Pacs and multislice ct current issues
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PACS and Multislice CT current issues. Stephen G Davies Royal Glamorgan Hospital. Background. PACS reprovision Multislice CT procurement Question to discussion board Where to report? What is stored? What is sent to web? Teleradiology?. Historical perspective.

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Pacs and multislice ct current issues

PACS and Multislice CTcurrent issues

Stephen G Davies

Royal Glamorgan Hospital


Background

Background

  • PACS reprovision

  • Multislice CT procurement

  • Question to discussion board

    • Where to report?

    • What is stored?

    • What is sent to web?

    • Teleradiology?


Historical perspective

Historical perspective

  • Data volume has always been a problem

    • Glass plates (mass and volume)

    • Multiple views – a novelty

    • Film – expanding range of studies

    • Space limitations

    • Microchip and digital image production

    • Networks, processing and storage.


Current problem

Current problem

  • Data volume increase inexorably

  • New approaches needed – TRIPTM =

    Transforming the Radiological Interpretation Process

  • Data volumes from MDCT rise faster than existing PACS systems can cope with them.


Phone a friend

Phone a friend

  • Strickland: “MDCT what do we do with all the images generated?” BJR 77(2004) S14-19

  • Presented four options:


Option 1

Option 1

  • Store everything as acquired

    • Overwhelm archive

    • Too many images at workstation and for clinicians

    • Network capacity?

  • Do we really need the full data set for reporting?


Option 2

Option 2

  • Store selection of images

    • Is this possible?


Option 3

Option 3

  • Report “thin” sections at CT workstation

  • Store “thick” sections

  • Becoming more practical

    • Data load on network and for archive

    • Data load for clinicians

  • BUT ??workflow

  • ALSO thin vs thick for fine detail??


Option 4

Option 4

  • Report “thin” sections at CT WS;

  • Store thin sections at WS

  • ?still export thick sections to archive

  • ?Workflow

  • ?need to report thin sections


Ask the audience

Ask the audience

  • Variety of responses depending on network capacity, archive and local practice

  • Summary:

    • Export thick (5mm) sections in primary (axial) plane and secondary (usually coronal) plane

    • Specialist processing at modality workstation


Advantages

Advantages

  • Radiologist workflow preserved

    • ?preferred reporting environment

  • PACS workstations very fast

    • Voice, RIS integrated

    • Hanging protocols

  • What happens when the data from MRI reaches these levels?


Disadvantages

Disadvantages

  • Not viewing the full data set for reporting

  • Demanding on archive and network

  • Problems with linking additional post processed data with original data set

  • IHE PWP profile


Other considerations

Other considerations

  • How long do we store for

    • At modality

    • On archive

  • What do we store (?thick slices +/- compression)


Discuss

Discuss


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