Giller Cole A, Clamp Scott J
Department of Neurosurgery, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8855, USA.
Neurosurgery. 2003 Jun;52(6):1499-502; discussion 1502-3. doi: 10.1227/01.neu.0000065175.87967.8d.
Although radiosurgical practice mandates meticulous radiological follow-up, even the most efficient radiology department can be overwhelmed by the large number of radiosurgical patients who have undergone diagnostic studies for many years at many different institutions to follow many separate lesions. Although the task of assembling these studies is theoretically possible, because they are spread out in time and space, it is often impractical. We therefore sought to construct a computer-based system that could store images from multiple sources and present them instantly for review.
We attached a flatbed film scanner to a standard desktop computer in our clinic and scanned selected sheets of film into an image database at each visit of a radiosurgical patient. "Low-tech" solutions were deliberately chosen-that is, to enhance ease and software compatibility, we used the operating system's directory structure for organization of data instead of proprietary software. Standard commercially available software was used to review studies that had been previously scanned.
During a 2- to 3-year period, images were scanned from 1129 studies performed on 435 patients. Images could be reviewed instantly and compared with current studies, and scanning a single piece of film required approximately 30 seconds. We estimate that the current capacity of our computer memory will satisfy our needs for approximately 12 years.
Assembly of an efficient and inexpensive system for image storage and retrieval suitable for radiosurgical practice is feasible and straightforward. Although our system is not a substitute for a radiology department, it obviates the constant frustration of "finding the films" and has become an essential part of our radiosurgical practice.
尽管放射外科实践要求进行细致的放射学随访，但即使是效率最高的放射科，面对大量放射外科患者也可能不堪重负，这些患者多年来在许多不同机构接受了针对多个不同病灶的诊断性检查。虽然从理论上讲可以收集这些检查资料，但由于它们在时间和空间上分布分散，往往不切实际。因此，我们试图构建一个基于计算机的系统，该系统可以存储来自多个来源的图像并即时呈现以供查看。
我们在诊所的一台标准台式计算机上连接了一台平板胶片扫描仪，在放射外科患者每次就诊时，将选定的胶片扫描到图像数据库中。我们特意选择了“低技术”解决方案，也就是说，为了提高便捷性和软件兼容性，我们使用操作系统的目录结构来组织数据，而不是使用专有软件。使用标准的商业软件来查看之前扫描的检查资料。
在两到三年的时间里，从对435名患者进行的1129项检查中扫描了图像。图像可以即时查看并与当前的检查资料进行比较，扫描一张胶片大约需要30秒。我们估计目前计算机内存的容量将满足我们大约12年的需求。
构建一个适用于放射外科实践的高效且廉价的图像存储和检索系统是可行且简单的。虽然我们的系统不能替代放射科，但它避免了“查找胶片”带来的持续困扰，已成为我们放射外科实践的重要组成部分。
