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PACS introduction

PACS introduction. Facilitator: Edward Wong. What is the role of PACS Administrator?. PACS Administrator’s roles. Implementing a PACS System Maintenance Image and Information Management For a 200,000 exams/year institution, 2-8 full time PACS Administrator is available!.

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PACS introduction

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  1. PACS introduction Facilitator: Edward Wong

  2. What is the role of PACS Administrator?

  3. PACS Administrator’s roles • Implementing a PACS • System Maintenance • Image and Information Management For a 200,000 exams/year institution, 2-8 full time PACS Administrator is available!

  4. PACS Administrator’s roles • Implementing a PACS - Financial and workflow study - Request for Proposal and Tender drafting - Workflow modification including job reallocation and resource relocation - Training and Operation Manuals - Acceptance of system • System Maintenance • Image and Information Management

  5. PACS Administrator’s roles • Implementing a PACS • System Maintenance - Contingency plan - Incompatibility handling - First line support and problems escalating - System security and Performance monitoring • Image and Information Management

  6. PACS Administrator’s roles • Implementing a PACS • System Maintenance • Image and Information Management - Maintain high Image Quality - Data Integrity - Quality Assurance program - TeleRadiography - Anytime Available Storage Management

  7. What is PACS ? P: Picture, Images & Reports A: Archive, Online, Near line, Offline C: Communication, Networking, Transfer Protocols S: System, Components & Architecture PACS: for storage and distribution of images and information when necessary

  8. PACS: Small or Large Web Server Distribution

  9. Scale of PACS • No. of Beds in Hospital/ Exams per year • No. of Modalities • No. of Switches Considerations: System connectivity, expandability, reliability and cost-effectiveness

  10. Types of images • 1D, 2D, 3D, 4D • Different DICOM Modality type: Cardiac / PET / 4D U/S….. • Image size: Resolution and bit depth • Image quality: Bit Depth and resolution • Color / Monochromatic • Exam. Size: image size x no. of images • Structured Reports • New DICOM IOD: Endoscopic & Microscopic images / ECGs / Security Profiles…..

  11. 1D, 2D, 3D, 4D, fusion

  12. 1D, 2D, 3D, 4D, fusion

  13. Image Resolution/ Bit depth U/S DF CR CR Mammogram 256 x 256 8 bit 65 KBytes 1k x 1k 10 bit 1.25 MByte 2k x 2.5k 12 bit 7.5 MByte 4k x 5k 12 bit 30 MByte

  14. Properties of image • Bit depth • Grayscale or color • Resolution in pixel • Example image size of mammogram = 4k x 5k x 12 bit = 30 MB

  15. PACS Architecture

  16. PACS – Central Architecture DICOM Modality Diagnostic Workstations (DICOM) Clinical Workstations (DICOM) Image Server (RAID) Gateway or Frame Grabber Diagnostic Workstation Non-DICOM Modality Film Digitizer Web Server Data Base Server CR/ DR QA Workstation Archive Computed Radiography or DR RIS

  17. Central Architecture • Image Server and Database Manager is the HEART • Any image, any where, any time • Unique central copy • Easy update of data • Requires high performance servers • Potential single point of failure at server • Bandwidth demanding

  18. PACS – Distributed Architecture DICOM Modality Gateway or Frame Grabber Diagnostic Workstations (DICOM) Clinical Workstations (DICOM) Web Server Non-DICOM Modality Diagnostic Workstation CR QA Workstation Film Digitizer Data Base Server Archive Computed Radiography RIS

  19. Distributed Architecture • Exams are routed from modality to selected workstations • Complex routing algorithms based on department / user preference • Difficult to support concurrent review of images • Less destructive for failure at database server

  20. Components of PACS • HIS/ RIS • Broker • ePR gateway • Database Server • Image Server (RAID) • Long Term/ Near line Archive • Networks • Digitizer

  21. Components of PACS • Acquisition Gateways • Non-DICOM modality gateway • DICOM Print Server • Media Server • Reporting Server • Monitor QC Server • Web Server • Workstations

  22. PACS layout 1

  23. PACS layout 2

  24. PACS layout 3

  25. GE Medical Systems IT - Radiology System ARC Proetus XR/a Prestiges II US Logic700 Proteus XR/d CR ID Preview 1 CR ID Preview 2 PathSpeed 1CWS PathSpeed 1CWS PathSpeed CRQA HIS/RIS I/F (SQL) (Mitra Broker) Long Term Archive MOD Jukebox Radwork5.0 MIU1 MIU3 MIU2 PCS 1 PCS2 HSA 1 E450 CPU 2B Diagnostic Workstations 2B Diagnostic Workstations RAID 5 ISU PARIS 1 PARIS 2 1CWS / Remote Admin Server Tuen Mun Hospital PACS System- Ambulatory Care Center (phase 1) Image Acquisition Modalities in ACC ACC Ortho Dept RW Film Digitizer PathSpeed SP CR PathSpeed MP CR 1C PathSpeed Review Stations Main Block Radiology Department Hospital RIS Network Server Rm Network Switch Closet CT Network MR Network RT Network 1 GBit Fiber Link Kodak Laser Printer 1 Kodak Laser Printer 2 600m / 12 Core Gbit Fiber Link KELP 2180 DryView 8700 Layer 3 Sw Layer 2 Sw

  26. PACS layout 4

  27. PACS Components ePR gateway Enterprise Archive DICOM Modality Diagnostic Workstations (DICOM) Through Acq. gateway W/S QA Server Clinical Workstations (DICOM) Image Server (RAID) Gateway or Frame Grabber Diagnostic Workstation Non-DICOM Modality Film Digitizer Web Server Data Base Server CR/ DR QA Workstation LTS Archive SAN/NAS Computed Radiography or DR Media Server Broker for RIS/HIS

  28. Acquisition (DICOM) Gateway HIS/RIS Interface (Broker) DG RIS W/S CR QA PCs Frame Grabber Film Digitizer R&F CT NM MR XRAY US CR

  29. Role of Acquisition gateway • Compression/ decompression and security • Check the images for integrity • Convert to PACS format (header, byte-order, matrix size) • Queue for images (priority) to database server (background) • Share the workload and no point of failure for multiple Acquisition gateway

  30. RAID Database Server and Image Server Database Server HIS/RIS Interface (Broker) DG RIS W/S CR QA PCs Frame Grabber Film Digitizer R&F CT NM MR XRAY US CR

  31. Database Server (PACS controller) • The Heart of the system • Integration cross point between HIS/RIS and PACS (status update) • Create and manages patient folders • Manage reading worklists and user profiles • Manage data transfer within the system • Support data mining and teaching folders

  32. Image Server (RAID) • Online (rapid access) exam storage and distribution device • Support simultaneous exam input and output transfer operations • Up to Three months of storage capacity • Scalable capacity

  33. What is RAID Redundant Array of Independent Disks Bandwidth equal to sum of disk transfer rates Highest speed disk storage available Hot Swap 2 MB/s 1 2 3 4 5 6 16 MB/s 7 8 Image Parity Disk Array

  34. RAID 5 configuration • If disk fails, disk can be rebuilt- fault tolerant • High data transfer rate for read, write slower • Min. 3 disks to start • Array capacity is N-1

  35. Bandwidth Bandwidth is a measure of the information (data) carrying capacity of a network 10/100/1000 MB/sec Information Flow Data Pipe (Network)

  36. Network Bottleneck The bandwidth of an information delivery system is limited to the bandwidth of the slowest component in the system Network Bottleneck

  37. Data Compression Data compression reduces the information rate a network must support Uncompressed Data Compressed Data

  38. Lossless Image Compression I - D = 0 C D I Decompressed image is identical to original image JPEG lossless compression Average compression of 2:1 for x-ray images

  39. JPEG 2000 Compression • Selected parts of the image can be defined as Regions of Interest, they can then be delivered before other parts of the image, or losslessly, whilst other parts of the image that are less critical use normal lossy compression • JPEG 2000 codestream can be ordered to deliver images of lower resolution before the full image can be transmitted • Motion JPEG 2000 does not have any form of extrapolation (and hence potential distortion) in the time domain.  Each frame is a separate JPEG 2000 coded image

  40. JPEG 2000 images

  41. RAID Storage Device (Long Term) Database Server MOD DLT HIS/RIS Interface (Broker) DG RIS W/S CR QA PCs Frame Grabber Film Digitizer R&F CT NM MR XRAY US CR

  42. Types of storage media

  43. Long Term Archive • Used to store digital data for longer periods of time • Storage ranges from 100 MB to 10 TB • Optical disk most common media - 5 1/4” MOD - 2.6 GB and 5.2 GB Capacity • DLT used for longer term storage and redundancy • ISP module

  44. RAID Storage Device (Near line) Database Server SAN/NAS MOD DLT HIS/RIS Interface (Broker) DG RIS W/S CR QA PCs Frame Grabber Film Digitizer R&F CT NM MR XRAY US CR

  45. Storage Area Network • SAN is a high-speed sub-network of shared storage devices • Contains storage device (disk) for storing data • SAN's architecture works in a way that makes all storage devices available to all servers • Use of Fiber Channel • High scalability for additional storage and redundant networks PCs Storage devices

  46. Network Area Storage • NAS is a class of dedicated hard disk-based storage devices which provide LAN users with additional disk storage through a standard network connection • In most cases, a NAS device (or NAS server) receives an IP address, connects to the LAN through an Ethernet cable, and resides on the LAN as an independent network device • Users are not demanding the server's processing time for mundane storage tasks -- often improving the performance of local application servers • NAS systems also include some onboard memory (RAM) to cache network data to or from the disks

  47. SAN Vs NAS • Difference between NAS and SAN is subtle • NAS devices are big, single purpose storage appliances that you plug into network • NAS sits between your application server and your file system • As perform only 1 task, can serve files very fast • NAS is network-centric • SAN is a defined architecture that sits between your file system and your underlying physical storage • SAN is data-centric

  48. RAID Display HIS/RIS Interface (Broker) Database Server MOD DLT Diagnostic W/S Dedicate W/S SAN/NAS DG RIS W/S CR QA PCs Frame Grabber Film Digitizer R&F CT NM MR XRAY US CR

  49. Workstations • Four Primary Categories - Advanced Analysis: Used by specialists for advanced diagnosis - 3D, volume rendering • Diagnostic: For primary diagnosis; located in reading rooms; high-end 2K monitors • Clinical: Used by clinicians and staff to consult; ICU / ER applications; less costly than diagnostic; 1K monitors • At Home Review: low-end; PC based; cost-effective; review application; lossy compressed for faster transmit

  50. Standalone Vs direct PACS w/s

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