SPOF,
Single Point of Failure,
is a term used in information technology,
business processes and workflow dynamics,
where a failure in a particular non-redundant aspect can cause failure of the entire system or process.
SPOF is that part of a system,
that if it fails,
it takes down the entire system with it.
Archive analysis of our centres' oncology imaging has shown certain pathologies are more commonly found in cancer patients and easily missed unless specifically identified.
These can be categorised into the SPOF mnemonic.
SPOFs are associated with morbidity and mortality and identifying them can help alleviate the suffering of a palliative patient in their last days of life,
through to young fit patients with localised disease.
SPOF Information technology example
A room receives high-speed fibre optic broadband and is plugged into the modem.
If the modem becomes faulty,
all linked devices will lose connectivity regardless of type or expense.
SPOF = modem
SPOF Workflow example
A surgical team regularly performs complex procedures to remove tumours and sends them to the histology department which is highly specialised in the area.
However,
the portering team regularly delays or damages the sample in transit thus affecting patient care.
SPOF = portering team
Optimising images
Windowing
It is essential to optimise window settings to derive maximum information from the images,
especially when evaluating vascular structures where contrast enhancement may be suboptimal.
Reformats and MIPs
All scans should be viewed in multi-planer reformats.
Vessels and lungs should also be evaluated using maximum intensity projections (MIPs).
Scanograms and localisers
There is an argument to not archive CT scanograms and MRI localisers as the images are often very suboptimal and can open the radiologist to accusations of malpractice for missing incidental,
non-target findings on what is at best extremely suboptimal imaging. However,
if these suboptimal images have been archived along with the main scan then they are worth evaluating for any gross pathology.