Documente Academic
Documente Profesional
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REVIEW
KEYWORDS
Internet; Digital imaging and communications in medicine
(DICOM); PACS
Digital imaging and communications in medicine (DICOM) is the standard image file
format used by radiological hardware devices. This article will provide an overview of
DICOM and attempt to demystify the bewildering number of image formats that are
commonly encountered. The characteristics and usefulness of different image file
types will be explored and a variety of freely available web-based resources to aid
viewing and manipulation of digital images will be reviewed. How best to harness
DICOM technology before the introduction of picture archiving and communication
systems (PACS) will also be described.
Q 2005 The Royal College of Radiologists. Published by Elsevier Ltd. All rights
reserved.
Introduction
0009-9260/$ - see front matter Q 2005 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.crad.2005.07.003
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DICOM demystified
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Figure 2 Image degradation resulting from excessive lossy data compression: (a) High-resolution JPEG image (144 kb)
of an axial T2-weighted MRI image of the brain showing a right-sided acoustic neuroma (white arrow); (b) moderate
compression of the same JPEG image (64 kb) showing no significant image degradation; (c) highly compressed JPEG
(32 kb) demonstrating marked image degradation.
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DICOM-viewing software
Third-party software
All of the image file types described above can
easily be opened and viewed on a standard personal
computer (PC) with a contemporary operating
system such as Windows XP (Microsoft, Redmond,
WA, USA) without the need for any special software. By contrast DICOM images require additional
software to be installed before they can be opened
and viewed. DICOM-viewing software falls into two
main categories: Proprietary viewers, which are
supplied with imaging systems such as CT or
magnetic resonance imaging (MRI) machines; and
third-party DICOM-viewing software, either in the
form of PACS or as a stand-alone viewer for
individual PCs.
Table 1
formats.
File type
Compression
method
JPEG
TIFF
PNG
Lossy
Lossy or
lossless
Lossless
JPEG 2000
GIF
Lossless
Lossless
DICOM demystified
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Feature
Osiris
DicomWorks
Osirix
eFilm
Yes
No
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
DICOM demystified
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that all the images are available for review and can
be windowed and reformatted (if supported by the
DICOM viewer) during the meeting.
Another option is to select specific images that
demonstrate the salient information and export
them as JPEG or TIFF files. This is a time-consuming
process but is useful when preparing presentations
for teaching. The easiest way to present these
images is by importing them into a presentation
package such as Microsoft PowerPoint. Clinical
cases can easily be made into slides with relevant
case history and images inserted. This method can
be used by trainees to prepare cases for departmental meetings. The presentations could subsequently be used as teaching resources as part of
a digital image library. The development of a digital
teaching file has been discussed in a previous article
in this series.19
Conclusion
The advent of the DICOM file format has been a
major step forward in clinical radiology by allowing
digital images to be easily stored and transferred
electronically. Digital images can be manipulated in
many ways and converted to different formats for
teaching and publication purposes. We have outlined a variety of ways in which radiologists may
utilize digital images and how to make the most of
the capabilities of DICOM before the introduction of
PACS.
References
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