Synchronized navigation of current and prior studies using image registration improves radiologist’s efficiency

  • Daniel ForsbergEmail author
  • Amit Gupta
  • Christopher Mills
  • Brett MacAdam
  • Beverly Rosipko
  • Barbara A. Bangert
  • Michael D. Coffey
  • Christos Kosmas
  • Jeffrey L. Sunshine
Original Article



The purpose of this study was to investigate how the use of multi-modal rigid image registration integrated within a standard picture archiving and communication system affects the efficiency of a radiologist while performing routine interpretations of cases including prior examinations.


Six radiologists were recruited to read a set of cases (either 16 neuroradiology or 14 musculoskeletal cases) during two crossover reading sessions. Each radiologist read each case twice, one time with synchronized navigation, which enables spatial synchronization across examinations from different study dates, and one time without. Efficiency was evaluated based upon time to read a case and amount of scrolling while browsing a case using Wilcoxon signed rank test.


Significant improvements in efficiency were found considering either all radiologists simultaneously, the two sections separately and the majority of individual radiologists for time to read and for amount of scrolling. The relative improvement for each individual radiologist ranged from 4 to 32% for time to read and from 14 to 38% for amount of scrolling.


Image registration providing synchronized navigation across examinations from different study dates provides a tool that enables radiologists to work more efficiently while reading cases with one or more prior examinations.


Efficiency Image registration Synchronized navigation PACS 



D. Forsberg is supported by a Grant (2014-01422) from the Swedish Innovation Agency (VINNOVA).

Compliance with ethical standards

Conflict of interest

D. Forsberg reports grants from VINNOVA and employment at Sectra (a PACS vendor), during the conduct of the study. The other authors declare that they have no conflict of interest.

Ethical approval

No procedures involving human participants were performed as the study was a retrospective study. For this type of study formal consent is not required.


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Copyright information

© CARS 2016

Authors and Affiliations

  • Daniel Forsberg
    • 1
    • 2
    Email author
  • Amit Gupta
    • 2
  • Christopher Mills
    • 2
  • Brett MacAdam
    • 2
  • Beverly Rosipko
    • 2
  • Barbara A. Bangert
    • 2
  • Michael D. Coffey
    • 2
  • Christos Kosmas
    • 2
  • Jeffrey L. Sunshine
    • 2
  1. 1.Sectra ABLinköpingSweden
  2. 2.Department of RadiologyCase Western Reserve University and University Hospitals Case Medical CenterClevelandUSA

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