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Medical Imaging 2000 - pacs design and evaluation: engineering and clinical issues

作者： Chacko, Anna K. Wider, Ronald Romlein, John Cawthon, Michael A. Richardson, Rob R. Lollar, Howard Wm. Cook, Jay F. Timboe, Harold L. Johnson, Thomas G. Fellows, Douglas W. Medical Research and Material Command Ft. Detrick United States

The Department of Defense has been a leader in Radiology re-engineering for the past decade. Efforts have included the development of two landmark pacs specifications (MDIS and DIN-pacs), respective vendor selection and implementation programs. A Tri-Service (Army, Navy and Air Force) Radiology re-engineering program was initiated which identified transitioning to digital imaging, pacs and teleradiology as key enabling technologies in a changing business scenario. Subsequently, the systematic adjustment of procurement process for radiological imaging equipment included a focus on specifying pacs-capable-digital imaging modalities and mini-pacs as stepping stones to make the hospitals and health clinics pacs-ready. The success of the pacs and teleradiology program in the DOD is evidenced by the near filmless operation of most Army and Air Force Medical Centers, several community hospitals and several operational teleradiology constellations. Additionally, the MDIS pacsystem has become the commercial pacs product for General Electric Medical Systems. The DOD continues to forge ahead in the pacs arena by implementing advanced configurations and operational concepts such as the VRE (Virtual Radiology Environment), the negotiation of Regional Archiving and Regional pacs Maintenance Programs. Newer regulations (HIPAA, the FDA approval of digital mammography) have been promulgated impacting the culture and conduct of our business. Incorporating their requirements at the very outset will enable us to streamline the delivery of radiology. The DOD community has embraced the information age at multiple levels. The Healthcare portion of this community with these initiatives is integrating itself into DOD's future. The future holds great possibilities, promises and challenges for the DOD pacs programs.

关键词： Medical imaging

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Evolution of the clinical review station for enterprise-wide multimedia radiology reporting

Evolution of the clinical review station for enterprise-wide...

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Medical Imaging 2000 - pacs design and evaluation: engineering and clinical issues

作者： Hanlon, William Valtchinov, Vladimir Davis, Scott Lester, James Khorasani, Ramin Carrino, John Benfield, Andrew Harvard Medical Sch Boston United States

Efforts to develop Picture Archiving and Communications Systems (pacs) for the last ten years have concentrated mainly on developing systems for primary interpretation of digital radiological images. Much less attention has been paid to the clinical aspects of the radiology process. clinical radiology services are an important component of the overall care delivery process, providing information and consultation services to referring physicians, the customers of radiology, in a timely fashion to aid in care decisions. Information management systems (IMS) are playing an increasingly central role in the care delivery process. No suitable commercial pacs or IMS products were available that could effectively provide for the requirements of the clinicians. We endeavored to fill this void at our institution by developing a system to deliver images and text reports electronically on-demand to the referring physicians. This system has evolved substantially since initial deployment eight years ago. As new technologies become available they are evaluated and integrated as appropriate to improve system performance and manageability. Not surprisingly, the internet and World Wide Web (WWW) technology has had the greatest impact on system design in recent years. Additional features have been added over time to provide services for teleradiology, teaching, and research needs. We also discovered that these value-added services give us a competitive edge in attracting new business to our department. Commercial web-based products are now becoming available which do a satisfactory job of providing many of these clinical services. These products are evaluated for integration into our system as they mature. The result is a system that impacts positively on patient care.

关键词： Medical imaging

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evaluation of the feasibility of security technologies in teleradiology as biometric fingerprint scanners for data-exchange over a satellite WAN

Evaluation of the feasibility of security technologies in te...

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Medical Imaging 2000 - pacs design and evaluation: engineering and clinical issues

作者： Soegner, Peter F.W. Helweg, Gernot Holzer, Heimo Nedden, Dieter zur Univ Hospital Innsbruck Innsbruck Austria

We evaluated the feasibility of fingerprint-scanners in combination with smart cards for personal identification and transmission of encrypted TCP/IP-data-packages via satellite between the university-hospital of Innsbruck and the rural hospital of Reutte. The aim of our study was the proof of the userfriendliness of the SkymedTM technology for security purpose in teleradiology. We examined the time of the personal identification process, the time for the necessary training and the personal satisfaction. The images were sent from the local pacs in Reutte via a Data-Encryption-and-Transmission-Box via satellite from Reutte to Innsbruck. We used an asymmetric bandwidth of 512 kbit/s from Reutte to Innsbruck and 128 kbit/s in the opposite direction. Windows NT 4.0-operating PCs were used for the electronical patient record, the medical inquiry of the referring physician and the final report of the radiologist. The images were reported on an UNIX-pacs viewing station. After identification through fingerprint-scanners in combination with the smart card the radiologist was able to open the electronic patient record (EPR) from Reutte and sign with his digital signature his confirmed final report before it was send back to Reutte. The used security technology enables encrypted communication over a WAN, which fulfil data-protection.

关键词： Medical imaging

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A biomechanical evaluation of the Christensen temporomandibular joint implant

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CRITICAL REVIEWS IN BIOMEDICAL engineering 2000年第3-4期28卷 399-403页

作者： Saha, S Campbell, CE Sarma, A Saha, S Christensen, RW Clemson Univ Dept Bioengn Bioengn Alliance S Carolina Christensen Biomech Lab Clemson SC 29634 USA TMJ ImplantsTM Implants Inc Golden CO 80401 USA

The Christensen TMJ implant is often used clinically as a total joint replacement of the temporomandibular joint. The system consists of a thin fossa component and a condylar component with a polished articular head. In this study, we analyzed the surface finish and the metal structure of the components. We also measured the contact areas between the two components for different load levels. Such information may be useful in evaluating clinical performance as well as in making future improvements in the design of these implants.

关键词： temporomandibular joint TMJ implant contact area metallurgical analysis cobalt chrome alloy

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Java-based pacs and reporting system for nuclear medicine

Java-based PACS and reporting system for nuclear medicine

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Medical Imaging 2000 - pacs design and evaluation: engineering and clinical issues

作者： Slomka, Piotr J. Elliott, Edward Driedger, Albert A. London Health Sciences Cent London Canada

In medical imaging practice, images and reports often need be reviewed and edited from many locations. We have designed and implemented a Java-based Remote Viewing and Reporting System (JaRRViS) for a nuclear medicine department, which is deployed as a web service, at the fraction of the cost of dedicated pacs systems. The system can be extended to other imaging modalities. JaRRViS interfaces to the clinical patient databases of imaging workstations. Specialized nuclear medicine applets support interactive displays of data such as 3-D gated SPECT with all the necessary options such as cine, filtering, dynamic lookup tables, and reorientation. The reporting module is implemented as a separate applet using Java Foundation Classes (JFC) Swing Editor Kit and allows composition of multimedia reports after selection and annotation of appropriate images. The reports are stored on the server in the HTML format. JaRRViS uses Java Servlets for the preparation and storage of final reports. The http links to the reports or to the patient's raw images with applets can be obtained from JaRRViS by any Hospital Information System (HIS) via standard queries. Such links can be sent via e-mail or included as text fields in any HIS database, providing direct access to the patient reports and images via standard web browsers.

关键词： Medical imaging

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Computer modeling and design of diagnostic workstations and radiology reading rooms

Computer modeling and design of diagnostic workstations and ...

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Medical Imaging 2000 - pacs design and evaluation: engineering and clinical issues

作者： Ratib, Osman Amato, Carlos Balbona, Joseph A. Boots, Kevin Valentino, Daniel J. UCLA Dep of Radiological Sciences Los Angeles United States

We used 3D modeling techniques to design and evaluate the ergonomics of diagnostic workstation and radiology reading room in the planning phase of building a new hospital at UCLA. Given serious space limitations, the challenge was to provide more optimal working environment for radiologists in a crowed and busy environment. A particular attention was given to flexibility, lightning condition and noise reduction in rooms shared by multiple users performing diagnostic tasks as well as regular clinical conferences. Re-engineering workspace ergonomics rely on the integration of new technologies, custom designed cabinets, indirect lighting, sound-absorbent partitioning and geometric arrangement of workstations to allow better privacy while optimizing space occupation. Innovations included adjustable flat monitors, integration of videoconferencing and voice recognition, control monitor and retractable keyboard for optimal space utilization. An overhead compartment protecting the monitors from ambient light is also used as accessory lightbox and rearview projection screen for conferences.

关键词： Medical imaging

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pacs-Graz, 1985-2000: From a scientific pilot to a state-wide multimedia radiological information system

PACS-Graz, 1985-2000: From a scientific pilot to a state-wid...

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Medical Imaging 2000 - pacs design and evaluation: engineering and clinical issues

作者： Gell, Gunther Univ of Graz Graz Austria

1971/72 began the implementation of a computerized radiological documentation system at the Department of Radiology of the University of Graz, which developed over the years into a full RIS. 1985 started a scientific cooperation with SIEMENS to develop a pacs. The two systems were linked and evolved into a highly integrated RIS-pacs for the state wide hospital system in Styria. During it's lifetime the RIS, originally implemented in FORTRAN on a UNIVAC 494 mainframe migrated to a PDP15, on to a PDP11, then VAX and Alphas. The flexible original record structure with variable length fields and the powerful retrieval language were retained. The data acquisition part with the user interface was rewritten several times and many service programs have been added. During our pacs cooperation many ideas like the folder concept or functionalities of the GUI have been designed and tested and were then implemented in the SIENET product. The actual RIS/pacs supports the whole workflow in the Radiology Department. It is installed in a 2.300 bed university hospital and the smaller hospitals of the State of Styria. Modalities from different vendors are connected via DICOM to the RIS (modality worklist) and to the pacs. pacsubsystems from other vendors have been integrated. Images are distributed to referring clinics and for teleconsultation and image processing and reports are available on line to all connected hospitals. We spent great efforts to guarantee optimal support of the workflow and to ensure an enhanced cost/benefit ratio for each user (class). Another special feature is selective image distribution. Using the high level retrieval language individual filters can be constructed easily to implement any image distribution policy agreed upon by radiologists and referring clinicians.

关键词： Medical imaging

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clinical evaluation of a new total hip prosthetic design: 100 consecutive cementless total hip arthroplasties using sulzermedica's "natural hip" with two- to six-year clinical and radiographic follow-up

Clinical evaluation of a new total hip prosthetic design: 10...

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18th Southern Biomedical engineering conference/2nd International conference on Ethical issues in Biomedical engineering

作者： Pace, TB

One hundred consecutive total hip arthroplasties were performed on 96 patients (age range 30 to 82 years) using the "Natural Hip" design of Sulzermedica (Austin, Texas). Follow up of the clinical and radiographic results with a minimum of 2 years is reported. Twelve patients were excluded for the lack of follow-up data, leaving 88 hips to study. All but three of the stems were used cementless, regardless of patient age or osteoporosis, as long as surgical stability was obtained. No stems were revised for loosening or pain. The only revisions were for infection (2), and minimal bone loss occurred with removal of this proximal ingrowth stem. Thigh pain was present in only one patient at 2 years, and none with longer follow-up. There were no cases of osteolysis, proximal stress shielding, or aseptic radiolucent lines with the cementless stems.

关键词： Hip prostheses

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Reliable medical imaging transmission for pacs over ATM networks

Reliable medical imaging transmission for PACS over ATM netw...

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Medical Imaging 2000 - pacs design and evaluation: engineering and clinical issues

作者： Wang, Wei Subramanian, K.R. Zhang, Liren Nanyang Technological Univ Singapore Singapore

In an ATM (Asynchronous Transfer Mode)-based PAC system, cell losses during the transmission might cause degradation on the quality of medical images. This in turn will affect the accuracy of the diagnosis. A three-step scheme to minimize the effect of cell losses on the quality of medical images is proposed in this paper. The first step is related to the medical imaging coding before it enters the network, in which, ROIs (Regions of Interest) of the medical imaging which are crucial to diagnosis are kept non-compressed and packetized with pixel-level inter-leaving. Non-compression can make the data of ROIs to be more robust to cell losses than any compression algorithms, while pixel-level inter-leaving is strong for bursty cell losses recovery combined with FEC (Forward Error Correction) at the receiver. The background part of the medical imaging will be compressed using fractal algorithm, which can get very high compression ratio to balance the large amount data of the ROIs. In the second step, the ROIs will be allocated the highest priority during transmission. While in the third step, FEC will be used to minimize the existed cell losses at the receiver. The balance and optimal of these three stages are discussed from the system-level point of view.

关键词： Medical imaging

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design of a full-pacs with experiences of Mini-pacs in Yonsei University Medical Center

Design of a full-PACS with experiences of Mini-PACS in Yonse...

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Medical Imaging 2000 - pacs design and evaluation: engineering and clinical issues

作者： Kim, Hee-Joung Huh, Jae-Man Kim, Nam-Hyun Kim, Kee-Deog Kim, Myoung-Jin Kim, Sang-Jin Yoo, Hyung-Sik Yonsei Univ Coll of Medicine Seoul Korea Republic of

Yonsei University Medical Center (YUMC) in Seoul, Korea is 114 years old and 1,582 beds in Shinchon Severance hospital in main university campus and 746 beds in affiliated Youngdong Severance hospital which is 20 miles away from the main campus. The dental hospital in main campus is also included in a full-pacs system. The numbers of exams/year for main, affiliated, and dental hospitals are approximately 558,000, 365,000, and 181,000, respectively. Since 1997, a Mini-pacs with 3×MRI, 2×DSI, and 2×CT in Shinchon Severance hospital has been operating to archive the digital data and to view them with DICOM viewer PiViewTM. An archiving system with 2×CT and 2×MRI in Youngdong Severance has been operating to archive the digital data. We are now designing a large-scale full-pacs for YUMC with experiences of running a mini-pacs for 3 years. The 11×US, 7×Endoscopy, 7×CR, 3×SPECT, 1×PET, 1×CT simulator, and digital camera based patient database in the Dept. of radiation oncology in Shinchon Severance hospital will be connected to an archiving server system through modality interface gateway. The 3×CR, 2×DSA, 2×FD, 5×US, 3×Endoscopy in Youngdong Severance hospital will be connected to the main archiving system. The 1×CT, 10×Intraoral X-ray unit DR, 4×Panoramic&cephalometric unit DR, 1×Transcranial CR, 1×Scanora X-ray unit CR, 1×Sectography CR in dental hospital will be connected to archiving server system through modality interface gateway. The estimated amount of data for Shinchon severance, Yongdong severance, and dental hospitals per year are 11.55TB, 5.88TB, and 0.96TB, respectively. The current mini-pacs server includes 54 GB RAID, 520 GB DLT with SUN SpectraTM server. The main server in Shinchon Severance hospital needs to be upgraded to 600 GB RAID for 30 days and 10TB ODJ or DLT for the 1st 2 years. Yongdong Severance hospital needs to be installed a main server with 600 GB RAID for >30 days and 10TB ODJ or DLT for >2 years. The interface between HIS/RIS and pacs need

关键词： Medical imaging

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