Exposures II: Chapter 24 - Informatics in Medical Imaging

Changing data and information into knowledge.

What is informatics?

A particular configuration of computer devices and processes.

What is platform?

Picture Archiving and Communication Systems

What does PACS stand for?

Computerized storage and transmission of digitized medical images

What is PACS?

1. Can be viewed and transmit in different places

2. Can manipulate images electronically for less repeats

3. Stored electronically

4. Report and image are kept together electronically

5. Cannot lose the image physically (but can be lost within the computer system)

What are the advantages of PACS?

Computer is used to acquire the image

• Laser printer does printing on the film

What are mini PACS?

1. CT

2. MRI

3. Ultrasound

4. Nuclear medicine

What were the early mini PACS?

Health Information System

•  This contains patient information and events (admit, discharge, etc.) used throughout the hospital.

• Communicates everything in radiology

What is HIS?

Radiology Information System

• It contains information used in the radiology department such as patient exam orders and reports.

What is RIS?

Text-based systems (words + numbers)

What type of system does HIS and RIS have?

This improves efficiency. 

• The patient name and identifying information may be entered into the computer once in HIS and then extracted by RIS as exams are ordered.

• Without having the work done by hand

Why is it important for HIS to interface with RIS?

Electronic Health Record

• It contains the patient’s entire medical record, including medical images and reports in a single file

What is the EHR?

Digital Imaging and Communication in Medicine

• It is the current set of standards that allows different components within the radiology department to communicate with each other.

• It is a protocol for exchanging and storing medical data in the form of image and associated text.

• Language or protocol that PACS speaks

What is DICOM?

Describes what to do with the objects

• ex: Storage, print

What is service class?

Contains information about the study (type of exam) and the patient

• ex: CT image

What is object class?

Service object pair

• It is a combination of an object with a service

• ex. CR image print

What is SOP?

Service class user

• User of the service

• The user who needs a service done

• ex: DR computer

What is SCU?

Service class provider

• is the provider of the service

• ex: laser print

What is SCP?

Standard that text-based HIS and RIS speak

What is HL7?

Electronic health information is protected via:

• data encryption - coded image

• firewalls - controls what go in and out of computer system

• user IDs

• passwords

What measures are used with PACS to ensure HIPAA compliance?

Integrating the Healthcare Enterprise

• an initiative that promotes the use of DICOM and HL7 standards among equipment manufacturers to ensure compatibility

What is IHE?

Local Area Network

• connects all computers within 1 system (a hospital for example). 

• ex: radiology department

What is LAN?

Wide Area Network

• connects computers separated by large distances.

What is WAN?

Refers to the computer programs, applications or operating systems that are stored as code within the hardware and executed by computers.

What is software?

refers to the operating system

• ex: microsoft windows

What is system software?

Refers to the programs that users interact with to perform specific tasks.

• ex: Powerpoint

What is application software?

Because image files are very large and need to be retrieved very quickly.  This would bog down the hospital network.

Why is a PACS network a separate network within a hospital?

Allows computers to exchange data and share resources

What does network do?

Connector to allow data to flow between networks

What are switches?

1. Hub

2. Bridge

3. Router

What are the 3 types of switches?

Hub

What is the simplest form of switch?

A type of switch that is the most inexpensive and simplistic of network switches

• acts as a passive method (no discrimination) for connected computers to transmit and receive data that are connected to it

What is hub?

Actively manages the connections between attached computers (not all information can pass through)

What is bridge?

Bridge

What is the advanced form of switch?

Router - uses IP

What is the most complex form of switch and what does it use?

Describes how much data can be moved at one time. 

• PACS networks require large bandwidth.

What is bandwidth?

beats per second (bps)

How is bandwidth measured?

Refers to internet based computing with virtual access that is location and device independent.'

• using the internet to work with data, software, and files that are stored somewhere else, not on your own computer

What is cloud computing?

x ⋅ y ⋅ B / 8

How do you calculate image file size?

Refers to images viewed on a monitor.

What is soft copy image display?

Refers to images viewed on film.

What is hard copy image display?

LED (Light emitting diode) and LCD (liquid crystal display) monitors regulate the image by using a light source behind the screen shining on individual pixels, which control the amount of light transmitted through.

How does LCD and LED monitor work?

It is a measure of brightness emitted from a monitor

What is luminosity?

The luminance of an image viewed on a monitor is less than that of an image viewed on a viewbox.

How does the luminance of an image viewed on a monitor compare with an image viewed on a viewbox?

1. RTs and referring physicians - use monitors with lower resolution than a monitor used by a radiologist. 

2. Radiologist - requires the highest resolution because he is viewing the image for diagnosis.

How do monitors used by a radiologist, RT, and referring physician compare?

Turning off lights to eliminate glaring or reflection.

How do you solve luminance?

Excessive light lowers contrast perception

How does excessive light affects contrast perception?

small pixel size = large matrix size = higher resolution

How is resolution determined?

1. Short-term

2. Hard drive

3. modality

1._______ storage is provided by the 2.______ of the 3.______ that created the image

RAID

What is used for short-term storage (few months)?

• Short-term storage

• Redundant array of independent discs for quick retrieval

What is RAID?

Juke box

What is used for long-term storage?

• Long-term storage

• May be in the form of tapes or disks in

• Automated retrieval

What is juke box?

Complete copy of all the files in another location

• used for data integrity in the event of a catastrophic event

What is off-site?

Makes image file smaller

What is compression?

1. Faster transfer time

2. Smaller storage

What are the benefits of compression?

Provides the smallest image file size but image quality is adversely affected.

• lowers resolution therefore radiologist cannot read this

What is lossy compression?

Larger file size but still small and preserves image quality

• Radiologist can read this

What is lossless compression?

Tangible components and connections within the computer

What is hardware?

1. CPU

2. memory

3. input + output devices (mic, keyboard, mouse)

4. Bus

What are the examples of hardware?

Central Processing Unit or microprocessor

• executes commands or instructions dictated by a computer program

What is CPU?

is used to store data and applications and can reside as physical memory or as physical media

What is memory?

Extensions of the hardware that allow us to interact with the computer

• ex: keyboard, mouse or trackpad, touch screen, microphones, and cameras.

What are input and output devices?

It connects the CPU and other parts on the motherboard.

• It helps to move data between them.

• The width of the bus means how much data can travel at one time — like how many cars can fit on a road.

What is bus?