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Picture Archiving and Communication System (PACS)
a system used to store, retrieve, manage, and store images produced by various medical imaging modalities
Picture Archiving and Communication System (PACS)
reduces the need for manually handling film-based images and provides instant access to images and reports across the healthcare system
basic pacs workflow
order entry, image acquisition, image transfer to PACS, radiologist review, distribution of results
order entry
a clinician orders an imaging exam for a patient
image acquisition
the imaging exam is performed, and the data is acquired
image transfer to PACS
the image data is transferred to the PACS for storage and accessibility
radiologist review
a radiologist accesses the images, performs an interpretation, and generates a report
distribution of results
the report and images are available for the referring physician and others involved in patient care
genetic workflow
refers to a universal approach to handling px data and images from different sources in a standardized and consistent way
genetic workflow
ensures data consistency, better resource management, and easy retrieval across multiple systems in the healthcare facility
Integrating the Healthcare Enterprise (IHE)
it establishes protocols and workflows to ensure that different systems (EHRs, PACS, IT systems) can communicate effectively (feasibility of network)
IHE Radiology Workflow
ensures smooth integration and coordination between radiology departments and other healthcare systems
key components of IHE radiology workflow
scheduled workflow profile, patient information reconciliation
Scheduled Workflow Profile
ensures seamless flow of px information from registration, image acquisition, final reporting, and archiving
Patient Information Reconciliation
resolves inconsistencies in patient demographics that may occur during imaging procedures
steps in radiology workflow
scheduling/order entry, patient registration, image acquisition, image processing, interpretation by radiologists, reporting and communication
scheduling/order entry
the process begins when a physician orders an imaging study
patient registration
accurate px information is entered into the system
image acquisition
technologists perform the imaging study using the appropriate modality
image processing
the images are processed and made ready for review (manipulation of images)
interpretation of radiologists
radiologists read and interpret the images, creating diagnostic reports
reporting and communication
the report is communicated back to the referring physician and any necessary follow-up is conducted
workflow analysis
analyzing the radiology workflow helps in identifying bottlenecks, inefficiencies, and opportunities for automation.
key metrics to analyze in workflow analysis
time from order entry to report availability, image acquisition time, report turnaround time, system uptime and downtime (PACS performance)
less than 5 minutes
standard image acquisition time
data silos
information is not easily shared between departments (information is casted out or isolated)
different formats
of imaging data makes it hard for systems to interpret and share data effectively
security and privacy concerns
especially with sensitive patient information (common issue is hacking)
Health Level Seven (HL7)
a set of international standards for the transfer of clinical and administrative data between HIS; it is essential for sharing data across different health IT systems
HL7
standard format for textual information
DICOM
standard format for images
Internet Standards
utilize standard internet protocols such as TCP/IP and HTTPS to ensure secure transmission of images and reports across networks (for security purposes, prevents potential hacking)
Transmission Control Protocol
TCP
Internet Protocol
IP
Hypertext Transfer Protocol Secure
HTTPS
Digital Imaging and Communication in Medicine (DICOM)
the global standard for the transmission, storage, retrieval, and display of medical images and related information
Digital Imaging and Communication in Medicine (DICOM)
it ensures that medical imaging devices from vendors can communicate with PACS, RIS, and EHR systems
key components of DICOM
file format standard, communication protocols, image compression
file format standard
for images, which include both the the image and metadata
metadata
annotation; information embedded in the image
communication protocols
for exchanging information across networks
image compression
for efficient storage and information transmission of large files
HL7 Overview
crucial for data exchange between information systems; i it covers everything from px records, to lab results, and medical imaging reports
HL7 in Radiology
it ensures that order information, px demographics, and report data are transmitted accurately between PACS, RIS, and EHR systems
Interoperability
it is the ability of different health systems and devices to work together (if there is no network, information has limited access)
IHE and Interoperability
IHE defines integration profiles that specify how systems should communicate to ensure interoperability
Scheduled Workflow (SWF)
coordinates the entire workflow from image order to reporting
Cross-Enterprise Document Sharing (XDS)
allows the sharing of px record, including images, across different healthcare institutions
Quality Evaluation
involves accessing the visual quality and diagnostic usefulness of medical images
Quality Evaluation
ensures that the images produced are adequate for diagnosis minimizing the need for repeat exposures
key parameters for quality evaluation
image quality metrics, subjective vs objective evaluation, artifacts and image degradation
spatial resolution
ability of an imaging system to distinguish small details; measured in line pairs per millimeter (lp/mm); sharpness of the image
contrast resolution
ability to distinguish between different intensities in an image, indicating the differences in tissue density; visibility of the image
signal-to-noise ratio (SNR)
measures the clarity of the image; higher SNR = better image quality
modulation transfer function (MTF)
describes how well an imaging system can reproduce or transfer detail from the object to the image
subjective evaluation
relies on human observers, such as radiologists, to assess mage quality based on visual perception; can be bias
objective evaluation
uses quantitative methods, such as mathematical algorithms and metrics to evaluate image without human bias
artifacts
unwanted things that are not included in the true anatomy
common artifacts
motion artifacts, aliasing, beam hardening
statistical anaylsis
used to extract meaningful information from images such as identifying patterns or quantifying image features
information entropy
measures the uncertainty or randomness within an image; aids in the evaluation of image complexity and data compression technique
mean, median, mode
measures of central tendency that describe the average intensity levels in an image
standard deviation and variance
indicate the spread or variability of pixels intensities, reflecting image contrast
histogram analysis
plots the frequency of occurrence of each intensity value in an image, helping to identify the distribution of pixel values and contrast
information entropy
measures the amount of information present in an image; used in image compression and noise reduction
segmentation
divides an image into distinct regions based on pixel characteristics such as intensity or texture, for further analysis
feature extraction
identifies specific patterns, shapes, or regions of interest within an image
coding and decoding
essential for efficient image storage and transmission
coding and decoding
enables compression, reduce file sizes, and facilitates secure image sharing without losing diagnostic quality
lossless compression
no data loss, og image can be perfectly reconstructed; PNG and GIF
lossy compression
some data is lost, reduces file size; JPEG and MP3
DICOM standard
the standard for handling, storing, and transmitting medical images; contains both image data and meta data
Huffman Coding
a lossless data compression algorithm that uses variable-length codes for encoding symbols based on their frequencies
Run-Length Encoding (RLE)
compresses consecutive runs of the same value, reducing redundancy in images
decoding
converts the compressed image back to its original form, retaining quality based on the chosen compression method
stable signal processing
involves predictable and consistent transformations that preserve integrity
stable signal processing
low-pass filtering and smoothing are examples of
unstable signal processing
may lead to unpredictable changes in the signal, potentially introducing artifacts or altering the og image content
unstable signal processing
common in non-linear transformations or when the input signal is highly variable
gaussian filtering
a linear filter that smooths images by reducing high-frequency components
high frequency components
consumes more process in RAM; high demand in computer performance
median filtering
a non-linear filter that reduces noise while preserving edges by replacing each pixel value with the median of neighboring pixel values
fourier transform and frequency analysis
decomposes an image into its frequency components, aiding in the analysis and filtering of specific frequencies
image transformation
mathematical operations that alter an image to enhance or extract specific features, making it easier to analyze or process
types of transformation
geometric, intensity, spatial and frequency domain, wavelet transform, principal component analysis
translation, rotation, and scaling
modify the position, orientation, and size of an image
affine transformation
includes translation, scaling, rotation, and shear; maintains collinearity and parallelism of points in the image
intensity transformation
modifies the intensity of pixel values to enhance image contrast or visibility of specific features
logarithmic and exponential transformation
enhance dark regions or compress bright regions in an image
spatial domain
direct manipulation of pixel values in an image
frequency domain
manipulation of images based on its frequency components
wavelet transform
decomposes an image into different frequency components, providing both spatial and frequency information; useful for denoising and feature extraction
principal component analysis (PCA)
reduces the dimensionality of an image dataset
principal component analysis (PCA)
highlight major components and eliminating redundancies
pre-medical image processing
involves manipulating raw data obtained from imaging devices to produce a high-quality image that accurately represents the scanned image
types of pre-medical image processing
image reconstruction, background removal, noise removal, image compression
image reconstruction
the process of creating visual images from raw data generated by medical imaging systems
types of image reconstruction
filtered back projection, fourier transform-based methods, iterative reconstruction
filtered back projection (FBP)
commonly used in CT; involves transforming raw data into an image by projecting it onto a grid
fourier transform-based methods
often used in MRI; help convert frequency data into spatial images
