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Stress Testing Data and Display Requirements

Stress Testing Data and Display Requirements. Stress: Protocol and Stage. Uses exercise or medication to increase the work of the heart – incremental stages Continuous 12 lead ECG monitoring during study Looking for changes in ECG (ST segments) or other clinical indicators. Procedure

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Stress Testing Data and Display Requirements

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  1. Stress Testing Data and Display Requirements

  2. Stress: Protocol and Stage • Uses exercise or medication to increase the work of the heart – incremental stages • Continuous 12 lead ECG monitoring during study • Looking for changes in ECG (ST segments) or other clinical indicators Procedure Protocol Stages

  3. Stress: Protocol and Stage • Procedure : Exercise Stress • Protocol: Bruce • Stages: • Standard Bruce has 7 stages • Stage 1: 1.7 mph @ 10 % grade • Stage 7: 6.0 mph @ 22 % grade Important Note: A procedure can be considered complete irrespective of the patient reaching the last protocol stage!

  4. Acquisition Modalities • Echo – label images by stage and view • Nuclear – format and label images in accordance with NM Image Profile • Stress ECG – output waveforms and results as DICOM objects • DICOM 12-lead and general ECG • Structured Reports • Encapsulated PDF • All modalities – synchronized time, modality worklist and performed procedure step status

  5. Stage and Views • Stress Echo • Stage Number & View Number • Stage Code Sequence & View Code Sequence – SNOMED codes

  6. Attribute Summary

  7. Image Manager / Image Archive • Must support all stress data objects • Echo, nuclear images • Multi-frame secondary capture images • 12-lead and general ECG • Structured Reports – Enhanced, Comprehensive, Procedure Log • Encapsulated PDF

  8. Image Display • Must display all stress data objects • Echo images – quad screen based on image labels • Nuclear images – ACC/ASNC layout • Multi-frame secondary capture images • 12-lead and general ECG • Structured Reports – Enhanced, Comprehensive, Procedure Log • Encapsulated PDF • Additional display requirements for SR in Evidence Documents Profile Stress Option

  9. Benefit: Stress EchoViewing Consistency

  10. Nuclear Cardiology • Image formats • Stress and Rest raw data review • Stress and Rest processed data • Gated SPECT data • Quantitative data • Screen captures, “snap shots” • Color maps • Gray scale is default • Color overlays can be applied

  11. Raw Data Images

  12. Perfusion Display • Standard perfusion display • Stress/Rest • Short axis • Horizontal long axis • Vertical long axis

  13. Perfusion Display - Color • Standard perfusion display • Stress/Rest • Short axis • Horizontal long axis • Vertical long axis • Color map can be overlaid on the image

  14. Gated SPECT Display • Apical, mid and basal short axis slices • Mid-ventricle vertical and horizontal long axis slices

  15. Gated SPECT Display • The whole screen can be gated as an option

  16. Quantitative Display • Output from 3rd party quantitative perfusion software can be displayed

  17. Quantitative Display • Output from 3rd party quantitative gated software can be displayed

  18. Screen Captures • Screen captures can be displayed to show important images

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