Pisa University Hospital uses Synapse 3D to improve diagnostic management of patient during the COVID19 pandemic

By developing a new technological solution to support radiologists in the emergency room, Synapse 3D has delivered faster and more objective visual analysis of the onset of COVID-19

The novel Coronavirus infection (severe acute respiratory syndrome SARS-CoV-2), which has led to the spread of COVID-19 around the world, has upset normal workflow in hospitals. The increased workload and stress, due to the necessity of implementing safe and separate diagnostic pathways, and the need to constantly monitor the development of the disease after its onset, continues to have a significant impact on clinicians working on the front line.

The professional relationship between Pisa University Hospital and Fujifilm Italia that has developed over many years has resulted in even greater synergy between medical staff and the company during the COVID-19 emergency. In particular, timely support from Fujifilm has been provided to help the improvement and speeding up of lung CT reports, which are a fundamental way of diagnosing the novel Coronavirus. This has been possible thanks to an update by Fujifilm of the configuration of the Synapse 3D software used by emergency room radiologists.

This new technological development it is useful to improving patient management of patients affected by COVID-19,  during the emergency situation.

The configuration of Synapse 3D was completed quickly, with the study of density ranges and a feasibility analysis carried out in a few days, meaning that this updated integrated workflow has been possible to use in hospitals since 1st April.

The Pisa University Hospital had already set up three levels of assessing Coronavirus patients – and with the support of Synapse 3D software, doctors have had the ability to quickly and easily identify the stage of pneumonia, and therefore hospitalise patients accordingly:

  • normal hospitalisation for patients with mild pneumonia not requiring respiratory support
  • assessment by a pulmonologist or intensive care doctor for patients with moderate pneumonia to plan suitable respiratory support
  • intensive care assessment for patients with severe pneumonia with a view to transferring them to the intensive care unit

In addition to the clinical data (fever, cough, dyspnoea and increased respiratory rate) and the instrumental data, the software has been a fundamental support to radiologists responsible for conducting patient analysis, promoting a timely assessment of the health and state of the lung at the same time as the report, optimising resources and saving time.

Thanks to the density analysis provided by Synapse 3D it is possible to divide the lung according to the different density of the pixels that make up the CT. Three groups were therefore defined based on different density ranges that allow the radiologist to evaluate the percentage of lung with lower density (emphysema), higher density (interstitial effort) and normal lung.

Chiara Romei, MD, PhD, Pisa University Hospital

As explained by Dr. Chiara Romei, Radiologist at the Pisa University Hospital,

“In a time of emergency such as this, it is crucial for us radiologists to detect accurate data as quickly as possible. Synapse 3D has enabled a quantitative analysis that is much faster and more objective than the visual analysis of the radiologist; in a couple of minutes it is possible to obtain data relating to the percentage of lung with greater and lesser density and to have a precise and objective, reproducible and shareable value.”

The elaborations obtained by Synapse 3D do not replace the molecular diagnoses made through the nasopharyngeal swab (RT-PCR) and do not replace the analysis and diagnosis work by the radiologist, but instead they support the reporting of daily exams to monitor and study the evolution of the disease, thus optimising workflow.

“For many years we have worked with Pisa University Hospital,” explains Davide Campari, General Manager Medical Systems Fujifilm Italia, “in a very short time we responded to the request for help by creating a tool to optimise the workflow, lightening and supporting the workloads related to the diagnosis and monitoring of COVID-19. At this delicate and particular moment, we wanted to make our most cutting-edge technologies available. In this situation, Synapse 3D supports radiologists and Fujifilm intends to help however we can, contributing to the constant improvement of the efficiency of medical instruments.”

About Fujifilm’s SYNAPSE 3D
SYNAPSE 3D is the visualization tool for diagnosis and clinical support decision making. It is designed to provide trained medical imaging professionals, including Physicians, Radiologists and Surgeons, with tools to aid them in reading, interpreting and reporting on images and in treatment planning.

About FUJIFILM Europe GmbH
FUJIFILM Europe GmbH (Düsseldorf, Germany) is the strategic headquarters for Fujifilm in Europe and supports the group’s European companies by formulating business and marketing strategies. With over 50 companies and branches present throughout Europe, Fujifilm employs approximately 4,500 people in research and development, production, sales, marketing, service and support. Across Europe, the Fujifilm business covers a wide range of industrial sectors, including medical and healthcare, graphic arts, electronics, chemicals, optics, rescue / archiving media and photographic technologies. Over the past decade, the company has focused more on healthcare and can now boast over 80 years of experience in medical imaging. Currently, Fujifilm is able to meet the needs of the entire healthcare sector, from prevention to diagnostics and therapeutic solutions. Today, research and development in the medical, bio-pharmaceutical and medical-regenerative fields are all part of Fujifilm’s unique offer.

For more information, visit the website: www.fujifilm.eu

About Pisa University Hospital (AOUP)
Pisa University Hospital (AOUP) is one of the four hospital-university structures in Tuscany and is divided into two hospital establishments (Santa Chiara and Cisanello), complementary and coordinated in order to guarantee overall both basic and high-level hospital services. To respond to the ongoing health emergency, the various specialist figures involved in the management of these patients (infectious disease specialists, pulmonologists, resuscitators, first aid and emergency medicine doctors) have created a protocol for the treatment of patients with COVID-19. In this way, entire areas of the hospital dedicated exclusively to COVID were set up, dividing the hospital structure into COVID and non-COVID areas and organizing dedicated task forces.


Fujifilm technology supports every step, from a patient’s arrival at the hospital until the completion of the service, helping Professionals giving a better care to their patient.

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During the emergency, ASST Vimercate Hospital chose REiLI, Fujifilm’s Artificial Intelligence, to support operators in the fight against COVID-19

Artificial Intelligence is an essential tool for healthcare operators on the front line in the fight against the Coronavirus pandemic. ASST Vimercate Hospital chose and implemented in the midst of the COVID-19 emergency REiLI, Fujifilm Medical Systems’ Artificial Intelligence.

During the novel Coronavirus emergency, operations and workflows in all Italian hospitals were disrupted, which significantly increased workloads. As a consolidated partner of Vimercate, Fujifilm wanted to ensure its cutting-edge tools were available to reduce the impact caused by the rapid spread of COVID-19 and to give a timely response to the spread of the pandemic.

In November 2019, a collaboration agreement between ASST of Vimercate and Fujifilm was signed with a view to exploring new approaches to the treatment of patients, with benefits both to the clinical services and to healthcare operators.

REiLI’s support,” says Marcello Intotero, Head of Radiology Structure and Diagnostic Services Department, “has allowed our radiologists to report examinations with greater speed and efficiency. In numerical terms, their workloads have not particularly increased, as other causes for non-urgent examinations were limited to avoid an excess flow of patients. This new technology has given great support to the workflow; all images that artificial intelligence identified as suspected COVID-19 were subjected to processing by the radiologist in a faster and more urgent manner than other images which, instead, the system analyzed as corresponding to a healthy lung.

REiLI’s processing of CT scans and chest x-rays provides important support for radiologists, offering them an extremely rapid, quantitative and objective assessment of the various zones of the lungs. The chest x-ray, in particular, is the best example of applying the new AI technology, in that it is a quick and simple examination which provides a large amount of useful information for evaluating the presence of the pulmonary parenchymal consolidation caused by the virus.

The data obtained from artificial intelligence does not replace the molecular diagnoses performed using the nasopharyngeal swab (RT-PCR) and, above all, nor does it replace the precious analyses and diagnoses performed by the radiologist. The data, however, does provide support in reporting on daily examinations conducted to monitor and study the development of the disease, and constitute a second opinion for the operators.

REiLI, Fujifilm’s Artificial Intelligence platform, is integrated with the Lunit Insight CXR module for the analysis and detection of the main types of pulmonary disease (nodules, atelectasis, fibrosis, calcifications, cardiomegaly, etc.). In fact, the Lunit Insight CXR3 module has been updated to provide support in specifically identifying the pulmonary parenchymal consolidation caused by the virus.

REiLI has been installed at ASST Vimercate in just two weeks, by installing a parallel PACS to avoid interrupting the daily workflow. On 30 March, REiLI was already operating and during its first five days it had worked on more than 600 images. During the emergency, more than 900 positive cases of COVID-19 were found, with an average of 80 chest x-rays per day, allowing precise and punctual data collection.

During the health emergency, more than 80 chest x-rays of inpatients and first-aid patients have been analysed each day at the Vimercate Hospital,” explains Giovanni Delgrossi, Head of IT Department, ASST Vimercate. “If no priority is set for the examinations to be reported, it may take hours to identify a particular x-ray which could require prompt, immediate action from doctors. In an emergency like the current one, we need to react and act even more quickly.”

Alternative Intelligence is a new operating concept projected towards collaborative intelligence between machine and man,” explains Nicola Bilibio, Clinical Specialist Medical Informatics (CSE) Fujifilm Europe GmbH. “This is a fundamental tool for optimizing the workflow and for screening patients from COVID-19. During the emergency, we promptly made our most advanced technologies available to make our concrete contribution to the crisis.”

Helping Europe’s healthcare workers harness the power of instax instant photography in the most difficult of situations

Across Europe, Fujifilm teams are stepping-up a unique patient-focused initiative to donate instax cameras and film to help share the smiles of doctors and nurses working on the frontline of the Coronavirus pandemic.

Left to right: [1-2] Healthcare workers at Florence Nightingale Group Hospitals, Turkey and [3] Azienda Socio-Sanitaria Territoriale (ASST) di Vimercate, Monza, Italy

Due to the Coronavirus, healthcare workers caring for COVID-19 patients are required to wear a significant amount of personal protective equipment (PPE). In many cases, this means that doctors and nurses treating patients have to obscure everything but their eyes. This can be scary, intimidating, and confusing to patients – and healthcare teams have been searching for new ways of sharing their face behind the mask.

Utilizing the ease and simplicity of instax instant photography, Fujifilm have stepped up to help medical staff identify themselves on their PPE by donating instax cameras and film. This has meant doctors or nurses can now effortlessly take a photograph and quickly attach a credit card-sized instant photo print of themselves to their hospital gowns.

Hiromoto Matsushima, Senior Vice President Photo Imaging, FUJIFILM Europe GmbH commented:

Donating instax cameras and film is just a small way in which Fujifilm is able to help – but to both healthcare workers and patients, we’ve been told that by being able to easily show the friendly face behind the PPE, it can help bring comfort and understanding in the most difficult of situations.

The instax products donated so far have been prioritized to healthcare teams working in intensive care units and critical care on the Coronavirus frontline. To date, approximately 120 instax cameras and 7,500 instax prints have been sent to hospitals in the United Kingdom, the Netherlands, Turkey, Italy, Portugal, Spain, Russia, France and Denmark.

Each Fujifilm business in Europe has a limited number of these packs available and healthcare teams on the frontline with should contact their local Fujifilm Corporate Communications representative.