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The rapid development of Artificial Intelligence/deep learning technology and its implementation into routine clinical imaging will cause a major transformation to the practice of radiology. Strategic positioning will ensure the successful transition of radiologists into their new roles as augmented clinicians. This paper describes an overall vision on how to achieve a smooth transition through the practice of augmented radiology where radiologists-in-the-loop ensure the safe implementation of Artificial Intelligence systems., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Radiological Picture Archiving and Communication Systems (PACS) have only relatively recently become abundant. Many hospitals have made the transition to PACS about a decade ago. During that decade requirements and available technology have changed considerably. In this paper we look at factors that influence the design of tomorrow's systems, especially those in larger multidisciplinary hospitals. We discuss their impact on PACS architecture (a technological perspective) as well as their impact on radiology (a management perspective). We emphasize that many of these influencing factors originate outside radiology and that radiology has little impact on these factors. That makes it the more important for managers in radiology to be aware of architectural aspects and it may change cooperation of radiology with, among others, the hospital's central IT department., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Picture Archiving and Communication System (PACS), which was originally designed as a tool for facilitating radiologists in interpreting images more efficiently, is evolving into a hospital-integrated system storing diagnostic imaging information that often reaches far beyond Radiology. The continuous evolution of PACS technology has led to a gradual broadening of its applications, ranging from teleradiology to CAD (Computer-Assisted Diagnosis) and multidimensional imaging, and is moving into the direction of providing access to image data outside the Radiology department, so to reach all the branches of the healthcare enterprise. New perspectives have been created thanks to new technologies (such as holographic media and GRID computing) that are likely due to expand PACS-based applications even further, improving patient care and enhancing overall productivity., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Teleradiology aims to even radiologists' workload, ensure on-call services, reduce waiting lists, consult other specialists and cut costs. Cross-border teleradiology widens this scope beyond the country borders. However, the new service should not reduce the quality of radiology. Quality and trust are key factors in establishment of teleradiology. Additionally there are organizational, technical, legal, security and linguistic issues influencing the service. Herein, we have used experiences from two partially European Union funded telemedicine projects to evaluate factors affecting cross-border teleradiology. Clinical partners from Czech Republic, Denmark, Estonia, Finland, Lithuania and the Netherlands went through 649 radiology test cases in two different teleradiology projects to build trust and agree about the report structure. Technical set-up was established using secure Internet data transfer, streaming technology, integration of workflows and creating structured reporting tool to overcome language barriers. The biggest barrier to overcome in cross-border teleradiology was the language issue. Establishment of the service was technically and semantically successful but limited to knee and hip X-ray examinations only because the structured reporting tool did not cover any other anatomical regions yet. Special attention has to be paid to clinical quality and trust between partners in cross-border teleradiology. Our experience shows that it is achievable. Legal, security and financial aspects are not covered in this paper because today they differ country by country. There is however an European Union level harmonization process started to enable cross-border eHealth in general., (Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.)

Due to a host of technological, interface, operational and workflow limitations, teleradiology and PACS/RIS were historically developed as separate systems serving different purposes. PACS/RIS handled local radiology storage and workflow management while teleradiology addressed remote access to images. Today advanced PACS/RIS support complete site radiology workflow for attending physicians, whether on-site or remote. In parallel, teleradiology has emerged into a service of providing remote, off-hours, coverage for emergency radiology and to a lesser extent subspecialty reading to subscribing sites and radiology groups. When attending radiologists use teleradiology for remote access to a site, they may share all relevant patient data and participate in the site's workflow like their on-site peers. The operation gets cumbersome and time consuming when these radiologists serve multi-sites, each requiring a different remote access, or when the sites do not employ the same PACS/RIS/Reporting Systems and do not share the same ownership. The least efficient operation is of teleradiology companies engaged in reading for multiple facilities. As these services typically employ non-local radiologists, they are allowed to share some of the available patient data necessary to provide an emergency report but, by enlarge, they do not share the workflow of the sites they serve. Radiology stakeholders usually prefer to have their own radiologists perform all radiology tasks including interpretation of off-hour examinations. It is possible with current technology to create a system that combines the benefits of local radiology services to multiple sites with the advantages offered by adding subspecialty and off-hours emergency services through teleradiology. Such a system increases efficiency for the radiology groups by enabling all users, regardless of location, to work "local" and fully participate in the workflow of every site. We refer to such a system as SuperPACS., (Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.)

This paper describes a novel teleradiology solution, its services and graphical user interfaces (GUIs), and the strategic decisions taken in the development of the services. The novel services are embedded in a radiology information infrastructure in Västra Götalandsregionen (VGR), Sweden. The application is fully integrated with all different RIS and PACS systems in the region and interconnected through the radiology information infrastructure. In practice, the solution offers new ways of collaborating through information sharing within a region. Knowledge can be used collectively to improve the radiology workflow and its outcomes for clinicians and patients. The new shared approach marks the beginning of a change from local to enterprise workflow. The challenges are to develop useful and secure services for different groups related to the radiological information infrastructure. It involves continuous negotiation with people concerning how they should collaborate within the region. The need for teleradiology as a service provided "by somebody" has disappeared in VGR; today it is a shared service embedded in the innovative radiology information infrastructure. This infrastructure is just a starting point for a novel and limitless telemedicine service including limitless healthcare actors and activities. The method applied for this study was action research. The study was carried out in collaboration between practitioners and researchers., (Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.)

Pathology and demography have combined to fuel exponential demand for advanced medical imaging. To support this demand, radiology must move beyond traditional department or modality-based picture archiving and communication systems (PACS) to solutions that ensure access regardless of location. This article delineates underlying reasons for the growth in demand for access to medical imaging in both Europe and the United States. It explains why teleradiology/PACS is critical to support this growth in Europe. It discusses the benefits of and barriers to its widespread implementation as discovered in Canada and the U.S. and how these lessons learned relate to Europe. The article establishes the technological imperatives for teleradiology/PACS and presents three real-world case studies of successful data sharing and shared workflow models via single imaging implementations. Finally, it provides a high-level list of selection criteria for teleradiology/PACS and examines how industry trends affecting the U.S. are important baseline considerations to the success of teleradiology/PACS in Europe., (Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.)