The ACR-NEMA standard [1] allows different medical devices to communicate compatibly in a Picture Archiving and Communication System (PAS) environment. In [13], the performance of a PACS, incorporating the ACR-NEMA standard, was analyzed. It was shown that the ACR-NEMA protocol results in excessive response time values for image viewing requests. In this paper, we pmpose and study the performance effects of a number of enhancements to tbe ACR-NEMA standard. The objective of such enhancements is to make the ACR-NEMA protocol better suited for transmission of large images. It is shown that such enhancements, indeed, result in a much improved system perfonnance.
I IntroductionPicture Archiving and Communication Systems (PASs) are those in which medical images and their related data are generated, transmitted, stored and requested. 1 objective of a PACS is to allow medical images to be communicated, analyzed, correlated and pmcessed singly and with respect to each other in a radiology center [2] or other specialized hospital areas. PACSs are usually employed in hospitals with medium to large number of beds, where Computed Tomography (Cr) and other digital diagnostic imaging'techniques are frequent. In a hospital PACS, different department in the hospital may be interconnected via a Local Area Network (LAN), or via several LANs connected to a back bone network. The system will also include at least one archive for storage of acquired images, one or more viewing rooms with several workstations, as well as various types of workstations throughout the hospital.Recently, there has been a surge in use and acceptance of digital imaging equipment, e.g. image acquisition devices and workstations. The need has then arisen for a StandariZed PACS protocol for interconnecting various devices from different manufactures/vendors. The American College of Radiologists (ACR) and the National Equipment Manufacturers Association (NEMA) recognized the need for such a standard. Theirjoint work resulted in the introduction of the NEMA standard 300-1985' which, in the remainder of this paper, we refer to as the ACR-NEMA standard. The design of the standard with its hierarchal communication pmtocol is intended to enhance both equipment conformance and performance. The standard is based on the ISORM (International Standards Organization Reference Model) and is briefly reviewed in Section 2.Several researcbers [4][5][6][7][8][9][10][11][12] have studied and evaluated the ACR-NEMA standard, of which only few were performance studies [10][11][12][13].Martinez et al. [10] conducted a simulation study of the ACR-NEMA standard. The performance criterion considered was the utilization of the ACR-NEMA bus. The study showed that in order to better utilize the bandwidth of the physical interface, the packet size should be increased above the 2K words specified in the standard. 1. A modified version ofthe standard has been introduced in 1988 [3]. Oi9194 -0541 -8/91/$4.00 SPIE Vol. 1446 Medical Imaging V. PACS Design arid Evaluation (1991) / 81 Download...