IMAGING

SCIENCE &
INFORMATICS

Lecturer:
Junry B. Quillano, RRT
 COURSE MODULE CONTENTS

Module 1 – Fundamental Medical Imaging and

informatics

Lesson 1 – Information Science and Information Technology

Lesson 2 – Digital Biomedical/Medicine and Health
Information Technology
Lesson 3 – Informatics
Module 2 – Medical Image Data

Lesson 1 – Medical Image, Image Quality, and Data

Formats
Lesson 2 – Medical Imaging Modalities
Lesson 3 – Medical Image Digitalization and Acquisition
Gateway
Module 3 – Workflow in Radiology

Lesson 1 – Genetic Workflow in Radiology and PACS

Workflow
Lesson 2 – Integrating the HealthCare Enterprise Workflow
Model
Lesson 3 – Key Steps Radiology Workflow and its Analysis
Lesson 4 – Integration, Standard, and Interoperability
Module 4 – Basic Medical Image Processing and
Analysis
Lesson 1 – Quality Evaluation
Lesson 2 – Statistics Analysis and Information Entropy
Lesson 3 – Coding and Decoding BAC
Lesson 4– Stable and Unstable Signal Processing
Lesson 5 – Transformations
Lesson 6 – Pre-Medical Image Processing
Lesson 7 – Post-Medical Image Processing
Lesson 8 – Medical Image Displaying, Visualization, and
Representation
Module 5 – Medical Image Distribution, Network and
Communications
 Lesson 1 – Network Architecture Topology and Protocols
 Lesson 2 – Network Structure and System Components
 Lesson 3 – Medical Image Data Transfer
 Lesson 4 – Internet Service
 Lesson 5 – Web Application, Web Service, and
Client/Server Distributed Computing
 Lesson 6 – Enterprise Computing for Medical Imaging
Informatics
Module 6 – Practical and Clinical Medical Imaging
Informatics
 Lesson 1 – Enterprise Diagnostic Medical Imaging
Modalities
 Lesson 2 – Computer Solution for Radiology Information
Systems
 Lesson 3 – Workflow in radiology
 Lesson 4 – PACS System
 Module 7 – Medical Imaging Informatics Systems

Lesson 1 – PACS Evaluation

Lesson 2 – Workflow Efficiency
Lesson 3 – Evaluation of Data Storage, Disaster discovery,
Data Flow, Fault-tolerance, Networking latency, and
Interoperability
Lesson 4 – RIS Assessment
Lesson 5 – HIS Integration Report and Decision-making
Assurance
Lesson 6 – Quality Assurance for Medical Imaging
 INFORMATION SCIENCE

• Is the study of the phenomena surrounding information,

including creation, acquisition, indexing, storing, retrieving,
and disseminating information.

• The study of processes for storing and retrieving information,

especially scientific or technical information belongs to the
scope.
 EXAMPLES OF INFORMATION SCIENCE
1. Picture Archiving and Communication System (PACS)

Example: Centralized Storage and Access

Application: PACS is a medical imaging technology used for
storing, retrieving, managing, and sharing radiographic images.
Information Science is used to organize and index these images
efficiently, enabling radiologists to quickly access patient imaging
history and compare new scans with previous ones.
Benefit: Facilitates easy access to imaging data from different
locations, supports remote consultations, and improves collaboration
among healthcare professionals.
 Picture Archiving and
Communication Systems
(PACS) becoming almost
universal for usage across the
United States, and in the
medical industry in Asia.
2. Radiology Information System (RIS)

Example: Integrated Workflow Management

Application: RIS is used to manage patient data, scheduling,
tracking radiology imaging orders, and reporting results.
Information Science principles are applied to integrate RIS with
other healthcare systems, such as Electronic Health Records
(EHRs), ensuring seamless data flow and communication.
Benefit: Streamlines radiology department workflows, reduces
administrative errors, and ensures timely access to patient
information.
3. DICOM (Digital Imaging and Communications in Medicine)
Standard

Example: Standardized Image Format

Application: DICOM is a standard protocol used for the management
and transmission of medical images and associated data. Information
Science ensures that radiographic images and related information are
stored in a standardized format, allowing interoperability between
different imaging devices and software systems.
Benefit: Ensures consistency in image storage and retrieval, enables
seamless sharing of images across different platforms, and supports
long-term data preservation.
4. Tele-radiology

Example: Remote Image Analysis

Application: Tele-radiology uses information science to transmit
radiographic images electronically to radiologists at different
locations for interpretation. This is particularly useful for providing
radiology services in remote areas where specialists may not be
available on-site.
Benefit: Expands access to expert radiological analysis, reduces the
time to diagnosis, and supports continuous care across geographical
boundaries.
5. Computer-Aided Diagnosis (CAD)

Example: Automated Detection of Abnormalities

Application: CAD systems use machine learning algorithms to
analyze radiographic images and automatically detect potential
abnormalities, such as tumors, fractures, or lesions. These systems
provide a second opinion to radiologists, highlighting areas of
concern that may require further examination.
Benefit: Increases the detection rate of certain conditions, reduces
human error, and supports radiologists in making more informed
decisions.
6. Artificial Intelligence in Radiography

Example: Automated Image Segmentation and Classification

Application: AI algorithms are applied to segment and classify
different tissues in radiographic images automatically. For
example, in chest X-rays, AI can identify and label different
anatomical structures or detect signs of specific diseases like
pneumonia or lung cancer.
Benefit: Enhances the speed and accuracy of image
interpretation, reduces the workload for radiologists, and
supports early detection of diseases.
The primary purpose of integrating Information Science into
Imaging Science and Informatics is to enhance the efficiency and
effectiveness of image data management and interpretation. This
integration aims to:

1. Improve Image Data Management: Efficiently handle large

volumes of image data, ensuring accurate and timely access to
relevant information.

2. Enhance Image Analysis: Facilitate advanced image analysis

techniques, enabling precise interpretation and better decision-
making.
3. Support Research and Development: Aid in the development
of new imaging technologies and methodologies through robust
data management and analysis tools.

4. Optimize Clinical and Industrial Applications: Improve the

quality and efficiency of imaging processes in medical, industrial,
and other applications.
 BENEFITS
1. Improved Accuracy and Efficiency
Data Management: Advanced algorithms and databases allow for efficient storage, retrieval,
and management of large volumes of image data.
Image Analysis: Sophisticated analytical tools enhance the accuracy of image interpretation,
aiding in better diagnosis and decision-making.
2. Enhanced Research Capabilities
Data Integration: Combining data from multiple sources provides a comprehensive view,
facilitating more thorough research and development.
Collaboration: Sharing of data and findings across institutions and disciplines promotes
collaborative research efforts.
3. Better Decision Making
Clinical Applications: Enhanced image analysis tools assist healthcare professionals in making
more accurate diagnoses and treatment plans.
Industrial Applications: Improved imaging technologies lead to better quality control and
monitoring in industrial processes.
 ADVANTAGES
1. Accuracy and Precision

Enhanced image processing algorithms provide more accurate

and precise analysis, crucial in medical diagnoses and industrial
inspections.

2. Efficiency

Automated data management and analysis reduce the time and

effort required for manual processing, increasing overall
efficiency.
3. Scalability

Information Science techniques can handle large volumes of

image data, making it scalable for extensive research and
industrial applications.

4. Collaboration

Facilitates data sharing and collaborative research across

different institutions and disciplines.
 DISADVANTAGES
1.Cost

The implementation of advanced information systems and

imaging technologies can be expensive, requiring significant
investment in infrastructure and training.

2.Complexity

The integration of Information Science into Imaging Science and

Informatics involves complex algorithms and systems that may
require specialized knowledge and skills to operate effectively.
3.Data Privacy and Security

Managing sensitive image data, especially in medical

applications, raises concerns about data privacy and security,
necessitating robust measures to protect patient information.

4.Dependence on Technology

High dependence on technology may lead to challenges in case

of system failures or technical issues, potentially impacting
critical processes.
CHARACTERISTICS OF INFORMATION SCIENCE

1. Data Management
Example: Efficient storage and retrieval of radiographic
images and patient information using systems like PACS
(Picture Archiving and Communication System).
Information Science principles ensure that large volumes
of imaging data are organized, indexed, and easily
accessible for radiologists and other healthcare
professionals.
2. Data Integration

Example: Integration of radiographic data with

Electronic Health Records (EHRs), allowing for
seamless access to patient history, previous imaging
results, and other relevant medical information. This
integration enhances the accuracy and efficiency of
diagnoses.
3. Data Security
Example: Implementation of encryption and access
control measures to protect sensitive patient information
and radiographic data from unauthorized access, ensuring
compliance with healthcare regulations like HIPAA.
 HIPAA

The Health Insurance Portability and Accountability

Act (HIPAA) is a U.S. federal law enacted in 1996
that sets standards for the protection of sensitive
patient health information, ensuring that this data is
properly safeguarded while allowing for the flow of
health information needed to provide high-quality
healthcare.
 SECURITY RULE

The HIPAA Security Rule specifically focuses on the

protection of electronic protected health information
(ePHI). It requires healthcare providers, health plans,
and their business associates to implement
administrative, physical, and technical safeguards to
ensure the confidentiality, integrity, and security of
ePHI.
 INFORMATION TECHNOLOGY

 Is the collection of tools that make it possible to access and use

information.
 Information Technology is a boon for mankind. It gives access
to information at your fingertips.
 Information Technology has reduced the space and time
between people, countries, and continents and ultimately has
led to the emerging concept of global society and a global
village.
 DEFINITION OF TERMS
1. Communication
• In IT refers to the exchange of information between devices or systems
through various protocols and mediums, enabling the transfer of data,
voice, video, and other forms of digital content.
2. Hardware
• Consists of the physical components of a computer system, such as the
central processing unit (CPU), memory, storage devices, and peripherals,
which work together to perform computing tasks.
3. Database
• Is an organized collection of structured data stored electronically, which
can be accessed, managed, and updated using a database management
system (DBMS) to support various applications and processes.
4. Security
• In IT refers to the measures and protocols implemented to protect systems,
networks, and data from unauthorized access, cyberattacks, data breaches,
and other threats, ensuring the confidentiality, integrity, and availability of
information.

5. Software
• Is a set of instructions, programs, or applications that run on computer
hardware to perform specific tasks, ranging from operating systems to
specialized applications like word processors or graphic design tools.
6. Applications
• Often referred to as apps, are software programs designed to perform
specific functions for users, such as word processing, web browsing, or
managing financial data, and can run on various platforms, including
computers, smartphones, and tablets.

7. Servers
• Are powerful computers or systems that provide resources, data, services,
or programs to other computers, known as clients, over a network,
facilitating operations like file storage, website hosting, and database
management.
8. Internet
• Is a global network of interconnected computers and servers that
communicate using standardized protocols, allowing users to access, share,
and exchange information and services across the world.

9. Network
Is a collection of interconnected devices, such as computers, servers, and
routers, that communicate with each other to share resources and data, often
over local (LAN) or wide-area (WAN) configurations.
 INFORMATION TECHNOLOGY COMPONENTS

a) Computer – A computer is a device that solves problems by

applying prescribed operations to data entered into it. It is a set of
interacting elements, responding to input so as to produce the
desired output.

b) Telecommunication – The communication channel is the

medium that carries the message/information/etc. send by the
sender and channel is the connecting cables.
c) Modem – It can be defined as “a device attached to a computer
that can convert signals to analog signals. The data signal
generated by a computer (digital signal) is different from the
signal that can be carried by telephone lines (analog signal).

d) Database – A database is a self-describing collection of

integrated records. It is self-describing because it contains as part
of itself, a directory or dictionary of its contents.
NEW TECHNOLOGIES IN INFORMATION TECHNOLOGY

• The new technologies that are emerging as part of Information

Technology include:

1. E-Commerce
2. Hyper Media
3. Online Analytical Processing
4. Data Mining
5. Video Conferencing/Net Meeting, etc.
COMMON TERMS USED IN INFORMATION TECHNOLOGY
1. Collection – refers to the process of acquiring or gathering
medical imaging data, such as X-rays, CT scans, or MRIs, from
patients using various imaging technologies.
• Ex. When a radiologist takes a series of X-rays to assess a broken
bone, the act of capturing these images is an example of data
collection in imaging science.
2. Transportation – involves the secure transfer of medical images
from one location to another, often between different departments,
facilities, or systems, ensuring that the images are available for
analysis and diagnosis.
3. Storage – refers to the systematic archiving of medical images
in digital format within a database or imaging repository,
allowing for easy access and retrieval in the future.
4. Processing – involves enhancing or analyzing medical images
using specialized software to improve image quality, extract
relevant features, or prepare them for interpretation by healthcare
professionals.
5. Retrieval – is the act of accessing and retrieving stored
medical images from a database or archive for review,
comparison, or diagnostic purposes.
The Evolution of the Imaging Informatics Professional

The field of medicine has went

through tons of revolutions
through the years, especially
with the entrance of the era
where the application of digital
structures are applied and can
be considered vital. industry in
Asia.
 INFORMATICS

The study and practice of data acquisition, storage, processing,

retrieval, analysis, and presentation to facilitate workflow and
increase the accuracy and value of the information contained
within the data.
 WHAT IS AN EXAMPLE OF INFORMATICS?

 Health informatics, which is the intersection of people,

technology, and data to improve the safety and quality of
patient care, can be found in many forms.

 A few examples include patient portals, electronic medical

records (EMRs), telehealth, healthcare apps, and a variety of
data reporting tools.
 PATIENT PORTALS

 Patient portals are secure online platforms that provide

patients with access to their personal health information,
allowing them to view test results, schedule appointments,
communicate with healthcare providers, and manage their
healthcare online.
 ELECTRONIC MEDICAL RECORDS (EMR)

 EMRs are digital versions of patients' paper charts

within a single medical practice or healthcare facility,
containing a patient's medical history, diagnoses,
medications, treatment plans, immunization dates,
allergies, radiology images, and laboratory test results.
 TELEHEALTH

 Telehealth refers to the use of digital communication

technologies, such as video conferencing, mobile
apps, and remote monitoring, to provide healthcare
services to patients remotely.
 HEALTHCARE APPS
 Healthcare apps are mobile applications designed to help users
manage their health and wellness, track medical information,
receive medical advice, or communicate with healthcare
providers.

 Example:

• MyFitnessPal: A popular app for tracking diet, exercise, and

other health metrics, helping users maintain a healthy lifestyle
and achieve fitness goals.
Transition from the IT culture
towards the field of medical
expertise can be sudden and
overwhelming without prior
knowledge or background towards
it, thus the need for having clinical
background and experience is of
importance. After all, most IT
systems do not require support that
is timely and urgent, with patient-
care decisions hanging in the
balance.
 The following advances in informatics, will play a central role
in bringing about the rapidly approaching era of filmless,
paperless, and errorless imaging in medicine, including:
1. further development and integration of digital imaging
modalities.
2. Picture Archiving and Communication Systems (PACS)
3. healthcare information systems
4. advanced image processing
5. other information technology tools
The core infrastructure of any modern Radiology department is
made up of computers/computer workstations and the
connectivity or networking capability between these devices.

All transactions between modalities, PACS, scheduling, billing,

dictation, and reporting systems are made possible through
specialized computer programs or applications that are
executed by computers.
 STEPS IN COMPUTED RADIOGRAPHY

1. The patient is positioned correctly on the examination table or

standing against a detector panel, depending on the type of
radiographic examination being performed.
2. The X-ray machine is adjusted to the appropriate settings (e.g.,
exposure time, kVp, mA) based on the part of the body being
imaged.
3. Instead of film, an imaging plate is exposed to x-ray or gamma
radiation.
4. The imaging plate is digitized by the scanner and then erased for
immediate reuse.
5. The digital image is then displayed on a computer monitor for
 STEPS IN DIGITAL RADIOGRAPHY
1. The X-rays that pass through the patient are captured by a digital detector, which
can be a flat-panel detector (FPD) or a charge-coupled device (CCD). The
detector converts the X-rays into an electronic signal.
2. The electronic signal generated by the detector is converted into digital data by
an analog-to-digital converter (ADC). This digital data represents the X-ray
intensity at different points in the image.
3. The digital data is processed by specialized software to enhance image quality.
This may involve adjusting brightness and contrast, noise reduction, edge
enhancement, and other techniques to improve the diagnostic quality of the
image.
4. The processed image is displayed on a monitor, where it can be reviewed by a
radiologist. The digital image can also be manipulated further, if needed, for
better visualization of certain areas.
5. The digital radiograph is stored in a Picture Archiving and Communication
System (PACS) or another digital archive, where it can be accessed for future
reference, comparison, or review.
 MEDICAL IMAGE DATA

 Image Quality

The quality of a medical image is determined by the

imaging method, the characteristics of the equipment, and
the imaging variables selected by the operator.

Image quality is not a single factor but is a composite of at

least five factors: contrast, blur, noise, artifacts, and
distortion.
1. Contrast - contrast refers to the difference in brightness or
intensity between different areas of an image, which helps to
distinguish between various tissues, structures, or features in a
medical image.
2. Blur - is the loss of sharpness in an image, causing edges and
fine details to appear smeared or out of focus. This can occur due to
patient movement, improper focus, or limitations of the imaging
system.
3. Noise - refers to the random variation of brightness or color
information in images, which can obscure or distort the visual
appearance of fine details. Noise is often caused by low signal
levels or electronic interference.
4. Artifacts - are unwanted anomalies or distortions in an image
that do not represent real structures and are often caused by
factors such as equipment malfunctions, patient movement, or
the presence of metal objects.

5. Distortion - refers to the alteration or warping of the true shape

or dimensions of an object in an image, often resulting from
issues with the imaging system's geometry, perspective, or other
technical factors.
 MEDICAL IMAGING MODALITIES
 Ionizing Radiation:
1. Diagnostic Radiology (X-rays)
2. Interventional Radiology
3. Computed Tomography (CT)
4. Nuclear Medicine
5. Positron Emission Tomography (PET)
No Ionizing Radiation:
1. Diagnostic Ultrasound (Ultrasonography)
2. Magnetic Resonance Imaging (MRI)
 COMPUTER SCIENCE

• It is the study of processes that interact with data and that can be
represented as data in the form of programs.

• It enables the use of algorithms to manipulate, store, and

communicate digital information.
How Computer Science is applied in Imaging Science and Informatics

1. Image Processing Algorithms

Example: Algorithms used to enhance image quality, such as edge

detection, noise reduction, and contrast enhancement, help
radiologists better visualize and interpret medical images.

2. 3D Reconstruction

Example: Techniques like 3D reconstruction from CT or MRI scans

allow for the creation of three-dimensional models of organs or
tissues, aiding in pre-surgical planning and patient education.
Example of 3D Reconstruction
3. Virtual and Augmented Reality

Example: VR and AR technologies are used in medical training and

education, allowing practitioners to simulate surgeries or explore
anatomical structures in an interactive 3D environment.
4. Robotic Surgery

Example: Integration of imaging data with robotic systems to assist

in precision surgeries, where real-time imaging guides the robotic
instruments, enhancing accuracy and patient outcomes.
 CORE COMPUTER HARDWARE

A. Components

 CPU
 Memory
 Input devices
 Output devices
 Bus
The central processing unit (CPU) or microprocessor
 largest integrated circuit on the motherboard.

 execute specific commands or instructions/machine code

dictated by a computer program.

 ability to process instructions and manipulate data at

amazing speeds.
 Memory
 is principally used to temporarily store data (and results)
and applications or programs.

 In contrast to the CPU, a memory module has no

capability to process instructions;

 instead memory is designed to reliably store large chunks

of data and then release these data on command (often at
the behest of the CPU).
B. Types of Data Storage

• Online
• Near-line
• Offline
1. Online - refers to data or storage devices that are readily accessible and
connected to a computer system or network, allowing immediate access and
retrieval of information.

Example: A hospital's PACS system with immediate access to medical images

stored on high-speed, directly-attached storage devices.

2. Near-line - refers to data that is not immediately accessible but can be

retrieved quickly when needed, often involving slower or less expensive
storage solutions like tape libraries or secondary hard drives.

Example: A healthcare facility's backup system that uses magnetic tape to

store copies of patient records, which can be retrieved within minutes if
necessary.
3. Offline - refers to data that is not directly accessible
by the computer system and requires manual
intervention to access, typically involving removable
media stored in a separate location.

Example: Archived medical records stored on DVDs that

must be manually retrieved and loaded into a computer
for access.
 Input/output devices

 are hardware extensions that allow humans (or other

devices) to interact with a computer.

 examples of input devices include the keyboard, touch

screen, mouse, microphone, and camera.

 typical output devices include the video display, printer,

plotter, and speaker.
 Bus

 The data bus is the physical data chain built into the
motherboard that allows for this efficient data transfer.

 This is supported by several ICs, known as the chipset,

which coordinates uninterrupted data transfers through
the bus.

 Multiple different designs have been developed; the most

common in use today is peripheral component
interconnect (PCI) and PCI-Express.
 COMPUTER TECHNOLOGY

 This combine the hardware of computers and

computer-controlled devices with software-
operating systems, authoring tools, expert systems
and courseware-to support training technology.
 INFORMATION TECHNOLOGY
 Bizbox is an example of information technology.
 Following factors states few common factors that reflect
on the needs and objectives of the information
processing:

Information technology applied to health and health care.

It supports health information management across
computerized systems.
Increasing impact of information processing for
organizational decision making.
BIZBOX
Changing employment scene world over, shifting base
from manual agricultural to machine-based manufacturing
and other industry related jobs.

Growth of IT industry and its strategic importance.

Need for sustainable development and quality life.

Improvement in communication and transportation

brought in by use of information processing.
WORKFLOW IN RADIOLOGY
CORRECT ORDER OF WORKFLOW IN RADIOLOGY

1. The patient is registered in HIS.

2. Patient information is registered in RIS.
3. An examination is performed.
4. The PACS will send the current image and any previous
images to the workstation for reading by the radiologist.
5. The radiologist can easily use some templates or a
structured report at the reading workstation to type out the
imaging findings.
 INFORMATION SCIENCE
• The study of processes for storing and retrieving information,
especially scientific or technical information belongs to the scope.

 Information Vs Data

Data - unprocessed facts and figures. Plain collected data as raw

facts cannot help in decision-making
 is the raw material that is organized, structured, and interpreted
to create useful information systems.
'groups of non-random symbols in the form of text, images, voice
representing quantities, action and objects'.
 INFORMATION SCIENCE
 Information - is interpreted data; created from organized,
structured, and processed data in a particular context.

 a data that has been processed into a form that is

meaningful to the recipient.

 File - is referred to as a collection of data or information

that is treated as a unit by the computer and has
extension names added after a period.
 Medicine and Health Information Technology

 Information technology has made significant contributions

to our world, namely in the medical industry.

 With the increased use of electronic health records (EHR),

telehealth services, and mobile technologies like tablets
and smartphones, physicians and patients are both seeing
the benefits that these new medical technologies are
bringing.
 EHR – is a systematized collection of patients’
electronically-stored health information in a digital format.
The benefits of Electronic Health Records include:

Better health care by improving all aspects of patient care,

including safety, effectiveness, patient-centeredness,
communication, education, timeliness, efficiency, and
equity.
 Digitalization in Biomedicine and Medicine
 Our life, public and private, is becoming digitalized
whether we like it or not, and so are medicine and patient
management.

 Probably no other change in the way we practice

medicine is currently met with so many emotions.
Personal preference, ethics, and concerns regarding
privacy protection impact on our opinion of the new
advances in digital technology.
 BIOMEDICINE

• Is the branch of medicine that studies the human body,

its structure and function in health and disease,
pathological condition, methods of diagnosis, treatment,
and correction.

• The goal of Biomedicine is to promote human health

and healing.
 Unfortunately, there still is an international discrepancy
regarding digitalization in medicine due to resources,
priorities, and legislation that substantially impacts on
implementation of digital advances in our own clinical
environment.

 Nevertheless, in medicine, the speed of digitalization

differs greatly between different hospitals as well as
between hospitals and private practices.
 In medicine, advancing digitalization for the benefit of
patients and caregivers requires a problem-solving
mentality rather than prospectively imposed detailed
legislation and regulatory barriers that discourage and
frustrate engaged health care workers and their patients
both in clinical routine and in research.
 Healthcare Information Technology (HIT)
 Health Information Technology (Health IT) is a broad term
that describes the technology and infrastructure used to
record, analyze, and share patient health data between
consumers, providers, payers, and quality monitors.

 Various technologies include health record systems,

including personal, paper, and electronic; personal health
tools including smart devices and apps.
 The purpose of Health IT is to provide better care for
patients and help achieve health equity.

 Health IT supports recording of patient data to improve

healthcare delivery and allow for analysis of this
information for both healthcare practitioners and ministry
of health/government agencies.

 This data is used for the implementation of policies in

order to better treat and prevent the spread of diseases.
Health IT improves the quality of:

1. healthcare delivery.

2. increases patient safety.

3. decreases medical errors, and

4. strengthens the interaction between patients and

healthcare providers.
Medical Image Digitalization and Acquisition Gateway

• Digital acquisition of data from the various imaging

modalities for input to a PACS is the first step in
eliminating film.

• Essential features for successful clinical implementation

include conformance with the DICOM standard, radiology
information system–hospital information system (RIS–
HIS) interfacing, and workflow integration.
 DICOM

Consists of a standard image format as well as a network

communications protocol;

Compliance with it enables an open architecture for

imaging systems, bridging hardware, and software
entities, allowing interoperability for the transfer of medical
images and associated information between disparate
systems.
• The DICOM standard is used, for example, to negotiate a
transaction between a compliant imaging modality and a
compliant PACS workstation.
• The scanner notifies the workstation, in the language that
both understand, that it has an image study to send to it.
• The workstation replies to the modality when it is ready to
receive the data.
• The data are sent in a format known to all, the workstation
acknowledges receipt, and then the devices end their
negotiation.
 RIS & HIS
• Equally essential, particularly at acquisition, is integrating
the RIS and/or HIS with the PACS.

• The RIS maintains radiology-specific data such as

imaging examination orders, reports, billing information,
etc.

• The HIS typically includes more general patient

information and may contain laboratory results, patient
histories, etc.
 This greatly facilitates input of patient demographics such
as the name, date, time, medical record number (MRN)
uniquely identifying a patient, accession number
(AccNum) uniquely identifying a particular imaging
examination, exam type, imaging parameters, etc.

 It also enables automatic PACS data verification,

correlation, and error correction with the data recorded in
the RIS–HIS.
 Most imaging modalities are now tightly coupled with the
RIS, providing automatic downloading of demographic
information from the RIS, via barcode readers or directly
to the scanner console (via modality worklist capability)
and hence to the DICOM header.

 This eliminates the highly error-prone manual entry of

data at acquisition.
 Healthcare Information System
• Also known as the “bizbox”.

• coordinates people, resources, systems, and work, an

information system that manages a process workflow
controls the work of individuals and may introduce delays
or constraints on how and when tasks are performed.

• process modeling has been identified as fundamental to

provide suitable solutions to the problems of designing
and building innovative healthcare information systems.
 DICOM Standards

 DICOM is the international standard for medical images

and related information (ISO 12052).
 It defines the formats for medical images that can be
exchanged with the data and quality necessary for clinical
use.
 DICOM is used in almost every medical domain and by
almost every medical imaging device manufacturer.
DICOM is used in virtually all hospitals worldwide. It
ensures the interoperability of systems used to:
1. Produce
2. Store
3. Display
4. Send
5. Print
6. Process
7. Query
8. Retrieve
 Interoperability and IHE standards
 Interoperability is the sharing of information between medical
devices and information systems. It is fundamental to lowering
costs, increasing access, and improving quality.

Example: In healthcare, interoperability allows electronic health

records (EHRs) from different hospitals to share patient information,
ensuring that a patient's medical history is accessible regardless of
where they receive treatment.

 IHE (Integrating the Healthcare Enterprise) promotes the

coordinated use of established standards such as DICOM and HL7
to address specific clinical needs in support of optimal patient care.
 IHE Radiology was formed in 1998 to address issues of
interoperability and information sharing that impact the quality of
care in medical imaging.

 IHE solutions are now available in hundreds of commercial

radiology-related information systems and are implemented in care
sites around the world.

 HL7 (Health Level Seven) refers to a set of international

standards for the transfer of clinical and administrative data
between software applications used by various healthcare
providers.