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Picture archiving and communication system
In medical imaging, picture archiving and communication systems (PACS) are computers or networks dedicated to the storage, retrieval, distribution and presentation of images. The medical images are stored in an independent format. The most common format for image storage is DICOM (Digital Imaging and Communications in Medicine).
Types of Images
PACS replaces hard-copy based means of managing medical images, such as film archives. It expands on the possibilities of such conventional systems by providing capabilities of off-site viewing and reporting (distance education, telediagnosis). Additionally, it enables practitioners at various physical locations to access the same information simultaneously, (teleradiology). With the decreasing price of digital storage, PACS systems provide a growing cost and space advantage over film archives.
PACS is offered by virtually all the major medical imaging equipment manufacturers, medical IT companies and many independent software companies.
The most difficult area for PACS is interpreting the DICOM image format. DICOM has enough latitude to allow various vendors of medical imaging equipment to create DICOM compliant files that differ in the internal tags used to label the data and the metadata. A feature common to most PACS is to read the metadata from all the images into a central database. This allows the PACS user to retrieve all images with a common feature no matter the originating instrument. The differences between vendors' DICOM implementations make this a difficult task.
Typically a PACS network consists of a central server that stores a database containing the images connected to one or more clients via a LAN or a WAN which provide or utilize the images. Web-based PACS is becoming more and more common: these systems utilize the Internet as their means of communication, usually via VPN (Virtual Private Network) or SSL (Secure Sockets Layer). The software (thin or smart client) is loaded via ActiveX, Java, or .NET Framework. Definitions vary, but most claim that for a system to be truly web based, each individual image should have its own URL. Client workstations can use local peripherals for scanning image films into the system, printing image films from the system and interactive display of digital images. PACS workstations offer means of manipulating the images (crop, rotate, zoom, brightness, contrast and others).
Modern radiology equipment, modalities, feed patient images directly to the PACS in digital form. For backwards compatibility, most hospital imaging departments and radiology practices employ a film digitizer.
A full PACS system should provide a single point of access for images and their associated data (i.e. it should support multiple modalities). It should also interface with existing hospital information systems: Hospital information system (HIS) and Radiology Information System (RIS).
Interfacing between multiple systems provides a more consistent and more reliable dataset:
An interface can also improve workflow patterns:
Recognition of the importance of integration has led a number of suppliers to develop fully integrated RIS/PACS systems. These may offer a number of advanced features:
The principles of PACS were first discussed at meetings of radiologists in 1982. Various people are credited with the coinage of the term PACS. Cardiovascular radiologist Dr Andre Duerinckx reported in 1983 that he had first used the term in 1981. Dr Samuel Dwyer, though, credits Dr Judith M. Prewitt for introducing the term.
Dr Harold Glass, a Medical Physicist working in London in the early 1990s secured UK Government funding and managed the project over many years which transformed Hammersmith Hospital in London as the first filmless hospital in the United Kingdom. Dr Glass passed away a few months after the project came live but is credited with being one of the foremost PACS experts in the United Kingdom until the time of his death.
|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Picture_archiving_and_communication_system". A list of authors is available in Wikipedia.|