PACS vendors hold few surprises at this year's RSNA conference

Full DICOM conformance is still at least two years away

If you plan on touring the PACS exhibits at this year's RadiologicalSociety of North America meeting, don't expect to be bowled overby new technological developments. While PACS vendors continueto win acceptance for digital image management and networking,they will probably fall short of last year's banner performance.

Vendors in the PACS market will jockey for position, with oneof the biggest battles occurring between factions that supportcomputed radiography, such as Fuji, and companies that favor theimplementation of digital (or direct) radiography, including SterlingDiagnostic Imaging. Both sides have their advantages and benefits,and peaceful coexistence should be possible. Unfortunately, neitherside is willing to concede any ground, which poses a dilemma forcustomers trying to decide on an x-ray digitization option.

Similar battles will be fought between wet-process and dry-processfilm printing technology, with an added challenge from the laser-paperfaction. Expect a serious push from dry-process vendors this year,especially in light of Sterling's recent purchase of Polaroid'sHelios product line and the growing momentum of Imation's DryViewproducts.

Market consolidation continues in the PACS arena. Several vendorsseem to be barely clinging to life, while others are trying fora phoenix-like revival. A few of the major companies that haveall but ignored PACS, including Toshiba and Picker, will rampup their involvement, while a few vendors that should have beenout of the market years ago will find their exits assisted bydisgruntled customers.

Look for numerous new partnerships and alliances, among themKodak/Applicare, IBM/Brit Systems, and Fuji/DeJarnette. Scuttlebuttwill continue to plague the market leader in medical imaging,whose possible relationship with a major defense contractor isbeing vehemently denied despite indications to the contrary.

Teleradiology vendors will be in full regalia again, with virtuallyevery vendor showing DICOM-compliant systems. Prices will remainfairly stable in comparison with last year, and no dramatic shake-upsin pricing or in vendors' corporate structures are anticipated.

Vendors will strut their DICOM stuff this year, but few attendeeswill be able to evaluate the level of compliance, due to the complexityof interpreting a vendor's DICOM statement. With few exceptions,the market remains at least two years away from full DICOM conformance.

This will be the first year in which there is a widespreadpush to demonstrate the role of PACS in an integrated informationand image management system. These products are highlighted byImnet (and partner HBO Systems), Dynamic Healthcare Technologies,SMS, and others, which are focusing primarily on image and informationdistribution to all clinicians, although radiology-specific productswill also be shown.

The few technological advances at the RSNA show will come fromcompanies openly discussing their planned use of DVD (digitalvideo/versatile disk) and the advent of lower cost, higher resolution(and gray-scale) plain-paper lasers. Most PACS players continueto use magneto-optical (M/O) drives as the archive medium. Butseveral companies will demonstrate low-cost CD-R (CD-recordable)jukeboxes, as well as migration paths to DVD when it becomes commerciallyavailable in late 1997.

By Michael Cannavo, president, Image Management Consultants