- Email: [email protected]
From PACS to the clouds
European Journal of Radiology 78 (2011) 161–162
Contents lists available at ScienceDirect
European Journal of Radiology journal homepage: www.elsevier.com/locate/ejrad
Editorial
From PACS to the clouds
Since the acronym “PACS” was cornered in 1984 in a SPIE conference held in 1982 in Los Angeles under the initiative of Dr. André Duerinckx and Samuel J. Dwyer III, PhD, its meaning and the scope of its applications have significantly changed. In the following years this new discipline has slowly matured through different early projects in the US and in Europe aimed toward the development of systems capable of handling large volumes of imaging data while providing the necessary tools for radiologists to review them and make adequate diagnosis. These early home-grown systems were clumsy and expensive, but they lead the way to the concept of a filmless radiology. Today, a range of different PACS architectures are available commercially and have been adopted widely by the medical community. These systems imbedded now in a wider variety of hospital informatics structures have extended toward enterprisewide image distribution as well as remote communication between different institutions. This expansion and broadening of the role of PACS and imaging informatics coincide with a major shift in healthcare where information technologies and computer assisted intervention techniques are becoming major players in patient management and effective patient care. In the era of communication and information technologies, medicine in general and healthcare providers in particular are embracing these new technologies as perfect answers to challenging economical constrains and increasing demand for critical care of complex diseases in an aging population of our industrial countries. While communication tools will allow the medical community to act more globally and react faster to changes in paradigm with better sharing of specialized skills and expertise, it will also provide the framework for better assistance and intelligent support for physicians and surgeons in their daily practice. There is no doubt that the rapid penetration of information technologies in operating rooms has contributed to the wide adoption of image-based surgical assistance and robotics. Easier access to image data between different categories of users as well as between remote sites has a major impact on patient management and decision-making where physicians and care providers rely on image data in their daily practice. Interpretation and analysis of medical images are no longer functions performed solely by radiologists. New software tools and image processing platforms are being tailored for clinical practitioners and care providers using those data for treatment planning and therapeutic interventions. This shift in paradigm is impacting the medical industry where a more generalized use of imaging informatics imposes a shift in system architecture as well as in financial models.
0720-048X/$ – see front matter © 2011 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ejrad.2010.12.097
The rapid evolution of information technologies and the emergence of new communication tools in our daily life such as Internet, social networks, mobile devices and the wide adoption of these devices in the general public has a clear influence in the evolution of our professional activities. Such evolution in information technology will also change the practice of medicine of our western world. This quantum leap to the next generation of imaging technology can only be accessible if supported by appropriate IT infrastructure for data communication, remote consultations and most importantly, training and continuous education of physicians and staff. This special issue of EJR covers a wide range of fundamental as well as innovative aspects of PACS and imaging informatics. Besides a review of the historical aspects of PACS several papers address innovative aspects of PACS and highlight the extension beyond radiology into general clinical practice. The integration with new concepts of electronic patient records as well as the increasing use of imaging data in surgery and in imaging-based interventions has also driven new aspects of image visualization based on 3D and 4D rendering as well as virtual navigation and computer-assisted diagnosis (CAD). New concepts on ontology and knowledge-based data retrieval can significantly improve workflow and data management. New trends in consumer markets such as mobile portable devices, social networks and facilitated data and document exchange, will also affect the way new systems are being implemented. A strong emphasis on mobility and portability will impact the design of image communication systems as well as the tools for image visualization and image analysis. These constant shifts resulting from unpredictable changes in technology as well as emergence of disruptive technologies require more flexibility and modularity in the design of information systems and PACS. Modularity and rapid development of software components lead to new paradigm such as Extreme Programming, a software development methodology which is intended to improve software quality and responsiveness to changing customer requirements by frequent “releases” in short development cycles. The shift toward online storage services providing large storage capacity and very competitive cost driven by general consumer market has lead to rapid development of “Cloud” computing. This new shift in technology that is slowly replacing conventional data storage centers could rapidly submerge and replace traditional storage and communication infrastructure of PACS. I would like to thank the authors of this special issue on PACS for their contribution and for putting together this historical review
162
Editorial / European Journal of Radiology 78 (2011) 161–162
and prospective vision of a rapidly changing domain of our professional life. I am also grateful to Professor Imhof and the editorial board for giving us the opportunity to publish a special issue on this topic.
Osman Ratib ∗ Dept. of Medical Imaging and Information Sciences, Nuclear Medicine Division, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva 14, Switzerland ∗ Tel.:
+41 022 372 71 45; fax: +41 022 372 71 84. E-mail address:[email protected] 27 December 2010
Contents lists available at ScienceDirect
European Journal of Radiology journal homepage: www.elsevier.com/locate/ejrad
Editorial
From PACS to the clouds
Since the acronym “PACS” was cornered in 1984 in a SPIE conference held in 1982 in Los Angeles under the initiative of Dr. André Duerinckx and Samuel J. Dwyer III, PhD, its meaning and the scope of its applications have significantly changed. In the following years this new discipline has slowly matured through different early projects in the US and in Europe aimed toward the development of systems capable of handling large volumes of imaging data while providing the necessary tools for radiologists to review them and make adequate diagnosis. These early home-grown systems were clumsy and expensive, but they lead the way to the concept of a filmless radiology. Today, a range of different PACS architectures are available commercially and have been adopted widely by the medical community. These systems imbedded now in a wider variety of hospital informatics structures have extended toward enterprisewide image distribution as well as remote communication between different institutions. This expansion and broadening of the role of PACS and imaging informatics coincide with a major shift in healthcare where information technologies and computer assisted intervention techniques are becoming major players in patient management and effective patient care. In the era of communication and information technologies, medicine in general and healthcare providers in particular are embracing these new technologies as perfect answers to challenging economical constrains and increasing demand for critical care of complex diseases in an aging population of our industrial countries. While communication tools will allow the medical community to act more globally and react faster to changes in paradigm with better sharing of specialized skills and expertise, it will also provide the framework for better assistance and intelligent support for physicians and surgeons in their daily practice. There is no doubt that the rapid penetration of information technologies in operating rooms has contributed to the wide adoption of image-based surgical assistance and robotics. Easier access to image data between different categories of users as well as between remote sites has a major impact on patient management and decision-making where physicians and care providers rely on image data in their daily practice. Interpretation and analysis of medical images are no longer functions performed solely by radiologists. New software tools and image processing platforms are being tailored for clinical practitioners and care providers using those data for treatment planning and therapeutic interventions. This shift in paradigm is impacting the medical industry where a more generalized use of imaging informatics imposes a shift in system architecture as well as in financial models.
0720-048X/$ – see front matter © 2011 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ejrad.2010.12.097
The rapid evolution of information technologies and the emergence of new communication tools in our daily life such as Internet, social networks, mobile devices and the wide adoption of these devices in the general public has a clear influence in the evolution of our professional activities. Such evolution in information technology will also change the practice of medicine of our western world. This quantum leap to the next generation of imaging technology can only be accessible if supported by appropriate IT infrastructure for data communication, remote consultations and most importantly, training and continuous education of physicians and staff. This special issue of EJR covers a wide range of fundamental as well as innovative aspects of PACS and imaging informatics. Besides a review of the historical aspects of PACS several papers address innovative aspects of PACS and highlight the extension beyond radiology into general clinical practice. The integration with new concepts of electronic patient records as well as the increasing use of imaging data in surgery and in imaging-based interventions has also driven new aspects of image visualization based on 3D and 4D rendering as well as virtual navigation and computer-assisted diagnosis (CAD). New concepts on ontology and knowledge-based data retrieval can significantly improve workflow and data management. New trends in consumer markets such as mobile portable devices, social networks and facilitated data and document exchange, will also affect the way new systems are being implemented. A strong emphasis on mobility and portability will impact the design of image communication systems as well as the tools for image visualization and image analysis. These constant shifts resulting from unpredictable changes in technology as well as emergence of disruptive technologies require more flexibility and modularity in the design of information systems and PACS. Modularity and rapid development of software components lead to new paradigm such as Extreme Programming, a software development methodology which is intended to improve software quality and responsiveness to changing customer requirements by frequent “releases” in short development cycles. The shift toward online storage services providing large storage capacity and very competitive cost driven by general consumer market has lead to rapid development of “Cloud” computing. This new shift in technology that is slowly replacing conventional data storage centers could rapidly submerge and replace traditional storage and communication infrastructure of PACS. I would like to thank the authors of this special issue on PACS for their contribution and for putting together this historical review
162
Editorial / European Journal of Radiology 78 (2011) 161–162
and prospective vision of a rapidly changing domain of our professional life. I am also grateful to Professor Imhof and the editorial board for giving us the opportunity to publish a special issue on this topic.
Osman Ratib ∗ Dept. of Medical Imaging and Information Sciences, Nuclear Medicine Division, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva 14, Switzerland ∗ Tel.:
+41 022 372 71 45; fax: +41 022 372 71 84. E-mail address:[email protected] 27 December 2010