PACS And Postprocessing Overview

Purpose

Efficient Storage Retrieval And Advanced Visualization Of Medical Images | Bridge Between Acquisition Modalities And Reporting

Core Components

Modalities (CT MRI US XR) | PACS Server | DICOM Router | Workstations And Viewers | Archive And Backup

Users

Radiologists Technologists Referrers And IT Support


Viewing Basics And Workflow

Study Retrieval

Search By MRN Accession Or Name

Use Patient Identifiers And Accession Numbers To Retrieve Studies | Verify Demographics And Side Markers Before Interpretation


Hanging Protocols

Automated Layouts For Efficiency

Configure Hanging Protocols To Display Relevant Series Side By Side | Use Modality Specific Presets For CT MRI And Mammography


Study Comparison

Prior Studies And Fusion

Load Prior Exams For Temporal Comparison | Use Fusion Tools To Overlay PET CT Or Prior MR For Localization


Image Adjustment And Optimization

Window And Level

Adjust For Tissue Contrast

Use Preset Windows For Lung Bone Soft Tissue | Fine Tune Window Width And Level To Highlight Subtle Findings


Zoom Pan And Rotate

Focus On Region Of Interest

Use Zoom For Small Lesions And Pan To Maintain Orientation | Rotate For Better Anatomical Alignment In 2D Views


Filters And Edge Enhancement

Improve Perceived Sharpness

Apply Noise Reduction Or Edge Enhancement Sparingly | Understand That Excessive Filtering Can Create Artifacts


MPR MIP And 3D Reconstructions

MPR (Multiplanar Reformat)

Coronal Sagittal And Oblique Views

Reconstruct Thin Axial Data Into Coronal Sagittal And Oblique Planes | Use Isotropic Voxels For High Quality Reformats


MIP And MinIP

Vascular And Airway Evaluation

Maximum Intensity Projection For Vascular Structures And Pulmonary Nodules | Minimum Intensity Projection For Airway And Low Attenuation Structures


3D Volume Rendering

Preoperative Planning And Education

Volume Rendered Images For Surgical Planning Orthopedics And Vascular Cases | Adjust Transfer Function And Opacity To Emphasize Structures


Measurements And Quantitative Tools

Linear And Area Measurements

Calipers And ROI Tools

Use Calipers For Lesion Size And Area Tools For Organ Measurements | Record Plane And Window Settings For Reproducibility


Volumetry And Segmentation

Automated And Manual Methods

Use Semi Automated Segmentation For Tumor Volumes Liver Spleen And Lung Nodule Tracking | Verify And Edit Automated Contours Manually


Density And HU Measurements

CT Attenuation Values

Place ROI For Hounsfield Unit Measurements | Document ROI Size Location And Phase (Pre/Post Contrast)


DICOM And Data Management

DICOM Tags

Patient Study Series And Image Metadata

Understand Key DICOM Fields (Patient ID Accession Study UID Series UID) | Use Metadata To Troubleshoot Matching And Routing Issues


Archiving And Backup

Short Term And Long Term Storage

Follow Institutional Retention Policies | Ensure Redundant Backups And Off Site Archives For Disaster Recovery


Privacy And Security

PHI Protection And Access Controls

Use Role Based Access Audit Trails And Encryption For Data In Transit And At Rest | Deidentify Studies For Teaching And Research


Exporting Images And Reporting

Export Options

DICOM CD PDF And JPEG

Export Studies As DICOM For Transfer Between Sites | Use PDF Or JPEG For Quick Clinical Sharing While Preserving Key Images And Measurements


Structured Reporting

Templates And Key Findings

Use Structured Report Templates To Ensure Consistent Communication | Include Technique Comparison And Critical Findings Section


Annotations And Burned In Text

Permanent Versus Soft Labels

Prefer Soft Annotations Stored In DICOM Over Burned In Text When Possible | If Burned In Labels Are Used, Document In Report


PACS QA And Troubleshooting

Daily Checks

Viewer And Network Connectivity

Verify Viewer Launch And Access To Recent Studies | Check Network Latency And Storage Availability


Common Issues

Missing Studies And Mismatched IDs

Troubleshoot With DICOM Logs Verify AE Titles And Routing Rules | Reconcile Patient Demographics And Use Merge Tools When Needed


Performance Optimization

Cache And Prefetch Strategies

Use Prefetch For Scheduled Reads And Cache Frequently Accessed Series To Improve Load Times | Coordinate With IT For Storage Tiering


Terminology

PACS

Picture Archiving And Communication System | Centralized Storage And Retrieval For Medical Images

DICOM

Digital Imaging And Communications In Medicine | Standard For Medical Image Data And Metadata

Hanging Protocol

Predefined Layout For Displaying Series On A Viewer

MPR

Multiplanar Reformatting | Reconstructing 2D Planes From Volumetric Data

Volume Rendering

3D Visualization Technique That Maps Voxel Intensity To Color And Opacity