Integrating MIRC-compliant Semiautomated Teaching Files into PACS Work Flow

Abstract

A Medical Image Resource Center (MIRC)-compliant teaching file system was created that can be integrated into a picture archiving and communication system (PACS) environment. This system models the three-step process necessary for efficient teaching file creation in a PACS environment: (a) identifying and transferring a case quickly and easily during primary interpretation, (b) editing and authoring the case outside of primary interpretation time, and (c) publishing the case locally and via MIRC standard-based mechanisms. Images from interesting cases are e-mailed to the teaching file system from either the PACS workstation or the radiologist's personal computer. Notes and clinical information may be included in the e-mail text to prompt the recollection of case details. Images are automatically extracted from the e-mail and sent to an image repository, and text fields are captured in a database. The World Wide Web-based authoring component provides tools for final authoring of cases and for the manipulation of existing cases. Authors designate access levels for each case, which is then made available locally and, potentially, to the entire MIRC-compliant community. Although this application has not yet been implemented as a departmental solution, it promises to improve and streamline medical education and promote better patient care.

CT colonography: Project of High National Interest No. 2005062137 of the Italian Ministry of Education, University and Research (MIUR)

“…The availability of the entire CT examination allows users to practise interpreting such studies. This aspect of the database is very innovative in that the radiology learning resources available on the Internet tend to present only the most significant images of a clinical case, which in most cases is adequate for the e-learning purpose of the resource in question [14][15][16]. In the case of CT colonography, the training of radiologists on an adequate number of cases is a prerequisite for defining the radiologist an "expert": according to several authors, radiologists need to have interpreted at least 50 examinations controlled with conventional colonoscopy before undertaking diagnostic activity [17][18][19][20].…”

“…La disponibilità dell'intero esame TC consente all'utente di esercitarsi nella sua interpretazione. Questo aspetto del database è da considerarsi molto innovativo, in quanto le risorse didattiche radiologiche disponibili su Internet si limitano a presentare le immagini più significative del caso clinico e nella maggior parte dei casi sono sufficienti allo scopo dell'e-learning della risorsa in oggetto [14][15][16]. Nel caso specifico della colonscopia virtuale, l'addestramento del radiologo su un congruo numero di casi rappresenta una fase necessaria affinché egli possa essere definito "esperto"; secondo alcuni autori il medico radiologo dovrebbe aver interpretato almeno 50 esami controllati con colonscopia tradizionale prima di iniziare l'attività diagnostica [17][18][19][20].…”

An Integrated Approach to a Teaching File Linked to PACS

“…The MIRC represents an initiative by the Radiological Society of North America to promote standards in the creation and exchange of teaching file cases. 7 Through these standards, a set of input fields are defined, so that the case can then be shared with other centers, in an expected format. As this teaching file has been developed outside of these standards, it currently would not meet the requirements of the MIRC, but it does have many common variables.…”

Vendor-Neutral Case Input into a Server-based Digital Teaching File System

“…Although some picture archiving and communication system (PACS) vendors enable images to be exported in desktop publishing formats, none currently offer a satisfactory solution for the creation of DTFs (3)(4)(5)(6)(7). Some academic institutions have struggled with a variety of methods to design in-house vendor-specific DTF solutions, while many others lack the resources to do so (8 -12).…”