Recent progress in digital image formatting and current trends in computers: their role in digital image storage and telemedicine. Commentary.

Abstract

This section of Current Opinion in Cardiology is dedicated to recent progress in imaging and echocardiography. Two trends apparent from the five articles in this symposium are the increasing importance of quantitation in cardiovascular imaging and the emergence of new modalities for assessing cardiac structure and function. The exploding volume of imaging data available to the practicing cardiologist has made it increasingly difficult to organize and manage this information in order to obtain an integrated picture of the patient's clinical status. Fortunately, we are also in the midst of a revolution in digital image storage and transmission, which will ease the task of organizing multimodal clinical images and avoiding unnecessary duplication of tests. This commentary reviews important progress in the past year in the development of standardized image formats as well as trends in better computer performance. In echocardiography, ultrasound loops can be stored with calibration data (spatial, temporal, and velocity) to facilitate automated application of some of the new quantitative algorithms outlined by Frank Flachskampf in his article (pp 634-639) [2]. Spatial localizing information can also be stored with the echocardiographic images to facilitate three- and four-dimensional reconstruction of these data. In cineangiography, the DICOM standard codifies methods for storing view orientation, interventional device identification, and the details of contrast administration, facilitating the threedimensional reconstruction and physiological analysis of catheterization data [3]. Finally, in the nuclear cardiology standard, entire protocols involving multiple radioisotopes may be encoded within a single digital study, facilitating the automated display and analysis, for instance, of such data as positron-emission tomography perfusion and metabolic imaging.