6. PACS Archiving & Peripherals Flashcards
PACS System 6 Main Components
- Image Acquisition
- Communication Network
- Patient Data
- Display of Images
- Recordings Archive
- Web Server
Requires the existence of medical devices with the appropriate interface of PACS such as: CT (Computed Tomography) MRI (Magnetic Resonance Imaging) Digital X-ray Machine
Image Acquisition
international standard for defining the mode of transmission of medical information and images that provides interoperability between different devices
DICOM
the ability of computer systems or software to exchange and make use of information.
Interoperability
The development of mobile radiology is linked to
Marie Sklodowska Curie
Origin of file
Metadata
DICOM is developed by:
ACR – American College of Radiology
NEMA – National Electrical Manufacturers Association
ACR
American College of Radiology
NEMA
National Electrical Manufacturers Association
DICOM
Digital Imaging and Communications in Medicine
Simple and easy-to-use Windows application for converting medical image files between different image formats
Medical Image Converter
can export whatever DICOM file you have to BMP, GIF, JPG, PNG, TIF, or WMF
if there’s a series of images, it also supports saving them to a video file in the WMV or AVI format
MicroDicom program
Transmits images and attached data
Ex. Name of the patient, Date of birth, etc.
Communication Network
is the standard that enables the interface of HIS and RIS
HL7 (Health Level Seven, 7th OSI layer protocol)
is done via personal computer in the office
Display of Images
A system for archiving recordings should be centralized, with support for DICOM and HL7 standards
Recordings’ Archive
Implementation of PACS
is reflected in:
- Saving space and time for archiving x-ray images
- Search for educational purposes
- X-ray records are stored on computer disks in electronic form
- Significant material saving
- There is no need for buying X-ray films because x-ray images are moved on compact disks (CD) whose price is lower.
- Improved x-ray image quality and speed of diagnostic radiology;
- Possibility to view images from remote locations;
- Better utilization of human resources;
- Possibility to networking computers of one or more health facilities;
- Modernization of work;
- Reduction in service costs and material consumption
Standard for handling, storing, printing and transmission of information in medicine
DICOM
A set of rules that allows the exchange of medical images and information between computers and hospitals
DICOM
Establishes a common language that enables the usage of images and information, made on one type of manufacturers’ equipment, in digital systems of other manufacturers
DICOM
It should be noted that _____ is not only a file format; it is directly related to the PACS
DICOM
consists of files, definition and network protocol communication
DICOM
DICOM Files are most likely saved with a ______ file extension, but some may not have an extension at all
.dcm or .dcm30
DICOM Disadvantages
arise in:
- Searching the database and image processing;
- Simultaneous display of multiple images on the monitor when the quality of individual images is decreased or certain segments are cut off;
- Appearance of false coloring which appears in the adjacent gray level, false coloring in contrasting colors, etc.
DICOM Basic Function
- Communication and sharing of digital medical images, regardless of the manufacturer; to enable PACS to become a part of HIS, RIS and other information systems;
- To ensure that the database of medical images become available irrespective of browser distance;
- To enable the functioning of teleradiology
form of medical information system, which requires the use of telecommunications system
Teleradiology
Forms of telecommunications system:
- Satellite
- Internet
- Mobile Phones
- Computers
for the exchange of data, images, video, audio or other radiological information in order to secure radiology services between remote locations
Teleradiology
The process of Teleradiology is based on 3 essential elements:
- an image recording and sending station
- a secure transmission network (HIPAA compliant and secure data server)
- an image receiving station
The appliance of ______ is possible in imaging centers that have digital radiology apparatus, and Digital Imaging and Communications in Medicine (DICOM)
Teleradiology
During _____, Marie Curie left her Lab behind, inventing a mobile x-ray unit that could travel to the battlefront
WW1
the new form of mobile radiology
Radiology through mobile phone
implemented the diagnostic radiology act mobile MIM 2011 (mobile radiology through mobile phone)
FDA (Food and Drug Administration)
Advantages of PACS
- PACS can solve the issue of image loss, stolen, or misfiled
- 2 physicians will be able to view same image at different sites
- Allows full range of tools for better visualization of image
- Economically efficient
- Increase in efficiency of data management
Disadvantages of PACS
- It is not a new technology but still has not been deployed at various health care institutes
- The financial cost may be huge, preventing hospitals to install it
- Utilize large amounts of bandwidth on a system, can “crash” even a very strong network
- Strong internet technology needed to handle PACS traffic efficiently
- To read PACS report high resolution monitors are needed and they are too expensive
a place where records or documents are persevered
Archive
MOD
Magneto-Optical Disk
provide storage and convenient access to medical imaged such as ultrasounds, MRIs, CTs, and X-rays
PACS
is both a protocol for transmitting images and a file format for storing them
DICOM
ensures that all the medical equipment installed in clinics, medical imaging centers, and hospitals will work together and distribute the digital medical images correctly, across countries, modalities and clinics
DICOM
The appliance of _____ is possible in imaging centers that have digital radiology apparatus, and DICOM
Teleradiology
X-ray machines, CT, MRI, Mammogram and other Radiological Devices into trucks with trailers, thus making them _____ to all communities, in all weather conditions, in peace or war
mobile and accessible
place where records or documents are preserved
Archive
serves as the new file room and warehouse for all DICOM imaging modalities
electronic archive
It stores all patient
and image data, often on magnetic tape or optical disk
PACS archive
controls the
receipt, storage, and distribution of new and historic images
PACS archive
is one of the fastest growing components in
the PACS
PACS archive
complex arrangement of computers and storage space, consists of several components, both hardware and software
PACS archive
2 major categories of archive:
- image manager/controller
2. image storage/server or archive server
contains the master database of everything that is in the archive
image manager/controller
It controls the receipt, retrieval, and distribution of the images it stores and also controls all the DICOM processes running within the archive
image manager/controller
The image manager generally runs a reliable commercial database such as
Sybase,
Oracle with SQL
SQL
Structure Query Language
This database contains only the image header information, not the image data
image manager/controller
The database is mirrored, meaning that there are two
identical databases running simultaneously so that if one goes down, the system can call on the mirror and continue to run as normal, a very important feature
image manager/controller
the PACS component that interfaces with the radiology information system (RIS) and the hospital information system (HIS), this allows the PACS database to collect additional patient information that is necessary for its
effective operation
image manager/controller
play a key role in populating image information into the hospital electronic medical record (EMR)
image manager/controller
contains the DICOM header
information, such as the patient name, identification information (ID), examination
date, ordering physician, and location
image manager database
The database has pointers associated with each image on the archive server that point
back to the data fields within the database
image manager/controller
Image manager process:
- An order is placed in the RIS for a radiology study.
- The images are acquired and sent to the archive.
- The image manager strips the image header from each image and assigns a pointer
to each image or series of images. - The database files the information in various fields and communicates back to the
RIS to verify certain information. - The study is then queried, and the pointers locate the images on the archive server
and send the images to the workstation.
consists of the physical storage device of the
archive system
image storage or archive server
It commonly consists of two or three tiers of storage
image storage or archive server
is a level,
layer, or division of something
tier
In an archive server, a tier represents a specific level of archive:
short term, mid term, or long term
Most PACS archive systems are set up
with a
short-term tier and long-term tier
means being online or available very quickly, usually within 3 to 5 seconds
Short-term
means near line, or images
that must be retrieved from a tape or disk storage device and brought to redundant
array of independent disks (RAIDs), could take 1 to 5 minutes
Long-term
RAID
Redundant Array of Independent Disks
commonly a redundant array of independent (inexpensive)
disks (RAID)
Short-Term Storage
is composed of several magnetic disks or hard
drives that are linked together in an array
RAID
The size of the RAID ranges from
several hundred gigabytes to several terabytes (500 GB to 3T)
coined the term RAID and year
David Patterson, Garth Gibson, and Randy Katz, 1998
The presentation introduced ____ levels of RAID; now there are approximately __
levels, most of which are combinations of the first five
five,
11
Four RAID levels
that are most commonly used:
- RAID 0: Data are “striped” across all of the connected disks. “Striping” means
that the data are broken up into pieces, and each disk will have one piece of the
data. When the data are called up from the RAID, all of the data are
put together from the disks and presented to the user as a whole. - RAID 1: All of the data sent to the RAID are mirrored onto two disks.
Mirroring means that all of the data are duplicated and placed onto two separate
disks. This RAID level has full redundancy, meaning that if one disk goes down,
the other one takes over and operation of the system continues. This is a very
expensive system because only half of the total storage is used. - RAID 3: The data are striped across all of the disks just like in RAID 0, but there
is one disk that is set aside for error correction. This disk is known as the parity
disk. - RAID 5: This RAID level is similar to RAID 3 but instead of having the parity written to one disk, it is striped along all of the disks within the RAID.
is the most common level used for a PACS archive because it provides
adequate redundancy and fault tolerance.
RAID 5
increases the reliability and performance of the system.
Striping of data
many hospitals use ____ storage for
both their short-term and their long-term archive
RAID
Other long-term storage products
that are still widely used are
optical disk,
tape, and magnetic disk
use a jukebox to hold the tapes or disks
Optical disk and
magnetic tape archive solutions
uses an array
magnetic disk
has controller software that interfaces with the image manager to keep track of exactly where each image is located
Jukebox
The ___-term archive has much higher access times than the ___-term archive,
but the price of storage per gigabyte is much less with the _____
long,
short,
jukeboxes
5 types of Optical Disk
- Magneto-optical Disk
- Digital Versatile Disk
- Ultra Density Optical
- Tape
- Magnetic Disk
is very similar to a compact disk (CD)
or digital versatile disk (DVD)
Magneto-Optical Disk (MOD)
it is read optically with a laser, but the disk itself
is housed within a plastic cartridge
Magneto-Optical Disk (MOD)
more reliable than some of the
other long-term storage options
Magneto-Optical Disk (MOD)
are rather robust and can withstand many
years of reading
Disks
can be read faster than some of their counterparts
MOD
MOD
Magneto-Optical Disk
The cost per
gigabyte is a bit higher for ____ than for some of the other long-term storage
options, but it is still a viable long-term storage option.
MODs
were first introduced for use in video
Digital Versatile Disk (DVD)
DVD
Digital Versatile Disk
have a much
higher capacity
DVD
DVD holds up to __ GB compared to CD 650 MB
17
are the least expensive method for long-term
archiving per gigabyte
DVD
is the new generation MOD
Ultra Density Optical (UDO) disk
UDO
Ultra Density Optical
utilizes blue laser technology in its read and write activities
UDO disk
introduced the first UDO disk in 2004 with a disk capacity of 30 GB (2006 MOD technology was at 9.1 GB), and the capacity is predicted
to increase to 60 GB and then to 120 GB to accommodate industry needs
Plasmon
Plasmon PLC, Hertfordshire, UK
its technology operating costs are less than MODs and very competitive with DVD technology
UDO
provide the greatest scalability of the long-term archive options
Tape libraries
can grow to hundreds of terabytes, possibly even a petabyte
Tape libraries
is a fairly low-cost archive medium that comes in various sizes
Tape
Most of the libraries are _____, meaning that additional libraries can be added to the original
scalable
One of the biggest disadvantages of tape (magnetic disk) is its _____ over multiple uses, can wear after several years of heavy use and may become damaged
unreliability
has a longer access time than its optical counterparts
Tape
3 types of Magnetic Tape
- Linear Tape Open (LTO),
- Digital Linear Tape (DLT)
- Advanced Intelligent Tape (AIT)
The capacity to be changed in size or scale
Scalability
The FDA approved the first diagnostic radiology app called ______ in _____
Mobile MIM,
2011
is the standard that enables the transfer and sharing of data between various healthcare providers
HL7
are contained within a jukebox or library that has multiple drives and a robot arm to move the tapes in and out of the drives
Magnetic Disk
CAD
computer-aided design
