PACS: Basic Principles and Applications

Bernie Huang is an acknowledged expert in the field of PACS and enjoys a well deserved international reputation. In 1996 he published a book entitled `PACS in Biomedical Imaging' which was intended for the training of medical informatics scientists. The present book is, by the author's admission, directed towards a wider audience beyond engineers and medical physicists. It is, in effect, a revision of his earlier book with a number of additional chapters and expanded material. The author has been able to draw upon the experience of past graduate students, postdoctoral fellows and colleagues who have contributed a number of sections. The text is comprehensive in scope ranging all the way from the fundamentals of digital imaging (including microscopic imaging, as well as MRI and nuclear medicine), through standards, compression algorithms, to telecommunications and system design. It concludes with some observations on applications, pitfalls to avoid and projected future developments of PACS. This reviewer found the material lacking in one significant respect. The only reference to any cost analysis of PACS is found in a short section tucked away at the beginning of chapter 15. Not surprisingly, it alludes to a study that demonstrates the cost effectiveness of PACS at a relatively small workload. Only one study is offered as evidence to support the installation of PACS and no contrary arguments are presented. Given the huge investment that PACS implies for any organization contemplating it, this appears to be a major omission in a text dealing with the implementation of the technology. The book should be capable of reaching the wider audience desired by the author. It is well presented with plenty of figures and illustrations to augment the text. It will certainly make a handy reference text for students in medical imaging. However, for those engaged in implementing PACS, it is disappointing not to see a broader overview of the subject with a more intense interest in the value of the technology and its place in the `business' of radiology. The material in this book is still very much bound to the world of academia, without focus on the wider provision of radiological services.