M6 PACS Archiving and Peripherals

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Image Acquisition

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116 Terms

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Image Acquisition

Modality used to acquire images

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Image Acquisition

Requires the existence of medical devices with the appropriate interface of PACS, such as CT scan, MRI, and Digital X-ray machine

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TRUE

As long as these modalities are compatible with PACS, they can send images to the PACS server

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digital imaging and communications in medicine

DICOM

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DICOM

international standard for defining the mode of transmission of medical information and images that provides interoperability between different devices

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DICOM

used worldwide to store, exchange, and transmit medical images

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DICOM

central to the development of modern radiological imaging

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.dcm

file extension : ___

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Interoperability

the ability of computer systems to exchange information and make use of that info

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Medical image converter

Used when the standard is not supported on medical devices

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Medical image converter

Simple and easy-to-use windows application for converting medical image files between different image formats

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MicroDicom program

Can export whatever DICOM file you have to BMP, GIF, JPG, PNG, TIF, or WMF

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WMV or AVI

If there’s a series of images, it supports saving them to a video file in __ or ___ format

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Communication Network

Transmits images and attached data Eg. name of the patient, date of birth, etc.

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Communication Network

Network structure has a crucial influence on the efficiency of the entire system

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Patient Data

Hospital Information System (HIS) and Radiology Information System (RIS) must have the same interface according to the PACS system

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PACS

used to view images

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RIS

used to view the result and patient’s info

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Interface

shared boundary across two or more separate components of a computer system exchange info

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Interface

device or program enabling a user to communicate with a computer

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Health Level 7

Standard that enables HIS and RIS to PACS System

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Health Level 7

Set of international standards used to transfer and share data between various healthcare providers

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Health Level 7

Aims to make sharing data easy, which in turn reduces the administrative burden on providers and staff while improving care delivery

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Open system interconnection

OSI

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Display of images

Done via personal computer in the office

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Display of images

Qualities of personal computers in the office are reflected in the monitor’s physical characteristics

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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

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Recordings Archive

System for archiving recordings should be centralized, with support for DICOM and HL7 standards

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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

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  1. Saving space and time for archiving x-ray images

  2. Search for educational purposes • X-ray records are stored on computer disks in electronic form

  3. 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

  4. Improved x-ray image quality and speed of diagnostic radiology

  5. Possibility to view images from remote locations

  6. Better utilization of human resources

  7. Possibility to networking computers of one or more health facilities

  8. Modernization of work

  9. Reduction in service costs and material consumption

Implementation of PACS is reflected in:

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Search for educational purposes

X-ray records are stored on computer disks in electronic form

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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

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Radiology Department Effectiveness

• Less exam time and effort • Less inefficiency and error

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Radiology Department Effectiveness

• Less diagnostic uncertainty • Less patient risk

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Radiology Department Effectiveness

• Less exam inaccuracy • Less IT footprint/support

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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

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Advantages of PACS

• Allows full range of tools for better visualization of image • Economically efficient • Increase in efficiency of data management

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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

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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

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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

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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

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DICOM and PACS

• Hard to imagine modern medicine without ___ and ___

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DICOM

• Consists of files, definition, and network protocol communication

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.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

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Basic Function of DICOM

  1. 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

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Basic Function of DICOM

  1. To ensure that the database of medical images become available irrespective of browser distance

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Basic Function of DICOM

  1. To enable the functioning of teleradiology

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Disadvantages arises in:

  1. Searching the database and image processing

  2. Simultaneous display of multiple images on the monitor when the quality of individual images is decreased or certain segments are cut off

  3. Appearance of false coloring which appears in the adjacent gray level, false coloring in contrasting colors, etc.

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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

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Teleradiology

• For the exchange of data, images, video, audio, or other radiological information in order to secure radiology services between remote locations

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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)

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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

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Global System for Mobile Telecommunications

GSM

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General Packet Radio Service

GPRS

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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

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Appliance of Teleradiology

is possible in imaging centers that have digital radiology apparatus, and DICOM

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Mobile Radiology

Development is link to Marie Sklodowska Curie

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little theory

Developed a mobile radiology, and called it __ __, trained 150 women to operate

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WW1

During ___, Curie left behind her Lab behind, inventing a mobile x-ray unit that could travel to the battlefront

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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

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Mobile MIM in 2011

mobile device application viewing in Radiology

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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

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digitization of medical equipment

Basis for the introduction of new technologies in medicine is the

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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

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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

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Archive

Place where records or documents are preserved

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Magneto-optical disk (MOD)

– example of archive server

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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

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PACS Archive

• Fastest growing component in PACS o More upgrades

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PACS Archive

• Complex arrangement of computers and storage space • Consists of server components, both hardware and software

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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

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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)

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SQL

– specialized language for updating, deleting, and requesting information from databases

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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

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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

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Electronic Medical Record (EMR)

Image manager or controller Plays a key role in populating image info into the hospital ____

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TRUE

Contains DICOM header info, such as patient’s name, identification number, examination data, ordering physician, and location

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TRUE

Database has pointers associated with each image on the archive server that points back to the data fields within the database

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Process

  1. An order is placed in the RIS for a radiology study

  2. The images are acquired and sent to the archive

  3. The image manager strips the image header from each image and assigns a pointer to each image or series of images

  4. The database files the info in various fields and communicates back to RIS to verify certain info

  5. The study is then queried, and the pointers locate the images on the archive server and send the images to the workstation

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Image storage or archive server

• Consists of the physical storage device of the archive system • Consists of two or three tiers of storage

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Tier

a level, later, or division of something

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short-term, mid-term, or long-term

In an archive server, a tier represents a specific level of archive:

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Short-term

▪ being online or available very quickly, 3 – 5s ▪ commonly a RAID

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RAID

– composed of several magnetic disks or hard drives that are linked together in an array

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500 GB – 3T

o Size ranges from several hundred gigabyte to terabytes

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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)”

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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)”

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Redundant Array of Independent (Inexpensive) Disks

RAID

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5

Presentation introduced __ levels of RAID

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11

Now, there are __ levels, most of which are combinations of the first 5

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Long-term

▪ means near line, images that must be retrieved from a tape or disk storage device

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hospitals

Most ___ use RAID storage for both short-term and long-term archive

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Other long-term storage products that are still widely used are

Other long-term storage products that are still widely used are

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Optical disk and magnetic type archive

– uses a jukebox to hold the tapes or disks

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Optical disk

▪ any computer disk that uses optical storage techniques and technology to read and write data

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Optical disk

▪ a computer storage disk that stores data digitally and uses laser bits to read and write data

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Magnetic disk

– uses arrays

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  1. Magento-optical disk

  2. Digital versatile disk

  3. Ultra density optical

  4. Tape

  5. Magnetic disk

Five types of Optical Disk

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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

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Magento-optical disk

• Disks are robust and withstand many years of reading • Can store 9.1 GB

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