Integration of Temporal Subtraction and Nodule Detection System for Digital Chest Radiographs into Picture Archiving and Communication System (PACS): Four-year Experience

Abstract

Since May 2002, temporal subtraction and nodule detection systems for digital chest radiographs have been integrated into our hospital's picture archiving and communication systems (PACS). Image data of digital chest radiographs were stored in PACS with the digital image and communication in medicine (DICOM) protocol. Temporal subtraction and nodule detection images were produced automatically in an exclusive server and delivered with current and previous images to the work stations. The problems that we faced and the solutions that we arrived at were analyzed. We encountered four major problems. The first problem, as a result of the storage of the original images' data with the upside-down, reverse, or lying-down positioning on portable chest radiographs, was solved by postponing the original data storage for 30 min. The second problem, the variable matrix sizes of chest radiographs obtained with flat-panel detectors (FPDs), was solved by improving the computer algorithm to produce consistent temporal subtraction images. The third problem, the production of temporal subtraction images of low quality, could not be solved fundamentally when the original images were obtained with different modalities. The fourth problem, an excessive false-positive rate on the nodule detection system, was solved by adjusting this system to chest radiographs obtained in our hospital. Integration of the temporal subtraction and nodule detection system into our hospital's PACS was customized successfully; this experience may be helpful to other hospitals.

Impact of a Computer-Aided Detection (CAD) System Integrated into a Picture Archiving and Communication System (PACS) on Reader Sensitivity and Efficiency for the Detection of Lung Nodules in Thoracic CT Exams

“…In addition, while the integration of CAD into a routine clinical PACS environment is gaining momentum [25][26][27][28], the interactive functionality for reviewing CAD marks within PACS is currently limited. The main purpose of the present report, therefore, has been to assess the impact on reader's identification of solid lung nodules employing a CAD server integrated into a PACS environment as a potential component of routine clinical CT interpretation.…”

Development of a Mini-Mobile Digital Radiography System by Using Wireless Smart Devices

“…Most of the DR system receives X-ray signals that have passed through a part of the patient and have been measured by an X-ray detector and directly converts these signals to digital signals, which are then directly sent to the image processing and PACS computer systems [9][10][11][12][13][14]. However, in the case of portable DR, all components cannot be split.…”

Thoracic Temporal Subtraction Three Dimensional Computed Tomography (3D-CT): Screening for Vertebral Metastases of Primary Lung Cancers

“…However, the detection of vertebral metastases by computer-aided diagnosis (CAD) on CT is challenging [4, 12]. Temporal subtraction of chest radiograph is a CAD technique that initial digital image subtract from follow-up image on workstation, and it has already been commercialized [13, 14]. In addition, a temporal subtraction method of three-dimensional CT (3D-CT) has been reported recently [15–17].…”