One of the advantages which a picture archiving and communications system (PACS) is supposed to provide over film-based operation is improved performance in retrieving images. While is seems self-evident that this should be so, we wanted to verify this, and provide some time comparisons for the two methods. The experiment consisted of randomly selecting ultrasound (US) and computed tomography (CT) cases and determining how long it took to retrieve them at one of our PACS workstations, and to retrieve them in person from the film room. To simulate actual retrieval volumes, a total of 40 cases from current to six months old, 20 cases from the past year, and 10 cases over one year old, was selected. Results indicate that indeed, PACS retrieval can be faster than file room retrieval. However, the difference is less for recent cases than for older cases. For cases six or fewer months old, the workstation retrieval was about two and one-half minutes faster per case than the film file room. This time difference increased markedly when extended to the one year and over one year groups. This paper details the results of this study, and will also provide information about the reliability of the two archives.

During a nine-month period, ultrasound reading was switched between a PACS workstation (CommViewR, AT&T/Philips) and a film alternator (PanoramascopeR RADX). The two radiologists who participated in this study were well acquainted with the operation of both systems. A total of 430 cases were read, and whether on film (n equals 292) or from the workstation (n equals 138), a routine mix of cases was interpreted. A timing study was performed which involved recording the time it took to read and dictate the cases. A previous study had concentrated on other facets of the total time, so these were not repeated. Over all cases read, the workstation readings took longer by an average of approximately 33 seconds per case. A review of the reports generated showed no differences in the average length, so that the time difference was thought to be due to other factors. The majority of the difference is the result of the longer time it takes to display all images at full resolution on the workstation. On the alternator, the average number of films per case can fit on one alternator panel, so to see all images, there is no need to page to the next panel. The workstation, on the other hand, can only display about half of the total images per study at once, so that paging must be done for almost all cases. This paper presents the detailed findings of this study and discusses the implications for the daily use of a workstation for reading.

One aspect of the Georgetown image management and communications system (IMACS or PACS) is a built-in capability to support teleradiology. Unlike many dedicated teleradiology systems, the support of this capability as a part of PACS means that any acquired images are remotely accessible, not just those specifically input for transmission. Over the past one and one-half years, two radiologists (SCH, BSG) in the abdominal imaging division of the department of radiology have been accumulating experience with teleradiology for on-call support of emergency abdominal imaging, chiefly in ultrasound. As of the time of this writing, use of the system during on-call (one of these attending radiologists primarily responsible) or back-up call (the attending responsible for the Fellow on primary call) has resulted in a marked reduction in the number of times one of them has to drive to the hospital at night or over the weekend. Approximately 80% of the time, use of the teleradiology system obviates having to go in to review a case. The remainder of the time, the radiologist has to perform a procedure (e.g., abscess drainage) or a scan (e.g., complex Doppler study) himself. This paper reviews the system used for teleradiology, how it is electronically and operationally integrated with the PACS, the clinical benefits and disadvantages of this use, and radiologist and referring physician acceptance.© (1991) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Georgetown University Hospital has been operating an image management and communications system (IMACS or PACS) for three-and-a-half years. This work was initially funded under the Army Medical Research and Development Command Digital Imaging Network Systems (DINS) project. The system was taken from a research system supporting only radiology tasks to one extended to clinical use, and has been used in clinical work for two-and-a-half years. This paper will summarize our PACS clinical experience and will describe the operational features implemented and those still necessary.