Picture Archiving And Communication System System Research Articles

The Impact of Implementing a Picture Archiving and Communication System (PACS) on Minimum Service Standards in the Field of Radiology

The use of Picture Archiving and Communication System (PACS) has become an important step to increase the efficiency of radiology services. With PACS, fast access and flexibility in accessing patient medical images has had a major impact on reducing waiting times for radiology examination results. The aim of this research is to determine the waiting time for radiology services at the UPTD Embung Fatimah Regional Hospital, Batam City after implementing PACS. The research uses a mix-method method, namely research that combines quantitative and qualitative methods. Quantitative method by collecting service time data. Qualitative method by conducting in-depth interviews (in-depth interviews) and focus group discussions (FGD) to obtain information on perceptions from service implementers and users, then researchers will assess the impact of PACS on Minimum Service Standards (SPM) in the field of radiology at UPTD RSUD Embung Fatimah Batam city.The results of this research are that the use of PACS has significantly reduced radiology service time at the UPTD Embung Fatimah Regional Hospital, Batam City. There was a significant decrease in service time for outpatient services previously from 101.09 minutes to 62 minutes or 35.3%, for inpatient services from 108.26 minutes to 65.6 minutes or 41.04% and for CITO patients from 104.27 minutes to 60.5 minutes or 41.06% after application of PACS. The views of radiologists and radiographers regarding the differences in the quality of radiology services before and after using the PACS system show that there are better changes in the efficiency and quality of radiology services in hospitals. Stakeholder perceptions related to the speed of radiology service time after using the PACS system through various factors are considered to have a positive impact. Implementation of PACS clearly shows the potential for improving the efficiency, speed, and overall quality of radiology services. There was a significant reduction in waiting time for radiology examination services at the UPTD Embung Fatimah Hospital, Batam City after the implementation of PACS, which can provide an alternative in changing workflow and efficiency of radiology services.

A novel practical method to predict anterior cruciate ligament hamstring graft size using preoperative MRI

BackgroundPredicting hamstring graft size preoperatively for anterior cruciate ligament (ACL) reconstruction is important for preempting an insufficient diameter in graft size intraoperatively, possibly leading to graft failure. While there are multiple published methods using magnetic resonance imaging (MRI) picture archiving and communication systems (PACS), most are not feasible and practical. Our study aims to (1) practically predict the ACL hamstring graft size in a numerically continuous manner using the preoperative MRI from any native MRI PACS system, (2) determine the degree of correlation between the predicted and actual graft size, and (3) determine the performance of our prediction method if we define an adequate actual graft size as ≥ 8 mm.MethodsA retrospective review of 112 patients who underwent primary ACL reconstruction with quadrupled hamstring semitendinosus-gracilis grafts at a tertiary institution was conducted between January 2018 and December 2018. Graft diameter can be predicted in a numerically continuous manner as √[2*(AB + CD)], where A and B are the semitendinosus cross-sectional length and breath, respectively, and C and D are the gracilis cross-sectional length and breath, respectively.ResultsA moderately positive correlation exists between the predicted and actual graft diameter (r = 0.661 and p < .001). Our method yields a high specificity of 92.6% and a moderate sensitivity of 67.2% if we define an adequate actual graft size as ≥ 8 mm. An area under receiver-operating characteristic curve shows good discrimination (AUC = 0.856).ConclusionsWe present a practical method to predict the ACL hamstring graft size with high specificity using preoperative MRI measurements.

DICOM Standard and Its Application in Radioinformatics

The DICOM standard is the emerging standard in the field of medical informatics. It defines the standard network interface and data model makes the medical image equipment manufacturers on the standard network equipment interconnection, simplify the development of various types of medical image, promote open unrelated to the factory of medical digital image transmission and exchange, prompting the image archiving and communication system of PACS (Picture Archiving and Communication Systems) and the combination of various hospital information system HIS (Hospital Information Systems). Radiation therapy departments in many hospitals have purchased more than one manufacturer of radiotherapy planning systems, and treatment information has to be communicated using DICOM standards. The use of DICOM in radiotherapy is called DICOM RT. At home, doctors are not fully aware of its importance and researchers do not. This paper mainly discusses the implementation and application of DICOM and protocol in precision radiotherapy system. The main contents include: (1) DICOM RT defines a total of seven information objects, which play a pivotal role in the information exchange of radiotherapy system. Discuss the content of DICOM RT; discuss the development of radiotherapy technology at home and abroad. (2) At present, DICOM standard has been widely used in the field of medical informatics, but no authority can provide DICOM compatibility verification of imaging equipment or DICOM application system, which still has many difficulties in system interconnection, that is, the research and implementation of DICOM test method. (3) The application of DICOM in PACS system. (4) Impaired compression study without visual loss in medical images based on DICOM standard.

PACS and Photoshop assisted isosceles triangle osteotomy and Kirschner wire tension buckle fixation in the treatment of cubitus varus in children

To investigate the clinical efficacy of picture archiving and communication system (PACS) and Photoshop assisted isosceles triangle osteotomy and Kirschner wire fixation with tension band in the treatment of cubitus varus in children. The clinic data of 20 children with cubitus varus treated with isosceles triangle osteotomy of distal humerus and Kirschner wire fixation with tension band from October 2014 to October 2019, were retrospectively analyzed. There were 13 males and 7 females, aged from 3.2 to 13.5 years old, the median age was 6.65 years old. PACS system was applied for the osteotomy design preoperatively, simulating and measuring the side length of isosceles triangle osteotomy. Then, Photoshop system was used to simulate the preoperative and postoperative osteotomy graphics, which could guide precise osteotomy during operation. All the 20 patients were followed up for 20 to 24 months, with a median of 22.5 months. At the last follow-up, the carrying angle of the affected limb was 5 ° to 13 °, with a median of 8.3 °. The clinical efficacy was evaluated according to the Flynn elbow function score:excellent in 16 cases, good in 2 cases, and fair in 2 cases. The treatment of cubitus varus in children by isosceles triangle osteotomy and Kirschner wire fixation with tension band assisted by PACS and Photoshop system has shown good clinical outcome.

Thực trạng sử dụng và sự hài lòng với hệ thống thông tin hỗ trợ chẩn đoán hình ảnh (PACS) của nhân viên y tế tại Bệnh viện Hữu nghị Việt Đức năm 2021

Background: The Picture Archiving and Communication System (PACS) is a medical imaging and information technology application system widely used in medical institutions, medical examination and treatment. This study was conducted to describe the use of PACS and the satisfaction level after deployment among medical staffs at Viet Duc University Hospital in 2021. Methodology: This is a cross-sectional study design with 188 participants in 2 groups including Doctors and Radiologists. Subjects were selected from 8 faculties/departments that have implemented the PACS system in 2021. Results: Most of the study participants have proficiently used the system and used it regularly in their daily work. There have been improvements in work performance noted after implementing the PACS system. In general, the groups of subjects in the study are satisfied with the products of radiographs/reports from the PACS system. Recommendation: Although some points need to be improved, the implementation of PACS system needs to continue to be maintained and strengthen in the near future. Keywords: Information system, hospital, diagnostic imaging, medical staff, PACS

Variation of the Implementation of PACS Functions and Image Data Management: Questionnaire Survey in Hokkaido Prefecture

The image management function of picture archiving and communication system (PACS) plays a very important role while electronically preserving medical records. However, details of these mechanisms vary from manufacturer to manufacturer, which could be a problem if system specifications or image management functions are not confirmed by a user during system installation or operation. The purpose of this research was to record the differences in PACS settings and image data management in hospitals. A questionnaire survey was conducted in 261 hospitals having the PACS system in Hokkaido prefecture, Japan. Questionnaire contents consisted of a face sheet and the following two items: 1) PACS image deletion method, 2) rules regarding the PACS receiving an image of data that was already registered. Results of the questionnaire survey showed that the image deletion method in the PACS server, and the overwriting rule in case of existent images being re-transmitted to the server were different between different hospitals. Furthermore, these variations were not dependent on the vendors or manufacturers, but on the settings of each hospital. Since the image management method of PACS is not standardized, we were considered to be needed more attention and appropriate regulation for safe management of electronic medical records as per the national guideline.

Diagnostic accuracy and reliability of smartphone captured radiologic images communicated via WhatsApp®.

IntroductionSending radiographic images as instant messages have become a common means of communication between physicians, aiding in triaging and transfer decision-making in emergencies. While use of technology is increasing, this is not the case for the underserved or rural areas of South Africa with no picture archiving and communications system or advanced hardware in place. In these areas, the medical staffing population have nearly universal access to smartphones and could benefit from the ability to share images quickly and easily with trained radiologists. South African data on diagnostic reliability of smartphone captured radiology images is lacking. The objective of the study was to determine the accuracy and reliability of diagnoses made on radiologic images captured with smartphone compared to radiologic images on picture archiving and communication system(PACS).MethodsA cross-sectional study was conducted with radiographs from June 2018 to July 2019 selected from the PACS system at Pelonomi Tertiary Hospital. Images were displayed on PACS computer screen and captured by principal researcher using a smartphone. Five radiology registrars received the images via WhatsApp® and reviewed them on smartphones. After three weeks, registrars viewed images in random order on PACS stations. McNemar's test was used to compare the diagnostic accuracy of smartphone vs PACS and Kappa values calculated for agreement. Reliability was assessed by analysing the results of different registrars and diagnoses separately.Results135 X-rays, representative of common emergency conditions, were selected. For all registrars, PACS accuracy was generally higher than smartphone accuracy. The Kappa values all indicated fair to moderate agreement between smartphone and PACS diagnosis.ConclusionCapturing radiographic images using at least 12-megapixel smartphone and sharing them via WhatsApp® is a reliable method that can be used with a high degree of confidence in emergencies to aid clinical decision making. This method of viewing medical imaging is however not a substitution for images viewed on PACS.

The current quality criteria of MRI reports distributed to healthcare stakeholders in Jordan

Purpose Many international radiology societies, including American College of Radiologists (ACR), have established guidelines for optimum forms and contents of medical imaging reports to ensure high quality and to guarantee the satisfaction of both the referring physician and the patient. Therefore, this study aims to analyze the criteria of magnetic resonance imaging (MRI) reports in Jordan according to the standards of the ACR. Design/methodology/approach This cross-sectional study was conducted in early January 2021 for two weeks. An invitation letter was sent to 85 MRI centers of various health-care sectors in Jordan to participate in the study. Each invitee was requested to send at least ten different MRI reports. The study used a questionnaire containing the checklist of the latest edition 2020 of ACR’s practice parameter to communicate the diagnostic imaging results and the demographic information of the participating MRI centers. Seven basic elements were assessed for content-related quality of MRI reports, which are administrative data, patient demographics, clinical history, imaging procedures, clinical symptoms, imaging observations and impressions. Statistical analyses were used to evaluate the data. Findings Forty-one MRI centers participated in the study with 386 different MRI exam reports. The majority (92%) of the reports were computer-generated. Free texted unstructured reports and head-structured reports had an almost equal percentage of around 40%. Exam and radiologist demography as well as exam findings criteria were 100% available in all reports. The percentage of exam conclusion, and exam description and techniques were 2% and 4.9%, respectively (N = 368). There was a positive association between computer-generated reports and the presence of picture archiving and communication systems (PACS)/health information systems r = 0.443. Originality/value Structured and free text unstructured reporting were the common types of MRI exam reports in Jordan. Handwriting exam reporting existed in few MRI centers, particularly in those that had no PACS and radiology information systems.

A diagnostic medical physicist’s guide to the American College of Radiology Fluoroscopy Dose Index Registry

A diagnostic medical physicist’s guide to the American College of Radiology Fluoroscopy Dose Index Registry

Study on the correlation between the arc height of cervical endplate and osteophyte in posterior margin of intervertebral space

To study the correlation and clinical value of the arc height of upper and lower endplates, the height of intervertebral space and osteophyte of posterior edge of intervertebral space in patients with cervical spondylosis. A total of 108 patients with cervical spondylosis who underwent cervical spondylosis surgery from September 2017 to September 2018 were included in the study. Including 48 males with an average age of 52 years (30 to 72) and 60 females with an average age of 54 years (37 to 79). Among them, C2,3 of 6 cases, C3,4 of 15 cases, C4,5 of 32 cases, C5,6 of 42 cases, C6,7 of 13 cases. X-ray films of cervical spine were taken before and after operation. The images were accessed by PACS (Picture Archiving and Communication Systems) system. The lower and upper endplate arc heights (L1, L2), intervertebral space height (L3), and posterior osteophyte width (L4) were measured. Spearman was used to analyze the correlation between them. L1 was negatively correlated with L4 (r=-0.34, P<0.05), L3 was negatively correlated with L4 (r=-0.36, P<0.05). L1 was positively correlated with L3 (r=0.38, P<0.05), L2 was positively correlated with L3 (r=0.48, P<0.05). There was no significant difference between L 1 and L2 (P>0.05), L2 and L4 (P>0.05). The arc height of the lower endplate is negatively correlated with the width of osteophyte in the posterior margin of the intervertebral space. The cervical degeneration degree can be determined by measuring the arc height of the lower endplate, which has guiding significance for the early prevention and treatment of cervical spondylosis.

Requirement Analysis of PACS and RIS Hospital Management Information System on Radiology Installation Based on Kano Method

Hospital management information systems are very helpful in carrying out services to customers. In this study, problems were found regarding the process of presenting the results of radiological image data that have not been facilitated throughout the patient’s examination room. The slow results of radiological image data, especially for immediate results (CITO) in emergency department services have not been facilitated due to having to wait for the results printed. The results of reading radiological images (expertise) are waiting to be printed first. To solve this problem, a research was conducted focusing on the development of the Radiology Information System (RIS) information system model and Picture Archiving and Communication System (PACS). The development of this system is analysed using the KANO method to classify the expected system menu needs attributes. The test results get the percentage of better value higher than the worse that is 9.81 which means that it can be known attributes that greatly influence the increase in customer satisfaction if these attributes are not fulfilled, the disappointment level is very high, but the implementation stage is not optimal so that future research can present results better research.

Effective Factors on continued use of the Picture Archiving and Communication System in Teaching Hospitals of Shiraz University of Medical Sciences

Introduction: The evaluation of information systems by health care professionals is one of the key factors for improving the acceptability and usability of systems. Picture Archiving and Communication System (PACS) is the support for more accurate diagnosis in the medical field. Therefore, the present study aimed to determine the factors affecting the continuance of this system in teaching hospitals of Shiraz University of Medical Sciences.Materials and Methods: This is a descriptive-analytic cross-sectional study conducted in 2014. The sample consisted of 200 PACS users (general practitioners, residents, specialists and radiologists) in Faghihi and Nemazee hospitals of Shiraz. They were selected by stratified random sampling. Data were collected using a researcher-made questionnaire. To confirm the reliability of the questionnaire, the Cronbach's alpha coefficient (84%) was used and 5 experts from health information management were used to confirm the validity of the questionnaire. The results of the present study were analyzed using descriptive statistics (frequency, mean and standard deviation) and inferential statistics (Independent t-test, ANOVA, Pearson correlation coefficient and regression tests) using SPSS 22 software.Results: The study showed that in selected hospitals according to the model, the highest correlation was found between the relationship between expectation confirmation of and satisfaction (r=0.682; R2=0.465) and the least correlation was related to the relationship between the expectation confirmation and the compatibility (r=0.347; R2=0.120). Also, there was a significant relationship between the level of education of users and the continuance intention to use the PACS system (P-value = 0.008). Radiologists have the highest tendency to continue using the PACS system and the least-favored were specialists.Conclusion: The results of the research indicate that for continued use of information systems by users and increase their satisfaction and the success of systems, consideration of users' expectations, requirements and technical requirements of systems to fit the system with the tasks of users before implementing information systems is necessary and inevitable.

Gestures for Picture Archiving and Communication Systems (PACS) operation in the operating room: Is there any standard?

ObjectiveGestural interfaces allow accessing and manipulating Electronic Medical Records (EMR) in hospitals while keeping a complete sterile environment. Particularly, in the Operating Room (OR), these interfaces enable surgeons to browse Picture Archiving and Communication System (PACS) without the need of delegating functions to the surgical staff. Existing gesture based medical interfaces rely on a suboptimal and an arbitrary small set of gestures that are mapped to a few commands available in PACS software. The objective of this work is to discuss a method to determine the most suitable set of gestures based on surgeon’s acceptability. To achieve this goal, the paper introduces two key innovations: (a) a novel methodology to incorporate gestures’ semantic properties into the agreement analysis, and (b) a new agreement metric to determine the most suitable gesture set for a PACS.Materials and methodsThree neurosurgical diagnostic tasks were conducted by nine neurosurgeons. The set of commands and gesture lexicons were determined using a Wizard of Oz paradigm. The gestures were decomposed into a set of 55 semantic properties based on the motion trajectory, orientation and pose of the surgeons’ hands and their ground truth values were manually annotated. Finally, a new agreement metric was developed, using the known Jaccard similarity to measure consensus between users over a gesture set.ResultsA set of 34 PACS commands were found to be a sufficient number of actions for PACS manipulation. In addition, it was found that there is a level of agreement of 0.29 among the surgeons over the gestures found. Two statistical tests including paired t-test and Mann Whitney Wilcoxon test were conducted between the proposed metric and the traditional agreement metric. It was found that the agreement values computed using the former metric are significantly higher (p < 0.001) for both tests.ConclusionsThis study reveals that the level of agreement among surgeons over the best gestures for PACS operation is higher than the previously reported metric (0.29 vs 0.13). This observation is based on the fact that the agreement focuses on main features of the gestures rather than the gestures themselves. The level of agreement is not very high, yet indicates a majority preference, and is better than using gestures based on authoritarian or arbitrary approaches. The methods described in this paper provide a guiding framework for the design of future gesture based PACS systems for the OR.

Augmentation of the think aloud method with users’ perspectives for the selection of a picture archiving and communication system

ObjectivesUsers attitude toward a picture archiving and communication system (PACS) and their interaction with this system are among the most important factors that influence its acceptance. This study aimed to augment the user's interaction with the user's perspective to select a usable PACS among three systems available on the market. MethodsWe augmented the think aloud (TA) usability evaluation method with the Post-Study System Usability Questionnaire (PSSUQ) to compare user interaction problems of three PACS user interfaces. Four radiologists and four internist physicians participated in this study. Usability characteristics including efficiency, effectiveness, learnability, error, and satisfaction were used to assess the usability of each PACS. ResultsThere was a significant difference in efficiency (p = 0.01), effectiveness (p = 0.005), learnability (p = 0.001), and satisfaction (p = 0.009). However, no significant difference in the number of errors (p = 0.18), mouse clicks and keystrokes (p = 0.12), and the number of usability problems (p = 0.6) were observed among the three PACS systems studied. ConclusionsThis study showed that applying the proposed approach to augment TA with the user's perspective addresses almost all of the theoretical aspects of usability and can be employed to select the most usable PACS.

Acceptability of picture archiving and communication system (PACS) among hospital healthcare personnel based on a unified theory of acceptance and use of technology.

Background and aimThe picture archiving and communication system (PACS) is a healthcare system technology which manages medical images and integrates equipment through a network. There are some theories about the use and acceptance of technology by people to describe the behavior and attitudes of end users towards information technologies. We investigated the influential factors on users’ acceptance of PACS in the military hospitals of Tehran.MethodsIn this applied analytical and cross-sectional study, 151 healthcare employees of military hospitals who had experience in using the PACS system were investigated. Participants were selected by census. The following variables were considered: performance expectancy, efforts expectancy, social influence, facilitating conditions and behavioral intention. Data were gathered using a questionnaire. Its validity and reliability were approved by a panel of experts and was piloted with 30 hospital healthcare staff (Cronbach’s alpha =0.91). Spearman correlation coefficient and multiple linear regression analysis were used in analyzing the data.ResultsExpected performance, efforts expectancy, social impact and facilitating conditions had a significant relationship with behavioral intention. The multiple regression analysis indicated that only performance expectancy can predict the user’s behavioral intentions to use PACS technology.ConclusionPerformance and effort expectancies are quite influential in accepting the use of PACS in hospitals. All healthcare personnel should become aware that using such technology is necessary in a hospital. Knowing the influencing factors that affect the acceptance of using new technology can help in improving its use, especially in a healthcare system. This can improve the offered healthcare services’ quality.

Assessment of Vertebral Curves Using the Manual Post-It Technique.

A prospective study of a new technique. The aims of this study were to report a manual technique for measuring vertebral curves on digital spine radiographs, and to assess the agreement of this technique with that of digital software for measuring vertebral curves. Modern picture archiving and communication systems (PACS) typically include software for evaluating radiographic measurements. However, in the outpatient spine setting, patients may present with radiographs stored on a physical disc, which may not include software for measuring vertebral curves. Certain smartphone applications may be used to determine curve magnitude; however, the need exists for an accurate manual technique to measure vertebral curves on digital radiographs in the absence of available analytic software or smartphone technology. We prospectively reviewed anteroposterior and lateral spine radiographs of 24 spinal deformity patients. Two independent observers measured Cobb angles for: (1) the major coronal curve; (2) the thoracic kyphosis (T2-T12); and (3) the lumbar lordosis (T12-S1). Measurements were made: (1) digitally using our institution's PACS; and (2) by a manual technique, which involves placement of an adhesive Post-It note directly on the computer screen, transcribing the angle onto the Post-It note with a pencil, and measuring the angle with a handheld goniometer. Intraclass correlation coefficients (ICCs) were calculated to determine the agreement between the 2 methods. For both observers, the agreement between the digital PACS and manual Post-It techniques was graded as excellent for both coronal and sagittal plane curves (all ICCs>0.9). Interobserver reliability between the 2 observers was also graded as excellent for both the PACS and Post-It techniques (all ICCs>0.9). The Post-It technique for measuring Cobb angles demonstrated excellent agreement with the PACS system in our series of spinal deformity patients. Curves on digital radiographs can be accurately measured using a convenient manual technique.

210: UTILIZATION OF MEDICAL IMAGES OF PACS FOR EVIDENCE BASED TRAINING

Background and aims:The more evidence the better decision making. Diagnosis is one of the medical determinants that seriously depend upon the evidence. Treatment and care as the other significant arms...

JavaScript Access to DICOM Network and Objects in Web Browser.

Digital imaging and communications in medicine (DICOM) 3.0 standard provides the baseline for the picture archiving and communication systems (PACS). The development of Internet and various communication media initiated demand for non-DICOM access to PACS systems. Ever-increasing utilization of the web browsers, laptops and handheld devices, as opposed to desktop applications and static organizational computers, lead to development of different web technologies. The DICOM standard officials accepted those subsequently as tools of alternative access. This paper provides an overview of the current state of development of the web access technology to the DICOM repositories. It presents a different approach of using HTML5 features of the web browsers through the JavaScript language and the WebSocket protocol by enabling real-time communication with DICOM repositories. JavaScript DICOM network library, DICOM to WebSocket proxy and a proof-of-concept web application that qualifies as a DICOM 3.0 device were developed.

Implementasi Picture Archiving and Communication System (PACS) dan Radiology Information System (RIS) di RSUP Dr. Sardjito Yogyakarta

Picture Archiving and Communication System (PACS) is an inter-and intra-institution computing system that manages the acquisition, transmission, storage, distribution, display, and interpretation of medical images. Advances in radiology informatics to date, including the integration of PACS and Radiology Information System (RIS) to department work?ow, has done much to improve the efciency of the department. PACS component includes image acquisition modality, network system, archiving system, image viewer system, radiology information system, and remote access. Acceptance testing is an important thing to be done before a user entirely accepts PACS and RIS system in a daily radiology practice.The purpose of this article is to deliver an important specifcation and the desired options and features of modern PACS, related to acquisition, archives and display system; connectivity of Radiology Information System (RIS); and distribution of images inside and outside the hospital. Some major practical issues that must be considered in the implementation of PACS and RIS will also be discussed. In addition, it will also discuss the process of implementation of PACS and RIS at Dr. Sardjito Hospital

SPEL – SOFTWARE PLATFORM FOR ELECTRODES LOCALIZATION. A TOOL TO AUTOMATICALLY LOCALIZE SUBDURAL ELECTRODES IN THE PRE-SURGICAL EVALUATION OF EPILEPSY PATIENTS

SPEL – SOFTWARE PLATFORM FOR ELECTRODES LOCALIZATION. A TOOL TO AUTOMATICALLY LOCALIZE SUBDURAL ELECTRODES IN THE PRE-SURGICAL EVALUATION OF EPILEPSY PATIENTS