(Holo-PACS): use of holograms to improve provider acumen when reading clinical radiographic scans

Abstract

Background and purpose: Vascular Neurology (VN) fellowship education in CTA interpretation is critical, given the increased opportunities for tissue salvage via neurointervention. Holo-Stroke-CTA 3D visualization has already shown improved accuracy and satisfaction for vessel occlusion detection. Our aim in this present analysis was to determine if focused education in CTA reading, including addition of Holo-Stroke-CTA and immediate access to clinical PACS images during team meetings (Holo-PACS), would improve fellow and team education. Methods: Four VN fellows scored 3 sets of de-identified CTAs (DICOM Group-A (n = 12), DICOM Group-B (n = 12), and Holo-Stroke-CTA Group-C (n = 24) to assess for LVOs/MeVOs. After each set, a training session was given. Concurrently, Holo-PACS, accessing our enterprise PACS system via secure Intranet, was utilized in weekly team conferences. Likert surveys assessed satisfaction. Wilcoxon Signed Rank was used for non-parametric, and Exact Binomial Test was used for preference comparisons. Results: The overall correct percentage was 63% DICOM Group A vs. 97% Group C Holo-PACS. MCA (75%,94%), ICA (75%,100%), and Basilar (100%,100%) locations scored high, with marked improvement for ACA (13%,100%), and PCA (38%,94%). Likert satisfaction overall was 47% DICOM vs. 94% Holo-PACS. ‘Satisfaction’ scores were (55%,90%), ‘Immersion’ (34%,96%), ‘Ease of Use’ (53%,87%), ‘Accuracy’ (55%,93%), ‘Technology Advancement’ (42%,98%), and ‘Enthusiasm’ (45%,97%). Conclusions: The Holo-PACS initiative, including focused CTA education and implementing both Holo-Stroke-CTA and secure connection to PACS imaging using Holo-PACS during weekly team meetings, resulted in an improved ability to interpret CTAs and robust immersive satisfaction. Holo-PACS is becoming integral to our stroke education and training, and may serve as a model for vascular neurology fellowship training programs.