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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 CTcurrent 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 • 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 • 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 • Strickland: “MDCT what do we do with all the images generated?” BJR 77(2004) S14-19 • Presented four options:
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 • Store selection of images • Is this possible?
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 • 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 • 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 • 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 • 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 • How long do we store for • At modality • On archive • What do we store (?thick slices +/- compression)