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PACS radiology: Will it replace traditional film?

The transition from traditional film-based methods to the advanced digital system known as PACS (Picture Archiving and Communication System) shows the latest technological evolution within the field of radiology. This system represents a significant leap in medical imaging, offering enhanced diagnostic accuracy and improved patient care.


In the realm of medical disciplines, radiology harnesses technological advancements to enhance diagnostic precision and imaging quality. Over the years, these technological strides have significantly transformed, contributing to improved patient care and diagnostic accuracy.

This transition has occurred from conventional radiography, characterized by a manual process involving the development of traditional film, to digital radiography and radiology AI and is known as PACS radiology (Picture Archiving and Communication System).

Radiology PACS: What is it?

PACS Radiology is an advanced system managed by software that electronically stores medical images and radiology reports, allowing images to be digitized and sent to a computer in a matter of seconds and therefor improving medical care and service. 

PACS system radiology is characterized by its immediacy, which has an impact on the generation of clinical reports. The sharper images of an X-ray PAC allows, helping to improve the diagnostic work of health professionals and, therefore, benefiting patient care.

How does a PACS radiology system work?

To make imaging systems in healthcare work more efficiently, a PACS system is needed. This system consists of servers that store electronic images and the corresponding reports. It helps with the medical decision process by giving quick access to these images. The system can share results across computers, aiding analysis and data exchange between medical departments and personnel, leading to improved and more accurate care.

The four main components of radiology PACS

The PACS system has a series of components that work together to provide high-quality medical diagnosis. Among those components, the following stand out:

  • Image modalities: This is the image management system (IMS), responsible for acquiring images across various medical imaging techniques, all standardized in the DICOM format (Digital Imaging and Communication in Medicine). This will allow for easier file management in the different processes.
  • Communication networks: The DICOM format facilitates the transmission and exchange of medical images between diverse devices by standardizing the way data is structured and shared. By employing a standardized format, DICOM ensures seamless interoperability, enabling secure and efficient transmission across various devices and systems within healthcare settings. This standardization minimizes compatibility issues, streamlines data interpretation, and promotes smoother communication among different medical imaging equipment and software, ultimately enhancing the reliability and speed of image transfer across the network.
  • Display WS: The PACS workstations are composed of high-resolution diagnostic and standard stations, equipped with monitors that allow for image evaluation and reporting.
  • Archive and server: Here,  results obtained from imaging examinations, both in the input and display process, are stored. Storage can be local or online, and for a short, medium, or long-term duration.

What is the difference between traditional film and PACS?

The past: Traditional film in radiology

In conventional radiology, X-rays are used. They contain ionizing radiation that generates a shadow on the bone density of the body, as well as on organs and tissues, producing images in which the internal structure of the body can be observed. 

The process of X-rays involves exposing the human body to low-level energy and radiation. Radiographic plates are used in this process specifically for capturing these X-ray images. These plates necessitate manual development, which is a time-consuming task requiring the involvement of multiple professionals. Moreover, the chemicals used in this process cause environmental pollution.

The future: PACS in radiology

Diagnosis for healthcare is considered of vital importance in terms of disease detection and treatment. This has improved with the support of conventional radiology, allowing physicians, radiologists, and other professionals to observe the internal structure of the human body through images. 

With the development of radiological PACS systems, iagnostic abilities have improved even further. These systems enhance image sharpness, quality, and speed while lowering radiation exposure. Further, this information can automatically be sent to a computer for image storage, creating a history that can be accessed from various devices. Based on these developments, medical teams can make better informed decisions, improving the quality of patient care.


Combining PACS software with RIS

Radiology departments use other systems that, together with PACS, complement, improve, and optimize imaging examinations. This serves to improve the workflow and efficiency of their processes, as is the case with Radiology Information Systems (RIS).

RIS allows better functioning of radiology services, as it incorporates various functions that permit the management of patient information, such as the recording of clinical history and appointment scheduling. Further, RIS is capable of storing images and relevant patient information, allowing patient follow-up, as well as providing shared access within a computer network. This can be accessed by physicians for review and analysis when appropriate, according to a study about Benefits of Integrated RIS/PACS/Reporting published by “Current Problems In Diagnostic Radiology” Journal.

Therefore, the combination of PACS Radiology software with RIS improves the diagnostic and care process carried out in radiology departments, through the integration and management of information. This is done by automating and digitizing processes ranging from data and image storage to their access and distribution, including billing processes and management of resources and materials. Thus, radiology departments that implement both systems together improve speed and efficiency, while reducing errors and simplifying administrative tasks.

What are the benefits of PACS?

  • Improved image and diagnostic quality: Digitizing images makes them clearer, sharper, and more detailed, improving diagnostic accuracy.
  • Distribution and access: Images and reports can be shared immediately among different teams, allowing specialists to view and analyze them for faster and more efficient decision-making.
  • Organization of the information: Since they are digital repositories, it is easier to organize the reports and other patient data. This is because digital repositories offer enhanced organizational capabilities for reports and patient data due to their inherent searchability, categorization features, and the ability to apply automated indexing and sorting functions, streamlining accessibility and retrieval processes.
  • Storage of images: Given that images are backed up locally or online, the safeguarding and search of information is guaranteed, allowing specialists to work quickly and easily without the risk of losing information.
  • Reduced environmental impact: The pollution associated with the development processes generated by conventional radiology is eliminated.

A study about the effects of PACS on different dimensions of users’ work published by the Radiology Research and Practice Journal states that, even though radiologists have a more in-depth understanding of the benefits of the PACS than general physicians, results showed that PACS benefits all users groups and has a positive impact. 

What are the challenges posed by PACS?

While PACS Radiology undoubtedly provides improved services for the well-being and health of patients, it is necessary to take into account the challenges that arise when including this system in hospital departments. These challenges can include increased costs, implementing adequate infrastructure like the necessary computer equipment and servers, training of medical and technical personnel, as well as the privacy and protection of stored data.

Should PACS be installed in healthcare facilities?

All healthcare institutions should aim to direct their actions towards optimizing their tasks and functions, adopting systems that allow them to improve their processes and workflows in order to offer  quality service and constant improvement. 

Digital radiology implemented through the PACS system contributes to this, improving the workflow in diagnostic imaging services, favoring modern medical care with an essential tool that benefits hospitals by generating an improvement in hospital administration, and creating channels that contribute to communication among their staff to make more accurate and efficient decisions.

Will PACS radiology completely replace traditional film?

The shift toward PACS replacing traditional film in radiology is a nuanced progression. PACS offers a paradigm shift by digitizing images, allowing for instant access, easier storage, and enhanced image manipulation. This digitization also aligns with the broader trend of healthcare digitization, promoting streamlined data management and integration.

However, some challenges persist. Adoption hurdles include initial capital investment, potential resistance from entrenched systems or professionals comfortable with film, and concerns about cybersecurity threats to digital data.

Moreover, some scenarios still favor film, like in remote areas with limited digital infrastructure. Upgrading warrants careful evaluation based on the institution’s needs, readiness for digital integration, and the balance between immediate benefits and long-term gains in patient care.

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