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    27 September 2005

    Hospital to install OsiriX: open source diagnostic workstation

    A small private hospital where I do a bit of work will be buying an iMac to run OsiriX, an open source diagnostic workstation developed at UCLA and the University of Geneva.

    It's not as sophisticated or as fast as the expensive Vitrea workstations we use in the big NHS hospital, but those cost about £35000, compared to £2000 for the iMac, and would not be financially viable for a small hospital with a relatively low volume of work.

    An iMac with 2G of RAM will be adequate for our requirements and the software is downloaded for free from the OsiriX website, so it's excellent value for money.

    Incidentally, one commercial company did offer us an outrageously expensive workstation with no multiplanar or 3D capability, that could not even read the discs produced by a CT scanner from their own company.

    Upgrades for OsiriX are frequent and free, the instruction manuals are on wiki, and excellent applications support is provided by the online community on a yahoo discussion group.

    As an open source product, anyone with the skills and interest can contribute to its development, and many people do.

    You can also plug your iPod straight into your Mac workstation and save files and pictures to it. (I'm not sure how radiology images on an iPod photo are of any real use, but I guess some people might think they look cute).
    Or download music from iTunes more easily than from your home PC .... oooops!

    For a lot more money, you can buy the most expensive available PowerMac, with lots and lots of RAM, and install a VolumePro board from TeraRecon, for which a special version of Osirix is available. This is meant to provide much better 3D performance but I haven't seen it myself. It's still cheaper than the commercial products though.

    The public healthcare sector might like to keep an eye on this, especially now that many state hospitals are feeling the squeeze financially. OsiriX is NOT a replacement for commercial 3D workstations, but it does have a lot of functionality at a low price, and is in continuous development.

    I am a PC user. I do not own a Mac. My mother has a Mac: I think it's fine, and I have nothing against Macs. I do not have an iPod either: I have a Zen Neeon, which does not work with Macs.

    Definition of Open Source
    Vitrea Diagnostic Workstation from Vital Images Inc.
    Zen Neeon Cheaper and better than the iPod
    Hospital bosses ordered to cut debts The Guardian 16 Sep 2005
    One third of the population mistakenly believes that an anaesthetist is not a doctor, according to a BBC Radio 4 programme I am listening to right now.

    I bet that's not the case with radiologists :-)

    24 September 2005

    Ultrasound instead of chest x-rays for nasogastric tube localisation

    I was giving a talk to our staff on "looking for medical information on the internet". There was a live demo on using PubMed, and the topic of nasogastric tubes was suggested by someone who clearly found the whole business of doing chest x-rays for localisation a bit tedious.

    This is an article we found:

    Sonography as an alternative to radiography for nasogastric feeding tube location.
    Vigneau C, Baudel JL, Guidet B, Offenstadt G, Maury E
    Intensive Care Med. 2005 Sep 20; [Epub ahead of print]
    Bedside sonography performed by nonradiologists is a sensitive method for confirming the position of weighted-tip feeding nasogastric feeding tubes. It is more rapid than conventional radiography and can easily be taught to ICU physicians. Conventional radiography could be reserved for cases in which sonography is inconclusive.

    Whoopee! Our ICU physicians have said they want to get their own ultrasound machine.

    We'll see.

    Making Gadolinium DTPA in your kitchen

    According to a lecturer (a chemist) at recent MRI course I attended, Gadolinium DTPA (the fabulously expensive contrast agent used in MRI scanning) is a very simple compound that any first year chemistry student could make at home.

    In China, they are not too concerned with copyrights and patents, I was told, so the pharmaceutical companies have started factories there to protect themselves. Enough said.

    My sister studied chemistry at university, but unfortunately that was some time ago and she is unable to assist our department in obtaining cheap supplies.