tailieunhanh - Ebook Digital mammography: Part 2

Part 2 book “Digital mammography“ has contents: PACS Issues, advanced applications of digital mammograph, digital mammography cases with masses, digital mammography cases with calcifications, miscellaneous digital mammography. | 9 PACS ISSUES FRED M. BEHLEN Some form of Picture Archiving and Communications System (PACS) is generally required to make a digital mammography system economically viable. The diagnostic benefits of digital mammography are attended by substantial expenditures for equipment and its maintenance. These costs need to be offset by cost savings and higher productivity if digital mammography is to be adopted in breast imaging departments already under economic pressure. Successful and efficient mammography reporting must bring together the current and prior images, prior reports, orders and other clinical information, and the reporting or dictation systems used to create the reports. While DICOM standards allow the connection of image acquisition units, displays, archives and reporting systems from different vendors, the practical integration of these devices usually hinges on a balance of technical and business factors. A key decision in many settings will be whether to acquire a “Mammography PACS,” usually bundled with the digital mammography system, or to use a departmental PACS resource. This chapter seeks to inform the reader in the issues of such a choice, beginning with a basic review of systems. BASICS OF PICTURE ARCHIVING AND COMMUNICATIONS SYSTEM Figure 9-1 illustrates schematically the information flows of diagnostic imaging and is applicable to either filmless or hardcopy practice. Images are acquired and sent to the image display, along with images of prior examinations retrieved from storage. Current images are also stored for future use as “priors,” either directly or, as in the case of hardcopy practice, after viewing. The radiologist reviews the images, together with the referring physician’s order, prior reports, and other clinical data, and then creates the report sent to the referring physician and inserted in the medical record. A PACS serves the image-handling aspects of this process. There are five principal functions of a PACS: 1. Image .