PACS - Picture Archiving and Communication System

Picture archiving and communication systems (PACS) underwent a rapid development for the past 15 years, influenced by new technologies, faster network connections and other technical improvements. PACS handles different tasks, aimed to replace former film based medical images and the according workflows in hospitals and medical practices. In a PACS, images are acquired from medical imaging modalities like Computer Tomography (CT), X-ray or nuclear medicine imaging and digitally stored. It is preprocessing these images and making them easy accessible from different workstations within a medical environment. Therefore, modern PACS consist of image acquisition components, a controller, a database server, an archiving system and an underlying network to connect them. Each of these components needs to fulfill certain hardware and software requirements. PACS can also be interacting with other hospital wide systems, e.g. Radiology Information System (RIS) and Hospital Information System (HIS), to add according patient data or to support an end-to-end workflow. The images are stored in an archive and can be requested from multiple PACS workstations, where physicians and radiologists can examine the images for primary diagnosis, write reports, prepare for medical procedures or compare them with former studies. These workstations are providing complex software to analyze the images, e.g. 3D animation and computer-aided diagnosis (CAD). Furthermore, PACS use industrial standards such as DICOM and HL7 to improve compatibility with new imaging modalities. There exist several different PACS implementations on the market, e.g. actual PACS systems from Siemens, AGFA, and the open source project openSourcePACS. The PACS development process is not going to stop yet, as there exist many trends and possible improvements for PACS in the future, like the improving resolution and data size of medical images, faster networks and mobile solutions for teleradiology, i.e. the cooperation of radiologists over long distances.