Image Acquisition
Modality used to acquire images
Image Acquisition
Requires the existence of medical devices with the appropriate interface of PACS, such as CT scan, MRI, and Digital X-ray machine
TRUE
As long as these modalities are compatible with PACS, they can send images to the PACS server
digital imaging and communications in medicine
DICOM
DICOM
international standard for defining the mode of transmission of medical information and images that provides interoperability between different devices
DICOM
used worldwide to store, exchange, and transmit medical images
DICOM
central to the development of modern radiological imaging
.dcm
file extension : ___
Interoperability
the ability of computer systems to exchange information and make use of that info
Medical image converter
Used when the standard is not supported on medical devices
Medical image converter
Simple and easy-to-use windows application for converting medical image files between different image formats
MicroDicom program
Can export whatever DICOM file you have to BMP, GIF, JPG, PNG, TIF, or WMF
WMV or AVI
If there’s a series of images, it supports saving them to a video file in __ or ___ format
Communication Network
Transmits images and attached data Eg. name of the patient, date of birth, etc.
Communication Network
Network structure has a crucial influence on the efficiency of the entire system
Patient Data
Hospital Information System (HIS) and Radiology Information System (RIS) must have the same interface according to the PACS system
PACS
used to view images
RIS
used to view the result and patient’s info
Interface
shared boundary across two or more separate components of a computer system exchange info
Interface
device or program enabling a user to communicate with a computer
Health Level 7
Standard that enables HIS and RIS to PACS System
Health Level 7
Set of international standards used to transfer and share data between various healthcare providers
Health Level 7
Aims to make sharing data easy, which in turn reduces the administrative burden on providers and staff while improving care delivery
Open system interconnection
OSI
Display of images
Done via personal computer in the office
Display of images
Qualities of personal computers in the office are reflected in the monitor’s physical characteristics
Computers
need to have an interactive user interface with a possibility to adjust image contrast, zoom, and move images and display data of the patient
Recordings Archive
System for archiving recordings should be centralized, with support for DICOM and HL7 standards
Web Server
Application that resides on a web server should provide adequate access and display of data to employees in medical institution and distant uses
Saving space and time for archiving x-ray images
Search for educational purposes • X-ray records are stored on computer disks in electronic form
Significant material saving • There is no need for buying x-ray films because x-ray images are moved on compact disks (CD) whose price is lower
Improved x-ray image quality and speed of diagnostic radiology
Possibility to view images from remote locations
Better utilization of human resources
Possibility to networking computers of one or more health facilities
Modernization of work
Reduction in service costs and material consumption
Implementation of PACS is reflected in:
Search for educational purposes
X-ray records are stored on computer disks in electronic form
Significant material saving
There is no need for buying x-ray films because x-ray images are moved on compact disks (CD) whose price is lower
Radiology Department Effectiveness
• Less exam time and effort • Less inefficiency and error
Radiology Department Effectiveness
• Less diagnostic uncertainty • Less patient risk
Radiology Department Effectiveness
• Less exam inaccuracy • Less IT footprint/support
Advantages of PACS
• Can solve the issue of image loss, stolen, or misfiled • Two physicians will be able to view same image at different sites
Advantages of PACS
• Allows full range of tools for better visualization of image • Economically efficient • Increase in efficiency of data management
Disadvantages of PACS
• It is not a new technology but still has not been deployed at various healthcare institutions • Financial cost may be huge, preventing hospitals to install it
Disadvantages of PACS
• Utilize large amounts of bandwidth on a system, can “crash” even a very strong network. Strong internet technology needed to handle PACS traffic efficiently • To read PACS report, high resolution monitors are needed and they are too expensive
DICOM
• Standard for handling, storing, printing, and transmission of information in medicine • Developed in 1985 by American College Radiology (ACR) and National Electrical Manufacturers Association (NEMA) • Both a protocol for transmitting images and a file format for storing them
DICOM
• Establishes a common language that enables the usage of images and information, made on one type of manufacturers’ equipment, in digital systems of other manufacturers • Not only a file format, but is directly related to the PACS
DICOM and PACS
• Hard to imagine modern medicine without ___ and ___
DICOM
• Consists of files, definition, and network protocol communication
.dcm or .dcm30 (DICOM 3.0)
Files in DICOM format are most likely saved with either a __ or ___ file extension, but some may not have an extension at all
Basic Function of DICOM
Communication and sharing of digital medical images, regardless of the manufacturer; to enable PACS to become a part of HIS, RIS, and other information systems
Basic Function of DICOM
To ensure that the database of medical images become available irrespective of browser distance
Basic Function of DICOM
To enable the functioning of teleradiology
Disadvantages arises in:
Searching the database and image processing
Simultaneous display of multiple images on the monitor when the quality of individual images is decreased or certain segments are cut off
Appearance of false coloring which appears in the adjacent gray level, false coloring in contrasting colors, etc.
Teleradiology
Form of medical information system, which requires the use of telecommunications systems in the form of: o Satellite o Internet o Mobile phones o Internet
Teleradiology
• For the exchange of data, images, video, audio, or other radiological information in order to secure radiology services between remote locations
o Image recording and sending station o Secure transmission network (HIPAA compliant and secure data server) o Image receiving station
How teleradiology works (three essential elements)
data transfer
For ___ ___, teleradiology uses the Global System for Mobile Telecommunications (GSM), General Packet Radio Service (GPRS), and 3G systems, which allow the transmission of multimedia content at high speed
Global System for Mobile Telecommunications
GSM
General Packet Radio Service
GPRS
Information and communication technologies
____ and ____ technologies allow the transfer of relevant medical information at distance with compliance with medical and technological standards, relating to the acquisition, storage, transmission, and retrieval of medical images, video, audio, and other radiological information
Appliance of Teleradiology
is possible in imaging centers that have digital radiology apparatus, and DICOM
Mobile Radiology
Development is link to Marie Sklodowska Curie
little theory
Developed a mobile radiology, and called it __ __, trained 150 women to operate
WW1
During ___, Curie left behind her Lab behind, inventing a mobile x-ray unit that could travel to the battlefront
Mobile Radiology
X-ray machines, CT, MRI, mammogram, and other radiological devices into trucks with trailers, thus making them mobile and accessible to all communities, in all weather conditions, in peace or war
Mobile MIM in 2011
mobile device application viewing in Radiology
Relevant features of mobile phones for mobile radiology in teleradiology
o 3 inches wide screens o Light from 250 cdl o RAM memory of 256 mb o 800 MHz processor o Mobile internet that supports HTML5 standard and JavaScript
digitization of medical equipment
Basis for the introduction of new technologies in medicine is the
Application of web technology
has made that health services become available to all, to give fast and effective treatment, and provide information to others at the right time
Archive
serves as the new file room and warehouse of all DICOM imaging modalities o No need for a physical file room because everything is centralized in a server already
Archive
Place where records or documents are preserved
Magneto-optical disk (MOD)
– example of archive server
PACS Archive
• Stores all patient and image data, often on magnetic tape or optical disk • Controls the receipt, storage, and distribution of new and historic images
PACS Archive
• Fastest growing component in PACS o More upgrades
PACS Archive
• Complex arrangement of computers and storage space • Consists of server components, both hardware and software
Image manager or controller
• Contains the master database of everything that is in the archive • Controls the receipt, retrieval, and distribution of the images it stores
Image manager or controller
• Controls all the DICOM processes running within the archive • Runs a reliable commercial database such as Sybase (Sybase Inc., Dublin, CA) or Oracle (Oracle Corp., Redwood Shores, CA) with Structured query language (SQL)
SQL
– specialized language for updating, deleting, and requesting information from databases
Database is mirrored
there are two identical databases running simultaneously so that is one goes down; the system can call on the mirror and continue to run as normal
Image manager or controller
• PACS component that integrates with the Radiology and Hospital Info System (RIS and HIS), allowing PACS database to collect additional patient info that is necessary for its effective operation
Electronic Medical Record (EMR)
Image manager or controller Plays a key role in populating image info into the hospital ____
TRUE
Contains DICOM header info, such as patient’s name, identification number, examination data, ordering physician, and location
TRUE
Database has pointers associated with each image on the archive server that points back to the data fields within the database
Process
An order is placed in the RIS for a radiology study
The images are acquired and sent to the archive
The image manager strips the image header from each image and assigns a pointer to each image or series of images
The database files the info in various fields and communicates back to RIS to verify certain info
The study is then queried, and the pointers locate the images on the archive server and send the images to the workstation
Image storage or archive server
• Consists of the physical storage device of the archive system • Consists of two or three tiers of storage
Tier
a level, later, or division of something
short-term, mid-term, or long-term
In an archive server, a tier represents a specific level of archive:
Short-term
▪ being online or available very quickly, 3 – 5s ▪ commonly a RAID
RAID
– composed of several magnetic disks or hard drives that are linked together in an array
500 GB – 3T
o Size ranges from several hundred gigabyte to terabytes
1998
Term was coined in ___ by David Patterson, Garth Gibson, and Randy Katz in an article entitled “A case for Redundant Arrays of Inexpensive Disks (RAID)”
David Patterson, Garth Gibson, and Randy Katz
Term was coined in 1998 by '__ __, ___ ___, and ___' in an article entitled “A case for Redundant Arrays of Inexpensive Disks (RAID)”
Redundant Array of Independent (Inexpensive) Disks
RAID
5
Presentation introduced __ levels of RAID
11
Now, there are __ levels, most of which are combinations of the first 5
Long-term
▪ means near line, images that must be retrieved from a tape or disk storage device
hospitals
Most ___ use RAID storage for both short-term and long-term archive
Other long-term storage products that are still widely used are
Other long-term storage products that are still widely used are
Optical disk and magnetic type archive
– uses a jukebox to hold the tapes or disks
Optical disk
▪ any computer disk that uses optical storage techniques and technology to read and write data
Optical disk
▪ a computer storage disk that stores data digitally and uses laser bits to read and write data
Magnetic disk
– uses arrays
Magento-optical disk
Digital versatile disk
Ultra density optical
Tape
Magnetic disk
Five types of Optical Disk
Magento-optical disk
• Very similar to compact disk (CD) or digital versatile disk (DVD) in that it is read optically with a laser, but the disk itself is housed within a plastic cartridge • More reliable than other long-term storage options
Magento-optical disk
• Disks are robust and withstand many years of reading • Can store 9.1 GB