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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)