As PACS products have become more ubiquitous across the landscape of diagnostic radiology, commercial implementations of the technology have become adept at supporting mainstream radiology workflow. However, according to developers at the radiology informatics laboratory at the University of Pittsburgh Medical Center (UPMC), radiologists frequently encounter situations requiring additional functionality not fully covered by commercial PACS.
Developers at UPMC laboratory have created a suite of free, downloadable, vendor-independent PACS add-ons, SimpleDICOM, to address four of these issues:
- SimpleDICOM Sender, which extracts images from CDs from outside an institution and sends them to a PACS;
- SimpleDICOM Wrapper, which imports nonradiologic images into the PACS;
- SimpleDICOM Reader, which de-identifies and stores DICOM objects; and
- SimpleDICOM Viewer, which displays DICOM images outside the PACS environment.
The UPMC team described the functionality of the tools in an article published in the September/October issue of the journal Radiographics. The software, designed to be distributed as freeware, was written for use on the Microsoft Windows operating system
SimpleDICOM Sender reads DICOM Part 10 files from a CD or other digital medium and transmits the images to a PACS or other DICOM receiver, according to the developers. It automatically scans the entire file structure of a disk to identify DICOM files and extracts the appropriate metadata such as: name, medical record number, date of birth, and date of examination.
“SimpleDICOM Sender is designed with connectivity and error checking built in, so that transmission errors can be readily identified,” the authors wrote.
In addition, the application allows patient metadata to be modified before export, which allows unique identifiers, such as a medical record number, to be modified to align with an importing institution’s system requirements.
The developers created SimpleDICOM Wrapper to take non-DICOM images, such as JPEG and TIFF files, and turn them into DICOM objects that can be stored in a PACS. This allows the images to be distributed with radiologic images throughout a PACS enterprise. Metadata such as patient name, medical record number, and study date and time are provided by the user in constrained input fields, and the user interface is customized to the type of image being incorporated, according to the authors.
Once users have ensured that patients are registered in the hospital information system and RIS before their images are sent to a PACS, the incorporated images will appear in the PACS timeline as though they were radiologic images.
|Dermatologic images, obtained with a digital camera, are uploaded into the University of Pittsburgh Medical Center-developed software. Appropriate metadata are assigned to the images with constrained data fields or by clicking on the homunculus at the upper right. Image and caption courtesy of the Radiologic Society of North America (RSNA).|
According to the developers, SimpleDICOM Receiver is a client-side DICOM Service Class Provider (SCP) that resides in the background on a client machine and saves and stores files from a DICOM Service Class User (SCU) such as a modality or PACS. It maintains a log of received files, and provides information to the user during transfer.
The software also has an option to deidentify incoming exams for compliance with the Health Insurance Portability and Accountability Act (HIPAA) requirements.
“In particular, the anonymization tool in SimpleDICOM Receiver has been useful for establishing deidentified research servers, which became necessary after the passage of the privacy regulations in HIPAA,” the authors wrote. “We have found anonymization particularly useful for multi-institutional trials, in which it allows images to be sent from one institution to another without elaborate security protocols.”
SimpleDICOM Viewer is software that allows for the display of DICOM images stored on a PC. The application includes basic PACS functionality such as window width and level as well as image manipulation functions such as flip, rotate, invert, and crop. In addition, SimpleDICOM Viewer can export images to traditional file formats such as JPEG or TIFF for use in teaching, research, or remote consultation, according to the developers.
The SimpleDICOM Suite is available at http://www.radiology.upmc.edu/software.html.