keep the workflow efficient and consistent.

Improving the workflow process by adding this new functionality means that less effort and fewer clicks are required. The feature is easily accessible in the image window of Sectra’s diagnostic application and connects seamlessly to the reporting editor. In addition, it integrates with third-party AI applications, and offers visual aspects to support analysis, such as the lesion graph. This enables radiologists to effortlessly adopt its usage and make the tool part of their daily work, resulting in more productivity and less time spent when considering the entire examination path, as pointed out by Dr. Ng:

“It’s not extra work if you look at it from the bigger picture perspective; it’s a long-term investment of time.”

Conclusion

The testimonials in this report serve as a reminder of the value offered and its potential for brilliant workflows with productivity and the following time and money savings. Derived from the interview with Dr. Seiler and Dr. Ng, tools like Sectra Lesion tracking helps radiologists save time by organizing and simplifying complex tasks, improving diagnostic accuracy and enhancing collaboration. This shows that investment in advancing technology can potentially lead to shorter patient pathways and thus enable more time for radiologists.

Dr. Ng: “So this is extremely useful. I haven’t really seen any other PACS that offers this capability before.”