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Contrast-detail characteristic evaluations of several display devices

JOURNAL OF DIGITAL IMAGING 2000年第2期13卷 162-167页

作者： Wang, JH Anderson, J Lane, T Stetson, C Moore, J Univ Texas SW Med Ctr Dept Radiol Dallas TX 75235 USA

The contrast-detail characteristic of a display system is a powerful tool for evaluating displayed image quality. It takes into account the physical properties of the display, the psychophysical aspects of the observer, and the viewing conditions. It is a more sensitive measurement of the displayed image quality than a simple Society of Motion Picture and Television (SMPTE) pattern. Yet, it is relatively simple to measure and requires no special equipment or analysis tools. In this presentation, the results of the evaluation of several cathode ray tube (CRT) monitors and a digital projector will be presented. Contrast-detail characteristics of these display devices were measured under various gamma and display settings. The results show excellent intraobserver and interobserver variance (<1 step on the grayscale). Extraneous light, such as room lighting, affects the contrast threshold more severely at low background levels more than at high background. Gamma settings on graphics adapters affect the shapes of the contrast-detail curve for all display types. Gamma settings of approximately 2.0 result in a better contrast threshold for both high and low background brightness. The results show complex differences in contrast-detail characteristics for different display types. The digital projector display not only has significantly worse performance than CRT monitors, but also is affected more by extraneous light. High-brightness monitors with optimal monitor and graphics adapter settings have better performance than color or low-brightness monitors. However, under some settings, the performance of high-brightness monitors is not always better at all object sizes and background levels. Copyright (C) 2000 by W.B. Saunders Company.

关键词：计算机终端数据显示放射学信息系统/仪器和设备人类

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Radiologist's clinical information review workstation interfaced with digital dictation system

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JOURNAL OF DIGITAL IMAGING 2000年第2期13卷 45-48页

作者： McEnery, KW Suitor, CT Hildebrand, S Downs, RL Univ Texas MD Anderson Canc Ctr Dept Diagnost Imaging Div Diagnost Imaging Houston TX 77030 USA

Efficient access to information systems integrated into the radiologist's interpretation workflow will result in a more informed radiologist, with an enhanced capability to render an accurate interpretation. We describe our implementation of radStation, a radiologist's clinical information review workstation that combines a digital dictation station with a clinical information display. radStation uses client software distributed to the radiologist's workstation and central server software, both running Windows NT (Microsoft, Redmond, WA). The client system has integrated digital dictation software. The bar-code microphone (Boomerang, Dictaphone Corp, Stratford, CT) also serves as a computer input device forwarding the procedure's accession number to the server software. This initiates multiple queries to available legacy databases, including the radiology information system (RIS), laboratory information system, clinic notes, hospital discharge, and operative report system. The three-tier architecture then returns the clinical results to the radStation client for display. At the conclusion of the dictation, the digital voice file is transferred to the dictation server and the client notifies the RIS to update the examination status. The system is efficient in its information retrieval, with queries displayed in about 1 second. The radStation client requires less than 5 minutes of radiologist training in its operation, given that its control interface integrates with the well-learned dictation process. The telephone-based dictation system, which this new system replaced, remains available as a back-up system in the event of an unexpected digital dictation system failure. This system is well accepted and valued by the radiologists. The system interface is quickly mastered. The system does not interrupt dictation workflow with the display of all information initiated with examination bar-coding. This system's features could become an accepted model as a standard tool fo

关键词：数据收集/仪器和设备数据显示病案系统计算机化/仪器和设备微型计算机放射学信息系统/仪器和设备软件用户计算机接口人类

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Experience measuring performance improvement in multiphase picture archiving and communications systems implementations

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 141-143页

作者： Reed, G Reed, DH Integrat Resources Inc Lebanon NJ 08833 USA

When planning a picture archiving and communications system (PACS) implementation and determining which equipment will be implemented in earlier and later phases, collection and analysis of selected data will aid in setting implementation priorities. If baseline data are acquired relative to performance objectives, the same information used for implementation planning can be used to measure performance improvement and outcomes. The main categories of data to choose from are: (1) financial data;(2) productivity data;(3) operational parameters;(4) clinical data;and (5) information about customer satisfaction. In the authors' experience, detailed workflow data have not proved valuable in measuring PACS performance and outcomes. Reviewing only one category of data in planning will not provide adequate basis for targeting operational improvements that will lead to the most significant gains. Quality improvement takes into account all factors in production: human capacity, materials, operating capital and assets. Once we have identified key areas of focus for quality improvement in each phase, we can translate objectives into implementation requirements and finally into detailed functional and performance requirements. Here, Integration Resources reports its experience measuring PACS performance relative to phased implementation strategies for three large medical centers. Each medical center had its own objectives for overcoming image management, physical/geographical, and functional/technical barriers. The report outlines (1) principal financial and nonfinancial measures used as performance indicators;(2) implementation strategies chosen by each of the three medical centers;and (3) the results of those strategies as compared with baseline data. Copyright (C) 1999 by W.B. Saunders Company.

关键词：规范计算机系统成本及成本分析数据收集诊断显像效率组织财务管理卫生设施/经济学卫生设施管理病案系统计算机化过程评价(卫生保健) 质量保证卫生保健放射学信息系统/经济学放射学信息系统/仪器和设备放射学信息系统/组织和管理时间因素人类

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Demystifying the hospital information system/radiology information system integration process

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JOURNAL OF DIGITAL IMAGING 2000年第2期13卷 175-179页

作者： Johnson, ND Garofolo, G Geers, W Childrens Hosp Med Ctr Dept Radiol Cincinnati OH 45243 USA First Consulting Grp Long Beach CA USA

Most organizations planning to implement picture archiving and communications systems (PACS) are aware of the need to integrate the hospital information system (HIS) and radiology information system (RIS) with the PACS, yet few are acutely aware of the challenges associated with this requirement. This report highlights the results of collaborative efforts between Children's Hospital Medical Center-Cincinnati (CHMC) applications specialists with expertise in the HIS and CHMC information system, radiology staff familiar with the enterprise and radiology workflow and data flow requirements;and General Electric integration engineers familiar with the SMS HIS and RIS, and GE PACS. CHMC received Board approval, including full funding of the entire PACS project, in October 1998. An aggressive time frame for installation was established, as CHMC's PACS leadership committed to the selection, design, and implementation of PACS and computed radiography (CR) within 18 to 20 months. CHMC selected GE (Milwaukee, WI) as its PACS vendor in July 1999, and began its implementation in November 1999. We will present the four-stage integration process undertaken at CHMC: (1) planning the integration effort, (2) designing the Interface, (3) building the interface, and (4) testing the Interface. Copyright (C) 2000 by W.B. Saunders Company.

关键词：计算机系统数据库管理系统医院信息系统医院儿科病案系统计算机化/仪器和设备俄亥俄放射学信息系统/仪器和设备人类

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Transmission failure rate for computed tomography examinations in a filmless imaging department

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JOURNAL OF DIGITAL IMAGING 2000年第2期13卷 79-82页

作者： Reiner, B Siegel, E Kuzmak, P Severance, S Baltimore Vet Affairs Med Ctr Baltimore MD USA Univ Maryland Sch Med Baltimore MD 21201 USA Dept Vet Affairs Technol Serv Silver Spring MD USA

The purpose of the study was to determine the frequency and causes of unsuccessful computed tomography (CT) transmissions in a filmless imaging department and to determine the added efficiency gains provided by the sequential addition of modality worklist software and a major network upgrade. Prospective data on CT transmission error rates were recorded over an 18-month period. During the study interval, modality worklist functionality was added, followed by a network upgrade. Failed transmissions were categorized as to the source of the error (human v technical), and the specific problem encountered. Prior to the introduction of modality worklist software, the initial CT transmission failure rate was 7.6%, which was primarily the result of human error (69%), in the form of data entry error. Upon the introduction of modality worklist software, the transmission failure rate decreased to 3.5%, with human error accounting for only 16% of all failed transmissions. The subsequent addition of a network upgrade from shared Ethernet to switched Ethernet further reduced the transmission failure rate to 2.0%, which was believed to be the result of a reduction in the number of network collisions. Other sources of failed transmission occur at the levels of the CT scanner (network interface card), picture archiving and communication system (PACS)/hospital information system (HIS) interface, and modality gateway. When planning the transmission from film-based to filmless operation, one should consider various hardware, software, and infrastructural requirements to ensure successful PACS implementation. Software upgrades, in the form of modality worklist software, serve to improve technologist productivity by minimizing data entry error. Infrastructural changes, in the form of network upgrading, ensure proper dissemination of electronic data with decreased frequency of network collisions. Collectively, these improvements lead to enhanced transmission of digital images, resulting i

关键词：计算机通信网络效率设备失效分析放射学信息系统/仪器和设备软件体层摄影术 X线计算机/仪器和设备人类

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A picture archiving and communications system featuring multiple monitors using Windows98

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 106-108页

作者： Ernst, R Le, VT Kawashima, A Caskey, C Zelitt, D Tamm, E Sandler, CM Univ Texas Sch Med Dept Radiol Houston TX 77026 USA

We present an effective approach to manage, review, and distribute Digital Imaging and Communications in Medicine (DICOM) images with multiple monitors using Windows98 (Microsoft Corp, Redmond, WA) that can be implemented in an office-based setting. Computed tomography (CT), magnetic resonance imaging (MRI), and angiographic DICOM images were collected, compressed, and stored using Medweb (Medweb, Inc, San Francisco, CA) software. The Medweb server used the Linux/UNIX operating system on a Pentium 333-MHz processor with 128 MB of RAM. Short-term storage capacity was about 2 weeks with routine usage of an 11-GB hard drive. Images were presented for reading on a dual-monitor Windows98 Pentium display station with 160 MB of RAM using a Medweb/Netscape (Netscape Communications Corp, Mountain View, CA) viewer. There was no significant discrepancy in diagnosis between electronic and conventional film images. Mean reading time for 32 cases was 118 seconds. The Medweb JAVA plug-in viewer loaded the first image within 30 seconds of selecting the case for review. Full uncompressed 16-bit images allowed different window settings to better assess for pathology. Multiple monitors allowed viewing various hanging protocols. Cine viewing was also possible. Key diagnostic images were electronically transmitted to referring physicians. On-call radiologists were able to access images through the Internet. By combining Medweb, DICOM, and web-browser software using desktop personal computers (PCs), an easily accessible picture archiving and communications system (PACS) is available to radiologists and referring physicians. Multiple monitors are easily configured and managed using Windows98. This system can sustain changes and can be extended to provide variable functions using inexpensive PCs. Copyright (C) 1999 by W.B. Saunders Company.

关键词：血管造影术计算机通信网络计算机系统数据显示诊断鉴别诊断显像图像处理计算机辅助信息存储和检索因特网磁共振成像微型计算机放射学信息系统/仪器和设备软件时间因素体层摄影术 X线计算机人类

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Simulation of disaster recovery of a picture archiving and communications system using off-site hierarchal storage management

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JOURNAL OF DIGITAL IMAGING 2000年第2期13卷 168-170页

作者： Avrin, DE Andriole, KP Yin, L Gould, R Arenson, RL Univ Calif San Francisco Dept Radiol Lab Radiol Informat San Francisco CA 94143 USA

The purpose of this communication is to report on the testing of the disaster recovery capability of our hierarchical storage management (HSM) system. Disaster recovery implementation is a requirement of every mission-critical information technology project. Picture archiving and communications systems (PACS) certainly falls into this category, even though the counterpart, conventional film archive, has no protection against fire, for example. We have implemented a method for hierarchical storage with wavelet technology that maximizes on-site case storage (using lossy compression), retains bit-preserved image data for legal purposes, provides an off-site backup (lossless bit-preserving wavelet transform), and provides for disaster recovery. Recovery from a natural (earthquake and subsequent fire) or technical (system crash and data loss) disaster was simulated by attempting to restore from the off-site image and database backup to clean core PACS components. The only existing loaded software was the operating system. The database application was reloaded locally, and then the database contents and image store were loaded from the off-site component of the HSM system. The following measurements were analyzed: (1) the ability to recover all data;(2) the integrity of the recovered database and image data;(3) the time to recover the database relative to the number of studies and age of the archive, as well as bandwidth between the local and remote site;and (4) the time to recover image data relative to compression ratio, number of studies, number of images, and time depth of the archive. This HSM system, which maximizes on-site storage, maintains a legal record, and provides off-site backup, also facilitates disaster recovery for a PACS. Copyright (C) 2000 by W.B. Saunders Company.

关键词：计算机存储设备数据库管理系统/仪器和设备灾害因特网局部网络放射学信息系统/仪器和设备人类

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Modality interfacing: The impact of a relay station

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JOURNAL OF DIGITAL IMAGING 2000年第2期13卷 88-92页

作者： Carrino, JA Khorasani, R Hanlon, VB Seltzer, SE Harvard Univ Sch Med Brigham & Womens Hosp Dept Radiol Boston MA 02115 USA

We evaluated the effect of a deploying a relay station on demographic discrepancies, image segmentation for routing, quality control (QC), and technologist workflow in a distributed architecture type picture archiving and communication system (PACS) environment. A currently existing PACS environment for computed tomography (CT) was evaluated before and after the implementation of a relay station for demographic error-rate and correct study routing to the workstations. Assessment of the technologists' perceptions with respect to numerous workflow factors was performed with a questionnaire. Statistical analysis was performed using a chi-square test. The demographic error rate for CT examinations was nearly abolished with relay station deployment (14.0% pre-Relay v 0.55% post-Relay, P < .001, chi(2)). The technologists' perception was favorable, with a substantial majority indicating that a positive impact is made on correcting demographic errors (90%), facilitating QC (67%), and ensuring proper routing (77%). A majority also felt the user interface was intuitive (93.3%) and preferred relay (90%) over film handling but that training should be provided both by didactic sessions and "hands on" time with a trainer. The times to perform tasks were favorable for the relay station (1 to 5 minutes) versus film production and handling (2 to 15 minutes). In conclusion, the relay station prospectively eliminates demographic errors, effectively segments images from the same study routing them to different workstations, and can be seamlessly integrated into the technologists' current workflow, This can be scalable and a lower cost solution as opposed to deploying dedicated PACS OC workstations. Copyright (C) 2000 by W.B. Saunders Company.

关键词：医学科学研究中心计算机通信网络/仪器和设备计算机系统质量控制放射学信息系统/仪器和设备作业完成和分析体层摄影术 X线计算机/仪器和设备用户计算机接口 X线增感屏人类

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Enhancing the expressiveness of structured reporting systems

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JOURNAL OF DIGITAL IMAGING 2000年第2期13卷 49-53页

作者： Langlotz, CP eDict Syst Inc Mt Laurel NJ 08054 USA Univ Penn Philadelphia PA 19104 USA

The overall goal of this research is to build a structured reporting system that reduces the cost, delays, and inconvenience associated with conventional dictation and speech recognition systems. We have implemented such a structured reporting system for radiology that replaces current dictation and transcription processes by allowing radiologists and other imaging professionals to select imaging findings from a medical lexicon. The system uses an imaging-specific information model, called a "description set,' to organize selected terms in a relational database. Unique features of the knowledge representation that enhance its expressiveness include its ability to codify uncertainty about an imaging observation and to represent explicitly the logical relationships among imaging findings. In addition, the system does not require the user to fill in "blanks' in a static text template. Instead, it allows entry of terms in arbitrary order and uses automated text-generation techniques to create a text report that referring physicians are accustomed to receiving. In parallel, the system also produces a multimedia report that the referring physician can use as a quick reference. Unlike the results of conventional dictation or speech recognition, each finding is coded in a relational database for later information processing. Thus, the structured report database can be used to index images by content, to provide real-time decision support, to enhance radiologists' performance, to conduct exploratory clinical research, and to transmit imaging report data to computer-based patient record systems. Copyright (C) 2000 by W.B. Saunders Company.

关键词：摘要和索引(主题) 人工智能计算机系统病案系统计算机化/仪器和设备放射学信息系统/仪器和设备软件用户计算机接口人类

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Evolution of a filmless digital imaging and communications in medicine-conformant picture archiving and communications system: Design issues and lessons learned over the last 3 years

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 178-180页

作者： Henri, CJ Cox, RD Rubin, R Bret, PM Couch, GG McGill Univ Ctr Hlth Dept Diagnost Radiol Montreal PQ Canada Toronto Hosp Dept Med Imaging Toronto ON M5T 2S8 Canada

This presentation describes our experience and lessons learned over the first 3 years of developing and operating a filmless picture archiving and communications system (PACS) for all computed tomography (CT), magnetic resonance (MR), ultrasound, and nuclear medicine studies in our hospital. The PACS conforms to the Digital Imaging and Communications in Medicine (DICOM) standard and includes a sophisticated Worldwide Web (WWW)-based interface to complement the regular DICOM services. The PACS has undergone many design modifications from its inception, which have addressed performance, functionality, support, and maintenance issues. The lessons we have learned through making these modifications are described here and may prove to be helpful to anyone planning to deploy a PACS of their own. Copyright (C) 1999 by W.B. Saunders Company.

关键词：计算机通信网络计算机系统诊断显像信息存储和检索因特网磁共振成像放射学信息系统/仪器和设备放射学信息系统/组织和管理放射性核素显像软件时间因素体层摄影术 X线计算机超声检查人类

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