PACS Chapter 8

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PACSChapter 8

• Picture Archiving and Communication System

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Anatomy of PACS

• Figure 8-1
• Digital acquisition
• Display workstations
• Storage devices
• Electronic version of reading room and the file
  room

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Digital imaging and communication in medicine

• AKA DICOM
• Each modality and PACS communicate via DICOM

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3 fundamental parts of PACS

• 1-Image acquisition
• US, CT,MRI, Nuc Med and finally general
  radiography
• Increased images per patient promoted the use of
  extra stations
• Many work station gave way to full PACs systems

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3 fundamental parts of PACS

• 2 Display workstation
• Receives images from archive or from various
  radiology modalities
• PACs application software for image manipulation
  (minor to more complex techniques)

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3 fundamental parts of PACS

• Archive Servers
• Electronic file room
• Short term or long term storage
• Controls the PACs workflow
• Archive receives images before they go to
  radiologist
• Why is this something the radiographer should be
  aware of?

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COMPARE THE FILM BASED WORK FLOW TO WHAT YOU DO
NOW
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PACS ARCHITECTURE

• Client/server-based system
• All images from all modalities go to a central
  archive server
• Images are then sent to the reading room

• Advantages?
• Disadvantages?

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PACS ARCHITECTURE

• DISTRIBUTED SYSTEMS OR STAND ALONE
• Images sent to a designated reading station.
• MRI to one station, CT to another

• Advantages?
• Disadvantages?

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PACS ARCHITECTURE

• Web based system
• Similar to client/serve application except the
  application software is web based

• Advantages?
• Disadvantages?

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DISPLAY WORKSTATIONS

• Number of monitors required by radiologists have
  reduced-why?
• LCD to soon replace all CRT tubes-why?
• CT viewed on a 1K
• CR/DR viewed on 2K
• Mammo 5K
• Lets review resolution

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Reading stations

• Radiologist
• Physician Review
• Can read report next to images
• Tech QC station
• What can be done here?
• What should be confirmed here?
• What is RIS?

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FILE ROOM/IMAGE MANAGEMENT STATIONS

• For image management purposes
• Look up examinations for other physicians
• Correct demographics before sent to archive

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FUNCTIONS

• Navigation functions
• Hanging protocols
• Study Navigation
• Image manipulation and enhancement functions
• What are these?
• ROI region of interest

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Patient demographics can be modified at the QC
station, the reading station and the file room
station

• Why are there so many places that one can modify
  patient info? Refer to figure 8-1

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ADVANCED FUNCTIONS

• Stitching
• Image post processing