We opened the 3D Imaging Service in the Radiology Department at Massachusetts General Hospital (MGH) in 1999 to provide image post-processing as a service for aiding radiologists and referring physicians in diagnosis and treatment planning. Our lab was one of the first of its kind and has grown to be one of the largest, processing over 130 exams per day for MGH, our affiliated imaging centers, and our Tele3D client hospitals around the country. Our growth was in parallel with the adoption of multi-slice CT and its expanding use for procedures requiring 3D post-processing, such as CT angiography (CTA). As we grew, it became difficult to keep up with our growth in volume, and increasing needs for extended hours of coverage.