Urology Testing: Image Quality and Clinical Outcomes

Dr Brad Schwartz comments on his satisfaction with current imaging systems used in urology and the impact of image quality on treatment decisions and clinical outcomes.

Kristie Kahl: In your experience, how important is image quality?

Brad Schwartz, DO, FACS: Realistically, it is probably the single most important component of all the imaging systems. The image quality is what you use to make a diagnosis. When you look at the impact of clinical outcomes and the medical care of the patients that we are treating, image quality could mean the difference between success and failure. It could mean the difference between seeing a defect and not seeing a defect.

High image quality could mean the difference between tracking the wire up into the kidney and actually having successful placement of the wire vs failing and then not being able to perform a retrograde approach. We would then have to convert it to an antegrade approach, thereby changing the entire outcome of that patient’s disease process. The quality of the imaging is key. You have to see what you are doing and you have to be able to track the course of the procedure to make sure it is going in the direction you want it to go. It is very crucial.

Kristie Kahl: How satisfied are you with the image quality of your current system in your workflow? What features are you most satisfied with?

Brad Schwartz, DO, FACS: We have the most current system, and of course I’m very happy with it. One of the beauties of the system that I use—which is a Liebel-Flarsheim system—is the independence the surgeon has when employing the system. We can control almost everything with foot pedals. We do not need anyone in the room to push buttons. We do not need the circulators to get involved and adjust settings. We can do virtually everything we want with just our foot pedals: we can magnify, do spot films, fluoroscopies, cone in, and cone out.

As surgeons, we can really have complete independence when dealing with these systems. That gives us real-time information and actually has been shown, in the literature, to decrease the amount of fluoroscopy that we use when we control that. The surgical independence is fantastic. The image quality is fantastic, and we can make some very high-level treatment decisions based on what we are seeing real time.

Transcript edited for clarity.

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