PACS-Based Multimedia Imaging Informatics

Basic Principles and Applications

H. K. Huang

• Éditeur: Wiley-Blackwell
• Année: 2018
• ISBN:
  9781118795774
• Édition: 3
• Sujet: Medicine
• Sous-sujet: Radiology, Radiotherapy & Nuclear Medicine

Thoroughly revised to present the very latest in PACS-based multimedia in medical imaging informatics—from the electronic patient record to the full range of topics in digital medical imaging—this new edition by the founder of PACS and multimedia image informatics features even more clinically applicable material than ever before. It uses the framework of PACS-based image informatics, not physics or engineering principles, to explain PACS-based multimedia informatics and its application in clinical settings and labs. New topics include Data Grid and Cloud Computing, IHE XDS-I Workflow Profile (Integrating the Healthcare Enterprise Cross-enterprise Document Sharing for Imaging), extending XDS to share images, and diagnostic reports and related information across a group of enterprise health care sites.

PACS-Based Multimedia Imaging Informatics is presented in 4 sections. Part 1 covers the beginning and history of Medical Imaging, PACS, and Imaging Informatics. The other three sections cover Medical Imaging, Industrial Guidelines, Standards, and Compliance; Informatics, Data Grid, Workstation, Radiation Therapy, Simulators, Molecular Imaging, Archive Server, and Cloud Computing; and multimedia Imaging Informatics, Computer-Aided Diagnosis (CAD), Image-Guide Decision Support, Proton Therapy, Minimally Invasive Multimedia Image-Assisted Surgery, BIG DATA.

• New chapter on Molecular Imaging Informatics
• Expanded coverage of PACS and eHR's (Electronic Health Record), with HIPPA compliance
• New coverage of PACS-based CAD (Computer-Aided Diagnosis)
• Reorganized and expanded clinical chapters discuss one distinct clinical application each
• Minimally invasive image assisted surgery in translational medicine
• Authored by the world's first and still leading authority on PACS and medical imaging

PACS-Based Multimedia Imaging Informatics: Basic Principles and Applications, 3 rd Edition is the single most comprehensive and authoritative resource that thoroughly covers the critical issues of PACS-based hardware and software design and implementation in a systematic and easily comprehensible manner. It is a must-have book for all those involved in designing, implementing, and using PACS-based Multimedia Imaging Informatics.

Foreword 1

PACS–Based Multimedia Imaging Informatics 3rd Edition, 2018

Medical imaging, PACS, and imaging informatics have revolutionized the approach to managing patients in both the inpatient and outpatient settings. While this has been true for many decades, the fusion and integration of medical images of all types, in the current era and in the future, will make these data sources all the more important and powerful. Medical imaging had traditionally been in the domain of radiology in schools of medicine. With the nearly universal use of electronic medical records (EMR), images from all sources can now be brought to bear on the diagnosis, prognosis, and treatment course of individual patients.

Thus, both traditional radiological images as well as pathological, photographic, retinal, and other imaging data can be integrated with genomic and other “omic” information to provide a much more comprehensive view of an individual. They are no longer based on the use of static two‐ or three‐dimensional snapshots of a given aspect of a patient’s state but, rather, four‐ and five‐dimensional imaging datasets can now be used to study dynamic processes or changing states for a given patient over time. Images from different patients can be combined, using modern imaging methodologies, to produce population images that better define aspects of a disease, patient groups, or genetic characteristics. Such population images will provide previously unavailable insights into the human state under both normal and pathologic conditions.

Dr H.K. “Bernie” Huang’s 3rd edition of his book is a comprehensive survey of the history, current use, and future opportunities for medical imaging, PACS, and imaging informatics. This comprehensive textbook expands upon the first two editions and provides new and previously unpublished information about how medical images and PACS systems will be used in the 21st century. With Dr Huang’s vast experience of this topic, he is the ideal individual to develop a comprehensive text of this sort and he has done just that. The four parts of the text carefully organize this vast topic into manageable and appropriately segregated components. Because the textbook includes both a retrospective, providing the reader with insight into how the field developed initially, and a more futuristic section (Part 4), which provides specific examples and future directions for the use of medical images in computer‐aided diagnosis, image‐guided decision support, specific types of radiation therapy imaging strategies and image‐assisted surgery, the overall content of the text is something that will be useful to students of these disciplines at any level. I also believe that a text of this type would be a valuable learning tool for policy makers who are studying advanced uses of the electronic medical record and insights that can be provided from the data contained in those records.

I have recently had the opportunity to visit facilities that are utilizing image‐assisted surgical systems for both open and laparoscopic procedures. These systems incorporate, not only three‐ and four‐dimensional imaging approaches, but also utilize captured real‐time images during the procedure to troubleshoot errors and complications. Furthermore, such approaches are now becoming instrumental in designing workflows for managing patients through various types of image‐associated therapies. As such, medical imaging has gone from a static early diagnostic tool to a comprehensive component of operational and quality control measures, critical in the modern approach to high‐quality, high‐throughput, patient care.

I highly recommend this text to students of medical imaging at all levels and particularly to those who are interested in expanding the horizons for the use of medical images and those who would like to advance the field of biomedical imaging informatics, population imaging, and imaging as a tool for quality and workflow management.

Dr Huang has done a superb job in producing an extraordinarily comprehensive text that is well illustrated and continues in the tradition of the previous two editions to be a comprehensive reference for students and practitioners of these disciplines.

John C. Mazziotta, MD, PhD
Vice Chancellor, UCLA Health Sciences
CEO, UCLA Health

Foreword 2

A Thought on PACS and CAD

The concepts of picture archiving and communication systems (PACS) and computer‐aided diagnosis (CAD) were introduced in the late 1970s and early 1980s, as digital imaging had been attempted in diagnostic radiology and medical imaging. Bernie Huang is one of the key pioneers who have been very active since the beginning of large‐scale research on PACS and CAD, as well as the development of many digital imaging systems. In the beginning, many assumed PACS and CAD to be just a “dream”. However, PACS has grown significantly over the years as the foundation of an infrastructure for image data and medical information in radiology and other branches of medicine. This version of PACS‐based Multimedia Imaging Informatics by Bernie Huang is the third edition of his book, which is an excellent book for researchers, practitioners, and students in the field of medical imaging, on the subject of informatics and PACS.

However, although CAD had limited success, for example, CAD for detection of breast cancer on mammograms, CAD is still in the early stage of infancy toward its full development in many imaging modalities and different types of examinations. The success of PACS has provided many benefits to physicians and to hospitals, and it has produced a vast database of image information stored in PACS. However, the image information in PACS has not been used extensively and actively, except for comparison of new and previous cases of the same patients and also in research and teaching, which constitutes a small fraction of the image data stored in PACS. Therefore, a vast amount of the images stored in PACS may be considered to be “sleeping” at this time. These images may be used for the development of many CAD schemes for the detection of lesions and for the differential diagnosis of abnormalities in many different imaging modalities by use of new approach such as machine learning and deep‐learning convolution neural networks.

In addition, images similar to those of a new clinical case could be identified by searching of clinical cases with known pathology stored in PACS, based on the contents of image information and subjective similarity of images. These are examples of ways in which this book may be used for finding solutions in radiology and other branches of medicine. This book PACS‐based Multimedia Imaging Informatics could be a useful source of information leading to a new approach for research and development in CAD and many other fields.

Kunio Doi, Ph.D.
Professor Emeritus, The University of Chicago
Professor Emeritus and Former President
Gunma Prefectural College of Health Sciences
Maebashi, Gunma, Japan

Foreword 3

Dr H.K. “Bernie” Huang's third edition of this book covers a tremendous amount of highly relevant topics in its 22 chapters; and yet it may still be considered as an essential introduction to the overall topic of PACS and Informatics. The organization of the book is such that the reader is presented with both a logical and temporal evolution of medical imaging systems, which demonstrates the general trajectory of these systems. Starting from closed, standalone systems (difficult to imagine now, but this was the state of technology he encountered when he created the first PACS system) and moving to the more integrated systems containing vast amounts of data that will undoubtedly be the sources of “Big Data” that will be explored, mined, and analyzed for years to come.

While medical images provide a tremendous amount of insight into establishing patients’ diagnoses, disease stage, response to therapy, and many other uses, this data is still underutilized. There is still tremendous potential in exploring the integration of this data with other information sources – the multimedia that Bernie refers to – such as radiology reports (free text and structured reporting), Computer‐Aided Diagnosis (CAD), quantitative imaging features (radiomics), as well as pathology information, genomics, proteomics, information extracted from other modalities (e.g. circulating tumor cells), and other sources. This book provides unique perspectives into these issues by starting with a brief history (Part 1 – Retrospective), the infrastructure necessary for integration between different systems (Part 2 – Standards and Guidelines), examples of integrated systems (Part 3 – Informatics, Archives, Electronic Patient Record, the Cloud), and then some example applications (Part 4 – CAD, Clinical Decision Support, Big Data).

Therefore, this book is highly recommended for a broad audience of practicing physicians, information scientists, system developers, researchers, and others in healthcare that seek to create and utilize integrated information sources. While at first glance this book may seem to be of primary interest to those in radiological and surgical disciplines, the approaches described here are broader than that and should also be of interest to those in other specialty departments such as pathology, cardiology, and orthopedics. Bernie has created another outstanding text, which will surely stand as both a standard reference and a signpost to the future for years to come.

Michael McNitt‐Gray, PhD, DABR, FAAPM, FACR
Professor, Department of Radiological Sciences
Director, Physics and Biology in Medicine Graduate Program
Assistant Vice Chancellor of Research, Radiation Safety
David Geffen School of Medicine at UCLA