An economical, personal computer-based picture archiving and communication system.

Taichung Veterans General Hospital has been developing a hospital-wide picture archiving and communication system (PACS) since 1993. A personal computer-based environment was implemented to reduce costs (only $2,500 for each view station) and take advantage of distributed system techniques. Other features of the PACS are automatic image acquisition, hierarchic storage management, efficient image transmission, robust fault tolerance, and user-friendly image manipulation. The system is integrated with the hospital information system so that Chinese-language patient data can be automatically transferred. A four-tier storage hierarchy and a multipath search strategy are used to improve reliability and efficiency. Image compression and efficient image transmission techniques (autorouting and prefetching) are used to reduce the response time. Robust fault tolerance is achieved with fault-tolerant hardware, image replication, and a system watchdog. User-friendly image manipulation features include easy adjustment of the brightness, contrast, or quality of the displayed image; several windows for image display; and image measurement capability. The PACS currently supports computed tomography, ultrasound, magnetic resonance imaging, computed radiography, and digital fluoroscopy; almost all appropriate personal computers in the hospital can be used as view stations. Users are satisfied with the quality, reliability, and performance of the system.