Advanced visualization is worming its way into PACS. Once-dedicated workstations are being democratized to support network access, thin-client servers gel with PACS, and native code embeds sophisticated postprocessing. The technology is no longer exclusively 2D.

This computing evolution was reflected at the Society for Imaging Informatics in Medicine exhibition in Seattle in May. Carestream displayed native 3D and productivity capabilities; Fovia touted an OEM strategy to bring its 3D horsepower to multiple brands of PACS; and Visage, TeraRecon, Agfa, and Siemens each presented varying degrees of thin-client and PACS-based 3D computing.

Inclusion of these products as an integral part of the PACS environment has become critically important to the routine practice of radiology, as clinical applications demand the evaluation of larger and more complex data sets. In a broad paradox, increasingly sophisticated technologies are harnessed to simplify the diagnostic process, just as productivity gains are coming from software that complements human intelligence.

One smart algorithm from GE Healthcare checks radiology reports to help ensure accuracy. This "thought checker," scheduled to begin routine shipment by the end of the year as an upgrade to the Centricity RIS-IC Reporting module, uses the context of reports to identify possible errors. The program might question, for example, whether the radiologist meant "left occipital lobe" rather than "right" by highlighting the directional term in blue. Or it might insert a red bar at a point where certain information needs to be added.

"It understands the concept of left and right and the need for certain measurements," said Michael Mast, GE senior manager of commercial marketing in the imaging integrated IT business unit. "It serves as an extra check in that it gives the radiologist a chance to clarify some points in a report."

Much of the power being added to PACS is coming from innovative fringes of the industry. GE's thought checker came from a partnership with M*Modal, whose AnyModal Conversational Documentation Services combines speech recognition and natural language to interpret the meaning of dictated reports and then identify possible errors.

McKesson's MyPACS.net, a web-based technology designed for radiology decision support and information exchange showcased at the SIIM meeting, came from Vivalog Technologies. This company, which began seven years ago with grant money awarded by the National Institutes of Health, partnered with McKesson before the IT giant purchased the company this spring.