Digital Imaging and Communications in Medicine (DICOM)

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Chapter 13 DICOM and Teleradiology
ogy never tried to use analog or general-purpose devices. It only addressed
the problem of expanding the digital image workflow beyond the limited
scope of the local PACS networks. In fact, the most advanced email radiology
users eventually managed to exchange images in DICOM rather than in JPEG.
Therefore, its obvious lack of DICOM and PACS support was more technical
than conceptual and, despite all the extreme issues as seen on Fig. 84, we can
call email radiology the first honest attempt to implement true teleradiology. It
also pointed in the direction of expanding the traditional, local PACS beyond
the scope of their departmental networks.
On many occasions, you can still see email radiology being used these days,
even when so many other tools are available. One of the main reasons now: it
doesn’t cost a thing.
13.3
Teleradiology
Teleradiology provides remote radiology services over computer networks.
With proper network infrastructure and adequate PACS software setup,
DICOM images can easily be shared over any distance. The images made in
one location (such as in the USA) can be interpreted and read in a completely
different one (for example, India, Israel, or Australia), bringing substantial cost
benefits, and speeding up the image-reading cycle. Terms such as those shown
below have become not only the buzzwords, but rather the cornerstones for
many of today’s radiology practices:
1. Moonlighting and night-hawking: reading images overnight in another
country with a different time zone.
2. Regional PACS: PACS, extended to large geographical regions and covering
multiple countries; for example, in the European Union.
3. Radiology outsourcing: hiring radiology companies in cost-efficient locations
to provide image interpretation services.
4. Teleradiology hubs: locations that harbor a host of teleradiology services
and resources.
5. Grid PACS: distributed computer networks to store and process imaging
data.
Their functionality, and perhaps there very existence, is completely based on
teleradiology. Reflecting globalization of the world’s economy and healthcare,
teleradiology has truly exploded in the past few years. Studies indicate that
more than 90% of all radiology examinations can be outsourced and read remotely
(Pattynama 2006). Practically speaking, many small facilities such as
imaging centers and community hospitals are already 100% percent teleradiology-based
(Fig. 85).