New technology gives doctors the big picture

By Rick Bentley / The Fresno Bee
03/20/07 03:45:11

Dr. Charles Smith, medical director of the Department of Medical Imagery, stares at the images on four computer screens. The screen is filled with the sonogram image of a kidney of one of his patients. The screen is covered with 16 smaller images of the same kidney.

The images give Smith the opportunity to look at how the patient's kidney has changed over the past year. And all it took was a few seconds on the computer.

Children's Hospital Central California is now using the multimillion-dollar Picture Archiving Communication System, or PACS. The system, put in place in December, will eventually phase out the way doctors have dealt with X-rays, CT scans and other ways to peek inside their patient's bodies. The old system required doctors to hold up huge sheets of X-ray film to a light for scrutiny. That system is being replaced by computerized imaging.

Now, instead of the images being on film, digital versions are collected and stored in the computer. These digital images can be accessed in an instant by the physicians. And they can be accessed by multiple doctors simultaneously, even doctors who happen to be on vacation at other points on the globe.

Keith Pipes, director of Imaging Services, says that the new system is better for the doctors, the patients, the hospital and even the environment.

"In the past, a patient would have an X-ray made. The film would have to be processed. That would take a few minutes. How much detail was in the image depended on the technician," Pipes says. "We now use what is called computerized radiography. There is no more film; it is like an Etch A Sketch. A special plate is used. You make the exposure with X-rays, but instead of going to the darkroom, you enter the plate into the computer, and it pops up on the screen immediately."

Under the old system, once the image was made, it had to be shipped around the hospital, depending on the patient's needs. If the X-ray got lost or misfiled, the doctors had no history of the patient's condition. With PACS, the images are available to be seen as soon the information can be loaded into the computer.

Another plus is the additional information available through the digital images. Film X-rays have only one contrast. Because the image is collected digitally, the doctor can change the contrast on the image to see as much or little detail as necessary.

"You could not do that with film." Pipes says. "This is considerably higher resolution than you can get from a view box."

A huge bonus for doctors is that the images can be shared. It is possible for the X-ray to be seen at the same time by a doctor doing an operation, a specialist in another part of the hospital and by the patient's doctor who is at home. Those doctors would have had to be in the same room to simultaneously view an X-ray under the old system.

Smith is a big supporter of the new system.

"In the past I would have had to look at large stacks of X-rays of the patient. To get those X-rays I would have to order them from the files. Sometimes they got lost. Now all I have to do is call up the images on the computer screen," Smith says.

PACS is designed to allow doctors to examine one image or multiple images taken over an extended period of time. The computers feature terabytes of storage and make it possible for the doctors to look at the patient's medical reports at the same time.

In the past, patients were given the large film X-rays when they left the hospital. Depending on how long the patient was under a doctor's care, that could end up being a hefty stack. Now, the patient is sent home with the images stored on a CD.