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Medical imaging, PACS, and imaging informatics: retrospective

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Historical reviews of PACS (picture archiving and communication system) and imaging informatics development from different points of view have been published in the past (Huang in Euro J Radiol 78:163–176, 2011; Lemke in Euro J Radiol 78:177–183, 2011; Inamura and Jong in Euro J Radiol 78:184–189, 2011). This retrospective attempts to look at the topic from a different angle by identifying certain basic medical imaging inventions in the 1960s and 1970s which had conceptually defined basic components of PACS guiding its course of development in the 1980s and 1990s, as well as subsequent imaging informatics research in the 2000s. In medical imaging, the emphasis was on the innovations at Georgetown University in Washington, DC, in the 1960s and 1970s. During the 1980s and 1990s, research and training support from US government agencies and public and private medical imaging manufacturers became available for training of young talents in biomedical physics and for developing the key components required for PACS development. In the 2000s, computer hardware and software as well as communication networks advanced by leaps and bounds, opening the door for medical imaging informatics to flourish. Because many key components required for the PACS operation were developed by the UCLA PACS Team and its collaborative partners in the 1980s, this presentation is centered on that aspect. During this period, substantial collaborative research efforts by many individual teams in the US and in Japan were highlighted. Credits are due particularly to the Pattern Recognition Laboratory at Georgetown University, and the computed radiography (CR) development at the Fuji Electric Corp. in collaboration with Stanford University in the 1970s; the Image Processing Laboratory at UCLA in the 1980s–1990s; as well as the early PACS development at the Hokkaido University, Sapporo, Japan, in the late 1970s, and film scanner and digital radiography developed by Konishiroku Photo Ind. Co. Ltd. (Konica-Minolta), Japan, in the 1980–1990s. Major support from the US National Institutes of Health and other federal agencies and private medical imaging industry are appreciated. The NATO (North Atlantic Treaty Organization) Advanced Study Institute (ASI) sponsored the International PACS Conference at Evian, France, in 1990, the contents and presentations of which convinced a half dozen high-level US military healthcare personnel, including surgeons and radiologists, that PACS was feasible and would greatly streamline the current military healthcare services. The impact of the post-conference summary by these individuals to their superiors opened the doors for long-term support of PACS development by the US Military Healthcare Services. PACS and imaging informatics have thus emerged as a daily clinical necessity.

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Most references cited were published in the 1960s to 1990s which reflected the time of publications on the state of the art technology in this era

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Prelude and acknowledgments

When my former two mentors, Professor Ledley at Georgetown University, and Professor Greenfield at UCLA, as well as Emeritus Chairman and Professor Kangarloo at UCLA passed away in the same year, 2012, in memory of these pioneers I delivered a special presentation: “In memory of three pioneers in Biomedical Imaging, Medical Physics, and PACS and Informatics [31], during the SPIE Annual Medical Imaging Conference—Advanced PACS-based imaging informatics and therapeutic applications, at Lake Buena Vista, Florida, USA. To my surprise, though it was the last day afternoon session, many colleagues with whom we had been working during the past 40 years showed up for the talk. After the meeting, several of them mentioned that I should write a paper to publicize the past contributions of the pioneers in these fields. I took their advice and searched for a suitable journal. Since the beginning of PACS, I had learned so much from my many Japanese colleagues, and I always felt that, without their early PACS concepts, the film scanner, CR and DR, PACS progress would not have moved so speedily, I contacted Professor Kunio Doi on May 9, 2013, and asked whether the journal “Radiological Physics and Technology”, published by Springer with its base in Japan, of which he is the Editor-in-Chief, would be interested in receiving such a “Pioneers” manuscript for review. He thought about my suggestion, and the following was his response on May 13 this year:

“Regarding your proposal about memory of pioneers, I agree that these would be a proper topic for our Journal of RPT. However, I have another suggestion for you to consider. Would you be able to consider the materials you will have and also your own activities at UCLA toward historical review on development of PACS and informatics? I believe that research activities at UCLA at that time were very influential to many researchers, and thus it would be useful to learn from historical review on PACS and informatics at that time.

You can include many aspects related to memory of pioneers in this format. I believe that with this format, you can describe also many of your activities at UCLA, which would be very informative to many readers of RPT.”

I took Professor Doi’s wisdom, suggestions, and guidelines, after several revisions, to come up with this manuscript for submission. For this reason, I deeply appreciate Professor Doi’s original idea that has definitely enriched the horizon of the current manuscript compared to the basic original “Pioneers” contents. In addition, it also brought in another aspect, which had often been neglected by other historical reviews, of Japan’s tremendous contribution to the basic conceptual technology development that led to facilitating the successful implementation of PACS in the 1990s. I would also like to thank Mrs. EF Lanzl for her meticuous editing.

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Correspondence to H. K. Huang.

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Huang, H.K. Medical imaging, PACS, and imaging informatics: retrospective. Radiol Phys Technol 7, 5–24 (2014).

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