Data Management

Chapter 9

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Informatics
• The collection, classification, storage, retrieval, and
dissemination (spreading) of recorded information.
• Radiology professionals use many types of medical information
systems
– Hospital information system (HIS)
– Clinical information system (CIS)
– Computerized physician order entry system (CPOE)

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Informatics (cont’d)
• Generic term for digital patient records
– Electronic health record (EHR) these are often composed
of Electronic medical record (EMR).Both terms are used
synonymously.

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Key Elements of Radiology Informatics
• Radiology information system (RIS)
– Most often used for scheduling patients, storing reports,
patient tracking, protocoling examinations, and billing.
• Picture archive and communication system (PACS)
– Technologies necessary for the storage, retrieval,
distribution, and display of images..

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• To be included in a PACS, images must be in a digital
form. CT, like magnetic resonance imaging (MRI) and
positron emission tomography (PET), is intrinsically
digital.
• All other modalities (i.e., nuclear medicine, ultrasound,
conventional radiography, angiography, and
mammography) have been modifi ed to allow direct
digital image capture.

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PACS Fundamentals

• Basic elements of the PACS

– Networking
– Digital image format standard
– Image acquisition
– Workstations
– Data storage
– Image distribution

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Networking

• A group of two or more computers linked together

• Many types and configuration of computer networks
exist
– Local area networks (LANs)
– Wide area networks (WANs)
– Wired networks
– Wireless networks

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Networking (cont’d)

• Common in the PACS setting is the client-server network

architecture
• Computers in this model are either servers or clients
• A server is a computer that facilitates communication
between and delivers information to other computers
• The server acts on requests from other networked
computers (clients), rather than from a person inputting
directly into it

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Networking (cont’d)

• Network bandwidth
– The amount of data that can be transmitted between
two points in the network in a set period of time
• Image data can be compressed to make transmission
more efficient
– Compression schemes can be lossless or lossy

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Electronic Standards
• Digital Imaging and Communication in Medicine (DICOM)
– Universally adopted standard for medical image
interchange
• Health Level Seven (HL7)
– Organization that works to develop universal standards in
healthcare (clinical and administrative )data
– Also refers to the specific standards created by the
organization

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Image Acquisition

• CT is inherently a digital modality, therefore the image

acquisition from the CT scanner to the PACS should be a
direct digital DICOM capture
• This allow the full spatial resolution and image
manipulation capabilities (such as adjusting window
width and level).
• An analog method (called frame grabbing) exists in which
an image on the monitor is converted to a digital format,
somewhat similar to a screen capture, but is inferior to
the digital method of image data transfer

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Data Storage

• CT departments generate a tremendous amount of data

• Archiving is the process of saving image data from the
originating modality to an electronic medium
– Only image data are stored

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Data Storage (cont’d)
• Devices are broadly classified as
– Online
• Instantly accessible to the user
– Near-line
• Readily, although not immediately, available
– Offline storage
• Data are kept in a less accessible location, requiring manual
intervention to use

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Review
Data stored on the CT system hard drive is classified as
a. Online
a. Near-line
b. Off-line

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Answer
a. Online

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Storage Devices
• Optical storage devices used for long term data storage.
– Compact discs (CD)
– Digital versatile discs (DVD) (stores 7 times more data
than cd)
– Blu-ray disc (BD) (3 times more data than DVD)
• Tape
– Magnetic tape (sequential not random access)

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Image Distribution

• PACS must get the correct images to the correct locations

in the shortest time possible
• The Internet is increasing being used for image
distribution
• Any image distribution must incorporate security devices,
such as
– Firewalls, passwords, usernames, secure socket
layers, virtual private networks

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Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins