[PACS: storage and retrieval of digital radiological image data]

The retention duration of digital images in picture archiving and communication systems

Introduction

Every year, a large number of medical images such as MRIs, CT scans, and radiographs are prepared in hospitals, and a lot of money is spent on their preparation. Picture archiving and communication system (PACS) is an integrated image management system for maintaining and storing digital images. The objective of this study was to determine the storage duration of digital images in PACS.

Methods

This was a scoping review study in which we searched the PubMed and Embase databases using a combination of terms related to radiography, storage, and duration. The reference lists of included articles were checked to identify other relevant articles. Moreover, we searched Google to retrieve relevant gray literature and other information sources including guidelines. The selection process was carried out in three stages and was reported based on the PRISMA flowchart and the data were extracted using the data collection form.

Results

Based on the database search 2867 articles were identified, of which 13 articles were eligible for inclusion. Searching for gray literature identified 7 relevant sources. The results showed that based on the institutions' plans and regulations, different countries have different storage policies. In general, to store images between 6 and 240 months for short-term storage and between 0 and 240 months for long-term storage were considered.

Conclusion

Due to financial constraints and storage space requirements, healthcare organizations can provide a solution by drafting guidelines on the appropriate storage duration for medical images. The findings of this study can assist healthcare authorities and healthcare centers in employing PACS systems to manage and minimize storage space for medical images, thereby reducing storage costs.

[Digital X-ray: interhospital data transfer by CD-ROM. Prospective data evaluation during the import process]

BACKGROUND

Increasing numbers of radiological imaging diagnostics are archived in digital form. In addition to the results of diagnostics performed in hospital a growing number of patients present with digital results of outpatient radiological investigations. These digitized images represent a challenge for the internal hospital work flow. The aim of the study was to determine the expenditure for the hospital when dealing with digital outpatient diagnostic results.

METHOD

Several parameters were observed and analyzed within the import process of nearly 400 CD-ROMs over a time period of 5 months. Only a negligible number of data on CD-ROMs could not be transferred into the hospital archive (1.5%). The duration of the process depended on the amount of data and the time period.

RESULTS

During regular hours the import process took on average 13 min per CD and 19 min per patient while the time increased significantly during on-call duties. This study demonstrates the significance of the import of digital outpatient radiological diagnostic results into the hospital archive which can in particular influence patient treatment.

[Conventional X-rays and conventional tomography in orthopaedics. Current status]

Although sonography, computed tomography (CT) and magnetic resonance imaging (MRI) are common tools in radiology, conventional X-rays still have a place in orthopaedic diagnostic investigation. The advantages of radiographic imaging are high local resolution concerning bone, economy of time besides relatively low costs and worldwide experience. The conventional X-ray is indispensable for planning surgical procedures and clinical monitoring. For several pathological processes an X-ray is sufficient for diagnosis and therapy (i.e. degeneration, fracture). Early changes of the bone (i.e. osteonecrosis) cannot be detected by X-ray. CT and MRI have closed the diagnostic gap. Indications for conventional tomography are rare.

Hard disk online caches in picture archiving and communication systems archives: how big is beautiful?

The objective of our study was to support algorithmic recommendations for the appropriate sizing of picture archiving and communication system (PACS) caches. For a large PACS installation, a detailed analysis of current radiographic (CR), CT and MRI studies (n=400 consecutive studies, respectively) was performed. In this process every available prior examination was also considered. A new algorithmic procedure for appropriate sizing of PACS caches was developed and applied to the given cache implementation. The number of all priors was 7.6+/-12.3. Of them, 61% were relevant priors with an average age of 203+/-385 days. A basic cache (BC) that covers 12 months of current imaging results in a pre-fetching quote of 15.4% (8.6% for 24 months). In the PACS installation examined, a minimal threefold increase in cache capacity was recommended. Studies that are retrieved, prior to viewing, from the long-term archive require additional space in the extended cache (EC). An intimate and mutual interaction between hospital information system (HIS), radiology information system (RIS) and PACS minimizes this requirement and increases the time during which actual image material from the BC is available online. A basic cache size covering actual imaging of 12 months up to 24 months is recommended. The parameters governing the individual dimensions of both cache spaces and a mathematical algorithm are demonstrated.

Technologies for image distribution in hospitals

After the establishment of web-based image distribution, three challenges for image distribution can be identified today. Firstly, PACS (picture archiving and communication system) and the distribution of radiological images and reports need to be integrated with the emerging electronic medical record. Secondly, report and image data should be available on mobile devices like PDAs (personal digital assistants) or smartphones in the future. Thirdly, future systems must be available not only to transmit sectional images, but also to allow access to three- and four-dimensional data that are produced by multidetector CT and modern MR scanners.