Digital Radiography & PACSDigital Radiography & PACS

:- Nag Nath:- Nag Nath P.K.PopliP.K.Popli

R.S.KapoorR.S.Kapoor

The Advantages:- Minimal Space demand.Minimal Space demand. Reduces radiation dose.Reduces radiation dose. Facility of post-processing. Facility of post-processing. Simultaneous availability of image.Simultaneous availability of image. Cost savings.Cost savings. Enhanced teaching and research Enhanced teaching and research

opportunity.opportunity.

How can it reduce radiation dose ?How can it reduce radiation dose ?

Decreased rate of Decreased rate of repeat. (post repeat. (post processing)processing)

Wide latitude of Wide latitude of CCD.CCD.

Increased tube life*

Cost savings:-Cost savings:-

Elimination of films.Elimination of films. Elimination of chemical and Elimination of chemical and

processors.processors. Reduction in maintenance cost.Reduction in maintenance cost. Less requirement of staff.Less requirement of staff. Reduction in space.Reduction in space.

Conventional film Vs CCDConventional film Vs CCD

Features:-Features:- FilmFilm CCDCCD

Construction:-Construction:- Thin, flexibleThin, flexible Thick, rigidThick, rigid

Life span:-Life span:- Single useSingle use Reusable, Reusable, >10000 exposure.>10000 exposure.

Image Image enhancement:-enhancement:-

Fixed Fixed (unchanged)(unchanged)

Multiple Multiple operationsoperations

Storage:-Storage:- Patient recordPatient record Variety of Variety of archiving archiving methods.methods.

Reporting on monitor,Reporting on monitor, how reliable it is? how reliable it is?

Monitor luminance- 200 to 800 cd/m².Monitor luminance- 200 to 800 cd/m². View box luminance- 2000 cd/m².View box luminance- 2000 cd/m². Hard copy image have fixed gray scale and Hard copy image have fixed gray scale and

relatively limited dynamic range.relatively limited dynamic range. Monitor have the option of changing Monitor have the option of changing

window and level in real time and therefore window and level in real time and therefore getting access to the higher contrast getting access to the higher contrast resolution.resolution.

Reporting on monitor,Reporting on monitor, how reliable it is? how reliable it is?

The printed radiographic film is typically The printed radiographic film is typically associated with a pixel array of about associated with a pixel array of about 4,000 × 5,000 for a 35cm × 43cm. 4,000 × 5,000 for a 35cm × 43cm.

For monitor with 30cm × 36cm size For monitor with 30cm × 36cm size 2,500 × 3,000 pixel is sufficient and 2,500 × 3,000 pixel is sufficient and combined with a regional zoom function combined with a regional zoom function provides a magnificent appreciation of provides a magnificent appreciation of image.image.

Requirements fulfilled by Requirements fulfilled by PACS:-PACS:-

Images must be acquired reliably and Images must be acquired reliably and at high speed.at high speed.

System & network must be able to System & network must be able to handle the heaviest anticipated work handle the heaviest anticipated work load.load.

Network must be expandable for Network must be expandable for recent development.recent development.

Must follow DICOM standards.Must follow DICOM standards.

Components installed in PACS:-Components installed in PACS:-

RAID (redundant arrays of RAID (redundant arrays of inexpensive discs) and RAID server.inexpensive discs) and RAID server.

Deep archive and deep archive Deep archive and deep archive server.server.

Patient data base server.Patient data base server. Work list generator.Work list generator. RIS interface.RIS interface. Image distribution cluster server.Image distribution cluster server.

Challenges:-Challenges:- Initial high equipment cost.Initial high equipment cost. Massive data storage requirements of Massive data storage requirements of

radiographic images.radiographic images. Physician & radiologist reluctance to Physician & radiologist reluctance to

interpret from monitor.interpret from monitor. Staff resistance.Staff resistance. Security.Security. System crash.

Data base management system

Long term archive Hard copy Non local communication

Remote

Work station

Imaging device

RIS

Voice

HIS

Manipulation & display

Tele radiology

Why India needs it:-Why India needs it:- LowerLower cost. cost. Less time per patient.Less time per patient. High through put.High through put. Better environment for medical research.Better environment for medical research. A step ahead towards globalization.A step ahead towards globalization. Future compulsion.Future compulsion.

Thank you.Thank you.