Resources
and Environment
The University
of Iowa Department of Radiology (UIDOR) occupies portions of
The University of Iowa Hospitals and Clinics and several associated
buildings, and has more than 100,000 square feet of space. UIDOR
provides all of the professional diagnostic and therapeutic
radiology services for the University of Iowa College of Medicine
and the UIHC. The technical radiology services are provided
by the UIHC. A total of 30,000 square feet of this space is
devoted exclusively to research. Research grants provide a total
of $2 million of extramural support annually. The UIHC is Iowa's
tertiary care center and serves as a national referral center.
Located in the heart of the University
of Iowa Hospitals and Clinics, the Department provides the imaging
requirements for UIHC's 800 beds and over 500,000 annual outpatient
visits. Ample clinical material is provided with over 175,000
diagnostic examinations and 6,000 nuclear medicine examinations
during the 1995-96 academic year. There are 57 examination rooms,
including: 6 rooms in musculoskeletal radiology, 3 rooms for
arteriography, and 4 radiation therapy treatment suites. There
are also 12 general x-ray mobiles, 4 mobile radiographic c-arms
and 2 portable ultrasound units.
The Department of Radiology is
equipped with the most modern diagnostic imaging systems. UIDOR
operated state-of-art imaging technologies in conventional radiology,
ultrasonography, head and body CT, single photon and positron
emission tomography, and digital vascular imaging. The Institute
is organized into five divisions: Diagnostic, Nuclear Medicine,
Radiation Sciences, Radiation Oncology, and the newly created
Research Division. The Diagnostic Division is divided into eight
sections, abdominal, cardiac, chest, interventional, magnetic
resonance imaging, musculoskeletal, neuroradiology, and pediatric.
Diagnostic equipment at UIDOR consists
of 4 computed tomography scanners (3 with Spiral CT capability),
a positron emission tomography scanner, 3 magnetic resonance
imaging scanners, 10 ultrasound machines, 3 linear accelerators,
3 vascular imaging systems, and an electron beam ultrafast CT
scanner.
The personnel at UIDOR consist
of over 400 employees, staff and students (of which 46 are MDs
and 12 are PhDs).
UIDOR provides facilities
that are conducive to clinical and basic research. Approximately
100 scientific papers are published annually by the faculty.
Research projects are currently active in nuclear medicine,
diagnostic and therapeutic radiology and cancer biology. Space
and equipment on campus is dedicated for research.UIDOR
also maintains a library with over 3,181 textbooks, more than
70 bound journals and over 229 audiovisuals. A new library and
faculty office center was opened in the Fall of 1993 in the
UIHC. It contains a modern health sciences library, an audio-visual
production and service complex, a computer teaching and information
management laboratory, and a health information network that
links regional, national, and international information resources.
Clinical
PACS Overview for The Department of Radiology
The UIHC Department of Radiology currently has a fully operational
Picture Archiving and Communication System (PACS) for Computed
Tomography (CT), Surgical Intensive Care Unit (SICU) and Central
Image Archive. The PACS is connected to the Magnetic Resonance
Imaging, Positron Emission Tomography, and the Nuclear Medicine
Divisions via a Cisco 4000 router to facilitate image transfer
for research and clinical functions. Image transfer within the
PACS is accomplished via standard and switched Ethernet and FDDI
using Transmission Control Protocol - Internet Protocol (TCP-IP)
and DICOM. The PACS currently supports, and is using a Wide Area
Network for digital image transfer from remote sites (Keosauqua
and Ottumwa) via T-1 and Frame Relay protocols.
PACS
High Speed Network Infrastructure
The Radiology Departmental PACS Infrastructure is comprised
of twelve high speed hubs, these Cabletron MMAC 5’s, one Cabletron
MMAC 8, and eight Cabletron series 9000 hubs. These hubs provide
FDDI and switched ethernet to the workstation. The infrastructure
is a collapsed backbone design with all twelve hubs having a
dual FDDI ring connection to the central switch, a Cabletron
MMAC Plus 14. All hubs and workstation connections use 62.5
micron multimode fiber optic cabling to ensure maximum bandwidth
while maintaining high noise immunity. All network hubs have
dual redundant power supplies with uninterruptible power systems.
PACS Worklist
Management
The Mitra Broker supplies
a worklist management capability via DICOM (Digital Imaging and
Communication in Medicine) and HL7 (Health Level 7) Communication
standards. Study scheduled events are sent from the HIS (Hospital
Information System) to the Broker. The Broker then forwards the
patient demographics information to the modality location where
the exam is to be performed. This process guarantees accurate
demographics data will be applied to an exam.
Computed Tomography
(CT)
The CT section currently consists
of 5 acquisition devices incorporated into the PACS system.
Imatron Ultrafast CT Scanner
The Imatron unit is interfaced to a Sun Sparc 5 workstation
through the use of a Bit 3 card in both the scanner and workstation,
using Imatron’s proprietary Megalink. In addition to a Bit3
interface card, the Sun workstation also contains a FDDI interface
card connecting it to the PACS via multi-mode fiber optic cable.
Images are acquired on the CT scanner and sent to the Sun workstation
via the Megalink, where a Megalink daemon running in the CEMAX
VIP 1.41 software receives and converts the data. Once the data
is converted and the workstation database is updated the images
are then made available to the PACS through NFS. The technologists
operating the scanner then uses the CEMAX software to window
and level the patient data set and film them through the PACS
system.
Toshiba Express CT
Three Toshiba Express CT scanners
attached to the PACS via on board ethernet interfaces. Data
is sent from the Toshiba Express SX using the DICOM standard
to a Mitra Relay Workstation located by each scanner console.
The Toshiba Express SX’s acquire data in a spiral fashion. One
of the Toshiba Express SX’s has a fluoro package. The Toshiba
Express SX located in Rad. Oncology has an optional Therapy
Planning Package. The Toshiba Express SX is capable of 1 second
tube rotation speeds
The Mitra relay provides DICOM
worklist management to guarantee accurate patient demographics
data is applied to the exam image set. The Mitra Relay is configured
to obtain its demographic data from the Mitra Broker.
Toshiba Aquilion
The Toshiba Aquilion acquires data in a spiral fashion.
The Aquilion is capable of .5 second tube rotation speeds.
The Toshiba Aquilion attaches to
the PACS via an on board Ethernet interface. Data is sent from
the Toshiba Aquilion using the DICOM standard to a Mitra Relay
workstation located adjacent to the Aquilion operator’s console.
The Mitra Relay provides DICOM worklist management to guarantee
accurate patient demographics data is applied to the exam image
set. The Mitra Relay is configured to obtain its patient demographic
data from the Mitra Broker. The Toshiba Aquilion has DICOM print
capability.
Toshiba Aquilion Multi-Slice
CT
The Toshiba Aquilion Multi-Slice CT is capable of 4 channel
multi-slice or 8 slices per second at 0.5 second scan time and
allows 4 0.5mm slices or up to 4 8mm slices. A SureStart-Contrast
monitoring system is available for precise timing of contrast
enhanced scans. Associated with 0.5 sec CT scanner is Fluoro-CT
screen for real-time monitoring of aspiration needles and real-time
Helical Scanning. Cardiac Gating can be used with complementary
Vital Images Vitrea 3D workstation for cardiac scoring applications.
3D Workstations
The DOR has 8 3D capable workstations.
Five are Vital Image Vitrea systems, the other three are CEMAX
VIP workstations.
The Vitrea application
runs on Silicon Graphics hardware platforms. The Vitrea application
supports DICOM Store and Export. Print function is provided either
by a DICOM compliant print module or PostScript printer interface.
The CEMAX VIP’s run on a Sun platform. The CEMAX VIP’s are print
capable via a proprietary CEMAX protocol. The VIP application
supports DICOM store.
Magnetic
Resonance Imaging (MRI)
The DOR correctly has three MRI
suites:
Seimens Magnetom VisionGE
Sigma AdvantageGE Cardio LX
All MRI acquisition devices are connected
to the PAC’s via onboard ethernet ports. Exam data is sent via
DICOM to one of three Mitra Relays located adjacent to each MRI
operator’s console. The Mitra Relay provides DICOM worklist management
to guarantee accurate good patient demographics data is applied
to the exam image set. The Mitra Relay is configured to obtain
its patient demographic data from the Mitra Broker.
Computed
Radiography (CR)
The DOR currently has 5 CR devices
deployed in UIHC. Locations are as follows:
Fuji AC-2 in the Surgical
Intensive Care UnitFUJI AC-3
CSID in the Neo Natal Intensive Care UnitFUJI
AC-3 in the Family Care ClinicFUJI
AC-3 CSID and a Fuji FCR 5000 in the Emergency Trauma Center.
CR employs a reusable phosphor plate,
which is exposed to X-ray and later converted to digital form
courtesy of the FUJI CR readers.
Each CR reader has a Quality Assurance
workstation connected to it, which allows the technologist to
perform any required changes to the image (ex. Image rotation,
window or level adjustments) before transmitting the image onto
the PACS. Four of five CR QA workstations are DeJarnette Image
Share 2100’s w/DICOM print modules, the other CR QA workstation
is a CEMAX Clinical View configured in QA mode.
All readers also have links via serial
connection to FUJI ID Gateway workstations. The ID Gateway provides
DICOM worklist capability (patient demographics) via the Mitra
Broker to guarantee accurate demographics data is applied to the
exam.
The DOR has deployed a CEMAX AutoRad
work cluster for primary Radiologist image review. The AutoRads
have dual 2.0Kx2.5K image display capability. All AutoRads access
a common database via the AutoRad Study Server. The common database
is stored on a 90 GB Mega drive EV 1000 RAID. The common database
allows the Radiologist to have access to the desired exams at
any of the AutoRad locations. Two of the AutoRads have Fibre Channel
connections, which allows access to image data at speeds that
are far in excess of a typical Fast Ethernet Connection.
The AutoRad workstation's hanging
protocol feature, based on modality, body part, and technique,
enables radiologists to access current and prior examinations
in a predetermined format.
Three DICOM servers are responsible
for accepting data from modalities on the PACS and transferring
the image data to the AutoRad Study Server.
The DOR has installed 15 CEMAX Clinical
Views (CV) throughout UIHC. The CV workstation has a 1Kx1.5K Image
display, most having dual display compatibility. The CV’s are
deployed in the following locations.
CV’s in the
Surgical Intensive Care Unit, one of which has a 16GB Raid for
image storage.CV’s in the Family
Care Clinics, one of which has a 18GB RAID for image storageCV
in the Neo Natal Intensive Care Unit area, which has a 12GB RAID
for image storage. 3 CV’s in
the Emergency Trauma Center, one of which has a 34 GB RAID for
image storage. CV in the CT
console work area, which has a 50GB RAID for image storage.CV
in the MR reading room which has 16GB of external image storage
(non-RAID).CV with a Lumisys
150 Film Digitizer.
The CV’s role is to provide the clinician
access to patient images very near to the actual physical location
of the patient. The CV application provides a variety of image
processing tools such as Window/Level, Zoom, Image Flip, and Rotation.
Philips
Thoravision Chest Room
The Thoravision employs a selenium-coated
drum as an X-ray detector. The X-ray exposure produces a latent
electrostatic image on the selenium surface. The image is read
out from the rotating drum by scanning electrometer probes, and,
after digital processing is immediately available to be sent via
DICOM standard to the PAC’s.
The Thoravision is configured to
automatically obtain known good patient demographics data from
the Mitra Broker.
The Thoravision currently prints
to an Imation Dry View Laser.
The DOR has deployed a CEMAX Archive
System. The CEMAX Archive Manager application runs on a SUN Enterprise
450 with dual processors. Storage is provided via SCSI by a DEC
450 RAID with 68 gigabytes storage and a Odetics ATL 2640 tape
library. The ATL 2640 tape library contains 264 Digital Linear
Tapes ( DLT ) and three DLT 7000 Tape Drives providing over 5
terabytes of image storage space. This version of Archive Manager
software supports DICOM Query Retrieve allowing access to a patient’s
previous exam. The Archive Manager provides intelligent automatic
real time routing of exam data to predefined destinations.
The following devices provide print
functionality.
Two Imation DryView Printers located
in the CT area. Each Dry View connects to a Multi Input Manager
(MIM) which is a duplex device that allows connectivity to the
Dry View printers via a number of input interfaces. These interfaces
include manual keypads located by CT operator consoles, a connection
to the CEMAX Print Server, and a connection to an Imation DICOM
Printer Server.
Two Imation Dryview Printers located
in the MRI area. Each Dryview connects to a Multi Input Manager
(MIM) which is a duplex device that allows connecting to the Dry
View printer via a number of input interfaces. These interfaces
include analog video console workstation inputs and a connection
to an Imation DICOM Print Server.
Two Imation Dryview Printers located
in the General Radiology area. Each Dryview connects to a Multi
Input Manager (MIM) which is a duplex device that allows connectivity
to the DryView printers via a number of input interfaces. These
inputs include the Philips Thoravision Chest Unit and an Imation
DICOM Print Server.
One Imation DryView Printer located
in the Emergency Trauma Center. The DryView is connected to a
Multi Input Manager (MIM) which is a duplex device that allows
connectivity to the Dry View via a number of input interfaces.
These inputs include a DeJarnette Laser Share 2100 and an Imation
DICOM Print Server.
Acquisition Devices that support
DICOM print standards may also print to a SEIKO DICOM printer
(CT) or to a KODAK 1120 (GI) with a Kodak PIU DICOM printer front
end.
Ultrasound (US)
The DOR has 10 Ultrasound carts,
9 of which have ALI Pcapt video capture devices. The Pcapt provides
a means to store an analog video image, convert that image to
digital form and transfer image data via DICOM to the PACS. The
remaining cart, a Seimens Elegra has an integrated DICOM interface.
Once transferred from the US cart
images are available for soft copy read via 6 Pwks workstations,
two of which have dual image display capability. Two single display
Pwks workstations are remotely located in the Emergency Trauma
Center and the Breast Imaging Center. Every evening, exams are
automatically archived to Magnetic Optical Disk on a HP Juke Box.
The Juke Box is connected via SCSI to the Ultra PACS Server, which
has an integrated RAID.
Patient demographics information
is automatically supplied via the Mitra Broker.
US exams may be printed to a Lexmark
Laser Printer, a Codonics Printer, or via DICOM print to a Kodak
PIU which is connected to a Kodak 1120 laser printer.
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Date last modified:
06-02-05
