PACS and Web-based image distribution and display.

Picture archiving and communication system (PACS) delivers images to the display workstations mostly through digital image communication in medicine (DICOM) protocols in radiology departments, and there are lots of medical applications in healthcare community needing to access PACS images for different application purposes. In this paper, we first reviewed a hospital-integrated PACS image data flow and typical diagnostic display software architecture, and discussed some Web technologies and Web-based image application server architectures, as well as image accessing and viewing methods in these architectures. Then, we present one approach to develop component-based image display architecture and use image processing and display component to build a diagnostic display workstation, and also, give a method to integrate this component into Web-based image distribution server to enable users using Web browsers to access, view and manipulate PACS DICOM images as easy as with PACS display workstations. Finally, we test and evaluate the performance of image loading and displaying by using the diagnostic display workstation and the component-based Web display system, the experimental results show that the image distribution and display performance from the Web server to browser clients is similar with that of the image loading and displaying procedure of the diagnostic workstation as more browser clients accessing the Web server at same time. We also discuss the advantages and disadvantages of the Web-based image distribution and display in different medical applications. Copyright 2002 Elsevier Science Ltd.