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Over the last decade, a picture archiving and communications system (PACS) has been accepted by an increasing number of clinical organizations. Today, PACS is considered as an essential image management and productivity enhancement tool. Image compression could further increase the attractiveness of PACS by reducing the time and cost in image transmission and storage as long as 1) image quality is not degraded and 2) compression and decompression can be done fast and inexpensively. Compared to JPEG, JPEG 2000 is a new image compression standard that has been designed to provide improved image quality at the expense of increased computation. Typically, the decompression time has a direct impact on the overall response time taken to display images after they are requested by the radiologist or referring clinician. In this paper, we present a fast JPEG 2000 decoder running on a low-cost programmable processor. It can decode a losslessly compressed 2048 x 2048 CR image in 1.51 s. Using this kind of a decoder, performing JPEG 2000 decompression at the PACS display workstation right before images are displayed becomes viable. A response time of 2 s can be met with an effective transmission throughput between the central short-term archive and the workstation of 4.48 Mb/s in case of CT studies and 20.2 Mb/s for CR studies. We have found that JPEG 2000 decompression at the workstation is advantageous in that the desired response time can be obtained with slower communication channels compared to transmission of uncompressed images.

The authors have developed a new classified vector quantizer (CVQ) using decomposition and prediction which does not need to store or transmit any side information. To obtain better quality in the compressed images, human visual perception characteristics are applied to the classification and bit allocation. This CVQ has been subjectively evaluated for a sequence of X-ray CT images and compared to a DCT coding method. Nine X-ray CT head images from three patients are compressed at 10:1 and 15:1 compression ratios and are evaluated by 13 radiologists. The evaluation data are analyzed statistically with analysis of variance and Tukey's multiple comparison. Even though there are large variations in judging image quality among readers, the proposed algorithm has shown significantly better quality than the DCT at a statistical, significance level of 0.05. Only an interframe CVQ can reproduce the quality of the originals at 10:1 compression at the same significance level. While the CVQ can reproduce compressed images that are not statistically different from the originals in quality, the effect on diagnostic accuracy remains to be investigated.

Displacement estimated interframe (DEI) coding, a coding scheme for 3-D medical image data sets such as X-ray computed tomography (CT) or magnetic resonance (MR) images, is presented. To take advantage of the correlation between contiguous slices, a displacement-compensated difference image based on the previous image is encoded. The best fitting distribution functions for the discrete cosine transform (DCT) coefficients obtained from displacement compensated difference images are determined and used in allocating bits and optimizing quantizers for the coefficients. The DEI scheme is compared with 2-D block discrete cosine transform (DCT) as well as a full-frame DCT using the bit allocation technique of S. Lo and H.K. Huang (1985). For X-ray CT head images, the present bit allocation and quantizer design, using an appropriate distribution model, resulted in a 13-dB improvement in the SNR compared to the full-frame DCT using the bit allocation technique. For an image set with 5-mm slice thickness, the DEI method gave about 5% improvement in the compression ratio on average and less blockiness at the same distortion. The performance gain increases to about 10% when the slice thickness decreases to 3 mm.