PACS

							Imaging Informatics


         By: Arsh Raince, Sana
         Sajjad, and Holly
         Goldfarb
What is Imaging Informatics?

Imaging informatics- “a subspecialty of
  Biomedical Informatics that aims to improve the
  efficiency, accuracy, usability and reliability of
  medical imaging services within the healthcare
  enterprise. It is devoted to the study of how
  information about and contained within medical
  images is retrieved, analyzed, enhanced, and
  exchanged throughout the medical enterprise.”
What is teleradiology?

Teleradiology is “the transmission of
  radiological patient images, such as x-rays,
  CTs, and MRIs, from one location to another
  for the purposes of interpretation and/or
  consultation.”
Why would a facility use teleradiology?


   Facilities would use teleradiology:
   If they are short on radiologists at the time
   if they do not have any radiologists at all.
   If they need to consult a sub-specialized
    radiologist.
How does it work?

Teleradiology uses specialized programs that
  transfer the use networks, such as the
  Internet and LAN, to transfer images.
What is nighthawking?

Nighthawking is using teleradiology to transfer
  images at night to radiologists who are
  available. It’s basically another name for
  teleradiology.
Advantages

There   is always a radiologist available to read
scans or for second opinions.
 It could help hospitals obtain and keep
radiologists because many radiologists do not
prefer to do the night shift.
Disadvantages

 Reimbursement for radiologists from
insurance companies may drop because
teleradiology companies charge less.
 Teleradiologists lack the patient’s records,
which could affect the diagnosis.
What is the Sonic Flashlight?

                  The sonic flashlight is a
                    device that places “the
                    [ultrasound] scanner
                    and a flat-panel display
                    on opposite sides of a
                    half-silvered,
                    translucent mirror.”
                    When the doctor looks
                    through the mirror an
                    ultrasound is visible and
                    perfectly aligned with
                    the patient’s skin.
It’s like having x-ray vision
Why would this be used?

   To give the doctor a better sense of the
    ultrasound.
   It would also make it easier for the doctor to
    do invasive procedures without having to
    look back and forth between the patient and
    the ultrasound display screen.
What is PACS?

   “combination of hardware and software dedicated to
    the short and long term storage, retrieval,
    management, distribution and
    presentation of images.”

   The first large-scale
    PACS installation was at
    the University of
    Kansas, Kansas City
    in 1982
What Are PACSs Used For?

   Hard-copy replacement
   Remote access
   Electronic image integration platform
   Radiology workflow management
Major Components

   Imaging systems
   A secure network
   Workstations
   Archives
PACS Workflow

   Modality            Reading workstation
   QA workstation      Reporting package
   Archive              (optional)
                        CD/DVD authoring
Back-Up and Archive

   PACS image backup is critical
   Streamed off-site
   Encrypted
    content
Integration

   PACS should have one place to access for data
   All PACS should interface with existing hospital
    information systems
   A more reliable dataset can be created through
    interfacing between multiple systems
   An interface can improve workflow patterns
   Fully integrated RIS/PACS are being developed
Images PACSs Handle

   Ultrasound
   MR
   PET
   CT
   Endoscopy
   Mammograms
   Digital radiography
   Computed radiography
   Etc.
Advantages

   Data in one place
   Digital
   DICOM
   Scanned documents
DICOM



    Digital Imaging and Communications in Medicine
    “Standard for handling, storing, printing, and
     transmitting information
     in medical imaging.”
    “Uses three different
     Data Element
     encoding schemes.”
DICOM – Services

   “DICOM consists of many different services”, some
    of which are:
    –   Store
    –   Storage Commitment
    –   Query/Retrieve
    –   Modality Worklist
    –   Modality Performed Procedure Step
    –   Printing
CAD

   Computer-Aided Diagnosis
   “Procedures in medicine that assist doctors in the
    interpretation of
    medical images.”
   “CAD systems seek
    to highlight suspicious
    structures.”
CAD (Cont.)

   “CAD cannot and may not substitute the doctor, but
    rather plays a supporting role.”
   “Today's CAD systems cannot detect 100% of
    pathological changes.”
   “The less FPs indicated, the higher the specificity is.”
CAD – Uses

   CAD is used for diagnosis in:
    –   Breast Cancer
    –   Lung Cancer
    –   Colon Cancer
    –   Prostate Cancer
    –   Bone Metastases
    –   Coronary Artery Disease
    –   Congenital Heart Defect
Works Cited
(2001, November 12). Body Scanner Sees Like Superman. Retrieved 23 October, 2011 from
    http://www.wired.com/science/discoveries/news/2001/12/48966
(2011, September 27). Computer-aided diagnosis. Retrieved 24 October, 2011 from
    http://en.wikipedia.org/wiki/Computer-aided_diagnosis
Howell, Whitney L.J. (2011, July 13). The Decision to Nighthawk Isn’t Always Crystal Clear. Retrieved
   23 October, 2011 from http://wljhowell.wordpress.com/tag/night-hawking/
(2011, September 26). DICOM. Retrieved 24 October, 2011 from http://en.wikipedia.org/wiki/DICOM
(2011, February 10). Imaging Informatics. Retrieved 23 October, 2011 from
    http://en.wikipedia.org/wiki/Imaging_informatics
(2010, March). Picture archiving and communication system (PACS). Retrieved 24 October, 2011 from
    http://searchhealthit.techtarget.com/definition/picture-archiving-and-communication-system-PACS
(2011, July 17). Picture and archiving communication system. Retrieved 24 October, 2011 from
    http://en.wikipedia.org/wiki/Picture_archiving_and_communication_system
(2011, July 28). Teleradiology. Retrieved 23 October, 2011 from http://en.wikipedia.org/
    wiki/Teleradiology
(n.d.). The Sonic Flashlight. Retrieved 23 October, 2011 from http://www.sonicflashlight.com/