Advances in Diagnostic Medical Imaging that have transformed Healthcare

Diagnostic Medical Imaging - Presented by PostDICOM

Just over a hundred years ago, the advent of X-rays was considered a significant leap in medical diagnosis. Over the last century, simple radiography has expanded into a specialized field—diagnostic medical imaging. X-rays have been harnessed using better technology via digitalized CT scans and new diagnostic medical imaging techniques, such as the MRI and ultrasound, have emerged. Medical imaging modalities continue to evolve and refine. As the actual imaging process progresses, there is a parallel, and equally important, improvement in the handling of medical images and the associated workflow. In this article, we zoom in on the most important advances in medical diagnostic imaging that have transformed the way physicians examine and treat patients.

The DICOM Standard

Medical imaging is used primarily to diagnose diseases as well as to monitor their progress. It is essential that the images produced are of the highest quality since they have a direct bearing on patient outcomes. To maintain quality, a set of standards for medical images was developed jointly by the American Society of Radiology and the National Electrical Manufacturers Association. It is referred to as the DICOM standards, which stands for Digital Imaging and Communications in Medicine. Images produced by all medical imaging hardware must conform to the characteristics described in this standard. Furthermore, there is a specific format available for storing and sharing medical images—referred to as the DICOM format.

All medical imaging equipment manufactured today is supposed to conform to the DICOM standards. Viewing of the images thus produced cannot be done by ordinary imaging programs available on a regular PC. A special diagnostic medical imaging program is required, known as a DICOM workstation. For commercial use in medical diagnosis, such diagnostic medical imaging programs need to be FDA approved and need a special license. These measures ensure that any application developed for clinical purposes is capable of accurate depiction of high quality medical images.

PACS Archiving

With the arrival of digitalized medical diagnostic imaging, the need to develop X-ray films has markedly declined. However, digital images are still being converted into ‘films’ with the aid of printers. Imaging films require proper storage under the right conditions to prevent damage over time. Retrieval of these images from storage can be a time consuming process and requires dedicated personnel for record-keeping.

PACS, which stands for Picture Archiving and Communications System, obviates the need for physical storage and retrieval of films. It is basically a platform for the virtual storage and retrieval of medical images. PACS makes it possible to handle enormous volumes of data related to medical images. Any computer that is connected to a specific PACS server is able to retrieve DICOM images and view and even modify them. The latest innovation has been the introduction of cloud-based PACS, where instead of local storage, the PACS is hosted on the internet and any user connected to the internet, with the right credentials, can access the images.

Not only has PACS simplified storage and retrieval, it has also made teleradiology a reality. Today, radiologists need not be present in the same area where images are being acquired. They can view images from different geographic locations and provide their expert opinion. Through teleradiology, a single radiologist can generate reports for images coming in from multiple hospitals. This saves precious time and resources, and helps to reduce healthcare costs.

Real-time Imaging

With the need for developing or printing of films gone, the workflow process for acquiring and viewing medical images has improved. Real-time imaging is a concept where there is no time lag between the acquisition of images from the patient and their viewing by the physician. Radiologists can literally view images while the patient is still within the scanner.

The faster interpretation of diagnostic medical images leads to immediate diagnosis, which in turn enables rapid medical intervention. Real-time medical diagnostic imaging plays a significant role in emergencies. For instance, in trauma patients, intra-abdominal injury was earlier determined by diagnostic laparoscopy or peritoneal lavage, both of which were invasive procedures. Today, however, the standard of care is to use FAST (Focused Abdominal Sonography in Trauma), which uses a real-time ultrasound to quickly determine whether or not a patient has suffered an intra-abdominal injury. Real-time ultrasound imaging is also used to monitor the health of the fetus in utero and assess growth parameters.

Functional Imaging

Most diagnostic medical imaging systems are designed to diagnose anatomical or structural abnormalities. Modern medical diagnostic imaging, in addition to that, can also assess abnormalities in tissue and organ function. This includes detection of abnormalities in physiological processes such as metabolism and blood flow. Functional imaging is largely achieved through nuclear medicine. Nuclear medicine is a speciality of radiology which involves injection of molecules that are ‘tagged’ radioactively into the body. These radioactive molecules may be preferentially taken up by specific organs for various physiological processes. After uptake, the organs can emit radiation, which is picked up by external scanners as ‘hot spots’. For instance, positron emission tomography (PET) reflects the uptake of radiolabeled glucose by cells. Cells that have increased metabolic activity, in particular cancer cells, tend to take up more glucose. This technique is therefore used to identify areas of metastasis within the body. Another functional imaging technique is the use of thyroid scans, which are used to detect hyperthyroidism. These scans depend on the uptake of radioactive iodine by thyroid cells.

Most functional imaging techniques, when used alone, can be difficult to interpret. This is because although they detect areas of abnormal physiological activity, it can be difficult to orient these areas anatomically. This may be overcome by a technique called image fusion. Modern diagnostic medical imaging programs allow fusion of two or more diagnostic techniques. For instance, fusion of a PET scan with a CT scan can help identify whether or not there is metastasis, and can also precisely identify the anatomical zones in which metastasis has occurred.

Notebook PostDICOM Viewer

Cloud PACS and Online DICOM Viewer

Upload DICOM images and clinical documents to PostDICOM servers. Store, view, collaborate, and share your medical imaging files.

Post-processing Techniques

Post-processing techniques refer to interventions applied to diagnostic medical images after the images have been acquired from the patient. Post-processing techniques are usually done using an advanced diagnostic medical imaging program. They provide the radiologist with information that is not available by just looking at the original images. Some of the most useful post-processing techniques used in medical diagnostic imaging are as follows:

Some Disruptive Technologies for the Future of Medical Imaging

Artificial Intelligence

Artificial intelligence (AI) is an exciting front that is slowly making inroads into medical diagnostic imaging. Artificial intelligence is the ability of machines to make cognitive decisions, such as learning and problem solving. By feeding computers deep learning algorithms, they can learn to distinguish between various digital patterns and can thus aid in diagnosis. A team of researchers at Stanford University, for instance, has developed such an algorithm for chest X-rays. The researchers claim that by using this algorithm, computers can recognize the presence or absence of pneumonia better than radiologists. The radiology team at UCSF meanwhile is partnering with GE to develop a series of algorithms that can help distinguish between normal and abnormal chest X-rays. Another medical application, called Viz, helps screen multiple images across several hospital databases for large vessel obstructions (LVO), which are indicative of imminent stroke. If an LVO is detected, the software can alert both the stroke specialist and the patient’s primary care physician to ensure that the patient receives prompt treatment.

Integration of Imaging Systems

While PACS stores medical images, other medical information is stored in different systems. For instance, health information systems (HIS) store information related to the patient’s medical history, clinical details, and laboratory investigations. Radiology information systems (RIS) manage imaging data apart from the actual images, such as referrals, requisitions, billing details and interpretations. All these information systems are separate from each other. Yet, in dealing with a patient, a physician must often have all these details together on hand to make a diagnosis and plan treatment. Integrating all information systems into a single medical record that can be accessed through a single server can help streamline workflow and improve both accuracy and throughput.

What are the Challenges as Medical Diagnostic Imaging continues to evolve?

Advanced Diagnostic Medical Imaging at your fingertips—with PostDICOM!

PostDICOM helps you and your practice keep pace with the ever-evolving landscape of advanced diagnostic imaging. This robust, yet easy-to-use diagnostic medical imaging program is a modern DICOM image viewer with several advanced features. PostDICOM offers a cloud-based PACS platform and is supported on multiple operating systems including Windows, Mac OS, Linux and Android. It allows you to access your DICOM files anywhere, from any device. PostDICOM has sophisticated post-processing tools that enable superior diagnosis and treatment planning. While our PACS is cloud-based, patient data is completely secure. We keep patient data separated by geographical regions, all data is encrypted, and secure SSL systems are used for communication. Images can be anonymized before uploading to the PACS server. PostDICOM is free to try with all features for limited time! Storage can be upgraded at a nominal cost. To harness the power of advanced medical imaging, visit and try your free viewer today!

Notebook PostDICOM Viewer

Cloud PACS and Online DICOM Viewer

Upload DICOM images and clinical documents to PostDICOM servers. Store, view, collaborate, and share your medical imaging files.