Free software can extract images from compact discs

A computer application that permits technicians to easily download images from compact discs produced by a variety of vendors, so long as they contain DICOM tags, can help to decode the increasing amount of imaging CDs radiology departments are receiving, according to an infoRAD presentation at the 2005 RSNA meeting.

Downloading CD-based images brought in by patients or sent by physicians has become a major headache for radiology departments everywhere. Often the CDs use proprietary formats, and technicians must devote considerable time to extracting the images so they can be reviewed by attending radiologists.

A team now based in the U.K. has developed a system to decode the CDs. The computer application automatically detects the CDs, scans them for medical images, makes any necessary DICOM header corrections, and routes the images to a DICOM viewer.

Best of all, it's free.

"We've had a big reaction from all over the world," said Arpad Bischof, manager of Image Information Systems. "They can't believe we're giving away this application for free."

Eventually, the group plans to develop and sell a commercial version, which would need to be approved by the FDA for use in the U.S. In the meantime, the free version is available at www.DICOMreader.com.

The problem of patients bringing their images on CDs into radiology departments is growing. More than 10% of the image CDs patients schlepp from one hospital facility to another cannot be transferred onto a PACS, according to a study from the University of Texas M.D. Anderson Cancer Center.

A poster presentation at the Society for Computer Applications in Radiology meeting in July 2005 outlined the facility's experience dealing with outside images brought in by patients. The study covered a time period from July 2004 through May 2005.

Researchers led by Dr. Kevin McEnery, an associate professor of radiology, were able to load 1429 of 1641 discs, or 86.5%, into their PACS using an in-house software program designed to grab outside images from CDs. Patient CDs came from 49 states in the U.S., the District of Columbia, Puerto Rico, and 43 countries around the world.

Sixty percent of the rejected discs contained data that had been saved in a proprietary image data format that basically prevented any images from being viewed or pushed to the PACS.

The remaining 40% of the rejected discs contained commercial imaging formats such as JPEG and TIFF files. While these images could be viewed on a PC or a Web browser, they could not be seen as medical images and could not be ported to the PACS.

The investigators also studied the Integrating the Healthcare Enterprise's portable data imaging integration file. They obtained 19 demonstration discs from the 2004 RSNA conference and successfully transferred all images from these discs to the PACS.

One problem posed by the variety of image CD-ROMs in circulation is the variety of different ways in which they are labeled. For the study, these methods included silk-screened (42.1%), handwritten with Sharpie markers (38%), automatically labeled by the CD-ROM-producing software (8%), and unlabeled (11.1%).

With the inconsistent labeling methods, the investigators could not determine the origins of the handwritten and blank discs. These could have been produced by the originating hospital, or they could be copies made by the patients themselves.

Because a relatively significant number of the CDs they received contained no DICOM data, the researchers recommended that centers that create these CDs instead of film should make sure that the imaging data are in the nonproprietary DICOM format.