Pukka-J manages molecular imaging workflow for the University Medical Centre at Groningen, Netherlands

Pukka-j, on behalf of Siemens Healthcare in the Netherlands, recently installed a Molecular Imaging (MI) Archive, Web View, Distribution and Management system for SPECT, SPECT/CT, CT, PET, and PET/CT workflow at the University Medical Centre in Groningen (UMCG), the Netherlands.

The modalities and workstations involved in the installation included two SPECT/CT, two SPECT and two PET/CT systems.   The solution, which includes a combination of Pukka-j’s DICOM, HL7 and WEB products, provides a fully automated workflow for Molecular Imaging.   The Pukka-j HL7 broker receives order and appointment messages from the hospital information system and creates a Modality Worklist for the SPECT, SPECT/CT, CT, PET and PET/CT modalities.   Pukka-j continually monitors all patient demographic updates to allow the data in the Molecular Image Archive to be kept fully synchronised with the UMCG hospital information system.

Once acquired, all SPECT, SPECT/CT, CT, PET and PET/CT study data is sent to the Pukka-j Molecular Imaging Archive and the Pukka-j system, which features intelligent data management rules and is able to transfer automatically the data to multiple destinations.  This means that for UMCG, the PET and PET/CT data is forwarded to four dedicated workstations and the SPECT and SPECT/CT data to another four dedicated workstations.   SPECT/CT cardiac is forwarded to a dedicated workstation and brain studies are again, forwarded to another dedicated workstation.  

After the study data is processed on the dedicated workstations and reaches a ‘report complete’ status, a HL7 message is the trigger for Pukka-j to collect from the archive all relevant Secondary Capture image data, which is automatically sent to the hospital’s radiology PACS system.

The 'Klinical (Clinical) Desktop', is the EPR (Electronic Patient Record) and general viewing tool of patient data within the UMCG environment.   Currently, the Agfa WEB100 application is used to display radiology images and the 'Klinical Desktop' launches the dedicated Pukka-j viewer for users to specifically view Molecular Imaging studies throughout UMCG.

EPR integrated Pukka-j Web Viewer for molecular imaging.

The UMCG, a highly regarded specialist centre for patient care and clinical research, is one of the largest of the eight Dutch university centres, with 8,500 employees and 1,300 beds.   It is the only university hospital located in the northern part of the Netherlands and therefore the final point of referral for many patients.  

The Pukka-j equipment includes Pukka-j’s WEB viewer, supporting multi-modality displays, including PET MIP display and SUV calculation.   In addition, all possible series: dynamic, gated tomography, reconstruction tomography (or combinations of these types), whole body, save-screens static, multi-frame secondary capture displays, NM colour tables, multi-monitor display, PET display scaled in cts/pix and kBq/ml, window levels and preset windows.

Another feature is the PET/CT list mode, raw data Archive.   This is a unique facility of the MI Archive for UMCG and provides Pukka-j with the ability to store raw ‘list mode data’ generated by the PET/CT.   When a thirty minute test is performed with an initial high activity, the size of the list mode dataset can generate as much as five gigabytes per study.   The list mode database within the Pukka-j Archive allows users to select the raw data from a list to re-import back to the dedicated workstations for reprocessing when required.

In addition, Pukka-j can also support and convert legacy ICON and ECAT data to DICOM files ready for use with the MI dedicated workstations.

The Archive itself receives data from two SPECT/CT systems, two SPECT systems and two PET/CT, generated from approximately 45,000 procedures per year.   The archive hardware was therefore designed to take into account ample disk capacity for archiving the expected molecular imaging data.  The solution features a primary archive of 30 terabytes with a higher level of RAID 50 providing 24TB of usable disk.   Pukka-j delivered their popular DICOM Mirror facility to allow a second copy of all data to reside on a remotely located, online, back-up server, which provides a highly resilient model with full redundancy.   The primary and secondary stores provide a total of 48 Terabytes of storage capacity and with Pukka-j’s 'lossless compression' automatically applied to the stored data the archives provide an enormous 72 terabytes to allow molecular raw and processed data to be accessed online throughout UMCG.