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Digital Imaging Is A Broad Term

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Digital imaging is a broad term.

Term was first used medically in 1970s in Computed

Tomography (CT).
Digital imaging is defined as any image acquisition process that

produces an electronic image that can be viewed and manipulated on a computer.


In radiology, images can be sent via computer networks to a

variety of locations.

Uses storage phosphor plates Uses existing equipment Requires special cassettes Requires a special cassette reader Uses a computer workstation and

viewing station and a printer

Method was slow to be accepted by radiologists. Installation increased in the early 1990s. More and more hospitals are replacing film/screen

technology with digital systems.

Picture-referring to images and reports.


Archiving-referring to the film file or film jacket

component of storing images.


Communications-referencing m1ultiple viewers of images

and reports at virtually unlimited viewing sites called workstations.


System-fostering the concept that a complex coordinated

network makes it all possible.

PACS is a medical imaging technology which provides


economical storage of, and convenient access to, images

from

multiple

modalities(source

machine

types).

Electronic images and reports are transmitted digitally via PACS. The universal format for PACS image storage and transfer is DICOM(Digital Imaging and Communications in Medicine).

Early systems did not have standardized image formats. Matching up systems was difficult. Vendors kept systems proprietary and did not share information. DICOM standards helped change this by allowing communication

between vendors products.

A PACS consists of four major components: The imaging modalities such as X-ray computed tomography(CT)

and magnetic resonance imaging (MRI)


A secured network for the transmission of patient information,

workstations for interpreting and reviewing images, and archives for


the storage and retrieval of images and reports.
Combined with available and emerging web technology, PACS has

the ability to deliver timely and efficient access to images, interpretations, and related data. PACS breaks down the physical and

time barriers associated with traditional film-based image retrieval,


distribution, and display.

There are seven basic functions carried out by a PACS system and network:
Image Capture Image Transfer Short Term Storage Long Term Storage Retrieval Image viewing Networking

NonDICOM Modality

Diagnostic Workstations (DICOM)

Clinical Workstations (DICOM)

Web Server

CR QA Workstation Computed Radiography

Film Digitizer

Data Base Server Archive

RIS

The first step in typical PACS system is the modality. Modalities are typically computed tomography (CT) ultrasound, nuclear medicine, positron emission tomography (PET), and magnetic resonance

imaging(MRI). Depending on the facility's workflow most modalities send to a quality assurance(QA) workstation or sometimes called a PACS gateway. The QA workstation is a checkpoint to make sure patient

demographics are correct as well as other important attributes of a study.


If the study information is correct the images are passed to the archive for storage. The central storage device (archive) stores images and in some

cases reports, measurements and other information that resides with the
images.

As the need for distribution of images and reports become


more widespread there is a push for PACS systems to

support DICOM part 18 of the DICOM standard. Web


Access to DICOM Objects (WADO) creates the necessary standard to expose images and reports over the web through truly portable medium.

Digital medical images are typically stored locally on a PACS for retrieval. It is

important that facilities have a means of recovering images in the event of an


error or disaster. While each facility is different, the goal in image back-up is to make it automatic and as easy to administer as possible. The hope is that

the copies won't ever be needed, but, as with other disaster recovery and
business continuity planning, they need to be available if needed. Images may be stored both locally and remotely on off-line media such as tape or

optical media, or partially or exclusively on hard disks ("spinning") media.


The latter is becoming more common. The hard drives may be configured and attached to the PACS server in various ways, either as Direct-Attached

Storage (DAS), Network-attached storage (NAS), or via a Storage Area


Network (SAN).

Made up of different components


Reading stations Physician review stations Web access Technologist quality control stations

Administrative stations
Archive systems Multiple interfaces to other hospital and radiology systems

Early PACS seen only in radiology and some cardiology

departments.
PACS now can be used in multiple departments. Archive space can be shared among departments. PACS reading stations may also have image processing

capabilities.
PACS allows radiologists to reconstruct and stitch images in

their offices.

Orthopedic workstations are available for the following:Surgeons can plan joint replacement surgery. Specialized

software

allows

matching

of

best

replacement for patient with patient anatomy.


System saves time and provides better fit.

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