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Integration of computer-aided diagnosis/detection (CAD) results in a PACS environment using CAD–PACS toolkit and DICOM SR

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Picture Archiving and Communication System (PACS) is a mature technology in health care delivery for daily clinical imaging service and data management. Computer-aided detection and diagnosis (CAD) utilizes computer methods to obtain quantitative measurements from medical images and clinical information to assist clinicians to assess a patient’s clinical state more objectively. CAD needs image input and related information from PACS to improve its accuracy; and PACS benefits from CAD results online and available at the PACS workstation as a second reader to assist physicians in the decision making process. Currently, these two technologies remain as two separate independent systems with only minimal system integration. This paper describes a universal method to integrate CAD results with PACS in its daily clinical environment.

Methods

The method is based on Health Level 7 (HL7) and Digital imaging and communications in medicine (DICOM) standards, and Integrating the Healthcare Enterprise (IHE) workflow profiles. In addition, the integration method is Health Insurance Portability and Accountability Act (HIPAA) compliant.

Summary

The paper presents (1) the clinical value and advantages of integrating CAD results in a PACS environment, (2) DICOM Structured Reporting formats and some important IHE workflow profiles utilized in the system integration, (3) the methodology using the CAD–PACS integration toolkit, and (4) clinical examples with step-by-step workflows of this integration.

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Abbreviations

CAD:

Computer-assisted detection and diagnosis

CARS:

Computer-assisted radiology and surgery

DICOM:

Digital imaging and communications in medicine

DICOM-SR:

DICOM structured reporting

FLAIR:

Fluid attenuated inversion recovery

HIPAA:

Health insurance portability and accountability act

HIS:

Hospital information system

HL7:

Health level 7

IHE:

Integrating the Healthcare Enterprise

IRB:

Institutional Review Board

IOD:

Information object definition

KIN:

Key image note

MRI:

Magnetic resonance imaging

MS:

Multiple sclerosis

PPM:

Post-processing manager

PWF:

Post-processing workflows

RIS:

Radiology information system

SINR:

Simple image and numeric report

SC:

DICOM secondary capture

SR:

Structured report object/document

WS:

Workstation

XML:

Extensible markup language

References

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Correspondence to Anh H. T. Le.

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Le, A.H.T., Liu, B. & Huang, H.K. Integration of computer-aided diagnosis/detection (CAD) results in a PACS environment using CAD–PACS toolkit and DICOM SR. Int J CARS 4, 317–329 (2009). https://doi.org/10.1007/s11548-009-0297-y

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  • DOI: https://doi.org/10.1007/s11548-009-0297-y

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