In fact, the total hospital image management system has been revolutionised with the advent of these systems that began with the use of DICOM image communication software in the clinical radiodiagnostics3.
With different providers coming forward and providing these archiving and management systems, the systems across hospitals are becoming increasingly computerised with use of digital optical archives. Although these are expected to ease the image and data acquisition, there could be mechanical troubles on acquisition devices, problems with the schemes of image transmission, problems with retrieval of images, and difficulty in displaying images4. These problems have been reported to be encountered in the early phase of implementation of these systems in some hospitals, currently, the providers like Agfa and Fujifilm provide advanced systems, and these new generation systems are comparatively easier to use. They have been able to accomplish these with the use of improved hardware and software. Despite these, these systems are not free from criticisms since many users have encountered problems with digitizer on one hand and on the other, use of this new and novel system was bugged with paucity of operating processes due to lack of experience5.
The greatest advantage was perceived to be the capability to access every archived radiologic image which had been impossible with the traditional flat plate radiographic image acquisition systems due mainly to inability to integrate images with the future investigations6. It has been strongly criticised, however, that the complicated image display system would need improvement since still now, the radiologists regard the conventional image viewing system to be the best. This indicates need for further research into this area to be able to develop and implement systems which are worth wider acceptability7.
The important thing to consider is that a PACS would be involved in integration of image and data acquisition, storage, and display subsystems across various digital networks. To begin with most systems utilised DICOM standards in image communication, format, and management. Therefore when different manufacturers developed PACS components, it had to be compatible with the existing standardized DICOM services such as image storage, query, retrieval, and printing8. Essentially PACS systems would ensure a seamless dataflow across networks where compatibility with DICOM systems and necessary image conversions would be one of major requirements for these systems to be implemented. This system was dealt with differently by various PAC systems from different providers through compatibility with different applications, some of which are "diagnostic, review, analysis, and interactive teaching, as well as desktop workstations for surgical simulation, radiation therapy planning and other applications9."
Therefore, briefly, the system has been designed to work in the following fashion. The radiologists use diagnostic workstations to make a primary diagnosis. This can be