With regard to the commentary on the article “The Wonders of New Available Post-analysis CT Software in the Hands of Vascular Surgeons” there are a few things we would like to highlight.
We agree with the authors that, before adopting post-processing software in clinical practice, some training is needed in order to prevent the misuse of such a delicate tool. We also agree with them that it should be mandatory to report the likelihood of a graft failure. We don't agree with them when they criticize the use of open source post-processing software, for the four reasons we give below.
First of all, we need to point out that the post-processing software has been used in order to further improve diagnosis, and not as the main instrument for primary clinical use. The authors followed the golden standard in this case and on this basis suggested how the diagnosis could be improved through further investigation.
In the second place, as far as we know, there are no guidelines about the use of post-processing software, therefore no legal issues are at stake in this case, and neither are ethical ones. Not only has no harm been done to the patient, but, more importantly, no harm could have been done.
Thirdly, there is growing literature in this field
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about the great effectiveness of open source software as compared to the approved versions. Open source software is updated at a rate that exceeds by far that of software updates in the industry, which makes it a better and more reliable tool than the approved types.Last but not least, it is the duty of the public service to adopt a resource with the best cost-effectiveness ratio. In this case the choice of software that is both open source and free of charge and that could guarantee the same, if not better, level of reliability than its approved and expensive version has been a responsible one, and should not be subject to criticism.
Reference
- Open-source software in medical imaging: development of OsiriX.Int J CARS. 2006; 1: 187-196
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Published online: May 22, 2012
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© 2012 European Society for Vascular Surgery. Published by Elsevier Inc.
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- Comments regarding “The Wonders of New Available Post-Analysis CT Software in the Hands of Vascular Surgeons”European Journal of Vascular and Endovascular SurgeryVol. 43Issue 4
- PreviewThe authors of this manuscript present a case where an endoleak was detected in a growing aneurysm sac, after endovascular aneurysm repair. This was presumed to be a type-II EL, and it was not until reconstructions with open source post-processing software were made that they discovered device failure as the origin of the endoleak.
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- Reply to Letter Regarding the Comments on ‘The Wonders of New Available Post-analysis CT Software in the Hands of Vascular Surgeons’European Journal of Vascular and Endovascular SurgeryVol. 44Issue 1
- PreviewWe feel obliged to reply to the letter regarding our previous comments on the use of open-source software for image post-processing, and explain our point of view some more. As we previously emphasized, post-processing software is very useful and can enhance insight in a patient's anatomy before and after endovascular aneurysm repair. In fact, detailed analysis using such technology may provide additional or alternative diagnoses and improve patient care. Naturally, a free software tool that can provide this added value is a great asset.
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