Abstract

The rapid pace of change in information technologies - computer hardware, software, and networking - has led to expectations among many in the cardiology community that these advances now make it a simple matter to replace 35mm cinefilm with digital techniques. This objective has been delayed, however, due to the difficulty of replacing all the roles played by cinefilm using digital alternatives. Recent developments in technology and in the implementation of standard methods for communicating information among cardiac laboratories and imaging systems demonstrate sufficient promise that it is now realistic to speak of an all-digital catheterization laboratory. It is even, in fact, now feasible to produce a patient and exam record in a digital format containing multiple imaging modalities: x-ray angiography, echocardiography, and nuclear cardiology. In addition to the digital acquisition and review systems which have become commonplace in today’s cardiac catheterization laboratory, it is now possible to exchange patient exams in a digital format using the internationally accepted DICOM standard. Development and acceptance of this standard, implemented using either portable exchange media or over a digital network, has served to overcome one of the most significant obstacles to the transition from cinefilm to an all-digital environment. In addition, the multiple options available for the long-term storage of digital x-ray angiograms make it possible for laboratories with varying needs to move to a cine-less practice. As these laboratories better define their local requirements and balance these needs against the cost and technical capabilities of available options, they will demonstrate that there is no single way to function without cinefilm but, rather, multiple paths that can be taken to the all digital catheterization laboratory.

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