BOSTON CHILDREN'S HOSPITALCASE STUDY: Synapse® 3D

THE CHALLENGE: Finding New Ways to Support Sub-specialized Pediatric Physicians

Ask any parent whose child has needed medical care, and they will tell you that Boston Children’s Hospital is the best of the best. The hospital was recently ranked by U.S. News and World Report as the number one children’s hospital in the nation—for the fifth consecutive year. It’s also nationally ranked in numerous pediatric subspecialties, including pediatric neurology, neurosurgery, neonatology, cardiology, heart surgery, cancer, and more.

A 404-bed comprehensive care center for pediatrics, Boston Children’s offers a complete range of healthcare services for children of all ages. Its world-renowned physicians are among the finest in the world, and supporting their numerous sub-specialties with timely, accurate diagnostic imaging answers is no easy feat.

“Our clinicians are all at the top of their game, so we Boston Children’s radiologists have to be at the top of every game,” said Dr. Prabhu, MBBS, FRCR, Staff Neuroradiologist and Medical Director of Imaging Informatics at Boston Children’s Hospital and Assistant Professor of Radiology at Harvard Medical School. “The pressure to keep up is a challenge for all members of our radiology faculty.”

THE SOLUTION: Innovative Uses of a Robust 3D Tool

With approximately 40 radiologists in the department, Boston Children’s Hospital performed an estimated 214,000 radiological examinations in 2018. The team has found that having access to the right imaging technology is critical. However, understanding the full capabilities of any given tool can make a profound impact as well.

In 2012, Boston Children’s began using Fujifilm’s Synapse® 3D, an enterprise-wide solution for quickly performing advanced visualization workflows and accessing 3D rendered images. The solution allows for a more collaborative approach to care by using advanced image recognition technology to produces high-quality images that help radiologists, cardiologists, surgeons, and other specialists make more informed treatment decisions, especially during tumor- and surgical-board meetings.

For example, one unique component of Synapse 3D, Sector MPR, was specifically designed to let abdominal radiologists render CT slices of structures and lesions in the abdomen was specifically designed to let

abdominal radiologists render CT and MR images of structures and lesions in the abdomen to localize them accurately on ultrasound studies.

Considering how his radiologist colleagues used this particular component in abdominal imaging, an out-of-the box idea occurred to Dr. Prabhu: Perhaps he could use this same Synapse 3D component to visualize the brains of babies who receive neuroimaging with CT or MRI, and have interval ultrasound exams for comparison.

He was correct—and it worked. Dr. Prabhu had discovered a whole new way to use Sector MPR in Synapse 3D to bring additional imaging value to patients.

That’s just one example of how Dr. Prabhu and his team are using Synapse 3D in new, innovative ways to support specialized pediatric oncologists, surgeons, neurologists, and others.

For instance, a child with a large and clinically complex brain tumor who had recently undergone chemotherapy treatment needed to be tracked to determine if the tumor was continuing to grow post-treatment. Using Synapse 3D to overlay multiple images taken over a period of months, Dr. Prabhu proved that the tumor was indeed growing, albeit so slowly that it would have been missed in standard imaging.

The overlaid serial 3D images gave physicians on the tumor board full confidence in ordering another round of chemotherapy, and helped to ensure that the right care was delivered at the right timeIn another case, a radiologist remotely logged in to Synapse 3D to consult a surgeon on whether or not invasive surgery was needed to remove a pencil that had gone through a child’s eye. The images showed the pencil had pierced the brain without causing significant vascular injuries, allowing the surgeon to remove the pencil without needing to operate.

“Having Synapse 3D in our toolbox helps us meet the challenge of answering clinical questions for all those super-specialized pediatric clinicians treating our patients.”

- Dr. Sanjay Prabhu, Staff Neuroradiologist & Medical Director of Imaging Informatics, Boston Children’s Hospital

XBUSSY130FUJIFILM Medical Systems U.S.A., Inc. 81 Hartwell Avenue, Suite 300, Lexington, MA 02421www.fujimed.com, 866-879-0006, ©2019 FUJIFILM Medical Systems U.S.A, Inc.

Sanjay Prabhu, MBBS, FRCR, Staff Neuroradiologist & Medical Director of Imaging Informatics, Boston Children’s Hospital Assistant Professor of Radiology, Harvard Medical School

Boston Children's Hospital

XBUSSY130

In another case, a radiologist remotely logged in to Synapse 3D to consult a surgeon on whether or not invasive surgery was needed to remove a pencil that had gone through a child’s eye. The images showed the pencil had pierced the brain without causing significant vascular injuries, allowing the surgeon to remove the pencil without needing to operate.

Dr. Prabhu and his colleagues have used Synapse 3D to create a new workflow for the hospital’s epilepsy service. By overlaying Synapse 3D postoperative MR images on top of preoperative images, they are able to create a “timelapse-like” video showcasing dysplasia or tumor morphology from time point A to time point B. In the case of lesions causing seizures, Synapse 3D is able to help decide whether the focal cortical dysplasia or tumor has been removed, and if additional surgery would be needed.

Simply put, Synapse 3D is solving a myriad of big problems for small patients at Boston Children’s.

“Having Synapse 3D in our toolbox helps us meet the challenge of answering clinical questions for all those super-specialized pediatric clinicians treating our patients,” said Dr. Prabhu.

RESULTS & NEXT STEPS: Driving Collaborative Care, Clinical Confidence

When it comes to a 3D solution, the team at Boston Children’s demands speed, access and accuracy. According to Dr. Prabhu, Synapse 3D meets all the criteria, while also offering another often overlooked attribute – easy imaging access.

“The key is ease of access: Can you quickly launch it from your PACS? Can users access it across the enterprise? And does it keep your costs down?,” said Dr. Prabhu. In fact, Synapse 3D provides seamless access from any Synapse diagnostic viewer.

What's more, Synapse 3D is helping to enhance care collaboration at Boston Children’s Hospital. In addition to the radiology team, many of the physicians in patient-facing departments and offices throughout the enterprise have access to Synapse 3D, meaning that diverse sub-specialists can exchange studies and share expertise, all in an effort to improve outcomes for pediatric patients.

Finally, notes Dr. Prabhu, Synapse 3D is boosting clinical confidence across the institution. “When you show the 3D overlay interpretation process to a tumor board or a group at our epilepsy surgery conference, everyone is amazed how clearly you can see what’s going on with the tumor or the dysplasia over time, for example,” said Dr. Prabhu. “We welcome this improvement to how care decisions can be made.”

To learn more about Fujifilm, visit www.fujimed.com.

Boston Children's Hospital

Sanjay Prabhu, MBBS, FRCR, Staff Neuroradiologist & Medical Director of Imaging Informatics, Boston Children’s Hospital Assistant Professor of Radiology, Harvard Medical School

FUJIFILM Medical Systems U.S.A., Inc. 81 Hartwell Avenue, Suite 300, Lexington, MA 02421www.fujimed.com, 866-879-0006, ©2019 FUJIFILM Medical Systems U.S.A, Inc.

To learn more, visit 3DEnterpriseImaging.com