3D Image Workflows: A Cross-Customer Challenge

Hi Guardian team,

As we prepare for your go-live with XV Capture, we want to ensure your imaging workflow aligns with your clinical needs and software capabilities.

Your Carestream CS 8100 unit is compatible with XV Capture for direct acquisition of 3D cone beam CT images. These images will automatically upload to Apteryx after capture. However, in some configurations, these CTs may not be saved in Carestream’s native software, which could impact your ability to use Carestream's tools for viewing or modifying CTs.

At other locations, we’ve implemented an export/import workflow to ensure CTs are available in both Apteryx and the manufacturer’s software. This approach is especially useful when clinicians rely on Carestream’s tools for advanced viewing, planning, or modification.

For your location, since direct capture is supported, we recommend evaluating whether:

• Direct capture into XV Capture and viewing/manipulating the CTs within Apteryx 3D meets all your clinical and workflow needs, or

• You would benefit from an export/import workflow to retain access to Carestream’s native software features.

If your team frequently uses Carestream’s software for post-processing or clinical planning, the export/import method may offer better continuity and flexibility.

🧠 Reimagining 3D Capture Workflows: A Cross-Customer Challenge

As we continue onboarding customers with 3D imaging capabilities, a recurring challenge has emerged that affects any customer using hardware capable of direct 3D capture into XV Capture—such as the Carestream CS 8100.

📍 The Core Issue

When a customer captures 3D cone beam CT images using XV Capture, the image reliably uploads to Apteryx. However, in some configurations, the CT does not also save in the manufacturer’s native software (e.g., Carestream’s CS Imaging or OrthoTrac). This can disrupt workflows where clinicians rely on those legacy tools for post-processing, planning, or visualization.

This raises a strategic question:
How should we guide customers when direct capture is technically supported, but may limit access to their preferred clinical tools?

🔍 Strategic Considerations for Product & Engineering

This challenge presents several paths forward:

1. Enhance Apteryx 3D or pivot strategy

   • We already know Apteryx 3D is not robust enough to replace most manufacturer software and is easily out-competed by native tools.

   • We must decide whether to invest in enhancing Apteryx 3D to compete—or pivot toward alternative workflows that acknowledge its limitations.

2. Enable viewer flexibility

   • Should we allow or encourage customers to use their preferred viewer, reducing pressure on us to compete with native 3D software?

   • This isn’t optional—clinicians will choose the tools that best support their workflow. It’s up to us to be clear about where our product stands in relation to others in the ecosystem.

3. Standardize export/import workflows

   • Where direct capture is possible but images aren’t automatically saved in the native software, should we standardize an export/import workflow to preserve access to native tools?

   • Where direct capture is not possible, we should promote workflows that stay within the native software, with optional export/import into Apteryx for customers who have an active Apteryx 3D subscription and want to use it for viewing or sharing.

4. Prioritize dual-saving configurations

   • Should we only support direct capture setups where CTs also save in the manufacturer’s software, ensuring clinicians retain access to their preferred tools?

5. Clarify documentation and expectations

   • We need to update our documentation to clearly reflect 3D workflow implications, including when native CT saving is supported, and what that means for clinical usability.

🧪 Real-World Impact

At Guardian’s location with CS8100 machines, even though direct capture is supported, the clinicians’ workflow may still require access to Carestream’s native tools. In this case, an export/import workflow might better serve their needs—even if it adds complexity.

This is not an isolated case. Other customers with similar hardware and workflows face the same dilemma. Our guidance, product capabilities, and documentation need to reflect this reality.

✅ What We Need

• A clear stance on whether Apteryx 3D is intended to replace manufacturer software—or complement it.

• A decision on which export/import workflows to support or discourage and which ones to prioritize.

  • Prioritize the XVCapture>Apteryx workflow and export/import to native software?

  • Prioritize the native software workflow and export/import to XVCapture/Apteryx?

• Updated documentation that sets expectations for whether or not direct-captured CTs will save in the native software for each device.