PACS Influence the Technologist s Work JAVAD GHASEMI ,BS ,MRT
Deputy Education OF Iranian Radiographic sciences association
(IRSA) - EUROPACS SOCIETY MEMBER Mohammad Fathi, BS , MRT Head of
Imaging Informatics Committee OF Iranian Radiographic sciences
association (IRSA)
Diagnostic imaging departments have a dual mission : 1-
maintain the highest quality 2- consistency of patient care while
maximizing efficiency and productivity.
3-5 TECHNOLOGIST : 1 RADILOGIST The primary focus of
productivity enhancements has been on technologists.
Common Steps for Film-Screen and Filmless Computed Radiography
: 1. Review requisition (paper or electronic). 2. Escort patient to
radiography room. 3. Position patient and acquire images.
Film-Screen Radiography (CONVENTIONAL) 1. Place exposed film in
pass box. 2. Develop film images, remove film from cassettes, place
film images into conventional processor, refill empty cassettes
with new film, replenish film bin if empty. 3. Complete paperwork
(historical and demographic information). 4. Remove film images
from processor. 5. Review images for quality control.
6. Annotate images and obtain repeated images as needed. 7.
Collate film images and paperwork. 8. Pull patient master film
jacket from file room. 9. Pull pertinent comparison film images and
reports from film jacket. 10. Submit un reviewed films for
radiologist interpretation.
Film-Screen Radiography( DAY LIGHT SYSTEM) 1. Place exposed
film cassettes into daylight processor. 2. Complete paperwork
(historical and demographic information). 3. Remove film images
from daylight processor. 4. Refill empty cassettes with new film.
5. Review processed film images for quality control.
6. Annotate images and obtain repeated images as needed. 7.
Collate film images and associated paperwork. 8. Take completed
study to file room for radiologist interpretation.
Filmless Computed Radiography 1. Place computed radiographic
images into plate reader. 2. Enter unique case information into
computer and open electronic folder for patient examination. 3.
Review computed radiographic images on PACS workstation and edit as
needed. 4. Verify examination electronically and close folder.
Film-Screen Radiography (CONVENTIONAL) TYPE VIEWS NO. TIME
(MAIN) CHEST 2 164 10.8 SPINE 3-5 83 13.9
Filmless Computed Radiography TYPE VIEWS NO. TIME (MAIN) CHEST
2 183 7.4 SPINE 3-5 160 8.6
Store The DICOM Store service is used to send images or other
persistent objects (structured reports, etc.) to a PACS or
workstation.
Storage commitment The DICOM storage commitment service is used
to confirm that an image has been permanently stored by a device
(either on redundant disks or on backup media, e.g. burnt to a
CD).
Query/Retrieve This enables a workstation to find lists of
images or other such objects and then retrieve them from a
PACS.
Modality worklist This enables a piece of imaging equipment (a
modality) to obtain details of patients and scheduled examinations
electronically, avoiding the need to type such information multiple
times (and the mistakes caused by retyping
Modality performed procedure step A complementary service to
Modality Worklist, this enables the modality to send a report about
a performed examination including data about the images acquired,
beginning time, end time, and duration of a study, dose delivered,
etc. It helps give the radiology department a more precise handle
on resource
Technologist Note: Labeling (SPINE) Time of sequence Patient
history , Type of contrast media Dose ,rate & volume of CM
Printing The DICOM Printing service is used to send images to a
DICOM Printer, normally to print an "X-Ray" film. There is a
standard calibration (defined in DICOM Part 14) to help ensure
consistency between various display devices, including hard copy
printout or paper.
DEVELOPER FIXER WASH DRY WATER - SOLVENT
DARKROOM PROCESSING & CHEMISTRY
PROCESSOR PROBLEM FIXER RETENTION
FILMLESS VS FILM/SCREEN FILM these can not be modified once
processed If copied lose quality Digital print from file no loss of
quality
POST PROCCEING Technologist must choose technical factors (mAs
& kvp) to optimally visualize anatomic detail The selection of
processing algorithms and anatomical regions controls how the
acquired latent image is presented for display HOW THE IMAGE LOOKS
CAN BE ALTERED BY THE COMPUTER EVEN WHEN BAD TECHNIQUES ARE
SET
POST PROCESSING :1
POST PROCESSING :2 Edit Annotation Measurement Zooming
Reversing Marker.
Post Processing In CT
cor mpr
min-mip
min-mip
Off-line media (DICOM files) It describes how to store medical
imaging information on removable media. Except for the data set
containing, for example, an image and demography, it's also
mandatory to include the File Meta Information.
DICOM transmission Patient CD DICOM file HTML WEB BASE
CONVENTIONAL RADIOGRAPHY VIEWING OF X-RAY FILM IMAGES
Internet VPN Digital Images Archive Database and Workflow
Engine Workstations Remote Remote Facilities
Portable imaging
QUALITY CONTROL
Radiological departments are changing rapidly due to the
implementation of digital images and PACS (Picture Archiving and
Communication Systems).
Digital imaging is not the end all, cure all for imaging
problems. It is still technologist dependent.
To Produce Quality Images For Conventional Projection or
Digital Radiography: The same rules, theories, and laws still apply
and can not be overlooked
FFD/OFD (SID/SOD) Inverse Square La Beam Alignment
Tube-Part-Film Alignment Collimation Grids Exposure Factors: KVP,
mAss Patient Position