Looking ahead at the PACS of the future

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PACS and imaging modalities are in a state of rapid evolution, said Bob Cooke, executive director of marketing at Fujifilm Medical Systems. Cooke outlined key trends impacting radiology and PACS during the Imaging Informatics Administration Symposium at SCAR 2006 yesterday in Austin, Texas.
   
Ultimately, radiology consists of two systems — order generation and result distribution. Radiology systems — RIS, PACS, modalities — are developed separately, and no single solution provide a comprehensive system for radiology. The radiologist is the knowledge worker who operates in the center of the system and must be equipped with tools to take advantage of all the systems and perform the job of image interpretation and reporting.
   
Cooke identified two key problems radiology must solve.

  • How will radiology manage the increasing amount of work (information)?
  • How will radiology complete its work?

Currently and going forward, radiologists read in multiple information domains that may be quite disparate. Information must be brought together effectively to facilitate the work of radiology. The worklist provides a starting point to organize work. A smart worklist establishes rules to effectively and efficiently feed data to the radiologist.
   
“Technology to sort work will improve,” predicted Cooke. Automation is mandatory, but information is needed to improve automation.
   
At the same time, modalities are digital and offer new ways to see functional and anatomical information. Advances like PET/CT, CAD and multidetector CT necessitate new tools like virtual colonoscopy and volume exploration. This makes web based-visualization necessary; servers must allow multiple volumes to be stored and multiple users to interact with the data. In addition, compression is required to store a large number of large data sets and to fit studies on disks, through networks and to the radiologist while retaining diagnostic quality. The end product created by the interaction of the radiologist with the various systems is a clear, consistent, efficient and computer-readable report, which improves the order and completes the study cycle.
    
PACS must absorb multiple new clinical applications and must be web-based, said Cooke. Information must move toward a more structured format to sort the work and increase its value. Finally, images and information must be joined to bring tools and provide new ways for radiologists to interact with the information.
   
A new class of servers and additional software that creates new viewing applications and produces and uses structured information are necessary. PACS will serve as the underlying technology or glue that joins clinical systems, software visualization tools and reporting applications and bringing the order and results together in the radiologist’s brain. “The challenge is incorporating all of these functionalities and performing each function effectively,” concluded Cooke.