Digital Mammography Integrated with PACS: Real World Issues, Considerations, Workflow Solutions, and Reading Paradigms

This article describes the 3.5 years experience of integrating digital mammography with a generalized Picture Archiving Communications System (PACS). Rather than implement a mammography mini-PACS solution (dedicated solely for use in full-field digital mammography), the vision was to integrate full-field digital mammography with the preexisting PACS archive, network, and Web distribution system from the beginning. Our enterprise still utilized a separate proprietary mammography reading workstation, as required by the FDA at that time. The pros, cons, and lessons learned from this approach are presented. The enterprise is currently transitioning away from a separate mammography reading station. This transition will more fully integrate, using the overall PACS for mammography reporting, mammography tracking, document imaging module may be added in the future, management reporting, task tracking, and billing output with a single unified RIS/PACS solution. This paper describes the core technologies required for this approach, along with the theoretical advantages.