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Ambulatory Systems
Published in Salvatore Volpe, Health Informatics, 2022
Curtis L. Cole, Adam D. Cheriff, J. Travis Gossey, Sameer Malhotra, Daniel M. Stein
The earliest and most basic clinical systems were result reporting systems that allowed viewing of the output of laboratory and other biomedical devices. Lab data are typically numeric and relatively easy to categorize and display. Textual results, such as pathology, microbiology, and radiology results were also fairly analogous to other data routinely managed by early business computers. Graphical results and images arrived later with the more powerful hardware and software required to support these modalities. Radiology results in particular bring in additional complexity, as the non-textual part of the result (the image) is stored and viewed on a picture archiving and communication system (PACS) typically separate from the EHR, requiring additional interface and patient context synchronization needs.
CDS Systems: Past, Present, and Future
Published in Paul Cerrato, John Halamka, Reinventing Clinical Decision Support, 2020
Previous chapters have highlighted the value of AI in a variety of diagnostic scenarios, including the diagnosing of diabetic retinopathy, breast cancer, and melanoma. But AI is also making progress in the radiology suite itself, offering clinicians tools that move beyond the traditional picture archiving and communication system (PACS). In the past, frontline practitioners would typically receive a plain text document from a radiologist. They would then have to review the images in question in a separate system. One problem with this approach is that it’s easy to misinterpret comments in the text report when it is not directly linked to a specific spot on the image in the second application. In practical terms, this means that the referring clinician may think the radiologist is referring to one abnormality on the image when he or she is actually referring to a different problem located elsewhere. Linking the two applications together and adding hyperlinks can significantly improve the quality of the report and the referring physician’s ability to interpret the radiology findings.
B-mode instrumentation
Published in Peter R Hoskins, Kevin Martin, Abigail Thrush, Diagnostic Ultrasound, 2019
The modern radiology department is based on imaging systems, including ultrasound scanners, which are connected to an imaging network. This system is generally referred to as a picture archiving and communication system (PACS). A PACS typically has workstations for review and reporting of image data, printers for producing hard copy of images and reports, and a large memory store for archiving patient data. Most reporting for ultrasound is performed in real time, with the operator saving images or video clips which illustrate the lesion (if present) or the measurement. A hard copy of images for inclusion in patient notes is usually done using a high-quality laser printer, though there may be no hard copy of images, with inclusion of only the report in the notes. Instead, if the referring clinician wants to inspect the images he or she can do so at a local terminal, connected to the hospital network, on the ward or in the clinic.
Pleural effusion volume in patients with acute pancreatitis: a retrospective study from three acute pancreatitis centers
Published in Annals of Medicine, 2021
Gaowu Yan, Hongwei Li, Anup Bhetuwal, Morgan A. McClure, Yongmei Li, Guoqing Yang, Yong Li, Linwei Zhao, Xiaoping Fan
All the thoracic and abdominal CT images were transferred to the picture archiving and communication system (PACS) station (INFINITT PACS, INFINITT Healthcare Co. Ltd., South Korea) for interpretation. The interpretation was independently performed by two radiologists (each with six and 10 years of experience in thoracic and abdominal CT imaging) without knowing the clinical data. If there were any disagreements, a third reviewer (with more than 15 years of experience in thoracic and abdominal CT imaging) was consulted. Whenever possible, the CTSI and EPIC scores on AP were calculated for each individual [21,22]. Based on the CTSI and EPIC scoring systems, the AP patients with less than four points were placed into the mild subgroup while those with four or greater points were placed into the severe subgroup.
Single-center study: the diagnostic performance of contrast-enhanced ultrasound (CEUS) for assessing renal oncocytoma
Published in Scandinavian Journal of Urology, 2020
Vincent Schwarze, Constantin Marschner, Giovanna Negrão de Figueiredo, Thomas Knösel, Johannes Rübenthaler, Dirk-André Clevert
This retrospective single-center study was approved by the local institutional ethical committee of the institutional review board and all contributing authors followed the ethical guidelines for publication in Scandinavian Journal of Urology. All study data were gathered according to the principles expressed in the Declaration of Helsinki/Edinburgh 2002. Oral and written informed consent of all patients were given before CEUS examination and their associated risks and potential complications have been carefully described. All CEUS examinations were performed and analyzed by a single skilled radiologist with more than 15 years of clinical experience (EFSUMB Level 3). All included patients underwent native B-mode, Color Doppler and CEUS scans. Up-to-date high-end ultrasound systems with adequate CEUS protocols were utilized (GE Healthcare: LOGIQ E9; Samsung RS80A Prestige, Siemens Ultrasound Sequoia S20000, S3000, Philips Ultrasound iU22, EPIQ 7). A low mechanical index was used to avoid early destruction of microbubbles (<0.2). For all CEUS examinations, the second-generation blood pool contrast agent SonoVue® (Bracco, Milan, Italy) was used [20–24]; 1.0 − 2.4 mL of SonoVue® was applied. After contrast agent was applied, a bolus of 5 − 10 mL sterile 0.9% sodium chloride solution was given. No adverse side-effects upon administration of SonoVue® were registered. All CEUS examinations were successfully performed and the image quality was sufficient in every single case, allowing for proper analysis of the sonomorphological appearance of the renal lesions. The patient files and imaging records were retrieved from the picture archiving and communication system (PACS) of our institution.
Multiparametric ultrasonographic analysis of testicular tumors: a single-center experience in a collective of 49 patients
Published in Scandinavian Journal of Urology, 2020
Vincent Schwarze, Constantin Marschner, Bastian Sabel, Giovanna Negrão de Figueiredo, Julian Marcon, Michael Ingrisch, Thomas Knösel, Johannes Rübenthaler, Dirk-André Clevert
This retrospective single-center study was approved by the local institutional ethical committee of the institutional review board and all contributing authors followed the ethical guidelines for publication in Scandinavian Journal of Urology. All study data were gathered according to the principles expressed in the Declaration of Helsinki/Edinburgh 2002. Oral and written informed consent of all patients were given before CEUS examination and their associated risks and potential complications have been carefully described. All CEUS examinations were performed and analyzed by a single skilled radiologist with more than 15 years of clinical experience (EFSUMB Level 3). All included patients underwent native B-mode, Color Doppler, CEUS scans and strain elastography (SE) or shear wave elastography (SWE). Up-to-date high-end ultrasound systems with adequate CEUS protocols were utilized (GE Healthcare: LOGIQ E9; Samsung RS80A Prestige, Siemens Ultrasound Sequoia S20000, S3000, Philips Ultrasound iU22, EPIQ 7). A low mechanical index was used to avoid early destruction of microbubbles (<0.2). For all CEUS examinations, the second-generation blood pool contrast agent SonoVue® (Bracco, Milan, Italy) was used. 1.0–2.4 ml of SonoVue® were applied. After contrast agent was applied, a bolus of 5–10 ml sterile 0.9% sodium chloride solution was given. No adverse side-effects upon administration of SonoVue® were registered. All CEUS examinations were successfully performed and image quality was sufficient in every single case allowing for proper analysis of the sonomorphological appearance of the testicular lesions. The patient files and imaging records were retrieved from the picture archiving and communication system (PACS) of our institution.