Medical Imaging – PACS

by admin on June 12, 2020


PACS is an acronym for Picture Archive and Communication System, which is a medical imaging technology that provides access to viewing, storing, receiving and sending exams from various modalities. PACS eliminates the need for and associated costs of film, including laborious viewing, filing and transporting. PACS makes workflow more efficient for radiologists, technologists, referring physicians and staff. It also greatly improves patient care, delivering quick turnaround of exam interpretation by both on-site and remote diagnosis. Modalities frequently viewed and stored on PACS include:
  • X-Ray
  • CR - Computer Radiography
  • DR - Digital Radiography
  • US – Ultrasound
  • MRI - Magnetic Resonance Imaging
  • CT - Computed Tomography
  • PET - Positron Emission Tomography
  • MG – Mammography
  • Nuclear Medicine
  • and many others.


PACS providers may offer a viewer, storage and disaster recovery layer. Viewers have functionality which allows users to manipulate images. Some basic functionality includes:
  • hanging protocol layout - generic & custom
  • splitting display windows vertically & horizontally
  • cross reference - active window cross-referenced against all other intersecting images
  • anatomic grouping - links relevant images within active exam
  • window/level values
  • filter sharpen
  • zoom/magnify/pan
  • annotate - symbols/comments/measurements
  • cine
Some PACS providers design additional advanced functionalities as native to their viewer software, while others may launch third-party systems to deliver added functionality, if at all. Advanced viewer functionalities also available include:
  • MPR - Multi-Planar Reconstruction - creates new image from selected slices of original
  • MIP - Maximum Intensity Projection
  • anatomic triangulation - synchronizes all visible series to same anatomic region
  • PET Fusion - PET CT
  • Tomosynthesis
  • Critical Result alerts - Radiologist may note, broadcast and monitor critical findings with referring
  • Peer Review - allows radiologists to score results from studies previously dictated by others
  • ED Discrepancy - Emergency Department Discrepancy


PACS access used to require an on-site workstation at a facility. With the advent of the internet, and secure communication capability, remote access has become both common and expected. Remote access provides a convenience to physicians--who can now, literally, read exams anywhere they have an internet connection--and created a market for teleradiology, allowing radiologists to receive exams day and night, interpreting and responding within a promised, finite time period. Accessing PACS remotely must be secure, which often requires the use of a VPN (Virtual Private Network).


Radiologists using PACS to interpret exams need the means to record their interpretation into a report. This is often done using voice recognition, or dictation into a recorder which is subsequently accessed by a transcriptionist memorializing the results into a typed document. Radiologist reports are made available to the referring physicians through a variety of means. Some basic PACS providers fax or email reports; sophisticated PACS providers allow secure access to referring physicians on their system remotely, delivering not only reports, but access to images, key image summaries, print pages and other useful patient and study documentation.


Many PACS providers install hardware on-site at a facility. Some offer access via the cloud, hosting at a data center. Though both have their advantages, using a data center removes the concerns normally associated with protecting and monitoring an on-site computer room. However, getting exams securely transmitted from a facility to a data center usually requires a VPN. Medical archives can consist of online and offline status exams. Online are typically on SSD or spinning disc servers, and retrievable within seconds. Offline archives may also be stored on spinning disc, or in fully-automated, robotic jukeboxes. These comparison exams are older and retrieved less frequently, so they can be stored in formats that may not be available instantaneously.


Disaster recovery is an additional layer of protection, where, at a minimum, duplicate copies of exams are stored in a separate location or on a different format, in order to ensure a level of comfort from an act of God destroying archives, a facility or worse. More experienced PACS companies not only preserve images, but offer duplication of all aspects of a work environment, so restoration after a calamity, though rare, can be efficient and thorough. Installation of PACS is usually a long-term commitment, with the expectation of a forecasted volume of exams on an annual basis, equating to a significant capital expense and multi-year relationship. Also, ongoing maintenance and support, along with software upgrades, are usually additional expenses.


The ImageQube Cloud data center delivers convenient access to PACS with no on-site hardware installation required! All modalities are displayed, including PET Fusion, Digital Mammography and Tomography. ImageQube offers built-in advanced functionality, including MPR, Peer Review, Critical Results, ED Discrepancy, Instant Messaging, Teleradiology and much more.


ImageQube Cloud makes PACS available without any of the usual constraints:
  • No Minimum Volume
  • No Commitment
  • No Up-Front Cost
  • Vendor Neutral Archive
  • Secure Communication - no VPN required
  • Unlimited Licenses
  • Disaster Recovery layer
ImageQube is platform independent, so the PACS viewer runs on any desktop operating system; users can work on a PC, Mac or Linux workstation. Our teleradiology module allows study data to be pushed to specified users for totally secure, diagnostic, on-call capabilities. It's encrypted and secure, with site-specific, remote imaging available anywhere. Scalable and fault-tolerant, it fits the needs of users and facilities of any size. So, the needs of multi-site hospitals, outpatient imaging centers and even individual teleradiologists can be met without sacrificing functionality or budget. Its paperless workflow includes the ability to drag 'n drop documents directly into a patient's portfolio. Referring physicians can be granted encrypted secure access to reports, images, key image summaries, print pages and critical result alerts, without requiring a VPN. ImageQube Cloud also includes software upgrades and maintenance and support at no additional cost. Support is available 24/7, while auto-diagnostics deliver hands-free monitoring with pre-alerts of any potential problems. Archives are DICOM and vendor neutral. Our disaster recovery provides a duplicate layer of protection, archiving images, the database and user preferences, eliminating threats from viruses, hackers, ransomware and media failures. Using our secure DICOM upload application, exams are transmitted to the data center without requiring a VPN. With "how to" videos accessible online and no on-site hardware installation required, ImageQube Cloud is almost DIY; no IT department is needed. Check out ImageQube Cloud with a no-obligation, free trial!