PACS Chapter 8 P icture A rchiving and C ommunication S ystem

Anatomy of PACS Figure 8-1 Digital acquisition Display workstations Storage devices Electronic version of reading room and the file room

Digital imaging and communication in medicine AKA: DICOM Each modality and PACS communicate via DICOM

3 fundamental parts of PACS 1-Image acquisition US, CT,MRI, Nuc Med and finally general radiography Increased images per patient promoted the use of extra stations Many work station gave way to full PACs systems

3 fundamental parts of PACS 2 Display workstation Receives images from archive or from various radiology modalities PACs application software for image manipulation (minor to more complex techniques)

3 fundamental parts of PACS Archive Servers Electronic file room Short term or long term storage Controls the PACs workflow Archive receives images before they go to radiologist Why is this something the radiographer should be aware of?

COMPARE THE FILM BASED WORK FLOW TO WHAT YOU DO NOW

PACS ARCHITECTURE Client/server- based system All images from all modalities go to a central archive server Images are then sent to the reading room Advantages? Disadvantages?

PACS ARCHITECTURE DISTRIBUTED SYSTEMS OR STAND ALONE Images sent to a designated reading station. MRI to one station, CT to another Advantages? Disadvantages?

PACS ARCHITECTURE Web based system Similar to client/serve application except the application software is web based Advantages? Disadvantages?

DISPLAY WORKSTATIONS Number of monitors required by radiologists have reduced-why? LCD to soon replace all CRT tubes- why? CT viewed on a 1K CR/DR viewed on 2K Mammo – 5K Let’s review resolution

Reading stations Radiologist Physician Review Can read report next to images Tech QC station What can be done here? What should be confirmed here? What is RIS?

FILE ROOM/IMAGE MANAGEMENT STATIONS For image management purposes Look up examinations for other physicians Correct demographics before sent to archive

FUNCTIONS Navigation functions Hanging protocols Study Navigation Image manipulation and enhancement functions What are these? ROI= region of interest

Patient demographics can be modified at the QC station, the reading station and the file room station Why are there so many places that one can modify patient info? Refer to figure 8-1

ADVANCED FUNCTIONS Stitching Image post processing