PACS Fundamentals Overview

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Questions and Answers

What is the main responsibility of the file room regarding patient demographics?

  • Creating patient records
  • Archiving patient images
  • Managing worklists
  • Correcting patient demographics (correct)

Which of the following functions is NOT categorized as an advanced workstation function?

  • Image management functions
  • Custom hanging protocols (correct)
  • Navigation functions
  • Image manipulation and enhancement

What is the purpose of a worklist in a PACS workstation?

  • To navigate through patients (correct)
  • To customize image settings
  • To manage user accounts
  • To enhance image quality

How can users navigate through images in a PACS system?

<p>With the scroll wheel or keyboard arrows (D)</p> Signup and view all the answers

What defines a hanging protocol in PACS?

<p>The manner in which images are displayed on the monitor (C)</p> Signup and view all the answers

What is a 'study' in the context of a PACS?

<p>The current or previous examination being viewed (B)</p> Signup and view all the answers

Which statement about PACS software is true?

<p>It generally adheres to the Windows look and feel. (D)</p> Signup and view all the answers

Which of the following is a method to scroll through images in a PACS?

<p>Using the stack mode function (B)</p> Signup and view all the answers

What is one major advantage of a PACS in patient care?

<p>It enables viewing of the same set of images from multiple locations. (D)</p> Signup and view all the answers

What primary function does a technologist QC station serve?

<p>To review images and verify patient demographic information. (A)</p> Signup and view all the answers

How does the QC station benefit the technologist before an examination?

<p>By allowing the retrieval of historic images. (C)</p> Signup and view all the answers

What has changed in file rooms within a PACS environment?

<p>They have moved from physical film shelves to digital storage on computers. (A)</p> Signup and view all the answers

What is a common practice for sharing patient images to outside physicians in a PACS?

<p>Burning images onto compact disks (CDs). (D)</p> Signup and view all the answers

What should the technologist avoid while manipulating acquired images?

<p>Over-adjusting the appearance from the original image. (A)</p> Signup and view all the answers

How does PACS contribute to enhancing image review efficiency in departments like ER and ICU?

<p>By allowing multiple healthcare professionals to view images simultaneously. (B)</p> Signup and view all the answers

Which feature is commonly associated with a technologist QC station?

<p>High-resolution monitors for image viewing. (B)</p> Signup and view all the answers

What does resolution refer to in the context of imaging?

<p>The capability to distinguish between individual parts of an image (A)</p> Signup and view all the answers

Which resolution is typically required for mammography?

<p>5K (B)</p> Signup and view all the answers

What is a primary function of a physician review station?

<p>It allows physicians to view previous reports alongside images. (D)</p> Signup and view all the answers

Which statement about display stations is correct?

<p>Display stations are categorized by their primary use and purpose. (C)</p> Signup and view all the answers

What is a characteristic of radiologist reading stations?

<p>Their monitors can be customized for better performance. (C)</p> Signup and view all the answers

Which aspect distinguishes a radiologist reading station from a physician review station?

<p>Reading stations are used for reporting and diagnosis. (B)</p> Signup and view all the answers

What is typically found in a radiologist reading station?

<p>High-quality hardware that requires little downtime. (D)</p> Signup and view all the answers

What is NOT a characteristic of display stations used in radiology?

<p>They always feature the same resolution capabilities. (D)</p> Signup and view all the answers

What is the primary purpose of the pan, zoom, and magnify functions in radiology?

<p>To increase the size of an area on the image (C)</p> Signup and view all the answers

Which measurement function can determine the angle between two structures?

<p>Angle measurement (B)</p> Signup and view all the answers

What is a significant concern when modifying patient demographics in a PACS?

<p>Maintaining accurate patient information (D)</p> Signup and view all the answers

What is one of the functions of the query/retrieve feature in a PACS?

<p>To retrieve studies based on multiple fields (C)</p> Signup and view all the answers

Why should patient information be removed before copying images into presentations?

<p>To ensure compliance with HIPAA regulations (D)</p> Signup and view all the answers

Which of the following describes a Region of Interest (ROI) measurement?

<p>A measurement of pixel intensity in a specific area (A)</p> Signup and view all the answers

What should be done before making changes to patient demographics in a PACS?

<p>Ensure the incorrect information is absolutely known (B)</p> Signup and view all the answers

How does the size of a pixel contribute to measurements in a PACS?

<p>It is a fixed reference for distance measurements (A)</p> Signup and view all the answers

What is the primary purpose of the cine function in imaging software?

<p>To navigate through a series of images frame by frame (C)</p> Signup and view all the answers

What do the terms 'window' and 'level' refer to in image manipulation?

<p>Window refers to the range of gray values, while level is the center value of that range (A)</p> Signup and view all the answers

What is the primary function of display workstations in radiology?

<p>Image manipulation and review (D)</p> Signup and view all the answers

Which of the following statements is true regarding annotations in PACS?

<p>Annotations allow the user to indicate various positions or times related to the image. (A)</p> Signup and view all the answers

What is the function of the close patient or close study icon in imaging software?

<p>To close the active patient or study and navigate to the next unread patient (C)</p> Signup and view all the answers

Which monitor type is likely to dominate the PACS display market due to its advantages?

<p>Liquid crystal display (LCD) (B)</p> Signup and view all the answers

How has the number of monitors required by radiologists changed over time?

<p>Decreased to an average of two monitors (C)</p> Signup and view all the answers

Why is it important to use lead markers during image adjustments like flipping and rotating?

<p>To ensure the correct anatomical orientation is maintained (C)</p> Signup and view all the answers

What basic picture element determines the resolution of a display?

<p>Pixel (C)</p> Signup and view all the answers

What does the window/level adjustment function change in an image?

<p>The brightness and contrast of the image (D)</p> Signup and view all the answers

Which feature is NOT typically associated with the cine function in imaging systems?

<p>Image enhancement through brightness adjustment (B)</p> Signup and view all the answers

Which of the following is NOT a common function of PACS?

<p>Hardware repair (C)</p> Signup and view all the answers

Which action should be avoided when using annotations on imaging software?

<p>Labeling sides of the patient's anatomy using digital markers (C)</p> Signup and view all the answers

What is a key advantage of LCD monitors over CRT monitors in a radiology department?

<p>Less maintenance required (C)</p> Signup and view all the answers

What has contributed to the decrease in the number of monitors used by radiologists?

<p>Development of better viewing software (A)</p> Signup and view all the answers

What is the relationship between pixels and resolution in imaging?

<p>More pixels indicate higher resolution (C)</p> Signup and view all the answers

Flashcards

Display Workstation

The primary reading station for radiologists, used for reviewing images and performing quality control.

PACS

Picture Archiving and Communication System. A system for managing and viewing medical images digitally.

Resolution (in displays)

Number of pixels on a display. Higher resolution means more detail in the image.

Pixel

The smallest unit of a digital image, representing a color, shade or brightness.

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LCD Monitor

A type of monitor used in PACS, known for good resolution, light output and low heat.

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CRT Monitor

A type of monitor, a predecessor to LCD, having been more common in the past, with some limitations.

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Quality Control (QC) Station

A station where technologists review images for quality.

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Image Manipulation

Adjustments or changes made to a medical image.

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Resolution in imaging

The ability to distinguish details in an image.

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Pixel Matrix

A grid of points that represents an image, each with a specific intensity level.

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High-resolution displays (medical)

Monitors with a large number of pixels that provide enhanced image quality, crucial in detailed examinations.

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PACS(Picture Archiving and Communication System)

Software/systems that store, manage, and share medical images.

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Physician Review Stations

Workstations designed for referring physicians, facilitating image and report review.

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Radiologist Reading Stations

Workstations for radiologists, optimized for diagnosis with top-quality hardware and software.

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RIS (Radiology Information System)

A system that manages patient information related to radiology.

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Different Display Station types

Dedicated workstations for radiologists, referring physicians, and technologists, each with different needs and capabilities.

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PACS Advantages

A PACS allows viewing the same images in multiple locations simultaneously, improving patient care continuity and speed.

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Technologist QC Station Role

The technologist QC station reviews images for quality before sending them to the radiologist.

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QC Station in Workflow

QC stations are often placed between imaging modalities and the radiologist to ensure images meet quality standards.

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QC Station Image Manipulation

Technologists can adjust images on the QC station, but changes must be minimal and approved by the radiologist.

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QC Station Past Image Access

Technologists can access previous images of a patient on the QC station to help with current procedures.

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File Room Evolution with PACS

File rooms in PACS environments are smaller and less reliant on physical film, relying more on digital storage.

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File Room Workstation Functions

File room workstations are used for retrieving images for physicians, creating copies for patient referrals, and even managing patient data.

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CDs for Patient Image Sharing

Many hospitals prefer CDs for patient image sharing instead of printed films to reduce costs.

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What does the archive depend on?

The accuracy of the patient demographics that are entered into it.

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What happens if the demographics are wrong?

It becomes difficult to retrieve the patient's images in the future.

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What are hanging protocols?

Customizable ways in which a set of images is displayed on the monitor - how many and how they are arranged.

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What is 'cine' mode?

Viewing a series of images in a continuous flow, like a short film.

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What are navigation functions?

Tools used to move between different parts of a PACS - images, series, studies, patients.

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What else helps navigation?

The scroll wheel, mouse right-click menu and keyboard arrows.

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How's a study defined in PACS?

A complete set of images from a single examination. Can be one or more series.

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Worklist

Customizable list where users can find and select patients.

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Cine Function

A feature that allows you to view images in a sequence, frame by frame. It's like a movie player for medical pictures.

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Window/Level Adjustment

Changing the brightness (level) and contrast (window) of a medical image to enhance visibility of details.

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Annotations in PACS

Adding text or drawings to a medical image for clarification or highlighting areas of interest.

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Flip and Rotate Function

This function allows you to adjust the orientation of a medical image to match the anatomical position of the patient.

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Importance of Lead Markers

Lead markers are vital in digital imaging to ensure the radiologist is viewing the correct side of a patient.

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Using Annotations Carefully

Avoid labeling left and right for patient's sides with annotations, as it can be easily manipulated.

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Close Patient/Study Icon

This icon allows you to close the current patient or study, either going back to the patient list or moving to the next unopened study.

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Icons for Navigation

Medical imaging software uses icons (small pictures) to represent actions like opening a patient’s studies or moving to the next unread patient.

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Magnify Function

Enlarges a square area of an image on a PACS station, allowing radiologists to examine details more closely. The square can be moved around the image to view different areas.

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Distance Measurement

Measures the distance between structures in a medical image on a PACS station, utilizing the known size of each pixel.

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Angle Measurement

Measures the angle between two structures in a medical image on a PACS station, commonly used to analyze the spine.

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Region of Interest (ROI)

A tool on PACS stations that identifies and analyzes the pixel intensity of a specific area in a medical image, helping radiologists distinguish between solid and fluid structures.

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Patient Demographics

Information like patient name, ID, date of birth, etc., which is crucial for correctly retrieving and managing medical images.

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Query/Retrieve Function

A PACS feature that allows users to search for and retrieve medical images from the archive using various criteria, such as patient name, date of service, or modality.

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Image Copy and Paste Function

Allows copying and pasting images into documents from PACS systems, commonly used for presentations, but patient information must be removed for privacy.

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Study Notes

PACS Fundamentals

  • PACS (Picture Archiving and Communication System) is a system for managing medical images.
  • Key functions include common functions, navigation, study, image manipulation, enhancement, and hanging protocols.
  • Display workstations include primary reading stations for radiologists, review stations for referring physicians, technologist quality control stations, and image management stations.

Display Workstations

  • The display workstation is the most interactive part of a PACS.
  • It has a monitor, computer, mouse, and keyboard with hardware tailored to user needs.
  • Conventional film/screen radiography uses large multi-viewer lightboxes for image display.

Radiologist Reading Stations

  • Used by radiologists for primary diagnosis.
  • High-quality hardware, including the best monitor, is used, with computers equipped to meet vendor needs and low downtime.
  • Mice and keyboards can be customized for enhanced efficiency.

Physician Review Stations

  • Step-down model of radiologist reading stations.
  • Vendors may limit advanced functions.
  • Ability to view current and previous reports alongside images is a key feature.
  • Often, reports are more important to referring physicians than images.

PACS Advantages

  • Ability to view images at multiple locations simultaneously.
  • Software can be installed on stand-alone stations or accessible through a web browser on any personal computer.
  • Software is helpful for medical record and quick diagnosis.

Technologist QC Stations

  • Used for image quality review after acquisition but before sending the images to the radiologist.
  • Can be used for patient demographic verification.
  • Images can be modified, if needed for quality control, to comply with departmental standards.
  • Usually a 1K monitor is used.

File Room/Image Management Stations

  • File rooms have evolved from large, open spaces with film jackets to rooms with computers and dry lasers for making copies.
  • CDs are used instead of film for image storage, with software for managing and viewing the images.
  • Responsible for correcting patient demographics in the archive.

Common Functions

  • Basic functions of a PACS workstation are available on all levels, except advanced ones.
  • Functions are categorized into navigation, image manipulation/enhancement, image management, and advanced workstation functions.
  • Used for navigating images, series, studies, and patients through patient worklists.
  • Customizable for users; one doctor can select specific types of scans while another may need to see all scans from a specific day.
  • Modern software often conforms to the Windows look and feel.
  • Tools like scroll bars and scroll wheels on a mouse can be helpful.

Hanging Protocols

  • Custom hanging protocols allow each user to determine how images will be displayed on the monitor.
  • Examples include varying the number of images viewed on each monitor for different types of scans.

Study Navigation

  • A study in a PACS is the current or previous medical examination being viewed.
  • Studies can consist of multiple series (ex: MRI) or single images (ex: CR, DR).
  • Images can be paged through using scroll wheels, arrow keys, or in stack mode (cine).

Image Manipulation and Enhancement

  • Used to change images' appearance.
  • Common functions involve manipulating brightness, contrast, or other image attributes through window/level adjustments.

Annotations

  • Annotations can be applied to identify areas of concern or pathology that may be helpful for radiologists.

Measurements

  • PACS workstations can provide various measurement tools such as distance or angle measurements, or create a region of interest (ROI).
  • ROIs can be helpful in determining various quantities such as tissue, or fluid types, or volumes of mass.

Image Management Functions

  • Enables user modification of patient information.
  • Important to ensure accuracy in patient demographics entered into the archive.
  • Limiting access to these functions minimizes error rates.

Query/Retrieve Function

  • Used to retrieve medical images from the archive.
  • Searches a study through multiple fields like patient identifiers, date of service, or specific medical procedures/modalities.
  • Also allows searches that can be based on diagnoses and comments.

HIPAA Compliance

  • PACS systems must be compliant with the Health Insurance Portability and Accountability Act of 1996.
  • Patient information must be removed from images before presentation or distribution.
  • Printing of medical images should be kept to a minimum for compliance's sake.

Additional Considerations

  • Health care systems have adapted to accommodate PACS's. These workstations may be used in high-volume areas such as Emergency departments, and Intensive Care Units.

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