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New use cases and the need for quality control and imaging data sharing in health studies require the capacity to align them to reference terminologies. We are interested in mapping the local terminology used at our center to describe imaging procedures to reference terminologies for imaging procedures (RadLex Playbook and LOINC/RSNA Radiology Playbook). We performed a manual mapping of the 200 most frequent imaging report titles at our center (i.e. 73.2% of all imaging exams). The mapping method was based only on information explicitly stated in the titles. The results showed 57.5% and 68.8% of exact mapping to the RadLex and LOINC/RSNA Radiology Playbooks, respectively. We identified the reasons for the mapping failure and analyzed the issues encountered.

Objective: Time-sensitive communication of critical imaging findings like pneumothorax or pulmonary embolism to referring physicians is essential for patient safety. The definitive communication is the radiology free-text report. Quality assurance initiatives require that institutions audit these communications, a time-intensive manual task. We propose using a rule-based natural language processing system to improve the process for auditing critical findings communications., Methods: We present a pilot assessment of the feasibility of using an automated critical finding identification system to assist quality assurance teams' evaluation of critical findings communication compliance. Our assessment is based on chest imaging reports. Critical findings are identified in radiology reports using pyConTextNLP, an open source Python implementation of the ConText algorithm., Results: In our test set, there were 75 reports with critical findings and 591 reports without critical findings. pyConTextNLP correctly identified 69 of the positive cases with 8 false-positives for a sensitivity of 0.92 and a specificity of 0.99., Discussion: Natural language processing can provide valuable assistance to auditing critical findings communications., (Copyright © 2019 American College of Radiology. Published by Elsevier Inc. All rights reserved.)

With progressive advancements in picture archiving and communication system (PACS) technology, radiology practices frequently look toward system upgrades and replacements to further improve efficiency and capabilities. The transition between PACS has the potential to derail the operations of a radiology department. Careful planning and attention to detail from radiology informatics leaders are imperative to ensure a smooth transition. This article is a review of the architecture of a modern PACS, highlighting areas of recent innovation. Key considerations for planning a PACS migration and important issues to consider in data migration, change management, and business continuity are discussed. Beyond the technical aspects of a PACS migration, the human factors to consider when managing the cultural change that accompanies a new informatics tool and the keys to success when managing technical failures are explored. Online supplemental material is available for this article. © RSNA, 2018.

Rationale and Objectives: The purpose of this study was to integrate web-based forms with a zero-footprint cloud-based Picture Archiving and Communication Systems (PACS) to create a tool of potential benefit to radiology research and education., Materials and Methods: Web-based forms were created with a front-end and back-end architecture utilizing common programming languages including Vue.js, Node.js and MongoDB, and integrated into an existing zero-footprint cloud-based PACS., Results: The web-based forms application can be accessed in any modern internet browser on desktop or mobile devices and allows the creation of customizable forms consisting of a variety of questions types. Each form can be linked to an individual DICOM examination or a collection of DICOM examinations., Conclusions: Several uses are demonstrated through a series of case studies, including implementation of a research platform for multi-reader multi-case (MRMC) studies and other imaging research, and creation of an online Objective Structure Clinical Examination (OSCE) and an educational case file., (Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

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.)

Advances in informatics and information technology are sure to alter the practice of medical imaging and image-guided therapies substantially over the next decade. Each element of the imaging continuum will be affected by substantial increases in computing capacity coincident with the seamless integration of digital technology into our society at large. This article focuses primarily on areas where this IT transformation is likely to have a profound effect on the practice of radiology., Key Points: • Clinical decision support ensures consistent and appropriate resource utilization. • Big data enables correlation of health information across multiple domains. • Data mining advances the quality of medical decision-making. • Business analytics allow radiologists to maximize the benefits of imaging resources.

The science and applications of informatics in medical imaging have advanced dramatically in the past 25 years. This article provides a selective overview of key developments in medical imaging informatics. Advances in standards and technologies for compression and transmission of digital images have enabled Picture Archiving and Communications Systems (PACS) and teleradiology. Research in speech recognition, structured reporting, ontologies, and natural language processing has improved the ability to generate and analyze the reports of imaging procedures. Informatics has provided tools to address workflow and ergonomic issues engendered by the growing volume of medical image information. Research in computeraided detection and diagnosis of abnormalities in medical images has opened new avenues to improve patient care. The growing number of medical-imaging examinations and their large volumes of information create a natural platform for "big data" analytics, particularly when joined with high-dimensional genomic data. Radiogenomics investigates relationships between a disease's genetic and gene-expression characteristics and its imaging phenotype; this emerging field promises to help us better understand disease biology, prognosis, and treatment options. The next 25 years offer remarkable opportunities for informatics and medical imaging together to lead to further advances in both disciplines and to improve health.

The conception and deployment of cost effective Picture Archiving and Communication Systems (PACS) is a concern for small to medium medical imaging facilities, research environments, and developing countries' healthcare institutions. Financial constraints and the specificity of these scenarios contribute to a low adoption rate of PACS in those environments. Furthermore, with the advent of ubiquitous computing and new initiatives to improve healthcare information technologies and data sharing, such as IHE and XDS-i, a PACS must adapt quickly to changes. This paper describes Dicoogle, a software framework that enables developers and researchers to quickly prototype and deploy new functionality taking advantage of the embedded Digital Imaging and Communications in Medicine (DICOM) services. This full-fledged implementation of a PACS archive is very amenable to extension due to its plugin-based architecture and out-of-the-box functionality, which enables the exploration of large DICOM datasets and associated metadata. These characteristics make the proposed solution very interesting for prototyping, experimentation, and bridging functionality with deployed applications. Besides being an advanced mechanism for data discovery and retrieval based on DICOM object indexing, it enables the detection of inconsistencies in an institution's data and processes. Several use cases have benefited from this approach such as radiation dosage monitoring, Content-Based Image Retrieval (CBIR), and the use of the framework as support for classes targeting software engineering for clinical contexts.

Unlabelled: The number of computed tomography examinations has continuously increased over the last decades and accounts for a major part of the collective radiation dose from medical investigations. For purposes of quality assurance in modern radiology a systematic monitoring and analysis of dose related data from radiological examinations is mandatory. Various ways of collecting dose data are available today, for example the Digital Imaging and Communication in Medicine - Structured Report (DICOM-SR), optical character recognition and DICOM-modality performed procedure steps (MPPS). The DICOM-SR is part of the DICOM-standard and provides the DICOM-Radiation Dose Structured Report, which is an easily applicable and comprehensive solution to collect radiation dose parameters. This standard simplifies the process of data collection and enables comprehensive dose monitoring. Various commercial dose monitoring software devices with varying characteristics are available today. In this article, we discuss legal obligations, various ways to monitor dose data, current dose monitoring software solutions and future perspectives in regard to the EU Council Directive 2013/59/EURATOM., Key Points: • Automated, systematic dose monitoring is an important element in quality assurance of radiology departments. • DICOM-RDSR-capable CT scanners facilitate the monitoring of dose data. • A variety of commercial and non-commercial dose monitoring software tools are available today. • Successful dose monitoring requires comprehensive infrastructure for monitoring, analysing and optimizing radiation exposure. Citation Format: • Boos J, Meineke A, Bethge OT et al. Dose Monitoring in Radiology Departments: Status Quo and Future Perspectives. Fortschr Röntgenstr 2016; 188: 443 - 450., (© Georg Thieme Verlag KG Stuttgart · New York.)

Digital imaging has been widely used in the field of oral and maxillofacial radiology. The present work summarizes the use of digital imaging from the following aspects: ①The origin of digital oral and maxillofacial imaging; ②The influence of digital imaging on the work mode and work flow of oral and maxillofacial radiology; ③ Application of picture archiving and communication system(PACS)in oral and maxillofacial radiology; ④The influence of three dimensional medical data sets on diagnosis, prognosis and treatment plan; ⑤Digital imaging facilitates the development of telemedicine and internet-medicine; ⑥The significance of establishing a medical database or data center; ⑦Problems and challenges.

Radiology studies are inherently visual and the information contained within is best conveyed by visual methodology. Advanced reporting software allows the incorporation of annotated key images into text reports, but such features may be less effective compared with in-person consultations. The use of web technology and screen capture software to create retrievable on-demand audio/visual reports has not yet been investigated. This approach may preempt potential curbside consultations while providing referring clinicians with a more engaged imaging service. In this work, we develop and evaluate a video reporting tool that utilizes modern screen capture software and web technology. We hypothesize that referring clinicians would find that recorded on-demand video reports add value to clinical practice, education, and that such technology would be welcome in future practice. A total of 45 case videos were prepared by radiologists for 14 attending and 15 trainee physicians from emergency and internal medicine specialties. Positive survey feedback from referring clinicians about the video reporting system was statistically significant in all areas measured, including video quality, clinical helpfulness, and willingness to use such technology in the future. Trainees unanimously found educational value in video reporting. These results suggest the potential for video technology to re-establish the radiologist's role as a pivotal member of patient care and integral clinical educator. Future work is needed to streamline these methods in order to minimize work redundancy with traditional text reporting. Additionally, integration with an existing PACS and dictation system will be essential to ensuring ease of use and widespread adoption.

Objective: The purpose of this article is to describe structured reporting and the development of large databases for use in data mining in breast imaging., Conclusion: The results of millions of breast imaging examinations are reported with structured tools based on the BI-RADS lexicon. Much of these data are stored in accessible media. Robust computing power creates great opportunity for data scientists and breast imagers to collaborate to improve breast cancer detection and optimize screening algorithms. Data mining can create knowledge, but the questions asked and their complexity require extremely powerful and agile databases. New data technologies can facilitate outcomes research and precision medicine.

Interdisciplinary ultrasound departments are sources for modern and effective ultrasound diagnostic procedures. Radiologists have a very important role as part of these centers for the establishment of new diagnostic ultrasound modalities like contrast-enhanced ultrasound (CEUS), image fusion between US and computed tomography (CT) and magnetic resonance tomography (MRI), resulting in new interventional procedures. Data acquisition and the development of solutions for PACS are also important points., (© Georg Thieme Verlag KG Stuttgart · New York.)

Mobile devices, wireless networks and software have significantly evolved since the late 1990s and are now available with sufficient computing power, speed and complexity to allow real-time interpretation of radiology studies. Emergency radiology (ER)'s time-sensitive nature would seem to be an excellent match for study interpretation using mobile devices, allowing the radiologist to read studies anywhere, at any time. While suitable for use by the radiologist outside of the hospital, or clinicians and surgeons at the bedside or in the operating room, these devices do have limitations, and regulatory approval for in-hospital diagnostic use is limited. In the ER setting, we suggest that the best use of mobile devices is to be available to consult directly with patients about their imaging findings and to the clinical team during rounds and at handover. This will bring the radiologist to the clinician and patient, helping us to better understand the patient's presentation, educate both the physician and patient and increase the visibility and value of the radiologist as a member of the clinical care team.

Rapid growth in the amount of data that is electronically recorded as part of routine clinical operations has generated great interest in the use of Big Data methodologies to address clinical and research questions. These methods can efficiently analyze and deliver insights from high-volume, high-variety, and high-growth rate datasets generated across the continuum of care, thereby forgoing the time, cost, and effort of more focused and controlled hypothesis-driven research. By virtue of an existing robust information technology infrastructure and years of archived digital data, radiology departments are particularly well positioned to take advantage of emerging Big Data techniques. In this review, we describe four areas in which Big Data is poised to have an immediate impact on radiology practice, research, and operations. In addition, we provide an overview of the Big Data adoption cycle and describe how academic radiology departments can promote Big Data development., (Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Objective: Informatics innovations of the past 30 years have improved radiology quality and efficiency immensely. Radiologists are groundbreaking leaders in clinical information technology (IT), and often radiologists and imaging informaticists created, specified, and implemented these technologies, while also carrying the ongoing burdens of training, maintenance, support, and operation of these IT solutions. Being pioneers of clinical IT had advantages of local radiology control and radiology-centric products and services. As health care businesses become more clinically IT savvy, however, they are standardizing IT products and procedures across the enterprise, resulting in the loss of radiologists' local control and flexibility. Although this inevitable consequence may provide new opportunities in the long run, several questions arise., Conclusion: What will happen to the informatics expertise within the radiology domain? Will radiology's current and future concerns be heard and their needs addressed? What should radiologists do to understand, obtain, and use informatics products to maximize efficiency and provide the most value and quality for patients and the greater health care community? This article will propose some insights and considerations as we rethink radiology informatics.

Objective: This article illustrates the importance of radiologist engagement in the successful implementation of radiology-information technology (IT) projects through the example of establishing a mobile image viewing solution for health care professionals., Conclusion: With an understanding of the types of decisions that benefit from radiologist input, this article outlines an overall project framework to provide a context for how radiologists might engage in the project cycle.

This research investigates the opinions of radiologists regards requirements for improving current Picture Archiving and Communication System (PACS). Responses to a questionnaire were collected from 120 of the 200 radiologists in five governmental hospitals of Kuwait. The study the determines the importance of the solutions for future PACS from the radiologists point of view as: PACS must be integrated with other hospital information systems (100%); there must be multi hospital PACS access across different organizations (99%); web based PACS solutions (97%) and PACS applications in mobile phones (97%) are seen as an improved solution for future PACS. Whereas, the radiologists expressed strong concerns over the barriers for implementing web PACS solutions including: technical issues (91%); lack of training (85%); and cost (76%).

The paper reviews the problem of using structured radiology reports. Their salient features are as follows: to work out a protocol in accordance with some pattern, to divide it into subheadings arranged consecutively and logically and broken down by main anatomical structures, types of disease, and study, and to use standardized terminology. The RSNA proposed RadLex system is the most known example of structured reports. The experience in using these protocols has shown that the latter may improve the clearness and informative value of roentgenologists' opinions and alleviate their understanding by physicians of other specialties. However, the systems of writing the structured radiology reports have a number of constraints for the time being, which interfere with their wide clinical introduction. Nonetheless, their use is substantially increasing in the years ahead.

The analysis of literature data showed that the creation and implementation of a new form of radiology reports into clinical practice is an actual problem of modern medicine. Although imaging modalities have undergone dramatic evolution over the past century, radiology reporting has remained largely static, in both content and structure. In recent years the necessity to create a structured reporting is widely discussed in the literature. A universal format of radiology report hasn't been found yet. The standard of reporting system is absent, a wide variety of styles in radiology reporting currently exists. The challenging goal is improvement of existing protocols and creation of a new form of radiology reports--the protocols of the future.

A picture archiving and communication system (PACS) for multi-vendor imaging servers is useful, since it can provide a variety of image-processing services. However, to delete an image file in the PACS, it is necessary to delete not only the image but all its associated images that are stored in multiple servers: this is a lengthy and painstaking process. To reduce this workload, we have developed a system consisting of a computer program with a graphical user interface that can delete the target image and all related images by means of batch processing. The developed system creates an extensible markup language (XML)-format file that describes the operation for deleting an image and forwards the XML file to the main server. Using a Windows file-sharing system (SMB/CIFS), each server shares the XML file and deletes the images in its own database in response to the instructions described in the XML file. We can also rigorously manage information concerning the deleted images using the information that is output from the main server to external storage. We also discuss the degree of load reduction in our system compared with that of ordinary systems.

Objective: Today in the hospital setting, several functions of the radiology information system (RIS), including order entry, patient registration, report repository, and the physician directory, have moved to enterprise electronic medical records. Some observers might conclude that the RIS is going away. In this article, we contend that because of the maturity of the RIS market compared with other areas of the health care enterprise, radiology has a unique opportunity to innovate., Conclusion: While most of the hospital enterprise spends the next several years going through the digital transformation converting from paper to a digital format, radiology can leap ahead in its use of analytics and information technology. This article presents a summary of new RIS functions still maturing and open to innovation in the RIS market.

Within six months of the discovery of X-ray in 1895, the technology was used to scan the interior of the human body, paving the way for many innovations in the field of medicine, including an ultrasound device in 1950, a CT scanner in 1972, and MRI in 1980. More recent decades have witnessed developments such as digital imaging using a picture archiving and communication system, computer-aided detection/diagnosis, organ-specific workstations, and molecular, functional, and quantitative imaging. One of the latest technical breakthrough in the field of radiology has been imaging genomics and robotic interventions for biopsy and theragnosis. This review provides an engineering perspective on these developments and several other megatrends in radiology.

A new digital technology has been developed by researchers at Wake Forest School of Medicine to allow unaffiliated institutions to transfer medical images, thus avoiding the hassle of CDs. Could the PCARE system offer a model for others to follow?

Picture archiving and communication systems (PACS) and the Internet have changed how clinicians interact with their clinical colleagues, both during the day and at night. Teleradiology may improve the quality of life for radiologists but it also improves the quality of the interpretations for the patients. Given the opportunity this provides to connect subspecialist clinicians with subspecialist radiologists, daytime and nighttime teleradiology is likely to increase. Although teleradiology may worsen the commoditization that started with PACS, patient care will likely be improved, and that should always be the highest priority., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Film-based radiographs are still being used to teach in a conference format, which presents several viewing challenges amongst other problems. In the age of cloud computing, which enables the use of online server storage space, this information could be used more effectively if it were digitized. However, digitizing film-based radiographs and making them available for use in the cloud is not as easy as it seems. In order to address the issue of digitizing the film-based radiograph libraries in our radiology department, we looked at several options. The option that we chose was a consumer-grade scanner, and this decision was based on price, resolution, shades of gray, built-in transparency function, and its physical attributes. Our goal was to digitize the film-based radiograph teaching files so they could be stored in a digital file locker such as Google Picassa for organization and quick access later. These files would constantly be updated in a Google document by residents, and this document would be called the "Living Document" based on its continuous expandability. This method would allow even the smallest radiology department to benefit from the use of modern technology to gain access to valuable information stored in film-based radiographs and give every resident the opportunity to benefit from it.