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PACS and Imaging Informatics: Basic Principles and Applications, Second Edition

Book Description

The definitive guide to PACS — now with more clinically applicable material

In recent years, the field of picture archiving and communications systems—PACS—and image informatics has advanced due to both conceptual and technological advancements. This edition of PACS and Imaging Informatics: Basic Principles and Applications addresses the latest in this exciting field. In contrast to the previous edition, this updated text uses the framework of image informatics, not physics or engineering principles, to explain PACS. It is the only resource that thoroughly covers the critical issues of hardware/software design and implementation in a systematic and easily comprehensible manner.

To strengthen and update the book, the author:

  • Emphasizes clinical applications of PACS and integrates clinical examples throughout the text

  • Reflects the many changes in the field, with new chapters on Web-based PACS, security, integrating the healthcare enterprise, clinical management systems, and the electronic patient record

  • Uses the framework of imaging informatics to explain PACS, making the book accessible to those without advanced knowledge of physics, engineering, math, or information technology

  • Explains how PACS can improve workflow, therapy, and treatment

  • With the most systematic and thorough coverage of practical applications available, this text is the complete guide for all those involved in designing, implementing, and using PACS. Professionals in medical and allied health imaging informatics; radiologists and their technical staff; surgeons and oncologists and their teams; medical and electronic engineers; medical informaticians; and fellows, graduate students, and advanced undergraduates will all benefit from this valuable resource.

    "An excellent book for people involved in the design, implementation, or simply the operations of PACS and an appropriate textbook."

    From a review of the previous edition in IEEE Engineering in Medicine and Biology

    "The strength of the book lies in the vast experience of the author, who has implemented PACS at numerous institutions in the United States and abroad."

    From a review of the previous edition in Radiology

    Table of Contents

    1. COVER
    2. TITLE PAGE
    3. COPYRIGHT
    4. DEDICATION
    5. CHART
    6. FOREWORD TO THE SECOND EDITION
    7. PREFACE
    8. PREFACE OF THE LAST EDITION, 2004
    9. ACKNOWLEDGMENTS
    10. H. K. HUANG SHORT BIOGRAPHY
    11. LIST OF ACRONYMS
    12. CHAPTER 1: INTRODUCTION
      1. 1.1 INTRODUCTION
      2. 1.2 SOME HISTORICAL REMARKS ON PICTURE ARCHIVING AND COMMUNICATION SYSTEMS (PACS)
      3. 1.3 WHAT IS PACS?
      4. 1.4 PACS IMPLEMENTATION STRATEGIES
      5. 1.5 A GLOBAL VIEW OF PACS DEVELOPMENT
      6. 1.6 ORGANIZATION OF THE BOOK
    13. PART I: MEDICAL IMAGING PRINCIPLES
      1. CHAPTER 2: DIGITAL MEDICAL IMAGE FUNDAMENTALS
        1. 2.1 TERMINOLOGY
        2. 2.2 DENSITY RESOLUTION, SPATIAL RESOLUTION, AND SIGNAL-TO-NOISE RATIO
        3. 2.3 TEST OBJECTS AND PATTERNS FOR MEASUREMENT OF IMAGE QUALITY
        4. 2.4 IMAGE IN THE SPATIAL DOMAIN AND THE FREQUENCY DOMAIN
        5. 2.5 MEASUREMENT OF IMAGE QUALITY
      2. CHAPTER 3: TWO-DIMENSIONAL MEDICAL IMAGING
        1. 3.1 PRINCIPLES OF CONVENTIONAL PROJECTION RADIOGRAPHY
        2. 3.2 DIGITAL FUOROGRAPHY AND LASER FILM SCANNER
        3. 3.3 IMAGING PLATE TECHNOLOGY
        4. 3.4 DIGITAL RADIOGRAPHY
        5. 3.5 FULL-FIELD DIRECT DIGITAL MAMMOGRAPHY
        6. 3.6 DIGITAL RADIOGRAPHY AND PACS
        7. 3.7 NUCLEAR MEDICINE IMAGING
        8. 3.8 2-D ULTRASOUND IMAGING
        9. 3.9 2-D LIGHT IMAGING
      3. CHAPTER 4: THREE-DIMENSIONAL MEDICAL IMAGING
        1. 4.1 2-D IMAGE RECONSTRUCTION FROM 1-D PROJECTIONS
        2. 4.2 3-D IMAGE RECONSTRUCTION FROM 3-D DATA SET
        3. 4.3 TRANSMISSION X-RAY COMPUTED TOMOGRAPHY (CT)
        4. 4.4 SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
        5. 4.5 POSITRON EMISSION TOMOGRAPHY (PET)
        6. 4.6 3-D ULTRASOUND IMAGING (3-D US)
        7. 4.7 MAGNETIC RESONANCE IMAGING (MRI)
        8. 4.8 3-D LIGHT IMAGING
        9. 4.9 3-D MICRO IMAGING AND SMALL ANIMAL IMAGING CENTER
      4. CHAPTER 5: FOUR-DIMENSIONALITY, MULTIMODALITY, AND FUSION OF MEDICAL IMAGING
        1. 5.1 BASICS OF 4-D, MULTIMODALITY, AND FUSION OF MEDICAL IMAGING
        2. 5.2 4-D MEDICAL IMAGING
        3. 5.3 MULTIMODALITY IMAGING
        4. 5.4 FUSION OF HIGH-DIMENSIONAL MEDICAL IMAGING
      5. CHAPTER 6: IMAGE COMPRESSION
        1. 6.1 TERMINOLOGY
        2. 6.2 BACKGROUND
        3. 6.3 ERROR-FREE COMPRESSION
        4. 6.4 TWO-DIMENSIONAL IRREVERSIBLE (LOSSY) IMAGE COMPRESSION
        5. 6.5 MEASUREMENT OF THE DIFFERENCE BETWEEN THE ORIGINAL AND THE RECONSTRUCTED IMAGE
        6. 6.6 THREE-DIMENSIONAL IMAGE COMPRESSION
        7. 6.7 COLOR IMAGE COMPRESSION
        8. 6.8 FOUR-DIMENSIONAL IMAGE COMPRESSION AND COMPRESSION OF FUSED IMAGE
        9. 6.9 DICOM STANDARD AND FOOD AND DRUG ADMINISTRATION (FDA) GUIDELINES
    14. PART II: PACS FUNDAMENTALS
      1. CHAPTER 7: PICTURE ARCHIVING AND COMMUNICATION SYSTEM COMPONENTS AND WORKFLOW
        1. 7.1 PACS COMPONENTS
        2. 7.2 PACS INFRASTRUCTURE DESIGN CONCEPT
        3. 7.3 A GENERIC PACS WORKFLOW
        4. 7.4 CURRENT PACS ARCHITECTURES
        5. 7.5 PACS AND TELERADIOLOGY
        6. 7.6 ENTERPRISE PACS AND ePR SYSTEM WITH IMAGE DISTRIBUTION
        7. 7.7 SUMMARY OF PACS COMPONENTS AND WORKFLOW
      2. CHAPTER 8: COMMUNICATIONS AND NETWORKING
        1. 8.1 BACKGROUND
        2. 8.2 CABLE PLAN
        3. 8.3 DIGITAL COMMUNICATION NETWORKS
        4. 8.4 PACS NETWORK DESIGN
        5. 8.5 EXAMPLES OF PACS NETWORKS
        6. 8.6 INTERNET 2
        7. 8.7 WIRELESS NETWORKS
        8. 8.8 SELF-SCALING WIDE AREA NETWORKS
      3. CHAPTER 9: INDUSTRIAL STANDARDS (HL7 AND DICOM) AND INTEGRATING THE HEALTHCARE ENTERPRISE (IHE)
        1. 9.1 INDUSTRIAL STANDARDS AND WORKFLOW PROFILES
        2. 9.2 THE HEALTH LEVEL 7 (HL7) STANDARD
        3. 9.3 FROM ACR-NEMA TO DICOM AND DICOM DOCUMENT
        4. 9.4 THE DICOM 3.0 STANDARD
        5. 9.5 IHE (INTEGRATING THE HEALTHCARE ENTERPRISE)
        6. 9.6 OTHER STANDARDS AND SOFTWARE
        7. 9.7 SUMMARY OF HL7, DICOM, AND IHE
      4. CHAPTER 10: IMAGE ACQUISITION GATEWAY
        1. 10.1 BACKGROUND
        2. 10.2 DICOM-COMPLIANT IMAGE ACQUISITION GATEWAY
        3. 10.3 AUTOMATIC IMAGE RECOVERY SCHEME FOR DICOM CONFORMANCE DEVICE
        4. 10.4 INTERFACE OF A PACS MODULE WITH THE GATEWAY COMPUTER
        5. 10.5 DICOM OR PACS BROKER
        6. 10.6 IMAGE PREPROCESSING
        7. 10.7 CLINICAL OPERATION AND RELIABILITY OF THE GATEWAY
      5. CHAPTER 11: PCS SERVER AND ARCHIVE
        1. 11.1 IMAGE MANAGEMENT DESIGN CONCEPT
        2. 11.2 FUNCTIONS OF THE PACS SERVER AND ARCHIVE SERVER
        3. 11.3 PACS ARCHIVE SERVER SYSTEM OPERATIONS
        4. 11.4 DICOM-COMPLIANT PACS ARCHIVE SERVER
        5. 11.5 DICOM PACS ARCHIVE SERVER HARDWARE AND SOFTWARE
        6. 11.6 BACKUP ARCHIVE SERVER
      6. CHAPTER 12: DISPLAY WORKSTATION
        1. 12.1 BASICS OF A DISPLAY WORKSTATION
        2. 12.2 ERGONOMICS OF IMAGE WORKSTATIONS
        3. 12.3 EVOLUTION OF MEDICAL IMAGE DISPLAY TECHNOLOGIES
        4. 12.4 TYPES OF IMAGE WORKSTATION
        5. 12.5 IMAGE DISPLAY AND MEASUREMENT FUNCTIONS
        6. 12.6 WORKSTATION GRAPHIC USER INTERFACE (GUI) AND BASIC DISPLAY FUNCTIONS
        7. 12.7 DICOM PC-BASED DISPLAY WORKSTATION
        8. 12.8 RECENT DEVELOPMENTS IN PACS WORKSTATIONS
        9. 12.9 SUMMARY OF PACS WORKSTATIONS
      7. CHAPTER 13: INTEGRATION OF HIS, RIS, PACS, AND ePR
        1. 13.1 HOSPITAL INFORMATION SYSTEM
        2. 13.2 RADIOLOGY INFORMATION SYSTEM
        3. 13.3 INTERFACING PACS WITH HIS AND RIS
        4. 13.4 INTERFACING PACS WITH OTHER MEDICAL DATABASES
        5. 13.5 ELECTRONIC PATIENT RECORD (ePR)
    15. PART III: PACS OPERATION
      1. CHAPTER 14: PACS DATA MANAGEMENT AND WEB-BASED IMAGE DISTRIBUTION
        1. 14.1 PACS DATA MANAGEMENT
        2. 14.2 PATIENT FOLDER MANAGEMENT
        3. 14.3 DISTRIBUTED IMAGE FILE SERVER
        4. 14.4 WEB SERVER
        5. 14.5 COMPONENT-BASED WEB SERVER FOR IMAGE DISTRIBUTION AND DISPLAY
        6. 14.6 WIRELESS REMOTE MANAGEMENT OF CLINICAL IMAGE WORKFLOW
        7. 14.7 SUMMARY OF PACS DATA MANAGEMENT AND WEB-BASED IMAGE DISTRIBUTION
      2. CHAPTER 15: TELEMEDICINE AND TELERADIOLOGY
        1. 15.1 INTRODUCTION
        2. 15.2 TELEMEDICINE AND TELERADIOLOGY
        3. 15.3 TELERADIOLOGY
        4. 15.4 TELERADIOLOGY MODELS
        5. 15.5 SOME IMPORTANT ISSUES IN TELERADIOLOGY
        6. 15.6 TELE-BREAST IMAGING
        7. 15.7 TELEMICROSCOPY
        8. 15.8 REAL-TIME TELECONSULTATION SYSTEM
        9. 15.9 SUMMARY OF TELERADIOLOGY
      3. CHAPTER 16: FAULT-TOLERANT PACS AND ENTERPRISE PACS
        1. 16.1 INTRODUCTION
        2. 16.2 CAUSES OF A SYSTEM FAILURE
        3. 16.3 NO LOSS OF IMAGE DATA
        4. 16.4 NO INTERRUPTION OF PACS DATA FLOW
        5. 16.5 CURRENT PACS TECHNOLOGY TO ADDRESS FAULT TOLERANCE
        6. 16.6 CLINICAL EXPERIENCES WITH ARCHIVE SERVER DOWNTIME: A CASE STUDY
        7. 16.7 CONCEPT OF CONTINUOUSLY AVAILABLE PACS DESIGN
        8. 16.8 CA PACS SERVER DESIGN AND IMPLEMENTATION
        9. 16.9 ENTERPRISE PACS
        10. 16.10 DESIGN OF ENTERPRISE-LEVEL PACS
        11. 16.11 THE HONG KONG HOSPITAL AUTHORITY HEALTHCARE ENTERPRISE PACS WITH WEB-BASED ePR IMAGE DISTRIBUTION
        12. 16.12 SUMMARY OF FAULT-TOLERANT PACS AND ENTERPRISE PACS WITH IMAGE DISTRIBUTION
      4. CHAPTER 17: IMAGE/DATA SECURITY
        1. 17.1 INTRODUCTION AND BACKGROUND
        2. 17.2 IMAGE/DATA SECURITY METHODS
        3. 17.3 DIGITAL ENVELOPE
        4. 17.4 DICOM SECURITY PROFILES
        5. 17.5 HIPAA AND ITS IMPACTS ON PACS SECURITY
        6. 17.6 PACS SECURITY SERVER AND AUTHORITY FOR ASSURING IMAGE AUTHENTICITY AND INTEGRITY
        7. 17.7 LOSSLESS DIGITAL SIGNATURE EMBEDDING METHODS FOR ASSURING 2-D AND 3-D MEDICAL IMAGE INTEGRITY
        8. 17.8 TWO-DIMENSIONAL AND THREE-DIMENSIONAL LOSSLESS DIGITAL SIGNATURE EMBEDDING METHOD
        9. 17.9 FROM A THREE-DIMENSIONAL VOLUME TO TWO-DIMENSIONAL IMAGE(S)
        10. 17.10 APPLICATION OF TWO-DIMENSIONAL AND THREE-DIMENSIONAL LDSE IN CLINICAL IMAGE DATA FLOW
        11. 17.11 SUMMARY AND SIGNIFICANCE OF IMAGE SECURITY
      5. CHAPTER 18: PACS CLINICAL IMPLEMENTATION, ACCEPTANCE, AND EVALUATION
        1. 18.1 PLANNING TO INSTALL A PACS
        2. 18.2 MANUFACTURER’S PACS IMPLEMENTATION STRATEGY
        3. 18.3 TEMPLATES FOR PACS RFP
        4. 18.4 PACS IMPLEMENTATION STRATEGY
        5. 18.5 IMPLEMENTATION
        6. 18.6 SYSTEM ACCEPTANCE
        7. 18.7 CLINICAL PACS IMPLEMENTATION CASE STUDIES
        8. 18.8 PACS SYSTEM EVALUATION
        9. 18.9 SUMMARY OF PACS IMPLEMENTATION, ACCEPTANCE, AND EVALUATION
      6. CHAPTER 19: PACS CLINICAL EXPERIENCE, PITFALLS, AND BOTTLENECKS
        1. 19.1 CLINICAL EXPERIENCE AT THE BALTIMORE VA MEDICAL CENTER
        2. 19.2 CLINICAL EXPERIENCE AT ST. JOHN’S HEALTHCARE CENTER
        3. 19.3 UNIVERSITY OF CALIFORNIA, LOS ANGELES
        4. 19.4 UNIVERSITY OF SOUTHERN CALIFORNIA
        5. 19.5 PACS PITFALLS
        6. 19.6 PACS BOTTLENECKS
        7. 19.7 DICOM CONFORMANCE
        8. 19.8 SUMMARY OF PACS CLINICAL EXPERIENCE, PITFALLS, AND BOTTLENECKS
    16. PART IV: PACS- AND DICOM-BASED IMAGING INFORMATICS
      1. CHAPTER 20: DICOM-BASED MEDICAL IMAGING INFORMATICS
        1. 20.1 THE MEDICAL IMAGING INFORMATICS INFRASTRUCTURE (MIII) PLATFORM
        2. 20.2 HIS/RIS/PACS, MEDICAL IMAGES, ePR, AND RELATED DATA
        3. 20.3 IMAGING INFORMATICS TOOLS
        4. 20.4 DATABASE AND KNOWLEDGE BASE MANAGEMENT
        5. 20.5 APPLICATION MIDDLEWARE
        6. 20.6 CUSTOMIZED SOFTWARE AND SYSTEM INTEGRATION
        7. 20.7 SUMMARY OF MEDICAL IMAGE INFORMATICS INFRASTRUCTURE (MIII)
      2. CHAPTER 21: DATA GRID FOR PACS AND MEDICAL IMAGING INFORMATICS
        1. 21.1 DISTRIBUTED COMPUTING
        2. 21.2 GRID COMPUTING
        3. 21.3 DATA GRID
        4. 21.4 FAULT-TOLERANT DATA GRID FOR PACS ARCHIVE AND BACKUP, QUERY/RETRIEVAL, AND DISASTER RECOVERY
        5. 21.5 DATA GRID AS THE IMAGE FAULT-TOLERANT ARCHIVE IN IMAGE-BASED CLINICAL TRIALS
        6. 21.6 A SPECIFIC CLINICAL APPLICATION – DEDICATED BREAST MRI ENTERPRISE DATA GRID
        7. 21.7 TWO CONSIDERATIONS IN ADMINISTRATING THE DATA GRID
        8. 21.8 CURRENT RESEARCH AND DEVELOPMENT ACTIVITIES IN DATA GRID
        9. 21.9 SUMMARY OF DATA GRID
      3. CHAPTER 22: MULTIMEDIA ELECTRONIC PATIENT RECORD (ePR) SYSTEM
        1. 22.1 THE ELECTRONIC PATIENT RECORD (ePR) SYSTEM
        2. 22.2 THE VETERANS AFFAIRS HEALTHCARE ENTERPRISE (VAHE) ePR WITH IMAGES
        3. 22.3 INTEGRATING IMAGES INTO THE ePR OF THE HOSPITAL AUTHORITY (HA) OF HONG KONG
        4. 22.4 THE MULTIMEDIA ePR SYSTEM FOR PATIENT TREATMENT
        5. 22.5 THE MULTIMEDIA ePR SYSTEM FOR RADIATION THERAPY TREATMENT
        6. 22.6 THE MULTIMEDIA ePR SYSTEM FOR MINIMALLY INVASIVE SPINAL SURGERY
        7. 22.7 SUMMARY OF THE MULTIMEDIA ePR SYSTEM
      4. CHAPTER 23: MULTIMEDIA ELECTRONIC PATIENT RECORD SYSTEM IN RADIATION THERAPY
        1. 23.1 BACKGROUND IN RADIATION THERAPY PLANNING AND TREATMENT
        2. 23.2 RADIATION THERAPY WORKFLOW
        3. 23.3 THE ePR DATA MODEL AND DICOM RT OBJECTS
        4. 23.4 INFRASTRUCTURE, WORKFLOW, AND COMPONENTS OF THE MULTIMEDIA ePR IN RT
        5. 23.5 DATABASE SCHEMA
        6. 23.6 GRAPHICAL USER INTERFACE DESIGN
        7. 23.7 VALIDATION OF THE CONCEPT OF MULTIMEDIA ePR SYSTEM IN RT
        8. 23.8 ADVANTAGES OF THE MULTIMEDIA ePR SYSTEM IN RT FOR DAILY CLINICAL PRACTICE
        9. 23.9 UTILIZATION OF THE MULTIMEDIA ePR SYSTEM IN RT FOR IMAGE-ASSISTED KNOWLEDGE DISCOVERY AND DECISION SUPPORT
        10. 23.10 SUMMARY OF THE MULTIMEDIA ePR IN RADIATION THERAPY
      5. CHAPTER 24: MULTIMEDIA ELECTRONIC PATIENT RECORD (ePR) SYSTEM FOR IMAGE-ASSISTED SPINAL SURGERY
        1. 24.1 INTEGRATION OF MEDICAL DIAGNOSIS WITH IMAGE-ASSISTED SURGERY TREATMENT
        2. 24.2 MINIMALLY INVASIVE SPINAL SURGERY WORKFLOW
        3. 24.3 MULTIMEDIA ePR SYSTEM FOR IMAGE-ASSISTED MISS WORKFLOW AND DATA MODEL
        4. 24.4 MINIMALLY INVASIVE SPINAL SURGERY ePR SYSTEM ARCHITECTURE
        5. 24.5 PRE-OP AUTHORING MODULE
        6. 24.6 INTRA-OP MODULE
        7. 24.7 POST-OP MODULE
        8. 24.8 SYSTEM DEPLOYMENT AND USER TRAINING AND SUPPORT
        9. 24.9 SUMMARY OF DEVELOPING THE MULTIMEDIA ePR SYSTEM FOR IMAGE-ASSISTED SPINAL SURGERY
      6. CHAPTER 25: COMPUTER-AIDED DIAGNOSIS (CAD) AND IMAGE-GUIDED DECISION SUPPORT
        1. 25.1 COMPUTER-AIDED DIAGNOSIS (CAD)
        2. 25.2 COMPUTER-AIDED DETECTION AND DIAGNOSIS (CAD) WITHOUT PACS
        3. 25.3 CONCEPTUAL METHODS OF INTEGRATING CAD WITH DICOM PACS AND MIII
        4. 25.4 COMPUTER-AIDED DETECTION OF SMALL ACUTE INTRACRANIAL HEMORRHAGE (AIH) ON COMPUTER TOMOGRAPHY (CT) OF BRAIN
        5. 25.5 EVALUATION OF THE CAD FOR AIH
        6. 25.6 FROM SYSTEM EVALUATION TO CLINICAL PRACTICE
        7. 25.7 SUMMARY OF COMPUTER-ASSISTED DIAGNOSIS
      7. CHAPTER 26: INTEGRATION OF COMPUTER-AIDED DIAGNOSIS (CAD) WITH PACS
        1. 26.1 THE NEED FOR CAD-PACS INTEGRATION
        2. 26.2 DICOM STANDARD AND IHE WORKFLOW PROFILES
        3. 26.3 THE CAD–PACS© INTEGRATION TOOLKIT
        4. 26.4 INTEGRATING USING THE CAD–PACS TOOLKIT
        5. 26.5 DICOM SR AND THE CAD–PACS INTEGRATION TOOLKIT
        6. 26.6 INTEGRATION OF CAD WITH PACS FOR MULTIPLE SCLEROSIS (MS) ON MRI
        7. 26.7 INTEGRATION OF CAD WITH PACS FOR BONE AGE ASSESSMENT OF CHILDREN—THE DIGITAL HAND ATLAS
        8. 26.8 INTEGRATION OF CAD WITH PACS FOR BONE AGE ASSESSMENT OF CHILDREN—THE CAD SYSTEM
        9. 26.9 RESEARCH AND DEVELOPMENT TRENDS IN CAD–PACS INTEGRATION
        10. 26.10 SUMMARY OF CAD–PACS INTEGRATION
      8. CHAPTER 27: LOCATION TRACKING AND VERIFICATION SYSTEM IN CLINICAL ENVIRONMENT
        1. 27.1 NEED FOR THE LOCATION TRACKING AND VERIFICATION SYSTEM IN CLINICAL ENVIRONMENT
        2. 27.2 CLINICAL ENVIRONMENT WORKFLOW
        3. 27.3 AVAILABLE TRACKING AND BIOMETRIC TECHNOLOGIES
        4. 27.4 LOCATION TRACKING AND VERIFICATION SYSTEM (LTVS) DESIGN
        5. 27.5 BENEFITS OF LTVS
        6. 27.6 COST ANALYSIS
        7. 27.7 ALTERNATIVE IDENTIFICATION DEVICES
        8. 27.8 FINGERPRINT SCAN AS AN ADD-ON SUBSYSTEM TO THE MISS ePR FOR VERIFICATION OF SURGICAL PATENT
        9. 27.9 SUMMARY OF THE LOCATION TRACKING AND VERIFICATION SYSTEM IN CLINICAL ENVIRONMENT
      9. CHAPTER 28: NEW DIRECTIONS IN PACS AND MEDICAL IMAGING INFORMATICS TRAINING
        1. 28.1 NEW DIRECTIONS IN PACS AND MEDICAL IMAGING INFORMATICS EDUCATION AND TRAINING
        2. 28.2 CONCEPT OF THE PACS SIMULATOR
        3. 28.3 EXAMPLES OF PACS AND IMAGING INFORMATICS TRAINING PROGRAM
        4. 28.4 TRAINING MEDICAL IMAGING INFORMATICS FOR INTERDISCIPLINARY CANDIDATES
        5. 28.5 CHANGING PACS LEARNING WITH NEW INTERACTIVE AND MEDIA-RICH LEARNING ENVIRONMENTS
        6. 28.6 SUMMARY OF PACS AND MEDICAL IMAGING INFORMATICS TRAINING
    17. PACS AND IMAGING INFORMATICS GLOSSARY
    18. INDEX