4 Atkins compared interaction methods for stack mode viewing and introduced a “navigation chart” as a way of illustrating stack mode navigation. 5 Weiss compared reader opinions after testing different UIDs in the clinical practice. Sherbondy compared the performance of different UIDs in identifying anatomical and artificial targets in large CT angiographic datasets. The performance and reader opinion of different UIDs in PACS work has been investigated in a few studies. In this study, we address the possibility of using alternative off-the-shelf UIDs originally designed for other domains for PACS work. 6 In other domains such as computer game industry and video editing industry, several new UIDs have been developed. However, the possibility of using different UIDs other than standard mouse and keyboard was not considered. In a review of ergonomics in PACS workstations, it is suggested that keyboard shortcuts should be used instead of the mouse, and if possible, one should alternate hands in using the mouse. 4, 5 This is a reasonable set of devices for a variety of computer application tasks, even PACS work, but as the radiological datasets increase in size, these UIDs become inadequate for navigation. Today, the dominating user interface devices (UIDs) in PACS work are the standard qwerty-keyboard and a standard two-button computer mouse with a scroll wheel or a trackball. 2 The TRIP initiative describes navigation and usability tools as one of six identified concepts to make progress in managing the increasing volumes of data. In particular, the multi-detector CT modalities contribute to the increase in dataset sizes since they make it possible to produce large image volumes of high spatial resolution while keeping scanning times within a few seconds. 1īecause of the rapidly increasing size of routinely captured datasets, it is now necessary to identify new tools for efficient PACS workflow. The digital PACS has in particular revolutionized the review process of examinations from volumetric modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) with the shift from tile mode to stack mode display. The transition to the digital PACS environment has enabled more efficient diagnostic review processes for many reasons. In the last decade, the workflow in radiology departments has changed dramatically from working with film-based examinations at light cabinets to working with digital images on a computer workstation (PACS). The results indicate that alternative user interface devices can improve the navigation of stack mode datasets and that radiologists should consider the potential benefits of alternatives to the standard mouse. One of the tested alternative devices showed a larger number of traversed images during the task. In the task-based experiment, one of the tested devices was faster than the standard mouse, while the other alternative was not significantly faster. After using the devices in the daily image interpretation work, the readers reported that both of the tested alternative UIDs were better in terms of ergonomics compared to the standard mouse and that both alternatives were more efficient when reviewing large CT datasets. We evaluated three UIDs both in clinical practice and in a task-based experiment. One basic approach to improve the navigation of the stack mode datasets is to take advantage of alternative UIDs developed for other domains, such as the computer game industry. With the increasing number of images in routinely captured datasets, the standard user interface devices (UIDs) become inadequate. The workflow in radiology departments has changed dramatically with the transition to digital PACS, especially with the shift from tile mode to stack mode display of volumetric images.
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