PACS mini refresher course. Wide area network strategies for teleradiology systems.

Teleradiology systems require the use of wide area networks (WANs). Design and implementation of a WAN depend on the number of images to be transmitted, desired digital image throughput (based on signaling rate), and cost of the communications link. Image transmission load must be estimated before the communications link can be selected. Communications links used in WANs include T-1 carrier point-to-point service, digital service (DS)-1 dial-up service, DS-3 point-to-point service, DS-0 dial-up service, digital microwave, fiberoptic local loop carriers, and metropolitan area networks (MANs). Depending on the distance between sites, T-1 service may be less costly than DS-1 service; however, for distances more than 200 miles, DS-1 service can be less expensive and more flexible. Both of these services and DS-0 service have lower signaling rates than DS-3 service, which is the fastest and most expensive link. Microwave and fiberoptic links are less expensive but have distance limitations of 14 and 30 miles, respectively. MANs are still being developed but hold the promise of higher signaling rates at lower costs.