Session S42.6

THOPACS: The Multi-Modality, Image Review, Diagnosis, Archiving and Analysis System

N van der Putten*, S de Winter, M de Wijs, R Hamers

Erasmus Medical Center
Rotterdam, Netherlands

Digital echocardiography and angiography have changed the clinical workflow in the last decade. The ability to have direct access to medical images for interpretation, and review is very useful in the clinical practice. In the Thoraxcentre in Rotterdam the images of 7 echo-machines, 4 X-ray systems and 2 IVUS systems have been archived in our THOPACS system for many years. All clinicians are capable to access the images at any location in the hospital. Access to the images has been extended to physicians home using VPN and to other hospitals in the Rotterdam region using the EVOCS system (web application for exchanging DICOM images between hospitals). Until recently the Thoraxcentre generated 800 GB image data a year. A number of significant changes have both dramatically reshaped our image landscape and extended our yearly image data production to 6 TB data. In the Cathlab the flat panel detector technology has been introduced. Instead of images with a resolution of 512*512 pixels of 8 bits much larger images until a resolution 2048*2048 pixels of 12 bits may be generated. New technologies like CT-mode scanning and new medical procedures in the Cathlab like aortic valve replacement enlarged the number of images per procedure. In the echocardiography department the introduction of 3D images in the clinical practice has extended the average study size from 30 MB image data into 200 MB image data. The introduction of larger angiographic images has enormous consequences for network, computer, computer screen and archiving strategy. In this paper we will address solutions for this problems. We introduced a three-level online storage strategy. In the first level all images are archived in diagnostic quality for 6-18 months. These images are only accessible at dedicated working places. All images are also archived in compressed format for a period of 3-5 years. These compressed images are accessible in every working place inside or outside the hospital. In the third level all images (in a very compressed format) are archived at a online accessible central PACS. Other discussed objectives: automatic uploading of images from other hospitals and the interoperability with image analysis systems.

(Abstract Control Number: 342)