More and more radiology departments — in both hospitals and radiology imaging centers — are implementing picture archiving and communications systems (PACS). As they do so, they’re discovering a wide range of benefits and challenges. Few radiologists, clinicians or administrators would dispute the benefits of going filmless. But most PACS on the market do have some limitations. For example, the typical run-of-the-mill PACS doesn’t integrate large datasets very well, such as multidetector CT (MDCT) 2D, 3D and 4D studies. Standard DICOM transfer protocols and review workstations get bogged down with large modern datasets, and the reality is that physicians throughout the hospital need to access these large datasets, not just radiologists with high-end reading stations. In many cases, multiple physicians need to simultaneously review and manipulate the same studies to determine the best course of treatment. This may be impossible with some PACS, or it may burden the system to the point where viewing or manipulating data is painfully slow.

Roger Katen, M.D. (left), formerly of Hospital of St. Raphael (New Haven, Conn.), describes how the hospital has integrated PACS workstations into the clinical workflow. “Right now our PACS clinical workstations are very limited. The radiologist reads the studies, and the clinical staff comes to the radiology department for the report.” It’s an arrangement the hospital has made work, but it’s not exactly an efficient way of doing business.

Hospital of St. Raphael plans to overcome the challenge by installing TeraRecon Inc.’s (San Mateo, Calif.) AquariusNET streaming 2D/3D medical imaging server. Katen says, “We realized the necessity of a rational approach to large datasets. Studies completed on the hospital’s multidetector CT scanner are so large that they tax the current PACS.”

Unlike other products on the market, AquariusNET employs a distributive approach and does not overburden the PACS. It also carries a host of other benefits and facilitates surgical planning, clinical collaboration and endovascular planning.

As 3D imaging becomes routine, advanced 3D image processing has become a clinical necessity. In an increasing number of cases, clinicians and surgeons need to visualize the anatomy and manage 3D data in order to plan and execute an effective treatment. That means 3D images, which are tremendously large datasets, need to be available throughout the hospital setting. Zenon Protopapas, M.D., of Hospital of St. Raphael, says, “Newer technologies like MR and CT produce image sets with hundreds of images. Moving this data around the hospital can be a network nightmare.”

Please refer to the June 2002 issue for the complete story. For information on article reprints, contact Martin St. Denis