Author: H. K. Huang, D.Sc., FRCR (Hon.)Publisher: Wiley-Liss Publication Date: July 2004ISBN: 0-471-25123-2Pages: 637Cost: $135The question is no longer, “Can picture archiving communication systems (PACS) be cost-justified?” but, “How can PACS best be implemented?” Reductions in hardware costs, case studies showing the benefits of PACS, and the maturing of all aspects of PACS have now put these systems or upgrades in the capital budget even at community hospitals. In his third book on PACS, Dr. Huang builds on his previous publications, PACS and Imaging Informatics and PACS: Basic Principles and Applications, by focusing on clinical best practices, the use of distributed PC-based high resolution workstations, enterprise systems, and other technological and practice changes.Audience: PACS planners and administrators, radiologists, information technology (IT) and systems engineers, clinical engineers, radiology administrators, high-level imaging technicians, and academics.Overview: The 23 chapters are grouped into five sections:The book starts off with a much-appreciated list of acronyms used in medical imaging, PACS, and IT. A historical perspective on PACS is offered, noting the concept's introduction in 1979 by Heinz U. Lemke. Pioneering efforts in PACS are covered, followed by a short presentation on PACS concepts and global implementation issues. The next section on digital imaging fundamentals includes image quality, compression, and major modalities, with an emphasis on digital attributes. The essential use of mathematical concepts in this section is not overwhelming.The PACS fundamentals section encompasses components, work flow, standards (e.g. DICOM, HL7, IHE), acquisition gateways, networking communication, controllers, servers, displays, and integration with radiology information systems, hospital information systems, and the electronic patient record (EHR). The section on PACS operation is especially helpful to those of us most familiar with the technical side of PACS. Data management, including web-based systems and tele-health, is discussed, along with the important areas of fault tolerance and security.Generic and case study presentations on implementation, installation, acceptance, upgrade, and evaluation are combined into well-constructed chapters. The remainder of the book includes coverage of informatics and enterprise PACS. Portions on image-assisted surgery and radiation therapy servers may be of the most interest to medical instrumentation enthusiasts. Finally, 21 pages of references, a glossary, and an index wrap up the publication.Assessment: His many years of experience in the field and his previous publications have led Dr. Huang to produce an inclusive, well-written book combining key concepts and practical, working solutions. Interesting elements include case studies showing cost justification, references for PACS requests for proposals, data mining by image matching, and the EHR. This is likely the most comprehensive work on PACS principles and applications, but at the same time is very readable and of practical value to anyone who may be involved with or is working with PACS.