"People will define the term PACS in a lot of ways," says Tim Kulbago, general manager of Merge Healthcare's Fusion Division. "From my perspective, it's always had three components: you have your server or back-end device that stores images and archives them; you have viewing technology specifically for the purposes of diagnosing - the technologies and functions that are displayed for radiologists to do the medicine of radiology; and the third class that usually goes on a PACS is a distribution technology."




All these pieces fit into a very dynamic and quickly evolving system, especially now as web-based technologies fuel the use of increasingly complex clinical applications.

Market forces create opportunities for new technology

Siemens Healthcare is waiting on FDA approval for syngo.plaza, a brand-new PACS driving the company's multimodality clinical IT system, syngo.via. Together, the two will enable two, three and four-dimensional viewing of image data. Henri Primo, national director of marketing and strategic relationships for Siemens' Image and Knowledge Management division, talked with DOTmed about the demands that have stretched health IT to today's grand proportions.

"The first thing that we see is that new applications are becoming increasingly combined with PACS and these new applications have become essential with the advent of new imaging technologies like multi-slice CT scanners and multi-sequence MR, all producing huge data loads and incredible amounts of images," says Primo.

The wizards behind the curtain

You have to have very powerful and versatile technology to be able to handle the data involved in advanced visualization. Multi-planar reconstruction, maximum intensity projection, and other three-dimensional viewing methods - these have been in use for a long time, but mostly within the academic and research environment. Now you see more of these technologies in everyday clinical use.

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