Current Status and Trends of Medical Imaging Workstations

The rapid development of computer and information technology has dramatically changed medical diagnosis and treatment models, shifting medical activities from the past experience-dominated model to a more scientific and precise digital model. The development and application of medical imaging workstations is a prominent example of this shift.

Through computer-aided intelligent processing of medical images and information, it allows image diagnosis to abandon traditional visual observation and subjective judgment. With the help of computer technology, the pixels of the image can be analyzed, calculated, and processed to obtain relevant complete data, providing more objective information for medical diagnosis. The latest imaging technology can not only provide morphological images but also functional images, and the fusion and reconstruction functions of the two types of images have appeared in many commercial software, enabling medical image diagnosis technology to move towards a deeper level.

The Concept of Medical Imaging Workstation

Currently, imaging workstations used in clinical practice and research range from simple, inexpensive microcomputer systems to complex, large-scale systems incorporating hardware. Based on China's national conditions, this article discusses the narrow sense of medical imaging workstations (software). It is an important subsystem of the PACS system, also known as the PACS medical imaging workstation or medical imaging digital workstation. It integrates the world's advanced computer data storage technology and digital image processing technology and is a medical imaging analysis and processing system developed on Windows, Unix, or other platforms.

Medical Imaging Workstation and PACS

PACS is a comprehensive application system that uses medical imaging technology, computer hardware and software technology, and network communication technology to achieve the acquisition, storage, management, diagnosis, and information processing of digital medical image information generated by medical imaging equipment such as CT, MRI, US, X-ray machines, and DSA. It is a product of the development of medical image diagnosis and an important part of the hospital information system. Its components mainly include computers, network devices, memory, and software. Medical imaging workstations involve two parts of PACS: medical image data storage and medical image and other information display processing. It can be said that the medical imaging digital workstation is a product of PACS development, and conversely, its development has greatly reduced the cost of building PACS, thus also promoting the development of PACS.

The Development of PACS

Currently, overseas research, development, and applications have covered various aspects of PACS, including access to imaging equipment, network transmission, the application of new methods for graphic image processing, and research on the standardization of key components in PACS. In their research, development, and application process, universities and hospitals, and companies and hospitals have played important roles and have close cooperative relationships, enabling PACS technology and applications to gradually enter a mature stage, with a large number of research achievements and successful application examples. The Medical Diagnostic Image Support System implemented in the United States in 1992 aimed to install PACS and remote medical radiology systems for many medical nodes domestically and overseas. This four-year project powerfully promoted the installation and practical application of large-scale PACS. In Europe, hospital-wide PACS were established in the 1990s, such as Hammersmith Hospital in London and SMZO Hospital in Vienna. In Japan, about 100 hospitals installed PACS of different scales in 1998. In 1989, Japan proposed the concept of the Image Save And Carry (ISAC) system. The difference between ISAC and PACS is that ISAC is an offline system, while PACS is an online system. The Japan PACS Association and the Medical Information System Development Center are responsible for the standardization and development of the ISAC system.

At present, the development situation of domestic hospitals is roughly equivalent to the beginning of the 1990s in foreign countries. Major hospitals have established practical hospital management information systems to varying degrees and are gradually developing from simple hospital management information systems to clinical diagnosis and treatment information systems. Recently purchased medical imaging equipment generally has a DICOM 3.0 interface, which provides a sufficient basis for establishing a practical medical image management system. At present, some large hospitals in Beijing, Shanghai, and Guangzhou are seeking to purchase or jointly develop PACS systems, and some hospitals have already established small-scale, experimental systems. Based on this, it can be expected that PACS will begin to be popularized in large and medium-sized cities in China in the next few years.

Development of Domestic Medical Imaging Workstations

Along with the development of PACS, medical imaging workstations have also undergone rapid development. In order to improve the modernization management level and work efficiency of hospitals, China began to pay attention to the construction of medical management information systems in the 1990s and established hospital information systems of different scales accordingly. Medical imaging workstation technology has also been unprecedentedly developed at the same time.

Compared with PACS, there are countless medical imaging workstation products on the domestic market. The most common are ultrasound imaging workstations, as well as endoscopy imaging workstations, radiology imaging workstations, electrocardiogram workstations, ultra-high magnification microscopy imaging workstations, and so on. With the progress of the national Golden Shield project, some research institutions, medical units, and commercial companies in China have entered the field of research. To date, medical imaging workstations have been widely used in many hospitals, laying the foundation for the in-depth development of PACS projects. However, there is also an unbalanced development trend with faster development in coastal cities.

Ultrasound Imaging Workstation

Application: This type of workstation has been widely used in relevant departments of hospitals. It generally has the following functions: basic information setting, glossary editor (for ultrasound description and conclusions of specific organs or parts to be examined), report editing, image parameter setting and video setting, query, statistics, and post-processing of acquired images.

The application of ultrasound workstations has greatly improved the work efficiency of ultrasound workers, reducing the cumbersome and error-prone nature of manual writing, providing convenient conditions for storing case data and comparing patient examinations before and after, and providing guarantees for the long-term preservation of image archiving and image data in the construction of digital hospitals. It is an indispensable software for modern office work and should be vigorously promoted. In terms of text information processing, there is basically no gap compared with foreign countries. However, in terms of application, foreign countries have already applied ultrasound imaging to surgical Navigator systems, ahead of China.

Conclusion

In the near future, medical imaging workstations will surely become popular in various hospitals. At the RSNA 2007 conference of the North American Radiological Society, regional imaging centers, three-dimensional reconstruction, computer-aided diagnosis (CAD) applications, diffusion technology, and image fusion of medical images became the hottest topics for participants to exchange. Therefore, the future development of workstations may explore and research the following aspects.

1) Improve the quality of acquisition of features of interest and further expand the range of features. Develop more advanced data mining methods to achieve the joint use of multiple feature extractors, transforming from simple lesion identification to disease nature analysis, breaking away from the current limited auxiliary detection function.

2) Increase the inspection of image legitimacy to ensure the accuracy of medical image transmission in PACS.

3) Develop specific functional modules that can be shared. Shorten the development cycle of medical imaging workstations, expand their general-purpose functions, launch universal imaging workstations, so that one set of imaging workstations can be used in multiple departments of a hospital. For example, the virtual endoscope function in Siemens PACS is realized by integrating the virtual endoscope function module of Viatronix.

4) Integrated System. The application-level image workstation software is directly installed into the existing imaging equipment to form a system-on-a-chip, shortening the image transmission distance and enabling real-time dynamic detection.

5) Integrate existing expert systems, knowledge discovery systems, and image workstations used for treatment to improve the human-computer interaction diagnostic model, support video format data, and develop a well-performing workstation that approaches the level of medical experts.

Due to the author's limited knowledge, this article only provides a brief introduction to the overall development status, trends, and characteristics of the workstation. The display technology, network architecture, and specific image post-processing technologies [3132, etc.] are not covered. In the 21st century, the country is accelerating the construction of independent innovation capabilities in the field of high and new technology. As an important part of the PACS project, medical image workstations will continue to develop in image processing, further synchronizing with the development of medical imaging equipment and leading the upgrading and iteration of medical imaging equipment.

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