title: Integration of computer-aided diagnosis/detection (CAD) results in a PACS environment using CAD-PACS toolkit and DICOM SR.
abstract: OBJECTIVE
  Picture Archiving and Communication System (PACS) is a mature technology in health care delivery for daily clinical imaging service and data management. Computer-aided detection and diagnosis (CAD) utilizes computer methods to obtain quantitative measurements from medical images and clinical information to assist clinicians to assess a patient's clinical state more objectively. CAD needs image input and related information from PACS to improve its accuracy; and PACS benefits from CAD results online and available at the PACS workstation as a second reader to assist physicians in the decision making process. Currently, these two technologies remain as two separate independent systems with only minimal system integration. This paper describes a universal method to integrate CAD results with PACS in its daily clinical environment.
  
  
  METHODS
  The method is based on Health Level 7 (HL7) and Digital imaging and communications in medicine (DICOM) standards, and Integrating the Healthcare Enterprise (IHE) workflow profiles. In addition, the integration method is Health Insurance Portability and Accountability Act (HIPAA) compliant.
  
  
  CONCLUSIONS
  The paper presents (1) the clinical value and advantages of integrating CAD results in a PACS environment, (2) DICOM Structured Reporting formats and some important IHE workflow profiles utilized in the system integration, (3) the methodology using the CAD-PACS integration toolkit, and (4) clinical examples with step-by-step workflows of this integration.
authors.affiliation: Image Processing and Informatics Laboratory (IPILab), Departments of Radiology and Biomedical Engineering, Keck School of Medicine, University of Southern California, Suite DEI 2100, Los Angeles, CA 90033, USA. anhhle@usc.edu
authors.forename: Anh H T
authors.initials: AH
authors.lastname: Le
authors.forename: Brent
authors.initials: B
authors.lastname: Liu
authors.forename: H K
authors.initials: HK
authors.lastname: Huang
mesh_terms: D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation*; D003952:Diagnostic Imaging / Q000379:methods*; D006801:Humans; D011873:Radiology Information Systems / Q000295:instrumentation*