Boston hospital gives away nuclear medicine PACS

Researchers at Beth Israel Deaconess Medical Center have developed a shareware nuclear medicine PACS software package that includes a display for fused PET/CT studies. It is freely available on the Internet, according to a web-exclusive article in the June issue of the American Journal of Roentgenology.

Dr. Larry Barbaras and colleagues note that unlike typical radiology PACS, the Beth Israel system incorporates many features a nuclear medicine environment requires to:

• analyze cardiac, renal, or gastric emptying or quantitative lung studies;

• display multiple cines, use different color schemes, or quantitate regions of interest; and

• display multiple serial scans or offset frames, as when comparing stress and rest myocardial perfusion slices.

The OpenPACS software runs on any PC using the Windows XP or 2000 operating systems. Studies can be interpreted from the database, a pending list of studies, and several proprietary camera formats, including variations of the DICOM format. Files can be written and deleted from the pending list, database, DICOM directory, and several proprietary camera format directories. Animated gif and tiff files may also be written for use in external programs.

The PET/CTview program displays side by side the PET image alone-either attenuation-corrected or uncorrected-the corresponding CT study, and the fused studies. The fused studies can be displayed using a choice of several color tables. Studies can be saved as DICOM files, individual slices as JPEG files, or maximum intensity projection cines as AVI files.

Staff at Beth Israel have been using the OpenPACS program since 2001 and the PET/CTview program since 2004. They have received more than 100 requests to download the program since presenting a poster and oral lecture on the topic at last year's Society of Nuclear Medicine meeting. The Internet download site for the nuclear medicine PACS shareware is http://bidmc.harvard.edu/default.asp?leaf_id=13580.

Because of the constant rotation of residents and fellows through the nuclear medicine division, researchers sought to make the OpenPACS and PET/CTview programs as intuitive and user-friendly as possible. When the institution initially introduced these programs, trainees had a choice to use them or the vendors' software.

'After three months, all residents were using PET/CTview and OpenPACS,' the study said. 'This was partly because the residents and fellows had a direct impact on the program development. When a request for a change was made, the change was usually made overnight.'

Researchers note that vendors typically charge up to $85,000 for a full-function nuclear medicine display station, which is rarely integrated easily into a radiology PACS display station. The expense will remain high because the market for nuclear display stations in the U.S. is small, they said.

Unlike nuclear medicine software that is sold in the U.S., the Beth Israel program does not need FDA approval because it is free shareware. The authors caution, however, that each department using the software is responsible for verifying that the software results meet the department's clinical criteria.