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DOI: 10.1148/rg.266065707
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Vendor-Neutral Case Input into a Server-based Digital Teaching File System1

Aaron W. C. Kamauu, MD, MS, MPH, Scott L. DuVall, Reid J. Robison, MD, MBA, Andrew P. Liimatta, Richard H. Wiggins, III, MD and David E. Avrin, MD, PhD

1 From the Department of Biomedical Informatics, University of Utah, 26 South 2000 East HSEB 5700, Salt Lake City, UT 84112-5750 (A.W.C.K., S.L.D.); the Departments of Psychiatry (R.J.R.) and Radiology (R.H.W., D.E.A.), University of Utah Health Sciences Center, Salt Lake City; and the Utah Center for Advanced Imaging Research, Center for Advanced Medical Imaging, Salt Lake City (A.P.L.). Received February 15, 2006; revision requested June 2; final revision received August 15; accepted August 16. Supported in part by training grant 2T15 LM07124 from the National Library of Medicine, National Institutes of Health; the Educational Computing Committee at the University of Utah School of Medicine; and Amirsys, Salt Lake City. S.L.D., A.P.L., R.H.W., and D.E.A. are consultants to Amirsys; R.H.W. and D.E.A. are also stockholders in Amirsys.

Figure 1
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  		Figure 1.  Imaging studies are pushed from the PACS to RadICS. Automatic image processing is handled by the image server, and the original DICOM files and newly generated Joint Photographic Experts Group (JPEG) files are moved to temporary (Temp) file storage on the server. The case authoring process, including key image selection, case description input, and key image optimization, is managed by the Web server. Selected key images are copied to permanent file storage, and case information is stored in a MySQL (Cupertino, Calif) relational database. HTML = hypertext markup language, JSP = Java Server Pages.

 

Figure 2
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  		Figure 2.  The image server manages the DICOM Receive and DICOM-to-JPEG conversion processes. A DICOM Receive Perl script runs the Oldenburger Forschungs- und Entwicklungs-institut für Informatik-Werkzeuge und –Systeme (OFFIS) DICOM toolkit (DCMTK) DICOM Service Class Provider (SCP) process. The image server parses the DICOM Header and determines appropriate window and level settings. All magnetic resonance (MR) images are processed through the Automatic Window and Level Calculator (AWLC), while all other images use preset window and level (WL) settings. The Perl script passes the window and level settings as parameters to the DCMTK, which generates full-size and thumbnail JPEG files in temporary (Temp) file storage.

 

Figure 3
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  		Figure 3.  At the PACS workstation, the radiologist opens an Internet Explorer (Microsoft) Web browser and logs into RadICS on the control monitor (left), while the study DICOM images are still viewable on the second PACS monitor (right). Thumbnail JPEG images of the original DICOM images are generated by using the window and level settings obtained from the automatic calculator. These images are displayed in RadICS for key image selection (left).

 

Figure 4
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  		Figure 4.  Testing of RadICS with the Philips Medical Systems PACS.

 

Figure 5
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  		Figure 5.  Testing of RadICS with the Stentor PACS.

 

Figure 6
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  		Figure 6.  Display of a completed interesting case in RadICS.

 




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