Abstract:
An imaging history display system and method is disclosed comprising diagnostic and patient summary interfaces for displaying, comparing and managing medical images. Imaging history display system displays studies in two interface modes in response to commands received from a user workstation. Display entities are displayed on display areas within display entity boxes that are defined by display entity layouts. Contextual summaries of display entities are provided in the patient summary interface to facilitate accurate and exhaustive diagnoses. Contextual summaries are generated in part based on pre-determined relevancy information. Display entities are easily organized in the patient summary interface. Display entities are easily activated in the diagnostic interface for diagnostic and comparison purposes.

Description:
FIELD 
   The embodiments described herein relate to an image viewing system and method and more particularly to a system and method for viewing and organizing medical diagnostic imaging studies on a contextual basis. 
   BACKGROUND 
   Commercially available image display systems in the medical field utilize various techniques to present image data to a user. Specifically, image data produced within modalities such as Computed Tomography (CT), Magnetic Resonance (MR) and the like is displayed on a display terminal for review by a medical practitioner at a medical treatment site. This image data is used by the medical practitioner to determine the presence or absence of a disease, tissue damage, etc. Through visual comparisons with prior imaging studies, medical practitioners are able to make or improve diagnoses based on changes in a patient&#39;s imaging studies over time. 
   Currently, large volume imaging studies utilized by medical treatment sites, such as CT and MR, pose a significant diagnostic problem due to the large number of image data files that are created and stored for later review. A typical image dataset may easily contain over 2000 slices that translate into a similar number of image data files organized into multiple series. Further, Picture Archiving and Communication Systems (PACS) utilized by medical treatment sites have the ability to present image datasets from multiple modalities, spanning several years. Although the availability of imaging studies from multiple modalities is of benefit to medical practitioners, it is difficult to isolate only relevant prior studies. Further, the amount of data available requires that medical practitioners engage in a time-intensive exercise to filter through studies, series and images, to identify only those that are most relevant to the current diagnosis. 
   This filtering process is difficult, making an exhaustive comparison of current medical images with a patient&#39;s prior history impractical. Moreover, image data is often presented by date. However, medical practitioners are less interested in exact dates than in time periods, for example, the previous quarter or year. 
   SUMMARY 
   The embodiments described herein provide in one aspect, a method for displaying a first image on a diagnostic interface, wherein the method comprises: 
   (a) providing a thumbnail representation of the first image at a point of origin on a patient summary interface positioned over the diagnostic interface such that the patient summary interface at least in part obscures the patient summary interface; 
   (b) determining whether the thumbnail representation has been selected and is being dragged on the patient summary interface from the point of origin; 
   (c) if (b) is true, then reducing the opacity of the patient summary interface such that the first image is no longer obscured by the patient summary interface; 
   (d) receiving a user command to display the first image on the diagnostic interface and causing the first image to be displayed on the diagnostic interface; and 
   (e) increasing the opacity of the patient summary interface such that the first image is again at least in part obscured by the patient summary interface. 
   The embodiments described herein provide in another aspect, a system for displaying a first image on a diagnostic interface, wherein the system comprises: 
   (a) a memory for storing the first image; 
   (b) a processor coupled to the memory for:
         (A) providing a thumbnail representation of the first image at a point of origin on a patient summary interface positioned over the diagnostic interface such that the patient summary interface at least in part obscures the patient summary interface;   (B) determining whether the thumbnail representation has been selected and is being dragged on the patient summary interface from the point of origin;   (C) determining if (B) is true, and if so then reducing the opacity of the patient summary interface such that the first image is no longer obscured by the patient summary interface;   (D) receiving a user command to display the first image on the diagnostic interface and causing the first image to be displayed on the diagnostic interface; and   (E) increasing the opacity of the patient summary interface such that the first image is again at least in part obscured by the patient summary interface.       

   The embodiments described herein provide in another aspect, a method of providing a contextual historical summary display within a viewable area on a patient summary interface for a plurality of images wherein each image is associated with a time period and adapted to be displayed on a diagnostic interface, said method comprising: 
   (a) associating a representative icon with each image; 
   (b) initially grouping one or more representative icons together according to time period; 
   (c) determining whether all of the representative icons can be displayed within the viewable area; 
   (d) if (c) is true then displaying the representative icons within the viewable area according to the grouping in (b); and 
   (e) if (c) is false then further grouping one or more representative icons according to time period and displaying the representative icons within the viewable area. 
   The embodiments described herein provide in another aspect, a system for providing a contextual historical summary display within a viewable area on a patient summary interface for a plurality of images wherein each image is associated with a time period and adapted to be displayed on a diagnostic interface, said system comprising: 
   (a) a memory for storing the plurality of images; and 
   (b) a processor coupled to the memory for:
         (A) associating a representative icon with each image;   (B) initially grouping one or more representative icons together according to time period;   (C) determining whether all of the representative icons can be displayed within the viewable area;   (D) determining if (C) is true, and if so then displaying the representative icons within the viewable area according to the grouping in (B); and   (E) determining if (C) is false, and if so then further grouping one or more representative icons according to time period and displaying the representative icons within the viewable area.       

   The embodiments described herein provide in another aspect, a method of associating a patient summary interface having a first and second element with a screen edge of a diagnostic interface, said method comprising: 
   (a) activating the first and second elements of the patient summary interface for display and displaying the active first and second elements of the patient summary interface; 
   (b) receiving a user command to associate the patient summary interface with a screen edge of the diagnostic interface; 
   (c) condensing the patient summary interface so that only the active first element is activated for display; and 
   (d) displaying the active first element of condensed patient summary interface along the screen edge of said diagnostic interface. 
   The embodiments described herein provide in another aspect, a system for associating a patient summary interface having a first and second element with a screen edge of a diagnostic interface, said system comprising: 
   (a) a memory for storing the patient summary interface; and 
   (b) a processor coupled to the memory for:
         (A) activating the first and second elements of the patient summary interface for display and displaying the active first and second elements of the patient summary interface;   (B) receiving a user command to associate the patient summary interface with a screen edge of the diagnostic interface;   (C) condensing the patient summary interface so that only the active first element is activated for display; and   (D) displaying the active first element of condensed patient summary interface along the screen edge of said diagnostic interface.       

   The embodiments described herein provide in another aspect, a method of dynamically adjusting the size of display entities having a graphic element and a textual element within a patient summary interface, said method comprising: 
   (a) receiving a user command; 
   (b) resizing the graphic element for each display entity in response to said user command; and 
   (c) adjusting the textual element for each display entity in response to said user command. 
   The embodiments described herein provide in another aspect, a system for dynamically adjusting the size of display entities having a graphic element and a textual element within a patient summary interface, said system comprising: 
   (a) a memory for storing the display entities; 
   (b) a processor coupled to the memory for:
         (A) receiving a user command;   (B) resizing the graphic element for each display entity in response to said user command; and   (C) adjusting the textual element for each display entity in response to said user command.       

   The embodiments described herein provide in another aspect, a method of displaying a first representative image in association with a first image and displaying a second representative image in association with a second image, said method comprising: 
   (a) displaying the first representative image adjacent to the first image and the second representative image adjacent to the second image; 
   (b) delineating the first representative image from the second representative image using an interactive user interface element; and 
   (c) hiding the first representative image if the interactive user element is selected. 
   The embodiments described herein provide in another aspect, a system for displaying a first representative image in association with a first image and displaying a second representative image in association with a second image, said system comprising: 
   (a) a memory for storing the first and second representative images; and 
   (b) a processor coupled to the memory for:
         (A) displaying the first representative image adjacent to the first image and the second representative image adjacent to the second image;   (B) delineating the first representative image from the second representative image using an interactive user interface element; and   (C) hiding the first representative image if the interactive user element is selected.       

   The embodiments described herein provide in another aspect, a method of associating a first image associated with a first anatomic region with a second image associated with a second anatomic region, said method comprising: 
   (a) defining an anatomical relevancy rule that maps the first anatomic region to at least one anatomic region including the second anatomic region; 
   (b) applying the anatomical relevancy rule to the first image to determine whether the first anatomic region is mapped to the second anatomic region; and 
   (c) if (b) is true then associating the first image with the second image. 
   The embodiments described herein provide in another aspect, a system for associating a first image associated with a first anatomic region with a second image associated with a second anatomic region, said system comprising: 
   (a) a memory for storing the first and second images; 
   (b) a processor coupled to the memory for:
         (A) defining an anatomical relevancy rule that maps the first anatomic region to at least one anatomic region including the second anatomic region;   (B) applying the anatomical relevancy rule to the first image to determine whether the first anatomic region is mapped to the second anatomic region; and   (C) determining if (B) is true, and if so then associating the first image with the second image.       

   Further aspects and advantages of the embodiments described herein will appear from the following description taken together with the accompanying drawings. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
     For a better understanding of the embodiments described herein and to show more clearly how they may be carried into effect, reference will now be made, by way of example only, to the accompanying drawings which show at least one exemplary embodiment, and in which: 
       FIG. 1  is a block diagram of an imaging history display system; 
       FIG. 2  is a schematic diagram illustrating the interface generated by one exemplary embodiment of the imaging history display system of  FIG. 1 ; 
       FIG. 3  is a schematic diagram of the image management tool displayed in the interface of  FIG. 2  that is used to represent a single study; 
       FIGS. 4A ,  4 B,  4 C and  4 D are schematic diagrams illustrating a method for changing the actively displayed image in the interface of  FIG. 2 ; 
       FIG. 5  is a flowchart diagram illustrating the operational steps executed by the imaging history display system performing the method of  FIGS. 4A ,  4 B,  4 C and  4 D, according to the swap module of  FIG. 1 ; 
       FIG. 6  is a schematic diagram of the study dataset history tool provided by the imaging history display system of  FIG. 2 ; 
       FIG. 7  is a flowchart diagram illustrating the operational steps executed by the study dataset history tool of  FIG. 6  in generating a display, according to the history module of  FIG. 1 ; 
       FIGS. 8A and 8B  are schematic diagrams of two embodiments of the condensed display of the image management tool of  FIG. 3 ; 
       FIG. 8C  is a schematic diagram illustrating the contextual menu of the image management tool of  FIG. 3 ; 
       FIGS. 9A and 9B  are flowchart diagrams illustrating the operational steps executed by the imaging history display system of  FIG. 2  in choosing a display mode for the image dataset series management tools of  FIGS. 3 ,  8 A and  8 B, according to the docking module of  FIG. 1 ; 
       FIG. 9C  is a flowchart diagram illustrating the operational steps executed by the image display and management tool of  FIGS. 3 ,  8 A and  8 B; 
       FIGS. 10A and 10B  are schematic diagrams illustrating a method for changing the arrangement of displayed image dataset series in the image dataset series management tool of  FIG. 3 ; 
       FIG. 11  is a flowchart diagram illustrating the operational steps executed by the imaging history display system performing the method of  FIGS. 10A and 10B , according to the resize module of  FIG. 1 ; 
       FIGS. 12A and 12B  are schematic diagrams of two embodiments of the contextual toolset of  FIG. 3 ; 
       FIGS. 12C and 12D  are schematic diagrams illustrating a method for changing the arrangement of image dataset series in the image dataset series management tool of  FIG. 3 ; 
       FIG. 13  is a flowchart diagram illustrating the operational steps executed by the imaging history display system of  FIG. 2  performing the method of  FIGS. 12C and 12D , according to the order module of  FIG. 1 ; 
       FIG. 14  is a flowchart diagram illustrating the operational steps executed by the imaging history display system of  FIG. 2  according to the organization module of  FIG. 1 ; 
       FIG. 15  is a flowchart diagram illustrating the operational steps executed by the imaging history display system of  FIG. 2  determining the presentation of the contextual toolset module of  FIG. 3 ; 
       FIG. 16  is a schematic diagram of the interface of the image dataset series management tool of  FIG. 3 ; and 
       FIGS. 17A and 17B  are schematic diagrams of the relevancy mapping interface generated by the relevancy module. 
   

   It will be appreciated that for simplicity and clarity of illustration, elements shown in the figures have not necessarily been drawn to scale. For example, the dimensions of some of the elements may be exaggerated relative to other elements for clarity. 
   DETAILED DESCRIPTION 
   It will be appreciated that for simplicity and clarity of illustration, where considered appropriate, reference numerals may be repeated among the figures to indicate corresponding or analogous elements or steps. In addition, numerous specific details are set forth in order to provide a thorough understanding of the exemplary embodiments described herein. However, it will be understood by those of ordinary skill in the art that the embodiments described herein may be practiced without these specific details. In other instances, well-known methods, procedures and components have not been described in detail so as not to obscure the embodiments described herein. Furthermore, this description is not to be considered as limiting the scope of the embodiments described herein in any way, but rather as merely describing the implementation of the various embodiments described herein. 
   The embodiments of the systems and methods described herein may be implemented in hardware or software, or a combination of both. However, optionally, these embodiments are implemented in computer programs executing on programmable computers each comprising at least one processor, a data storage system (including volatile and non-volatile memory and/or storage elements), at least one input device, and at least one output device. For example and without limitation, the programmable computers may be a personal computer, laptop, personal data assistant, and cellular telephone. Program code is applied to input data to perform the functions described herein and generate output information. The output information is applied to one or more output devices, in known fashion. 
   Each program is optionally implemented in a high level procedural or object oriented programming and/or scripting language to communicate with a computer system. However, the programs can be implemented in assembly or machine language, if desired. In any case, the language may be a compiled or interpreted language. Each such computer program is optionally stored on a storage media or a device (e.g. ROM or magnetic diskette) readable by a general or special purpose programmable computer, for configuring and operating the computer when the storage media or device is read by the computer to perform the procedures described herein. The inventive system may also be considered to be implemented as a computer-readable storage medium, configured with a computer program, where the storage medium so configured causes a computer to operate in a specific and predefined manner to perform the functions described herein. 
   Reference is first made to  FIG. 1 , which is a block diagram illustrating an exemplary embodiment of an imaging history display system  100 . Imaging history display system  100  is controlled by a medical practitioner user  106  via a user workstation  150  and is adapted to perform processing functions on one or more display entities  147  obtained from an image server  108 . Display entities  147  may take various forms including complete medical imaging studies, distinct image series within a study or individual images. In addition, it should be understood that one or more studies, series or images are typically associated with a particular patient. 
   Imaging history display system  100  creates a list of imaging studies  143 , each imaging study  143  containing one or more imaging series  141 . The list of imaging studies  143  is displayed on a patient summary interface  140 . Imaging history display system  100  further displays studies  141  for the patient whose study or studies are currently displayed on a diagnostic interface  145  on a user workstation  150 , through a display driver  132 , in response to commands issued by user  106 . In the result, both patient summary interface  140  and diagnostic interface  145  are seen by user  106  via a user workstation  150 . Imaging history display system  100  works contextually and dynamically to allow user  106  to manipulate user interface elements, such as icons representing studies  141 , using user workstation  150 , and therefore arrange said elements on-screen in a manner conducive to accurate and thorough medical diagnosis. 
   User workstation  150  contains a monitor  152  and an input device  154 , and can be any number of devices including but not limited to a personal computer, laptop, medical imaging device terminal, cell phone, and personal data assistant (PDA). Imaging history display system  100  is used to provide image display formatting depending on user input through user workstation  150 . Imaging history display system  100  is installed either on the non-volatile memory of user workstation  150  and/or on a central image server  108  such that user workstation  150  works with image server  108  in a client-server configuration. 
   Diagnostic interface  145  is optimized to provide high-resolution image display of display entities  147  (e.g. from studies  141 ) to user  106 . Diagnostic interface  145  may display one or more display entities  147 . Diagnostic interface  145  is optionally viewed on medical imaging quality display monitors with relatively high resolution typically used for viewing CT and MR studies (e.g. black and white “reading” monitors with a resolution of 1280×1024 and up). 
   Patient summary interface  140  is optimized for the review, gross comparison and organization of imaging studies  141  and therefore provides a user with, among other things, a study list  142 . Patient summary interface  140  may not be displayed initially, and is invoked by user  106  when functions of the interface are required. Thereafter, patient summary interface  140  may also be dismissed by user  106  to provide maximal viewing area for display entities  147  on diagnostic interface  145 . 
   Study list  142  provides a combined graphical and textual format listing of display entities  147  (e.g. studies  141 ) that are available for display. Study list  142  also includes associated identifying indicia (e.g. body part, modality, etc.) and organizes studies  141  in current and prior study categories. Typically, user  106  will review study list  142  and select listed studies  141 . User  106  may select a study  141  and perform various operations using imaging history display system  100 , including displaying the selected study  141  on diagnostic interface  145 . Other associated textual information (e.g. patient information, image resolution quality, date of image capture, etc.) is simultaneously displayed within study list  142  to assist the user  106  in selection of studies  141 . Patient summary interface  140  is optionally implemented as a graphical user interface window overlaying diagnostic interface  145 . 
   It should be understood that many other types of display configurations could be utilized within imaging history display system  100  including the use of one, two or more displays. 
   Display entities  147  are obtained from image data generated by a modality  107 , which is stored in an image database  109  on image server  108 , where it may be retrieved by imaging history display system  100  for further processing. Modality  107  is any conventional image data generating device (e.g. computed radiography (CR) systems, computed tomography (CT) scanners, magnetic resonance imaging (MRI) systems, positron emission tomography (PET), ultrasound systems, etc.) utilized to generate image data that corresponds to patient medical exams. The image data generated by modality  107  is then utilized for making a diagnosis (e.g. for investigating the presence or absence of a diseased part or an injury or for ascertaining the characteristics of the diseased part or the injury). Modalities  107  may be positioned in a single location or facility, such as a medical facility, or may be remote from one another. 
   Imaging history display system  100  includes of a main image processing module  110  which coordinates the activities of a viewer swap module  112 , a key image module  114 , a resize module  116 , a scroll module  118 , a paging module  119 , an add module  120 , an order module  121 , a sort module  122 , an organize module  123 , a dock module  124 , a relevancy module  125 , a history module  128  and a report module  130  in response to user commands sent by user  106  from user workstation  150  and stored user display preferences from a user preference database  126 . Display driver  132  further generates patient summary interface  140 , containing imaging study list  142 , and diagnostic interface  145  for viewing images, containing display entities  147 . Specifically, image processing module  110  is adapted to receive a request from user workstation  150  that indicates that particular display entities  147  (e.g., studies  141  or series  142 , etc.) being displayed on the interfaces  140  and  145  are to be displayed in a reformatted manner selected to improve the usability of the overall medical imaging system. The various types of image display formatting and display options provided will be discussed. 
   Paging module  119  generates contextual toolbar  315  ( FIG. 12A ) for display in patient summary interface  140  for any medical imaging study view  250  that is linked with display entities  147  currently opened in diagnostic interface  145 . The contextual toolbar  315  contains user interface elements to enable user  106  to incrementally view each display entity  147  within the current medical imaging study view  250  in detail on diagnostic interface  145 . 
   Swap module  112  is utilized by image processing module  110  to provide user  106  with image swapping functionality between non-diagnostic and diagnostic interfaces  140  and  145 . Swap module  112  allows user  106  to directly modify the actively viewed display entity  147  within diagnostic interface  145  by dragging a desired thumbnail over an unwanted display entity  147 . This results in the unwanted display entity  147  being supplanted with a desired display entity  147  and thus occupying the display area previously executed by unwanted display entity  147 . Swap module  112  will be discussed in more detail in respect of  FIGS. 4A ,  4 B,  4 C,  4 D and  5  below. 
   Key image module  114  allows the user  106  to select specific display entities  147  for display as “key” images. “Key” images are displayed in a preferred position when arranged in series in studies  141 . Key image module  114  allows user  106  to quickly identify important display entities  147  when viewing a study  141 , because highlighted display entities  147  will have been previously identified as important by the current user  106  or by other users  106  with similar expertise. Key module  114  will be discussed in more detail in respect of  FIG. 16  below. 
   Resize module  116  is utilized by image processing module  110  to provide user  106  with resizing functionality within patient summary interface  140 . Resize module  116  allows user  106  to dynamically grow and shrink all thumbnail representations of the series  141  for each study  143  displayed in the patient summary interface to make identification of relevant series  141  and studies  143  possible from a thumbnail image. Resize module  116  reduces the need for user  106  to specifically and individually resize studies  141  (i.e., reducing unnecessary user-interface interaction) and facilitates efficient identification of relevant studies  141 . Resize module  116  will be discussed in more detail in respect of  FIGS. 10A ,  10 B and  11  below. 
   Scroll module  118  is utilized by image processing module  110  to provide user  106  with paging functionality within patient summary interface  140 . Scroll module  118  allows user  106  to scroll through a group of display entities  147  that occupy more than the viewable area of the patient summary interface  140  by identifying when the viewable area is full and enabling scroll bars to facilitate scrolling. Only vertical scroll bars are used. If the thumbnails of series  141  for a single study  143  do not fit horizontally in the patient summary interface  140 , then the thumbnails are wrapped onto a second line so the user never has to scroll horizontally to see all series/images for a study. Also, the scrolling module supports the use of the mouse scroll wheel, normally the center scroll button on a standard mouse, to scroll vertically through the patient history summary interface. 
   Add module  120  is utilized by image processing module  110  to provide user  106  with organizational functionality within patient summary interface  140 . Add module  120  allows user  106  to add one or more display entities  147  together such as imaging series  141  to another imaging series  141  to allow for improved grouping of display entities  147  and therefore better display and comparison of studies, series and images for diagnostic purposes. 
   Order module  121  is utilized by image processing module  110  to provide user  106  with organizational functionality within imaging studies  141  displayed within study lists  142  within patient summary interface  140 . Order module  121  allows user  106  to rearrange the order of imaging series  141  within a specific study  143  to, for example, correct the order of imaging series  141  that are displayed out of chronological order. Such functionality is particularly desirable where modalities  107  predate digital imaging methods and studies  143  were digitized in a random order. Order module  121  allows user  106  to initiate an ordering mode, drag and drop imaging series  141  to the desired positions, terminate the ordering mode and thus effect permanent changes to the ordering of imaging series  141  for the future. Use of an ordering mode is desirable because ordering actions are performed infrequently by user  106 , while drag and drop operations are performed more frequently in a different context. 
   Sort module  122  is utilized by image processing module  110  to provide user  106  with sorting functionality within imaging studies  141  displayed within study lists  142  within patient summary interface  140 . Sort module  122  allows user  106  to sort imaging series  141  by attributes relevant to the current study  141 , for example, slice position, MR echo time, acquisition time, etc. Sort module  122  allows user  106  to quickly effect a temporary change in the arrangement of imaging series  141  that is desirable for comparative purposes to facilitate medical diagnosis. 
   Organize module  123  is utilized by image processing module  110  to provide user  106  with organizational functionality within patient summary interface  140 . Organize module  123  allows the user  106  to add, duplicate, combine or split display imaging series  141  to allow for improved grouping of imaging series  141  and therefore better display and comparison of images for diagnostic purposes. 
   Dock module  124  is utilized by image processing module  110  to provide user  106  with docking functionality for patient summary interface  140  within diagnostic interface  145 . Dock module  124  allows user  106  to position primary elements of patient summary interface  140  along an edge of diagnostic interface  145  while hiding secondary elements and providing maximal viewing area for display entity  147  displayed on diagnostic interface  145 . Dock module  124  facilitates a drag and drop operation on the primary elements of patient summary interface  140  by the user  106  to position them on one of the vertical or horizontal edges of diagnostic interface  145  and determines an appropriate arrangement of interface elements as will be described in respect of  FIGS. 8A ,  8 B,  8 C,  9 A and  9 B below. 
   Relevancy module  125  is utilized by image processing module  110  to facilitate automated identification of relevant prior imaging studies, based on a plurality of rules. Image database  109  may contain a very large number of imaging studies  143  for each patient, which may not be relevant for the current user  106 . Relevancy module  125  provides a means to filter irrelevant data from display, by mapping procedures and modalities to uniform, macro-anatomic regions. For example, an ultrasound of the kidney is mapped to the “abdomen” macro-anatomic region. Cross-anatomic studies, such as a body CT, which cover several macro-anatomic regions are associated with each of the regions the study covers, to ensure that no data is overlooked by user  106 . User confidence in the relevancy mappings is paramount and it is important that each user  106  understand how relevancy is mapped. Further, the user can then map macro-anatomic regions to related macro-anatomic regions. For example, all “abdomen” studies can be mapped to other “abdomen” studies, along with “chest” studies and “pelvic” studies so that all studies for relevant body parts will be covered. The operation of relevancy module  125  is described in greater detail below, with respect to  FIGS. 17A and 17B . 
   History module  128  is utilized by image processing module  110  to provide user  106  with historical summary functionality within patient summary interface  140 . History module  128  allows user  106  to quickly identify imaging studies  141  available in the current patient summary interface  140  by generating an iconic summary of imaging studies  141  and arranging them in a compact, reverse chronological fashion such that more relevant imaging studies  141  are easily identifiable. The layout function uses an arrangement protocol to optionally condense the display of older imaging studies  141  and allow the display of newer imaging studies  141  in as much detail as possible. History module  128  will be discussed in more detail in respect of  FIGS. 6 and 7  below. 
   Report module  130  is utilized by image processing module  110  to provide user  106  with display functionality for patient summary interface. Report module  130  allows user  106  to view clinical reports related to imaging studies  141  to facilitate the identification of “normal” or “abnormal” studies  141 . The reports can be displayed in three ways. After clicking on a reports link, the entire imaging history summary interface  240  can replace all of the thumbnail images for each study with the report. So, each study that has a report will display that report, while studies that do not have reports can still display their thumbnail images of series. Alternately, the user can display the report for just one study by clicking on a report link within the study box. The report link only appears when a study has a dictated and/or approved report. The report can either replace the thumbnail images of series in the study slot, or be displayed in a pop-up window over the interface. The user can then close the pop-up when done reading the report. 
   It should be understood that in respect of the various functional modules discussed above, the user is using the thumbnail versions of the imaging series  141  in the imaging history summary interface  240  to make the discussed changes to the interface display. 
   Display driver  132  is a conventional display screen driver implemented using commercially available hardware and software. Display driver  132  ensures that various display entities  147  (e.g. studies, series, images, etc.) are displayed in a proper format within display interfaces  140  and  145  using an appropriate layout (e.g. study layout, series layout, image layout, etc.) on the user workstation  150 . 
   While the functionality of the imaging history display system  100  will be discussed in relation to the display and arrangement of studies  141  within study lists  142  in interfaces  140  and  145 , it should be understood that the functionality of imaging history display system  100  is equally applicable to the display and arrangement of any other display entity  147  within a prescribed display area. More generally, it should be understood that the functionality of the swap module  112 , key image module  114 , resize module  116 , scroll module  118 , paging module  119 , add module  120 , order module  121 , sort module  122 , organize module  123 , dock module  124 , relevancy module  125 , history module  128  and report module  130  can be applied to any form of display system that is used to display entities  147  to a user  106 . 
     FIG. 2  is a schematic diagram illustrating one exemplary embodiment  200  of the patient summary interface  140  and diagnostic interface  145  generated by display driver  132  of the imaging history display system  100 . Patient summary interface  140  contains a control interface  201 , an imaging history summary interface  240  and imaging study list  142 . The patient summary interface  140  typically overlays diagnostic interface  145 . 
   The control interface  201  contains user interface elements for delivering information to the user, allowing modification of the display and arrangement of patient summary interface  140  and controlling the display of data in the imaging study list  142 . 
   These user interface elements include a manipulation area  210 , for initiating the operation of moving the patient summary interface  140  to a new location on the display; a patient information display  220  for displaying information related to the current patient history under review (e.g. name, sex, birthday and identification number); a toolset area  230  which allows user  106  to perform various actions on displayed data; a close button  235  for closing the patient summary interface  140  to fully reveal images that may be displayed beneath it; a scroll bar  270  which may be displayed only when necessary to allow vertical scrolling through a plurality of imaging studies in imaging study list  142 ; and a resize control  280  for changing the vertical and horizontal dimensions of the patient summary interface  140 . Imaging history summary interface  240  provides an iconic summary of imaging studies and arranges them in a compact reverse chronological manner, and is described in relation to  FIG. 6  below. 
   Imaging study list  142  contains a list of one or more medical imaging studies  143 . Referring now to  FIG. 3 , there is shown a more detailed schematic diagram of medical imaging study view  250 . Each medical imaging study view  250  has an open control button  305 , which when selected, opens the entire study into the diagnostic interface  145  (e.g. imaging series  290  in  FIG. 2 ). If diagnostic interface  145  is configured for tabbed workspaces, clicking on open control  305  creates a new tab and displays the study  143  therein. If diagnostic interface  145  is configured for a windowed workspace, clicking on the open control  305  creates a new window and displays the study  143  therein. 
   As shown in  FIG. 3 , medical imaging study view  250  also displays study information  310  (e.g. a study number, date and time etc.); a reporting tool  312  for reviewing the reports of dictated studies as described above with respect to report module  130 ; and a contextual toolbar  315  for paging through the imaging series  290  and performing other operations, as described below. Each imaging series  290  is composed of a thumbnail image  340  and a text description  350 , which may appear over multiple lines and contain information such as the series name, number of images in the series, time of series creation and slice thickness, where appropriate. A thumbnail image  340  consists of a representative image from a series of images. The thumbnail image  340  represents all of the images in a single series. The combination of the thumbnail image  340  and the thumbnail text description  350  will be referred to in the present disclosure as a “thumbnail”. 
   Furthermore, medical imaging study view  250  may display visual cues to indicate the selection status or historical status of each imaging series  290 , such as for example: the active view shading  370  which highlights the text description  350  for a particular series that is currently visible in the diagnostic interface  145 ; the selected study outline  355  which indicates that imaging series  141  from the imaging study  143  currently outlined by the thin line are selected in the patient summary interface  140  or diagnostic interface  145 ; the selected series outline  380  which indicates that images from the series currently outlined by the thin line are selected in diagnostic interface  145 ; and a viewed indicator  375  which indicates that a particular series has already been reviewed by a user  106  (e.g. a checkmark, etc.) in the diagnostic interface  145 . 
   For PACS with color monitors  152 , the selected study outline  355  is displayed in a color that matches the medical imaging study view  250  on patient summary interface  140  and diagnostic interface  145 . Furthermore, contextual toolbar  315  displays varying options depending on the selection status of the instant imaging study. If an imaging study is not selected, contextual toolbar  315  is not visible. If an imaging study is selected, but not visible in diagnostic interface  145 , only a subset of the features of toolbar  315  will be available. Additionally, text within a study, such as text description  350  or study information  310 , appears as a brighter color or brighter shade of gray if that study is currently in view in the diagnostic interface  145 . 
   Referring now to  FIGS. 4A ,  4 B,  4 C,  4 D, and  5 , there is illustrated a method for changing the actively displayed image in the diagnostic interface  145  using the swap module  122 . Specifically,  FIG. 5  is a flowchart diagram illustrating the process steps  500  that are executed by swap module  112  and image processing module  110  to provide image swap functionality between patient summary interface  140  and diagnostic interface  145  when user  106  selects an imaging series  141  for display. 
   The process begins at step ( 505 ). At step ( 510 ), user  106  invokes an interface, such as patient summary interface  145 . The interface is displayed at step ( 520 ) and indicates any selected (or active) studies. 
     FIG. 4A  illustrates a diagnostic interface  405 , corresponding to diagnostic interface  145 , overlaid with patient summary interface  420 , corresponding to patient summary interface  140 , such that patient summary interface  420  obscures a currently displayed medical image  410  from a medical imaging series represented by thumbnail  430 . Also shown is a thumbnail  432  corresponding to another medical imaging series. In this illustration, it is assumed that the user  106  wishes to change the actively displayed imaging series in diagnostic interface  405  from the series represented by thumbnail  430  to that represented by thumbnail  432 . 
   To change the actively displayed series, user  106  selects and begins to drag thumbnail  432  away from its point of origin at step ( 530 ) as graphically shown in  FIG. 4B . As thumbnail  432  is moved, the opacity of patient summary interface  420  is reduced at step ( 540 ), such that the currently displayed medical image  410  is less obscured and more visible. As thumbnail  432  is dragged progressively further from its point of origin, patient summary interface  420  grows progressively less opaque, until it finally disappears ( FIG. 4C ). Simultaneously, at step ( 550 ), a drop target  450  appears to indicate where a swap can be activated. With patient summary interface  420  now completely invisible, user  106  can drag thumbnail  432  toward the drop target  450 . The color of drop target  450  corresponds to the color used for selected study outline  355  and selected series outline  370 . 
   At step ( 555 ), user  106  may choose either to change the imaging series  141  in view on diagnostic interface  405  or to position a new imaging series  141  adjacent to the currently displayed imaging series  141 , to facilitate comparison. If the decision is to replace the current imaging series  141  (i.e. engage in a “swap”) then user  106  drags thumbnail  432  in close proximity to the drop target  450  and releases the mouse button at step ( 560 ) to complete the drag-and-drop operation. With the mouse button released, medical imaging series  410  is substituted with a medical imaging series  412 , at step ( 570 ). 
   Alternatively, user  106  drags thumbnail  432  onto diagnostic interface  145 , but not onto drop target  450 , and releases the mouse button at step ( 565 ). Swap module  122  resizes imaging series  141  on diagnostic interface  405  to fit all images within the available display area at step ( 575 ). This allows the user  106  to quickly compare two imaging series  141  side by side. 
   Subsequently, the opacity of patient summary interface  140  begins to increase at step ( 580 ) as shown in  FIG. 4D , such that it fades back into view, obscuring medical image  412 . Patient summary interface  140  is updated to indicate the new actively displayed image(s) at step ( 590 ), and may be dismissed by selection of the toolbar close button  235 , mouse button, or shortcut key, or the like, to allow for unencumbered diagnostic viewing. 
   Referring now to  FIGS. 6 and 7 , there is illustrated an imaging history summary interface  240  generated in part by history module  128 .  FIG. 6  is a schematic diagram that illustrates how imaging history summary interface  240  provides a snapshot view of all imaging studies of interest in the PACS for a given patient. The patient imaging studies are arranged vertically in such a manner as to display as much relevant information as possible in the current interface area without the need for a scroll bar. 
   At the top of the imaging history summary interface  240  the DATE OF NEWEST STUDY indicator  610  is displayed to indicate the month and year of the newest imaging study. Following the DATE OF NEWEST STUDY indicator  610 , there are arranged, in reverse chronological order, one or more study icons  630  representing extant imaging studies. Underneath these study icons  630 , a DATE OF OLDEST STUDY indicator  650  is displayed, followed by a contextual MODE OPTIONS list  660  and a LEGEND  670 . 
   Each study icon  630  corresponds to exactly one imaging study view  250  and is colored to indicate a particular modality or body part, depending on the current display mode of the imaging history summary interface  240 . Each study icon  630  is grouped according to its temporal relationship with other study icons  630  to create one or more time period groups  635 . These time period groups  635  are identified by one or more time period indicators  620 . Time period indicators  620  provide the month and year of a group (e.g. “August 2005”) or, alternatively, only the year. In the case where time period groups  635  span more than one year, one year or more separator  640  is displayed within imaging history summary interface  240  to separate time period groups  635 , by year, as appropriate. 
   If there is overflow, one or both of the newest study indicator  610  and oldest study indicator  650  becomes a paging hyperlink  625  ( FIG. 6 ) which allow the user  106  to adjust date ranges of imaging studies within the viewable area of imaging history summary interface  240 . Before paging hyperlinks  625  are enabled, certain formatting rules are employed to condense information to fit within the viewable area of imaging history summary interface  240 , beginning with the least relevant data. 
   The formatting of time periods is conducted according to certain time period formatting rules. For example, if there is enough room in the imaging history summary interface  240 , then the view of all study icons  630  is expanded to show all of the imaging studies by month, up to 12 months back from a current date. If a previous year has imaging studies that span over more than one month then the year is only identified, but as discussed above, a line separator is provided between the years. 
   If a patient has many imaging studies, then the history module  128  will start to compress the time periods to show as much within the imaging history summary interface  240  as possible. For example, for the 12 months back from the current date, the time periods will be compressed from months into quarters (i.e. under time period headings “within 3 months”, “within 6 months”, “within 9 months”, “within 1 year”, etc.). Since the individual month headings have been removed from display, study icons  630  are shown month by month on separate lines underneath the quarterly time period headings. Then, going back, the rest of the time periods will be provided year by year (e.g. time period headings “2003”, “2002”, etc.) Again, if imaging studies from more than one year are shown, a line is displayed in between the years. 
   Further, it is possible to further compress collapsed quarters by arranging study icons  630  grouped together underneath quarterly time period headings (e.g. “within 3 months”, “within 6 months”, etc.) so that they flow together sequentially along a line without separate line breaks for differing months. This is contrast to the regular display under quarterly time period headings discussed above where study icons  630  associated with different months are displayed on separate lines. According to this formatting style, while the study icons  630  flow together, those associated with different months are optionally separated by space breaks in the line. This way it is possible to show more years on-screen. 
   Accordingly, various time period formatting rules or “heuristics” are employed by imaging history summary interface  240 . The following time period formatting rules are provided to be illustrative only and it should be understood that many other rules could be utilized in place of or in combination with the following rules. 
   First, the basic principle of showing as much of the patient history onscreen as possible is observed even if this requires compression of time periods, as discussed above. Also, imaging studies are always displayed backwards in time from the most recent exam to the least. Few details of the imaging study are shown, except the box that indicates by its color, the modality of the imaging study and by its location its gross time period. Time periods are skipped if no imaging studies are available for those time periods. Months are collapsed to quarters to years and the quarters are labeled not by date but by the time period headings “within 3 months”, “within 6 months”, etc. When space within the imaging history summary interface  240  is scarce, the quarterly view is collapsed to a “compressed” quarterly view (where as discussed above, the imaging studies are shown to flow together sequentially along a line instead of being positioned on new lines). If the only imaging studies within a particular year fall within one particular month, then the particular month and year is shown on the time period heading. Finally, only the current year is shown in the month or quarterly formats. 
   Study icons  630  corresponding to imaging studies currently available on the diagnostic interface  145  are optionally highlighted by a highlight outline  690  (e.g. lined box shown in  FIG. 6 ), with the study currently in view further indicated by an active study indicator  695  (e.g. a dot as shown in  FIG. 6 ). 
   Contextual MODE OPTIONS list  660  provides a number of hyperlinks to change or arrange the display of imaging studies within imaging history summary interface  240  according to particular criteria. These criteria can include, for example, showing all available studies (“Show all”), limiting the display of imaging studies to relevant prior studies only (“Show only relevant”), displaying imaging studies by modality (“Show by modality”) or displaying imaging studies by body part (“Show by body part”), etc. 
   For example, imaging history summary interface  240  is designed to operate by default to display only relevant imaging studies. Relevancy of imaging studies is determined in accordance with relevancy module  125 , as described in detail below with respect to  FIGS. 17A and 17B  below. In this default mode, the hyperlink “Show all” is displayed within the contextual MODE OPTION list  660 . If the user  106  selects the “Show all” hyperlink then the imaging history summary interface  240  will display all prior imaging studies for that patient. The hyperlink “Show relevant” will then be displayed within the contextual MODE OPTION list  660 . 
   As discussed above, the contextual MODE OPTIONS list  660  can also include hyperlinks that allow the user  106  to display imaging studies by modality (“Show by modality”) or by body part (“Show by body part”). Depending on whether the “Show by modality” or the “Show by body party” MODE OPTION is selected (or provide by default), a LEGEND  670  will display an appropriate list of legend icons  672  and a description  674  for each, to disclose the meaning of each icon  630 . The legend icons  672  within the LEGEND  670  are color coded (or grayscale coded) to assist the user  106  in identifying which study icons  630  displayed above the LEGEND  670  have the characteristics (e.g. body part or modality identity, etc.) identified by the particular legend icons description  674  (e.g. “Hip”, “Pelvis”, or “CT”, etc.). Optionally, the LEGEND  670  is designed to only allow a limited number (e.g. 3) of legend icons  672  to be displayed at one time. In such a case the user  106  could “hover” over the LEGEND  670  to obtain a full legend in a “popup” box (not shown). 
   Optionally, the imaging history summary interface  240  is designed to operate by default to show prior imaging studies within imaging history summary interface  240  by body part and the MODE OPTION “Show by modality” is displayed. Again, the legend icons  672  will each represent a body part (e.g. “Hip”, “Pelvis”, “Abdomen”, “Knee”, etc.) and through color coding (or grayscale coding) be clearly identifiable with certain study icons  630  displayed above the imaging history summary interface  240 . 
   If the user  106  selects the “Show by modality” hyperlink then the imaging studies are shown within imaging history summary interface  240  by modality and the link changes to “Show by body part”. Again, the legend icons  672  will each represent a modality (e.g. “CT”, “MRI”, etc.) and through color coding (or grayscale coding) be clearly identifiable with certain study icons  630  displayed above the imaging history summary interface  240 . 
   Finally, the user  106  can use the imaging history summary interface  240  to navigate to prior imaging studies that he wants to use for comparison. Specifically, the user  106  would move his cursor to the position of a study icon  630  and then by hovering over the study icon  630 , the user  106  can cause a “popup” box to be displayed that contains more details about the specific imaging study represented by the study icon  630 . Based on these details, the user  106  can then decide to select the study icon  630  to display the imaging study on the right side of the imaging history summary interface  240  and make that imaging study the “active” study. 
     FIG. 7  is a flowchart diagram illustrating the operational steps  700  executed by history module  128  to fit as much information as possible within the viewable area of imaging history summary interface  240 . The process begins at step ( 701 ), by loading prior imaging studies. 
   At step ( 710 ), a test is performed to determine if there are any prior imaging studies more than 12 months old. If there are no studies older than 12 months, the process proceeds to step ( 720 ). Otherwise, a separate branch is followed, beginning at step ( 712 ). At step ( 712 ), year separators are added to the display, to facilitate identification of older data. Next, a test is performed to determine if there are previous years containing only imaging studies from a single month, at step ( 714 ). If no, the process proceeds to step ( 720 ). Otherwise, data from each of the years with more than one month of imaging studies is collapsed into a single group for each year at step ( 716 ) and the process proceeds to step ( 720 ). 
   At step ( 720 ), a test is performed to determine if all imaging studies will fit in the viewable area of imaging history summary interface  240 . If yes, information is displayed at step ( 780 ). If not, imaging studies from the current year have their date identifiers stripped and are collapsed into quarters, with each quarter identified by its relative date range (e.g., “less than 3 months ago”), at step ( 730 ). 
   At step ( 740 ), a test is performed to determine if all imaging studies will fit in the viewable area of imaging history summary interface  240 . If yes, information is displayed at step ( 780 ). If not, imaging studies for each quarter are further condensed by removing line breaks between quarters, at step ( 750 ). 
   At step ( 760 ), a test is performed to determine if all imaging studies will fit in the viewable area of imaging history summary interface  240 . If yes, information is displayed at step ( 780 ). If not, paging hyperlinks, such as those described above are activated at step ( 770 ), and information is displayed at step ( 780 ). 
   Referring now to  FIGS. 8A and 8B , the patient summary interface  140  may be condensed or docked by user  106  to a vertical or horizontal edge (e.g. top, bottom, left or right side) of diagnostic interface  145 , to retain some display elements while eliminating others and therefore facilitate effective display of underlying medical diagnostic images  147 . 
     FIG. 8A  illustrates the patient summary interface  140  in a horizontal docked patient summary interface mode  800   a , which is generated by dock module  124  when user  106  drags patient summary interface  140  to the top or bottom edge of diagnostic interface  145 , using manipulation area  210  and imaging history display system  100  enters into a “docked mode”. In horizontal docked patient summary interface mode  800   a , ordinary features of patient summary interface  140 , such as imaging history summary interface  240  and non-selected medical imaging study views  250  are omitted to minimize required display area and to focus only on the imaging study  143  on the active screen. 
   Otherwise, horizontal docked patient summary interface mode  800   a  contains primarily the same functional elements as a normal patient summary interface  140 , including: manipulation area  805   a , corresponding to manipulation area  210 ; patient data display  810   a , corresponding to patient data display  220 ; toolset area  815 , corresponding to toolset area  230 ; and display entities  830   a , corresponding to display entities  147  and containing a thumbnail image  840   a  and text description  850   a.    
     FIG. 8B  illustrates patient summary interface  140  in a vertical docked patient summary interface mode  800   b , which is generated by dock module  124  when user  106  drags patient summary interface  145  to the left or right edge of diagnostic interface  145 , using manipulation area  210 . In vertical docked patient summary interface mode  800   b , ordinary features of patient summary interface  145 , such as imaging history summary interface  240  and non-selected medical imaging study views  250  are omitted to minimize required display area and focus only on the selected studies. 
   Otherwise, vertical docked patient summary interface mode  800   b  contains primarily the same functional elements as a normal patient summary interface  140 , including: manipulation area  805   b , corresponding to manipulation area  210 ; patient data display  810   b , corresponding to patient data display  220 ; toolset area  815 , corresponding to toolset area  230 ; and display entities  830   b , corresponding to display entities  147  and containing a thumbnail image  840   b  and text description  850   b.    
   Vertical docked patient summary interface mode  800   b  is necessarily constrained to a narrow width, but only vertical scroll bars  820  are displayed. Dock module  124  arranges elements such as patient data display  810   b  and toolset area  815  in a vertically stacked arrangement. In particular, patient data display  810   b  may not fit in the available horizontal display area, therefore text will be truncated in the display. The full text of patient data display  810   b  is revealed when user  106  performs a mouse “hover” operation, that is placing the input device  154  (e.g. mouse) cursor over the truncated text for a predetermined length of time (e.g. 2 seconds). In response to a hover action, dock module  124  temporarily displays an ancillary text display  811   b , containing the full text of patient data display  810   b  until user  106  terminates the hover action. 
   To initiate docked patient summary interface mode, the operational steps  900  shown in the flowchart diagram illustrated in  FIG. 9A  are followed. User  106  uses input device  154  to select manipulation area  805   a  or  805   b  at step ( 902 ) and performs a drag operation towards a horizontal or vertical edge (i.e. top, bottom, left or right side) of diagnostic interface  145  at step ( 904 ). When the manipulation area  805   a  or  805   b  has been dragged close to one edge, dock module  124  displays a gray-line to indicate a potential docking position, at step ( 906 ). If user  106  desires this location for a docking position, the mouse button is released at step ( 908 ). Dock module  124  then hides imaging history summary interface  240  at step ( 910 ) and hides all studies  141  except those actively displayed on diagnostic interface  145 , at step ( 912 ). 
   Dock module  124  evaluates if the indicated screen edge is a vertical screen edge (i.e., left or right) or a horizontal screen edge (i.e., top or bottom), at step ( 914 ). If the indicated screen edge is horizontal, horizontal docked patient summary interface mode  800   a  is enabled at step ( 916 ). Otherwise, vertical docked patient summary interface mode  800   b  is enabled at step ( 918 ). The docked patient summary interface mode becomes ready for use at step ( 920 ). 
   While in docked patient summary interface modes  800   a  or  800   b , a second patient summary interface mode  140  may be invoked by user  106  in addition to the docked patient summary interface mode interfaces. Additional patient summary interfaces  140  may also be docked using dock module  124  and the procedures outlined above. 
     FIG. 9B  illustrates the operational steps  930  associated with termination of docked patient summary interface modes  800   a  or  800   b . User  106  uses input device  154  to select manipulation areas  805   a  or  805   b  at step ( 932 ) and performs a drag operation away from the edges of diagnostic interface  145  at step ( 934 ), releasing the device button when the manipulation area  805   a  or  805   b  has been dragged towards the centre of the display area, at step ( 936 ). When the user drafts the interface away from the edge, the entire interface is shown once again. Dock module  124  then hides the docked patient summary interface mode  800   a  or  800   b , at step ( 938 ), and redisplays patient summary interface  140  at step ( 940 ). Imaging history summary interface  240  and imaging study list  142  are redisplayed at steps ( 942 ) and ( 944 ), respectively. 
     FIG. 9C  is a flowchart diagram illustrating the process for using and operational steps  950  of a contextual menu  880  ( FIG. 8C ) that is available while docked patient summary interface mode  800   a  or  800   b  is active. The contextual menu  880  ( FIG. 8C ) can be displayed by user  106  through clicking on contextual menu arrow  809 A or  809 B. User  106  clicks contextual menu arrow  809 A or  809 B to invoke contextual menu  880  at step ( 962 ). Dock module  124  displays a list of open imaging studies and command options at step ( 864 ). Command options include “terminate docking mode”  888 , “resize docking mode display”  889  and “close patient summary interface”  890 , as illustrated in  FIG. 8C . 
   At step ( 966 ), user  106  decides to either select a study for display from the open imaging studies list or invoke one of the available commands  888 ,  889  or  890 . If user  106  chooses to select a study  882 ,  883  or  884  for display, the selection is made at step ( 966 ) and dock module  124  determines if the study is already in view in diagnostic interface  145  at step ( 968 ). If the study is currently not in view, it is brought into view at step ( 970 ). In either case, the study  882 ,  883  or  884 , which was selected for display in diagnostic interface  145 , is commensurately displayed in docked patient summary interface mode  800   a  or  800   b  in the appropriate form, at step ( 972 ). 
   If user  106  chooses a command option  888 ,  889  or  890  at step ( 965 ), dock module  124  determines which command was delivered at step ( 981 ). If “terminate docking mode”  888  was chosen, the docked patient summary interface mode termination procedure, outlined above, is carried out at step ( 982 ), resulting in the redisplay of the full patient summary interface  140 . If “resize docking mode display”  889  was chosen, a resize function is initiated by dock module  124  at step ( 984 ), allowing user  106  to reshape the dimensions of docked patient summary interface  800   a  or  800   b . If “close patient summary interface”  890  was chosen, the docked patient summary interface  800   a  or  800   b  is closed at step ( 986 ) and no patient summary interface  140  is displayed, either. 
   Referring now to  FIGS. 10A ,  10 B and  11 , there is shown a process for modifying the size of thumbnails  340  in imaging study list  142 , using resize module  116 . Reducing the size of thumbnails  340  ( FIG. 10A ) allows user  106  to perform gross comparisons quickly between large numbers of display entities  147 . Conversely, increasing the size of thumbnails  340  ( FIG. 10B ) allows for more of text descriptions  350  to be displayed, enabling user  106  to see more information about each display entity  147  currently in view. The resize module  116  provides user  106  with the ability to quickly make gross comparisons to identify display entities  147  of interest and quickly identify specific display entities  147  based on their text descriptions  350 , without necessitating the use of diagnostic interface  145 . 
     FIG. 11  illustrates the process steps  1100  involved with changing the size of thumbnails  340 . The resize module  116  is triggered by the user  106  through the selection and dragging of a resize slider  1030  from a position  1030  to a position  1032  at step ( 1105 ). 
   At step ( 1110 ), based on the relative coordinates of positions  1030  and  1032 , resize module  116  determines if resize slider  1030  was dragged to the right, directing an increase in thumbnail size, or to the left, directing a decrease in thumbnail size. If resize slider  1030  was dragged to the right, resize module  116  increases the size of thumbnails  340  commensurate to the relative distance between positions  1030  and  1032  at step ( 1114 ). Conversely, if resize slider  1030  was dragged to the left, resize module  116  decreases the size of thumbnails  340  commensurate to the relative distance between positions  1030  and  1032  at step ( 1112 ). 
   Resize module  116  determines if text description  350 , as currently formatted, will fit in the allotted text area  1122   b  beneath each thumbnail  340 , at the new size, at step ( 1120 ). If the current format of text description  350  requires no change to fit in the allotted text area  1122   b  and no extra detail can be added, no change is made. If the current format of text description  350  is too large to fit in the allotted text area  1122   b , resize module  116  condenses text description  350  for each thumbnail at step ( 1122 ), progressively trimming less relevant data in a preferred order. For example, resize module  116  eliminates the display of slice width, time, the word “images”, in that order, and finally truncates the thumbnail name for each text description  350 . If the current format of text description  350  is condensed and more space is available in allotted text area  1122   b , resize module  116  expands text description  350  for each thumbnail at step ( 1124 ), progressively adding more relevant data in a preferred order. For example, resize module  116  adds the full name, the word “image”, time and slice width, in that order, to each text description  350 . 
   At step ( 1130 ), resize module  116  rearranges or “reflows” thumbnails  340  to accommodate their new size, while observing the display width limit by increasing the vertical size of imaging study list  142 , pushing thumbnails  340  onto new lines, if necessary. At step ( 1135 ), resize module  116  determines if scroll bars  1040   a  or  1040   b  are required to scroll through study list  142  and enables or disables them as necessary. Finally, the new arrangement of imaging study list  142  is displayed at step ( 1140 ). 
   Referring now to  FIG. 12A  there is shown a schematic diagram of contextual toolbar  315 . Contextual toolbar  315  is generated by paging module  119  for display in patient summary interface  140  for any medical imaging study view  250  that is linked with an imaging study  143  currently opened in diagnostic interface  145 . Correspondingly, contextual toolbar  315  is available in docked patient summary interface modes  800   a  or  800   b . Contextual toolbar  315  contains user interface elements to enable user  106  to incrementally view each imaging series  141  within the current medical imaging study view  250  in detail on diagnostic interface  145 . 
   Specifically, contextual toolbar  315  contains: a backward double-arrow  1212 , for paging backward through imaging series  141  in medical imaging study view  250  (e.g., selecting backward through the current study list  142  by a number equal to the amount of currently displayed imaging series  141 , until the study list is exhausted); a backward single-arrow  1213 , for selecting backward through imaging series  141  in medical imaging study view  250  one at a time; a forward single-arrow  1214 , for selecting forward through imaging series  141  in medical imaging study view  250  one at a time; and a forward double-arrow  1215 , for paging forward through imaging series  141  in medical imaging study view  250  (e.g., selecting forward through the current imaging study  143  by a number equal to the amount of currently displayed imaging series  141 , to the end of all series for the study. Additionally, contextual toolbar  315  contains a tool menu disclosure command  1218  to invoke the display of a tool menu (not shown). 
   User  106  may also invoke a contextual tool menu  1220  by right-clicking any thumbnail, whereby sort module  122  generates and displays menu items based on relevant attributes of the currently displayed thumbnails.  FIG. 12B  illustrates one example embodiment of contextual tool menu  1220 . For example, relevant attributes to display as menu items  1224  may be slice position, MR echo time, acquisition time, etc. Not all such attributes are relevant to all thumbnail (series), accordingly sort module  122  identifies relevant attributes based on a plurality of rules and dynamically generates the list of menu items  1224 . 
   Additionally, sort module  122  always displays the menu items  1222 , for specifying the sort ordering, either original or reverse. The current display order is indicated by an indicator checkmark  1221 . 
   Referring now to  FIGS. 12C ,  12 D and  13 , there is shown a process for reordering imaging series  141  in imaging study view  250  using order module  121 . For certain modalities, for example angiography, it is common for series ordering and series descriptions to be incorrect. Alternatively, images in older imaging studies  141  may have been acquired in a random order, as they were scanned from film. Order module  121  allows user  106  to quickly correct inaccuracies in the order of imaging series  141  and retain changes for future sessions. 
   User  106  begins at step ( 1310 ) by invoking reorder mode from the list of options display when tool menu disclosure command  1218  is selected. Order module  121  provides a visual indication that reorder mode is active at step ( 1312 ), by altering the series outline  355  to incorporate a drop-down tab  1232  containing commands to apply order changes  1233   a  or cancel reorder mode  1233   b . User  106  selects one or more series thumbnail  1240   a  to rearrange at step ( 1315 ) and begins dragging it at step ( 1320 ). As user  106  drags series thumbnail  1240   a , order module  121  draws and redraws a gray line  1234  at step ( 1325 ) proposing a position that series thumbnail  1240   a  will take up upon immediate conclusion of the drag operation. When user  106  is satisfied with the proposed position, a mouse button (on, e.g., input device  154 ) is released at step ( 1330 ) to complete the drag operation. 
   Order module  121  then displays imaging series  141  in the newly-selected position. If user  106  is satisfied with the change, apply order changes  1233   a  command is clicked at step ( 1340 ). If user  106  is dissatisfied with the change, cancel reorder mode  1233   b  may be selected (step not shown) or a new drag operation may be initiated, as described above. If changes were made, order module  121  applies new numbers to each imaging series  141 , to indicate the new order, at step ( 1345 ) and patient summary interface  140  returns to normal operation at step ( 1350 ). It should be understood that more than one series can be moved at a time by selecting multiple series and moving them together (e.g. using the “Shift-select” method to select consecutive series and the “Ctrl-select” method to select non-consecutive series). 
     FIG. 14  is a flowchart diagram illustrating the operational steps  1400  taken by user  106 , using add module  120 , to add medical images to imaging study  141 . The process begins at step ( 1410 ) by determining which method to follow, based on the display state of the image. If the image is already in view elsewhere, the user  106  drags the image onto medical imaging study view  250  at step ( 1420 ). 
   The user  106  then decides if a new series  290  is desired at step ( 1422 ). If yes, user  106  drags the image between two series thumbnails at step ( 1426 ), add module  120  creates a new series  290  to accept the image. If a new series is not desired, user  106  drags the image onto an existent series thumbnail at step ( 1424 ), whereby add module  120  determines that the image should be added to the selected series. If the image is not already in view elsewhere, user  106  must invoke the import tool item from the menu list obtained by issuing tool menu disclosure command  1218  at step ( 1430 ). Add module  120  displays a file system browser at step ( 1432 ) and user  106  selects an image at step ( 1434 ) to add to the currently selected series  290 . 
   At step ( 1440 ), add module  120  adds the desired image to the series  290  identified as the target in the respective above branch followed. Add module  120  further alters the text description  350  of the modified series to display in italicized text, to indicate that it has been modified, at step ( 1450 ). 
   It should be understood that while the process steps  1400  are being described with respect to adding a single image, more than one image may be added concurrently using the same method. 
   User  106  uses organize module  123  to duplicate, combine or split imaging series  290  displayed in medical imaging study view  250 . To employ any of the features of organize module  123 , user  106  must first either select a series  290  in diagnostic interface  145  or select one or more series  290  in patient summary interface, before activating tool menu  1218 . Upon activation of tool menu  1218 , organize module  123  determines contextual menu (not shown) options to display, based on the display entities  147  currently selected. 
   The duplicate function of organize module  123  allows user  106  to create a temporary copy of an imaging series  290 . This allows user  106  to easily compare window levels on a series with itself. For example, the imaging series can be displayed with a window level that highlights bone, while the duplicated imaging series can have a tissue window level applied. Series  290  may be duplicated by organize module  123  based on a user command, or in response to a drag operation dragging an already-open series from patient summary interface  140  into a supplemental viewing area of diagnostic interface  145 . 
   The combine function of organize module  123  allows user  106  to temporarily combine imaging series  290  into a single series. This may be necessary for medical images originating from certain modalities  107 , for example, CR and ultrasound. 
   Referring now to  FIG. 15 , there is shown a flowchart diagram illustrating the operational steps  1500  executed by organize module  123 , to determine which command options to include in the contextual menu. Organize module  123  begins at step ( 1510 ) by identifying how many series  290  are currently selected. If there is no currently selected series  290 , organize module  123  adds a “combine all” command to the menu list at step ( 1512 ). If there is only one currently selected series  290 , organize module  123  adds a “duplicate” command to the menu list at step ( 1514 ). If there is more than one currently selected series  290 , organize module  123  adds a “combine” command to the menu list at step ( 1516 ). 
   At step ( 1520 ), organize module  123  determines if there is a combined series in the current selection. Combined series are series  290  which have been logically grouped into a single, virtual series by user  106 . If yes, organize module  123  adds a “split” command to the menu list at step ( 1526 ) and displays the tool menu at step ( 1530 ). If there is no currently selected combined series, organize module  123  determines if there is a multi-phasic study, in the current selection at step ( 1522 ). Multi-phasic studies are series  290  which contain more than one imaging “pass” or “phase”, such as a multiple-pass CT scan. If yes, organize module  123  adds a “split multi-phasic” command to the menu list at step ( 1524 ). In either case, the tool menu is displayed at step ( 1530 ). 
   The operations of organize module  123  are manipulations that cannot be saved. Temporarily combined series are indicated by the word “Combined” in the text description  350 , along with the series indices in brackets (e.g., [2,3]) to identify which series are combined. Temporary duplicate series are indicated by the word “Copy” in the text description  350 , which is also presented in italicized form. However, manipulated series may be saved as a snapshot. Snapshots are described in greater detail below. 
   Referring now to  FIG. 16 , there is shown a medical imaging study view  250  with a key image  1620  and a snapshot image  1622 , generated by the key image module  114 . Key images  1620  and snapshot images  1622  may be established by the user  106  to facilitate later identification and comparison of a study  141  and are unique to each particular user  106 , although all users can view other user&#39;s key images. 
   Key images  1620  and snapshot images  1622  are displayed first in each study  141  and indicated by a key icon  1621  and a camera icon  1623 , respectively. Key images  1620  and snapshot images  1622  are further distinguished from other images in each study  141  through display of a divider bar  1624 . User  106  may click divider bar  1624  to hide key images  1620  and snapshot images  1622  for each study  141 . To redisplay key images  1620  and snapshot images  1622 , user  106  right-clicks in an open space in medical imaging study view  250  and chooses a command option to display key images  1620  and snapshot images  1622 . Key images have particular application for use with relevancy module  125 , described in greater detail below with respect to  FIGS. 17A and 17B . 
   The user  106  may elect to view key images  1620  and snapshot images  1622  selected by other users  106 , by clicking an alternative key images command  1625 . When alternative images  1625  are selected, key image module  114  displays a list of all key images  1620  and snapshot images  1622  created for the current study  141 , along with the role and name of the user  106  who selected the images  1620  and  1622  and the number of highlighted images. By default, key image module  114  displays key images  1620  and snapshot images  1622  created by other users  106  in the same roles as the current user  106 , including snapshots and key images created by the current user, if applicable. For example, for a radiologist user  106 , key image module  114  will display images  1620  and  1622  created by other radiologists, and not surgical key images created by a neurosurgeon user  106 . 
   The user  106  may also wish to review only imaging studies  141  of interest in patient summary interface  140 . Therefore, imaging study view  250  allows user  106  to mark studies of interest and select a limited view mode, which hides unmarked studies. To redisplay all studies, user  106  issues a command to display all studies. 
   Referring now to  FIGS. 17A and 17B , there are shown schematic diagrams of the relevancy mapping interface generated by relevancy module  125 . Medical practitioner users  106  typically prefer to identify as many relevant prior studies as possible, to avoid missing any potentially important studies. For this reason, relevancy module  125  allows an administrative user  106   a  (not shown) to create or modify relevancy mappings between study description keywords or phrases and anatomic regions and then to create or modify relevancy mappings between anatomic regions, as will be described. 
   Referring first to  FIG. 17A , the anatomic region mapping interface  1701  allows administrator  106   a  to create or modify mappings using a mappings table  1720 . Each mapping rule contains a matching description  1724 , which is used to identify a key word or phrase (i.e. “textual element”) appearing in study descriptions. Matching description  1724  may contain wildcard characters (e.g. “%”) to group sets of studies. If a study description contains the text specified in one of the matching descriptions  1724  in mappings table  1720 , then the study will be mapped to the one or more anatomical regions listed in the associated association field  1726  by relevancy module  125 . 
   Each mapping rule also contains an association field  1726  that comprises a list of one or more anatomical regions (e.g. “Head”, “Neck”, “Spine”). The administrator  106   a  can edit the association field  1726  to select or deselect existing anatomical regions listed therein and reduce or expand the definition of the association field  1726  to remove or include selected anatomical regions. Anatomical regions include, for example, the following: “Whole Body”, “Head”, “Neck”, “Spine”, “Chest”, “Abdomen”, “Pelvis”, “Upper Extremities” and “Lower Extremities”. It should be understood that these are only provided as examples and that various other anatomical regions could be utilized (e.g. “Hand to Shoulder”, “Hip to Foot”, etc.). 
   Mappings table  1720  allows administrator  106   a  to define new mapping rules using a new rule button  1730 . Mappings may be imported in an extensible markup language (XML) format by clicking an XML import command  1710 . Alternatively, mappings may be imported in a human-readable text description format, whereby each mapping is specified using one line of text (i.e., rules are delineated by a newline character), by clicking an import text descriptions command  1714 . Correspondingly, mappings may be exported in XML or human-readable text formats by clicking XML export command  1712  or export text descriptions command  1716 , respectively. Import and export of mappings between sites is desirable because it facilitates uniformity and predictability of results across systems. External systems may contain more detailed descriptions and mappings. If data is imported that conflicts with existing data, administrator  106   a  is given the option of replacing or appending mappings to the existing table of mappings. 
   Referring now to  FIG. 17B , once studies have been mapped to specific anatomical regions, the imaging history display system  100  then allows the administrator  106   a  to define relevancy relationships among anatomical regions using an anatomic region relevancy interface  1799 . For example, user  106  may wish to see prior pelvic studies when reviewing an abdominal study, but not all abdominal studies will be inherently mapped to the pelvic region. Anatomic region relevancy interface  1799  allows administrator  106   a  to specifically define broad relevancy criteria, along with preferred relevancy rankings for each anatomical region. 
   For example, “Head” studies are related to “Neck” and “Spine” studies but, when reviewing a “Head” study, users  106  will prefer to see prior “Head” studies first, followed by “Neck” studies and “Spine” studies, in that order. By defining these criteria using anatomic region relevancy interface  1799  (specific example illustrated in  FIG. 17B ), the relevancy module  125  will ensure that prior studies are presented to the user  106  in the preferred order. The relevancy module  125  will also ensure that each study is displayed only once in a list of relevant prior studies, in the case that a study matches more than one mapping. That is, if a study falls into multiple anatomical regions, it would only show up in the first available group in the list. 
   Using anatomic region relevancy interface  1799 , the administrator  106   a  may import rules from an XML file using XML import command  1750 . Correspondingly, rules may be exported using XML export command  1752 . Administrator  106   a  may also manually specify rules using relevancy table  1760 . Each row of relevancy table  1760  contains an anatomical region identifier  1761 , specifying to which anatomical region the rule applies, and a relevancy ranking field  1762 , which specifies associated relevant anatomical regions and the preferred order of relevancy. The administrator  106   a  may modify the list to add or delete anatomic regions, or change relevancy order. 
   Once studies have been classified in respect of anatomical regions as discussed above in relation to  FIG. 17A , when a user  106  opens a study for review, the relevancy module  125  will examine the classification of the study and attempt to open all relevant prior studies that match the relevancy rules specified in table  1760 . In some cases, this may create the problem of displaying too much information. 
   Therefore, the administrator  106   a  can specify constraints on relevant prior studies, using the constraints table  1770 , which must be met in order for prior studies to be automatically opened. Rules in constraints table  1770  are specified by user identification, modality and anatomical region and may include: a “Same Modality” checkbox, to select only prior studies originating from the same modality; a “Same Anatomical Region” checkbox, to select only prior studies on the same anatomical region (note that when this checkbox is selected, the related anatomical region checkbox is unavailable); a “Related Anatomical Region” checkbox, to select only prior studies on a related anatomical region (note that when this checkbox is selected, the same anatomical region checkbox is unavailable); an “Oldest Relevant” checkbox, to select only the oldest relevant prior study; a “Key Image” checkbox, to select only prior studies that have key images; a “Show Key Images Only” checkbox, to only open key images from a selected prior study; a “Maximum Studies Limit”, to specify the maximum number of relevant prior studies to open; and a “Maximum Age” limit, to specify the maximum age of a prior study to open. 
   In some cases, images from multiple modalities may be displayed within imaging history summary interface  240  ( FIG. 6 ) that are not of the same anatomical region, and thus have conflicting relevancy relationships. To resolve relevancy conflicts and determine a list of relevant prior imaging studies  141  for display when the user  106  selects the “Show relevant” (or in the case of default operation), the relevancy module  125  uses a plurality of rules. 
   For example, all prior imaging studies  141  that have yet to be reported (e.g. are “to be dictated”) are displayed first within the imaging history summary interface  240  ( FIG. 6 ), regardless of relevancy conflict. 
   Also, the very first imaging study  141  displayed within the imaging history summary interface  240 , determines the relevant prior imaging studies to be displayed. For example, if a “CT Chest” imaging study is the “newest” study for a “Chest/Abdomen/Pelvis” combination of imaging studies to be dictated then all relevant prior imaging studies for the “CT Chest” are displayed within the diagnostic interface  145  and the imaging history summary interface  240  is updated accordingly. 
   Subsequent unreported (i.e. undictated) imaging studies  141 , which may not have all relevant prior imaging studies displayed, have a “View relevants” tool, located beside reporting tool  312  ( FIG. 3 ) to force the display of relevant prior imaging studies, in lieu of the first set. If user  106  selects the “View relevants” tool for a particular unreported imaging study, the relevant prior imaging studies displayed within diagnostic interface  145  and imaging history summary interface  240  change to reflect the newly-selected study. Also, the “View relevants” tool appears for the former first imaging (or primary) study, and the “View relevants” tool disappears for the newly-selected study, to indicate that it is now the first imaging (or primary) study. When “show relevants” is selected, only relevant imaging studies  143  are displayed in both the imaging history summary  240  and the study list  142 . Also, the color of all of the “open control buttons” will match the color of the study icons used. 
   It will be appreciated that while imaging history display system  100  has been described in the context of medical image management in order to provide an application-specific illustration, it should be understood that imaging history display system  100  could also be applied to any other type of image or document display system. The system, processes and methods described are capable of being distributed in a computer program product comprising a computer readable medium that bears computer usable instructions for one or more processors. The medium may be provided in various forms, including one or more diskettes, compact disks, tapes, chips, wireline transmissions, satellite transmissions, internet transmission or downloadings, magnetic and electronic storage media, digital and analog signals, and the like. The computer useable instructions may also be in various forms, including compiled and non-compiled code. 
   While certain features of the invention have been illustrated and described herein, many modifications, substitutions, changes, and equivalents will now occur to those of ordinary skill in the art. It is, therefore, to be understood that the appended claims are intended to cover all such modifications and changes as fall within the true spirit of the invention.