Imaging Technology News - January/February 2009 - (Page 19)

> > special report inherently less intrusive,” added Levin. “So PACS administrators can spend more time focusing on new users and referring physicians, enhancing protocols or rolling out new sites.” Off-the-shelf hardware is typically used for Web-based PACS, often leading to a faster return-on-investment for the facility, he says. Web-based toolkits For many solutions, ActiveX (Microsoft) is the applet that enables certain functions, such as the imaging algorithm. The use of http protocols then enables data to stream directly to the desktop. “There are different technologies for distributing large datasets to the desktop,” added Morgan, “so buyers should inquire on the use of compression technologies and the speed of the data as they evaluate different solutions.” To provide users with the full functionality of a client-server PACS, GE Centricity-IW uses Apache Tomcat, which is an implementation of the Java Servlet and Java ServerPages technologies, as its Web server. The Web viewer is designed with C++, providing users with various ways to launch the software, while a Microsoft SQL database server supports nearly any network configuration (SAN, NAS, DAS, etc.), says Levin. Agfa’s IMPAX uses Waddo for access to static and dynamic DICOM objects. Yet, Dyer believes server-side rendering will lead to the “democratization of image rendering.” Rather than sending or downloading an application and image, clinicians will point to an image set residing on the server. The necessary technology to render the images remains on the server, which renders the image back to the user’s viewer. “This technology is particularly useful when accessing large imaging files, such as a 1,000-slice CT study,” he added. While Carestream’s PACS is also Waddo compliant, the company has developed an underlying streaming technology that “intelligently provides the content as quickly as possible, without requiring the user to wait for the entire data set,” said Maune. For example, if the user is interested in slice 650 in a 2,000-slice CT study, the slices surrounding slice 650 are streamed to the desktop first, enabling the user to begin viewing the study as quickly as possible. The Google Web Toolkit (GWT) also does not require any downloads, says Fisher. According to Google’s Web site, GWT lets software developers “quickly build and maintain complex yet highly performant JavaScript front-end applications in the Java pro2 gramming language.” As a result, BRIT programmers have developed an AJAX application across all major browsers for the company’s newly-launched Web-based PACS, Roentgen Files II. “The real benefit is that AJAX allows real-time update of information from the server to the viewer without the need to either refresh or update the screen,” said Fisher. As for the OS, Fisher says her company has started using Ubuntu for a more user-friendly Linux solution that is also easier to install. Photo courtesy of TeraRecon thin-client without additional human effort. With a Web-based PACS, Homan also finds that clinical display protocols specific to an assigned user will follow that user wherever he or she logs in. “Many of our radiologists cover for another hospital, so if they log into our system remotely, they have the same configuration as if they were here.” The result: Homan travels less to referring physician offices to set display protocols and, in general, spends less time with applications settings. Multi-media PACS Looking forward, it appears that Web-based PACS will become the preferred architecture, particularly as diagnostic imaging embraces multi-media. “We expect to see a montage of data delivered at higher speeds using better compression techniques,” said Morgan, “including video clips for dynamic studies such as angiography or echocardiography.” Delineation of imaging studies as ‘radiology’ or ‘cardiology’ will continue to dissipate as the virtual desktop becomes more prevalent. Levin sees the need for a single viewer for all types of studies, using the same interconnected infrastructure that provides clinicians with a single, longitudinal patient jacket. “Everything will come full circle and we will see the consolidation of department PACS into one centralized system,” he added. Likewise, archives will continue to migrate to a centralized, enterprise solution, said Dyer. “As with Google, viewers will connect directly to that data center, allowing clinicians and patients to view data,” he added, “using XML and html for the presentation of studies.” The use of ‘cloud computing’ will continue to grow, says Fisher, where the underlying technology is not a server, rather multiple servers that manage the storage of data across multiple systems. “Just as we have redundancy of data, we will see redundancy of the application, removing single points of failure to ensure continued accessibility by users,” she said. Fisher also believes the “new PACS world” will be much like the “Google world,” with systems talking to each other. Additional clinical efficiencies, such as the availability of 3D over the Web, will continue to take hold, particularly as workstations become more integrated, notes Maune. “We expect to see greater utilization of hosted storage solutions, an ideal solution for smaller sites such as doctor offices,” he said. Hosted solutions not only reduce IT management expense at the healthcare facility, but also provide disaster recovery and business continuance solutions. The result will be the proliferation of health information across the Web, which may make it easier to access a patient’s complete electronic medical record (EMR). As the U.S. federal government seeks ways to reduce the cost of healthcare and, simultaneously, provides incentives for healthcare providers to implement EMRs, advisors and analysts should examine the growth and success of Web-based PACS as a model for a lower cost, highly accessible, Web-based EMR. special report > 19 http://new.reillycomm.com/imaging/special-report-b.php http://code.google.com/webtoolkit

Table of Contents Feed for the Digital Edition of Imaging Technology News - January/February 2009

Imaging Technology News - January/February 2009 Contents IMRT Imaging RT Solutions for Troublesome Tumors PACS Radiology to Close the Imaging Loop Will Web-Based PACS Take Over? Is CT Dose Under Control? The Best in Digital Mammography Breast Biopsy Systems MX Series Monitors Provide University of Pennsylvania Quality Assurance Reduce Waste to Raise Revenue

Imaging Technology News - January/February 2009

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