PACS-based multimedia imaging informatics: third edition (Conference Presentation)

Purpose: PACS, digital report and informatics were originally developed for radiology application to replace film and paper. During the past more thirty more years, these technologies have been integrated and progressed to a must radiological diagnosis clinical component for daily use. Profession Huang wrote two Editions of the “PACS and Imaging Informatics” series in 2004 and 2010 published by Wiley and Sons. Due to the maturity of PACS and major advancement in imaging informatics during the past seven years, the original DICOM PACS and informatics technologies has been extended and expanded to many related clinical imaging applications. However, adopting DICOM standard to be a general image based standard in Internet communications for other types of non-radiological images and signals has some major drawbacks. There were many new protocols and technologies being introduced into PACS and Imaging Informatics practices and industry in past few years. This presentation is brief of new “PACS and Imaging Informatics” series to reflect the new developments, but the name of the series has been slightly changed to “PACS-BASED MULTIMEDIA IMAGING INFORMATICS”, Third Edition, which will be published by Wiley and Sons in 2018. Major Content and Materials of the Third Edition: This series was written to discuss the development and growth of medical imaging and PACS related technology during the past 25 more years. This presentation is the continuation of the “PACS and Imaging Informatics” series in 2004 and 2010 published by Wiley and Sons, and being organized in four Parts in 22 Chapters: Part I. The Beginning – Retrospective Part II: Medical Imaging, PACS fundamental, Industrial Guidelines, Standards, and Compliance Part III: Informatics, Data Grid, Workstation, Radiation Therapy, Simulators, Molecular Imaging, Archive Server and Cloud Computing Part IV: Multimedia Imaging Informatics, Computer-Aided Diagnosis (CAD), Image-Guided Decision Support, Proton Therapy, Minimally Invasive Multimedia Image-Assisted Surgery, Big Data. Selected portions of the PACS-based Imaging Informatics series 2004, 2010 and some pre-printed materials in 2017 have been used as lecture materials in undergraduate and graduate courses: "Medical Imaging and Advanced Instrumentation" at UCLA, UCSF, and UC Berkeley; "Biomedical Engineering Lectures" in Taiwan, and the People's Republic of China; "PACS and Medical Imaging Informatics" at the Hong Kong Polytechnic University; and required courses at the "Medical Imaging and Informatics" track at the Department of Biomedical Engineering, School of Engineering, USC. The Future Growth: The term “PACS-based imaging multimedia” can loosely mean that any clinical specialist would have the opportunity to extract and integrate the patient’s existing data, images, graphs, tables, reports, 3-D, 4-D, 5-D images, movies, and scripts based on the PACS-based technology to compose their needed contents in a physician workstation, as well as to view, diagnose, report, and archive. Multimedia can be recorded, played, displayed dynamically and interactively accessed from information content processing devices such as computerized and electronic device, and can as well as be part of a live performance. The majority practicing physicians nowadays do have experience in using PACS-based images and reports from medical Web servers and workstations to help them to take care of their patients. Using the PACS-based technology platform, these multimedia PACS-based biomedical imaging informatics can enrich the clinical specialists to facilitate their patient care. It is our greatest hope that this new edition will continuously be used not only to provide information and guidelines for those contemplating a PACS-based Imaging Informatics career but also inspire others to apply this technology as a tool toward a brighter future for healthcare delivery. Some Key Protocols and Technologies Discussed in the Third Edition: In early 2010s, RSNA (Radiological Society of North America) along with the Integrating Healthcare Enterprise (IHE) initiated the concept of “IHE XDS-I profile (Integrating Healthcare Cross-Enterprise Document Sharing - Imaging)”. Several major manufacturers and research Institutes were invited by RSNA to participate in this initiative. Because of the successful of IHE XDS-I profile since 2010, the PACS climate has changed dramatically. It seems that the future trend of PACS is broken into pieces, the term is now called “deconstructed PACS”. Traditional PACS vendors are now not only focusing their business in pure PACS market or storage archive solution, but also on viewing software and imaging workstations. And storage solution is now called the VNA technology (Vendor Neutral Archive) that concentrates storing the image files in the native DICOM file. VNA is also used to store all other kinds of data including non-Radiology images whether they are DICOM or non-DICOM. PACS vendors still sell PACS because they have knowledge of the Radiology workflow so that their viewing software will embed these workflow features. Most VNA technologies don’t know the deeper DICOM fields, they just extract basic patient information and archive by using the Web technology and the IHE XDS-I profile. The recent drastic change of “PACS” concept has inspired and influenced the further understanding of the combination of DICOM, Medical imaging, PACS and Informatics.