SCAR's tone and scope reflect PACS changes

The seeds of PACS have been scattered widely in radiology. The sprouting popularity of Society for Computer Applications in Radiology meetings is one indication of how deeply the roots have reached. Attendance at this May's 19th annual meeting in Cleveland grew to the point that the gathering required a convention center instead of a hotel venue. Registration increased to about 2000, roughly a 17% spurt.

More conference space meant room for more vendors. The floor of the Cleveland Convention Center was temporary home to 96 exhibitors, nearly twice as many as there were four years ago at the SCAR meeting at the Houston Westin Galleria Hotel, which housed 51 vendor booths.

More registrations meant more sessions. This year, 120 speaker sessions were scheduled over the four days of the meeting, compared with 86 sessions four years ago, a 28% increase. While the range of speaker topics was equally broad at both meetings, the focus has shifted, reflecting the turn of the industry away from PACS implementation and early adopter experiences to matters of a more operational nature:

• HIPAA angst (13 sessions)

• improving workflow and productivity (10)

• emerging modalities such as CR and DR (10)

• enterprise image distribution (10)

• structured reporting/speech recognition (8)

• quality assurance/quality control (6)

SCAR University, in its third year, again offered a full curriculum of 48 courses in 12 sections for beginner, intermediate, advanced, and graduate level students. The pitches seem to be improving, although the redundant nature of some of the sessions from year to year can make it difficult to find the pearls.

I nearly missed the induction of Sam Dwyer as a SCAR Fellow at the noon lunch membership symposium on Friday. So did Dwyer.

The meeting, originally scheduled in one of the Center's smallest conference rooms, was moved after the program was printed to one of the largest. There's always that 0.0001% who don't get the word.

I found Dwyer, the venerable University of Virginia radiology professor, at 11:40 a.m., sitting by himself reading the paper in the room erroneously listed in the program. Figuring I must be in the right place, I took a seat nearby and for 10 minutes or so he and I enjoyed a nice chat about Cleveland restaurants, the Jefferson phantasm at the University of Virginia, and how PACS got its name. Dwyer, who is known as the Father of PACS, neglected to mention he was to be named SCAR Fellow at the meeting we didn't know we were missing.

By the absence of box lunches, however, or anyone to eat them, we soon deduced we were in the wrong place and set out to find the meeting. No sooner had we found it and picked up our sandwich and salad, the lights dimmed and a photo taken some years ago at a PACS meeting in Tokyo appeared on the overhead. A garrulous Sam Dwyer was seen apparently attempting to persuade a rather reticent geisha of the productivity benefits possible with PACS.

Dwyer is good at persuasion. He once convinced an entire industry its future was digital. By naming Dwyer a SCAR Fellow, the Society's ninth such honoree, that same industry was recognizing his unique contribution to making PACS a reality in medicine.

Many radiologists departing the SCAR meeting met a familiar device in front of the ticket counters at Cleveland's Hopkins International Airport. New scanners have begun to appear in airport lobbies, part of the government's attempt to tighten security in the aftermath of Sept 11. Departing passengers checking bags are now required to feed them through an industrial CT scanner. The federal government plans to deploy nearly 3000 of the units at a cost of $2.5 billion.

The devices let security technicians running the machines get a fairly detailed look at the contents of suitcases passing through on the way to their flights.

One wonders when some enterprising imaging group will strike a deal with the airlines and/or airport operations to offer full-body CT scans there in the airport lobby in conjunction with baggage inspection. Why not? Imaging boutiques are already popping up in shopping malls.

Operators of these imaging enterprises would have an almost infinite number of potential customers, most of them with nothing else to do while waiting in line to check their bags. Travelers could have the scanner peer inside their bodies for polyps at the same time it examines their baggage for bombs.

"Your bags are okay, sir, but it appears you have degenerative disc disease throughout the cervical spine, most severe from C4 to C7 inclusive, with marked spur formation to the intervertebral foramina bilaterally at these levels ..."