Interventional radiologists use PACS to archive JPEG images

A new use for PACS has emerged in New York City, where interventional radiologists at St. Luke's-Roosevelt Hospital Center have begun using the system to catalogue photographic images.

The new approach provides an efficient electronic alternative to manual methods previously used.

Other medical centers have extended PACS use to manage medical images acquired within the enterprise, including nonradiology imaging applications such as endoscopy and microscopy and photographic images obtained in dermatology and ophthalmology.

"Use of PACS for archiving visible-light photographic images can be a valuable tool for an interventional radiologist's vein practice," said Dr. James E. Silberzweig of the center's radiology department.

The technique is documented in the current issue of the Journal of Vascular and Interventional Radiology (2007;18(4):577-579).

Aside from DICOM format, most PACS are capable of importing files in other formats, such as JPEG and TIFF.

Silberzweig found that JPEG format suits the purpose for image acquisition and transfer to PACS, even though TIFF gives the best-quality image because it is losslessly compressed.

"However, use of TIFF comes at the expense of large image size. Digital camera images of patients acquired in JPEG format have been shown to be reliable for plastic surgery and vascular surgery," he said.

Initial clinical evaluation of patients with lower extremity insufficiency includes consultation report, lower extremity venous duplex ultrasound, and photographs of lower extremities.

Photographic documentation is used to evaluate treatment progress. Also, insurance carriers may request photographic documentation.

Prior to implementation of photographic image transfer to PACS, all photographic images were typically transferred from the camera to a desktop computer as JPEG files. The files were either stored on the computer's hard drive, with intermittent manual backup to CD, or were printed and filed in the patient's folder.

"Among the limitations enforced by maintaining a hard-copy system are inadequate image backup and redundancy and inability to access patient data remotely when necessary," Silberzweig said.

Silberzweig said secondary capture of JPEG files is a feature that should be considered when purchasing or upgrading a PACS.

"PACS provides access to a reliable, secure, HIPAA-compliant, virtually limitless image and clinical data archive, offering the clinician a completes chronological view of the patient clinical record," he said.