Wednesday, July 11, 2012

PACS



What is PACS?
PACS is an acronym that stands for Picture Archiving and Communication System:
Picture
- referring to radiographic images and radiology reports.
Archiving 
- referring to the film file or film jacket component of storing images.
Communications 
- referencing multiple viewers of images and reports at virtually unlimited viewing sites called workstations.
System 
- fostering the concept that a complex coordinated network makes it all possible.

PACS is hardware and software that stores and manipulates digital information in the form of images and text data. It provides a contemporary radiology department with optimal storage of images and patient data files. It is also a digital centralized electronic storage system that provides easy access to images transmittable to any workstation on its network. An important key to understanding PACS is to realize that its software manages patient information data and radiographic images so that both can be viewed simultaneously. The advantages of PACS over analog film/screen imaging and processing are tremendous. Through PACS there is a whole new way in which radiographic images are displayed and archived. Reflect on the traditional scheme of imaging that requires the technologist to expose a plate, chemically process it, and transfer it with pertinent patient information such as the film jacket and reports from previous studies to the radiologist to be interpreted.

•PACS is more than just picture display and archiving, the way in which the image is captured for PACS is digitally and not analog film/screen processing.
•Because the image is an electronic data set, each can be stored into what is called memory in computer language. Memory is the key concept in archiving, which takes up less space than a counterpart x-ray film jacket.
•Through computer technology unlimited viewers can review and manipulate PACS images without degradation of the image, or permanent changes to the image data. Digital data can be communicated to any computer or workstation within its network.
•PACS software can interface with most computers commonly used in medicine to include the hospital information system (HIS) and radiology information systems (RIS). Patient information and radiology reports can be displayed with radiology images eliminating the need to store paper information as well.

There are seven basic functions carried out by a PACS system and network:
1) Image Capture
2) Image Transfer
3) Short Term Storage
4) Long Term Storage
5) Retrieval
6) Image viewing
7) Networking


These seven components of PACS are functional solutions to those problems that have plagued film/screen radiography for tens of years. Through PACS radiography has evolved into a high quality acquisition system that displays and archives. In the past these functions were handled in the post-processing component of radiographic imaging.

i) Because images are digitally captured the need for a radiographic darkroom and all of its chemical vapor hazards are eliminated; water drainage problems and silver recovery issues are also eliminated since images are electronically processed.
ii) The storage of radiographic images, patient information, and radiographic reports into memory greatly diminishes the need for large film storage areas.
iii) Through PACS radiographic images can be viewed from any workstation within its network.

*.Unlike analog films where the view box is the center of image review, a workstation is a dynamic electronic view box with enhanced capabilities. Any workstation in the network can be used and workstations can be distributed throughout a facility or to off location facilities.

**.The PACS workstation adds a new dimension, that of image manipulation: windowing (density and contrast), image rotation, and algorithm variation (bone window, soft tissue window), measurement, magnification, etc.

***.Retrieval of all digital exams in a patient's electronic file is also permitted with PACS, along with all associated radiographic reports and printing features. With so many potential functions performed by a PACS system, especially with the type of upgrades found at a large multimodality facilities, the system must be monitored and responsibility for it functioning properly managed by a specialized team. All functions of the PACS system and network are managed by a PACS administrator.

The PACS team sets up file server(s), registers users, and assigns passwords. They also maintain the network and correct information and transfer errors as they occur, such as the wrong patient name entered on a study. Special training beyond basic radiology technology education is required to be a PACS administrator. The PACS administrator is considered a specialized modality which is gaining in its own right to specialty recognition.

So why do we need PACS?
Some benefits of PACS include reduction or elimination of lost films, reduced retakes due to poor image quality, significant reduction in storage space and film printing cost, greatly improved communications, productivity and efficiency between the radiology department and physicians greatly improves because images and reports are readily available to remote sites, clinics, and hospital wards immediately after acquisition.

Before PACS was introduced: The radiologist requires
films to be hung or stacked for him to read.



What is the difference between the PACS and RIS?
PACS = Picture Archive and Communication System.
RIS = Radiology Information System

RIS is more and administrative tool to manage a radiology departement: patient workflow and patient records.
PACS is mainly a system use to store the images acquired on a modality and distribute them on demand to processing workstation or reviewing workstation.
PACS and RIS are almost always coupled. You can from the RIS start the PACS application to see the images or start the RIS from the PACS application to see the patient records.

*A picture archiving and communication system (PACS) is a computerised means of replacing the roles of conventional radiological film: images are acquired, stored, transmitted, and displayed digitally.
**PACS gives us fast and reliable access to radiology and speeds up reporting, saves time, produces a better diagnosis, and results in an improvement in the quality of healthcare.


Our film stores and racks of films are now only a receding memory.......

Before PACS: Conventional x-ray films
had to be kept in huge storage rooms



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