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CHAPTER 18

CHAPTER 18. Nonimaging Components of the FFDM Network. THE NETWORK INFRASTRUCTURE. Server Multiuser computer that provides a service or resources over a network connection Firewall Dedicated piece of equipment or software that inspects network traffic; used to prevent intrusion Switch

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CHAPTER 18

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  1. CHAPTER 18 Nonimaging Components of the FFDM Network

  2. THE NETWORK INFRASTRUCTURE • Server • Multiuser computer that provides a service or resources over a network connection • Firewall • Dedicated piece of equipment or software that inspects network traffic; used to prevent intrusion • Switch • Device that connects segments of network and directs information to proper destination

  3. THE NETWORK INFRASTRUCTURE • Router • Device to forward information to designated recipients • “Network Backbone” • Collection of equipment and direct connection from one piece to the next that enables communication across network • Each link and manner in which they are linked has impact on speed of system

  4. NETWORK BANDWIDTH Bandwidth – maximum rate that data may be transferred across network

  5. INTEGRATING THE HEALTHCARE ENTERPRISE INITIATIVE (IHE) • Standardization of computer languages in healthcare • Systems developed using IHE standards • Communicate with one another better • Are easier to implement • Enable care providers to use information more effectively

  6. COMMUNICATION AND LANGUAGES • Health Level 7 (HL7) • Used by information systems (RIS, HIS, MIS) to store database of patient demographics • Digital Imaging and Communication in Medicine (DICOM) • Very specific standard language for PACS, used to move images and image information around system using query, retrieve, and send commands

  7. RIS, HIS, AND MIS • RIS: Radiology Information System • Database of patient information used within a radiology department • HIS: Hospital Information System • Database of patient information used throughout entire hospital or healthcare system by all departments • MIS: Mammography Information System • Information used solely within mammography department

  8. MODALITY WORKLIST

  9. MODALITY WORKLIST • Various formats available • By workstation • By day • By physician • By technologists

  10. MODALITY WORKLIST

  11. PACS • Component of imaging network where everything comes together • Workstations • Not all are the same; different software depending on user • Able to “talk” to other stations • Minimum 5-megapixal monitor required for diagnostic stations

  12. PACS

  13. VIEWING FUNCTIONS AND HANGING PROTOCOLS • Image and information management • Display features • Hanging protocols • Image manipulation • Window width and window length • Look-up tables • Image metrics • Advanced functions • Modality-specific functions

  14. STORAGE AND IMAGE ARCHIVING • Storage • Instant access (online) • Occasional access (near-line) • Long-term storage (off-line) • No set standards for storage • Each facility must decide what works best for them • Redundant disaster archive, typically off-site

  15. STORAGE HARDWARE • Redundant array of independent (or inexpensive) disks (RAID) • Fast, relatively inexpensive • Multiple devices • Most common short-term storage technology • Storage area network (SAN) • Most expensive • High-performance, high-availability storage networks • Online all the time

  16. STORAGE HARDWARE • Network area storage (NAS) • Server generally used as archive and for pre-fetching images • Stand-alone solution • Multiple NAS servers can be used to increase storage capacity • Magneto optical disks (MOD) • Similar to CD or DVD • Long-term storage

  17. IMAGE SIZE • Measured in megabytes (MB) • Single FFDM image is approximately 50 MB • Average digital mammogram (4 views) is approximately 200 MB • Single-view chest x-ray is approximately 1 MB • Storage used will depend on number of examinations

  18. IMAGE SIZE IMAGE SIZE

  19. PROCESSED VERSUS RAW IMAGES • Raw images: Actual data that are captured, pixel by pixel, from imaging detector • Processed images: Information captured by pixels with mathematical algorithms applied • Radiologist views processed images • Expensive to store both • Each facility must decide which image to store

  20. DATA MIGRATION • Technology continues to change daily at rapid pace • Must be able to access images for at least 7 to 10 years • Ensure vendor can guarantee all data will be accessible or able to migrate to new technology

  21. DATA COMPRESSION • Allows data to be stored in smaller package • Improves transmission performance • Some data are lost in process; image quality never recovered • Lossy • Can be performed at ratios up to 30:1 • Lossy compression cannot be used to archive FFDM images • Lossless compression ratio 2:1

  22. PRINTERS • Ability to print FFDM images required by FDA • Hardcopies are sometimes needed due to lack of access of referring physicians and/or consultants • Studies and phantom images being sent for accreditation must be sent as hardcopy • May change in future with development of newer technology • FDA requires that printed image must be comparable in quality with image seen on softcopy review workstation

  23. COMPUTER-AIDED DETECTION (CAD) • Has become standard of care for many mammography practices • Can be utilized with both film and FFDM studies • Equipment must be compatible with PACS • Must be approved by FDA for use

  24. TELEMAMMOGRAPHY • Teleradiology – Electronic transmission of radiological patient images for purpose of interpretation and/or consultation • Virtual private network – Connects client site and telemammographer • Adequate bandwidth • Prior images may be unavailable • Credentialing – major obstacle • Malpractice insurance – major concern • Some experts believe telemammography is the future

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