Implementation of a large-scale picture archiving and communication system.

This paper describes the implementation of a large-scale picture archiving and communication system (PACS) in a clinical environment. The system consists of a PACS infrastructure, composed of a PACS controller, a database management system, communication networks, and optical disk archive. It connects to three MR units, four CT scanners, three computed radiography systems, and two laser film digitizers. Seven display stations are on line 24 h/day, 7 days/wk in genitourinary radiology (2K), pediatric radiology in-patient (1K and 2K) and outpatient (2K), neuroradiology (2K), pediatric ICU (1K), coronary care unit (1K), and one laser film printing station. The PACS is integrated with the hospital information system and the radiology information system. The system has been in operation since February 1992. We have integrated this PACS as a clinical component in daily radiology practice. It archives an average of 2.0-gigabyte image data per workday. A 3-mo system performance of various components are tabulated. The deployment of this large-scale PACS signifies a milestone in our PACS research and development effort. Radiologists, fellows, residents, and clinicians use it for case review, conferences, and occasionally for primary diagnosis. With this large-scale PACS in place, it will allow us to investigate the two critical issues raised when PACS research first started 10 yrs ago: system performance and cost effectiveness between a digital-based and a film-based system.

A fiber-optic broadband CT/MR video communication system.

Our department operates three magnetic resonance (MR) and three computed tomography (CT) scanners that are located in three different buildings up to 2 km apart. We have designed and implemented a multichannel, fiber-optic broadband video communication system as a remote scanner monitoring network. This system consists of baseband and broadband fiberoptic transmitters, receivers, and multiplexers. The structure of the video network is supported by two strategically located headends (distributors) connecting local/remote scanners and monitoring stations. The system is capable of serving up to 5 km from each headend. The video signal from each scanner is sent through a baseband fiber-optic link to a headend, where it is frequency modulated, multiplexed with other scanner video signals, and distributed over broadband fiber-optic links to monitoring stations. Each receiver consists of a demodulator, a channel selectable tuner, and a video monitor. The current design provides up to 16 scanner channels and 16 remote monitoring station connections. Monitoring stations are placed in 14 clinical locations including the following reading rooms: thoracic, neuro, abdomen, musculoskeletal, gastrointestinal, genitourinary, and pediatric radiology. A radiologist can use any of these 14 monitoring stations to view a patient's CT/MR images in real-time as they appear on any of the six scanner consoles. By selecting the proper channel assigned to a patient's scanner, the radiologist may monitor the examination while using the telephone to communicate with the technologist at the scanner site. This fiber-optic broadband video communication system has been integrated into daily clinical use for over 6 months.