Gateway system lets PACS go global

A new DICOM gateway server system solves the problem of integrating local hospital DICOM-based PACS with PACS from other manufacturers. The gateway solution could enable the creation of a global PACS network, according to its developers.

"Our DICOM gateway server is based on 'pure' DICOM ideology, and it therefore can connect to any DICOM-compliant PACS," said Mikhail Miltchenko, a research assistant in the computer science department at Louisiana State University.

Standard PACS implementations provide only basic DICOM functionality, substantially limiting the architecture and scalability of PACS networks. Most Web-accessible PACS are connected only to their own proprietary servers and cannot communicate with other manufacturers' PACS networks, even if they are part of the same hospital.

"Images from PACS in one hospital have to be printed on film, mailed to another hospital, and digitized there again," Miltchenko said.

He explored the possibility of a global PACS network in a paper presented at the November 2003 RSNA meeting.

The LSU gateway uses unexploited DICOM functionality to support advanced features like message routing. Miltchenko said this gateway server can redirect queries for DICOM entities that cannot communicate directly through the custom encoding in user-defined DICOM message fields.

"These custom fields do not violate any DICOM standard and can be safely ignored by PACS that do not support them," he said. "By connecting our server to the PACS from a different vendor, all DICOM entities in the local network have access to all resources available to our server. They do not require additional individual configuration, which isn't the case with standard DICOM."

This scheme simplifies the configuration and maintenance effort, making any PACS easily scalable and flexible, he said.

The LSU solution, deployed in 2002 soon after it received FDA approval, is available at http://www.unipacs.com. It features the department's light Java client, which connects to the gateway server and can connect (with proper authorization) to any DICOM network accessible by this server. It supports online medical data viewing/exchange and all major PACS functions.

"Similar gateway servers are already installed in our radiology department, for internal and teleradiology use," Miltchenko said.