Digital echocardiographic laboratory: where do we stand?

The transition to an all-digital echocardiographic laboratory has been slow despite the advantages of digital echocardiography, the dramatic improvement in computer technology, and the acceptance by all major vendors and professional organizations of the Digital Imaging and Communications in Medicine image-formatting standard. This review article examines some current issues in digital echocardiography, including types of digital output, disk versus network exchange, digital and clinical compression techniques, and the choice of image storage format. Although specific exceptions exist, we conclude that the optimal solution will be one based on a network exchange of formatted images that follow the Digital Imaging and Communications in Medicine standard, now available from several manufacturers. For a clinical interpretation, modest compression with the Joint Photography Expert Group algorithm appears acceptable, though possible enhancements to this compression standard are also discussed. We hope this review will enable the echocardiographic community to make more intelligent choices as digital storage and transmission products become available in the marketplace.