New ideas confront challenges posed by PACS

March 9, 2008

PACS developers face formidable challenges in their quest to create the ideal working environment for radiologists. These include coping with the explosion in the quantity of data produced in a modern hospital, efficiently retrieving and displaying that information both within the hospital environment and beyond, and achieving improved integration of images derived from different modalities.

PACS developers face formidable challenges in their quest to create the ideal working environment for radiologists. These include coping with the explosion in the quantity of data produced in a modern hospital, efficiently retrieving and displaying that information both within the hospital environment and beyond, and achieving improved integration of images derived from different modalities. They hope to demonstrate rapid progress in all of these areas at this year's ECR. One of the main technical issues facing radiology departments is that in many hospitals, islands of diagnostic skill have developed using separate platforms, such as radiology, cardiology, and mammography PACS, according to Carestream Health information solutions consultant Mark Kirk. He is concerned that busy clinical staff should not be using different systems with multiple data streams when diagnosing complex ailments and creating a patient care plan that prevents collateral drug effects."Our PACS provides the ability to view a complete patient history, using Integrating the Healthcare Enterprise guidelines to review DICOM and non-DICOM images in the same viewing area and using user-friendly tools and display protocols to show all the relevant data in one interface," he said.The latest platform will enhance staff efficiency by delivering optional integrated applications such as native 3D, image fusion, orthopedic templating, and cardiac analysis to authorized users at remote locations as well as onsite diagnostic workstations. It also uses specialized display protocols that organize images into each radiologist's preferred format so that interpretation can begin in seconds instead of minutes, he said.Increasingly, radiological images are being examined on workstations that are dependent for their processing functions on a central server that may even be based outside that hospital. At ECR 08, Visage Imaging, a subsidiary of Mercury Computer Systems, is demonstrating its thin-client-enabled product range containing a number of novel features intended to optimize workflow. The Visage CS Thin Client product includes new advanced tools for 2D, 3D, and 4D image review and interpretation, postprocessing, data management, and image distribution."Radiologists and clinicians need access to medical imaging data and clinical applications throughout the entire hospital at the click of a mouse in order to interpret and manipulate 2D, 3D, and 4D medical imaging data," said company president Marcelo Lima. "Our integrated thin-client-based PACS combines enterprise-wide image management and advanced visualization in a single platform." All PACS need to handle vast quantities of image data, often in a network environment that performs poorly and has long latencies. Sectra's new IDS7/dx diagnostic workstation is designed to help overcome some of these difficulties. It incorporates patent-pending technology for retrieving and displaying image data of extreme size that eliminates a number of the problems associated with handling large data sets. The advanced streaming facility can deal with variations in network quality and perform efficiently over high latency networks. It also includes tools for sorting CT and MR data, a 3D package, and full solutions for RIS and speech recognition integration.The major multinational suppliers of imaging hardware are also displaying the latest products in their range of data processing tools. Philips Medical Systems, for example, recognizes that physicians do not always need all the information that modern imaging technologies can provide. Its iSite PACS uses patented encoding technology to provide lossless, flexible representations of the data, which allows on-demand delivery of those parts of the image that the clinician requires at an appropriate level of detail.The product delivers full-fidelity medical images over existing hospital networks, which makes large infrastructure upgrades unnecessary, according to the manufacturer. It aims to balance the workload across the entire network system, instructing the server to deliver just the required amount of data to use the client PC image display. As a result, users can navigate complex multimegabyte, multislice data sets with relative ease.Fujifilm Medical Solutions is demonstrating the latest upgrade of its Synapse PACS for radiology, cardiology, and mammography. Synapse version 3.2.1 software delivers a number of user-requested enhancements to increase efficiency and provide greater functionality for the interpretation of digital mammography studies, according to the company. Key changes include a new graphic user interface designed to provide significant productivity improvements and enable radiologists to identify and access information and generate reports.Agfa Healthcare is also striving to make sure that the benefits of cutting-edge PACS are realized more widely than just in the radiology department. It is showcasing the latest refinements to its IMPAX Enterprise system designed to unify all clinical departments within the hospital. It provides an integrated enterprise infrastructure that allows each user to work the way he or she wishes, while sharing information and maintaining a seamless workflow between individual departments, according to Agfa.Specifically, the system uses persona-based user interfaces and a fully integrated RIS/PACS/reporting technology. It also provides the benefits of a web-based system with the functionality of a client server application and a proactive 24/7 global system monitoring and reporting solution, the company said.On the display side, Barco is unveiling new technology designed to help ensure that radiologists can perform their duties efficiently and in comfort. Its Coronis Fusion 6-megapixel DL diagnostic workstation is based on Hitachi's IPS-Pro advanced liquid crystal display technology. The 30-inch (76-cm) color monitor can be used as two uninterrupted 3-MP displays or a wide-screen 6-MP display. This gives the freedom to read images from different modalities side-by-side on a single wide-screen viewport.The device has another important advantage over older LCDs: It can be read easily at the same time by two people seated alongside each other. Conventional systems tend to suffer from substantial color and contrast changes when looked at from an angle. This restricts the maximum viewing angle in which contrast levels are high enough to detect subtle lesions to about 70°. With IPS-Pro, that angle is almost doubled to 120°.Staff at Sectra have arrived at ECR 08 in a buoyant mood after signing an agreement with British Telecommunications to provide PACS to many of London's public hospitals. BT is the local service provider for the U.K. National Health Service's London Programme for IT. Sectra will, as a subcontractor to BT, begin to assume responsibility for the support and maintenance of the systems of 21 London trusts comprising 25 hospitals performing more than four million radiology examinations annually. The company will also supply additional PACS products to these hospitals.

 
Dr. Marc Garant evaluates spinal image using Kodak Carestream PACS workstation at Oregon Medical Group in Eugene, U.S. Vendor's PACS platform offers optional integrated applications, such as image fusion and orthopedic surgical templating, in addition to native 3D imaging and advanced cardiac features. Vendors continue to put great emphasis on comfort for PACS operators, many of whom spend several hours a day staring at a screen. (Provided by Philips Healthcare)