Rationale and Objectives
The purpose of this study was to integrate web-based forms with a zero-footprint cloud-based Picture Archiving and Communication Systems (PACS) to create a tool of potential benefit to radiology research and education.
Materials and Methods
Web-based forms were created with a front-end and back-end architecture utilizing common programming languages including Vue.js, Node.js and MongoDB, and integrated into an existing zero-footprint cloud-based PACS.
Results
The web-based forms application can be accessed in any modern internet browser on desktop or mobile devices and allows the creation of customizable forms consisting of a variety of questions types. Each form can be linked to an individual DICOM examination or a collection of DICOM examinations.
Conclusions
Several uses are demonstrated through a series of case studies, including implementation of a research platform for multi-reader multi-case (MRMC) studies and other imaging research, and creation of an online Objective Structure Clinical Examination (OSCE) and an educational case file.
Introduction
Cloud-based picture archiving and communication systems (PACSs) have been widely available for the past several years. The National Institute of Standards and Technology broadly defines cloud computing as a “model for enabling ubiquitous, convenient, on-demand network access to a shared pool of configurable computing resources” . Such a rapidly elastic framework offers several advantages to a PACS implementation, including offloading of server considerations to the cloud provider with resultant reliable and maintenance-free performance, and ensuring broad compatibility across computing platforms and handheld devices.
The functionality of a cloud-based PACS can potentially be further enhanced by integrating web forms to allow easily customizable data collection linked to each DICOM (Digital Imaging and Communications in Medicine) examination. Web forms are commonly used in research, education, and administration. However, the integration of images into web-based forms such as Google Forms (Google Inc., Mountain View, MA) or SurveyMonkey (San Mateo, CA) is relatively primitive, and to our knowledge, there is no online form provider that supports the DICOM standard and allows standard PACS functionality. Combining a zero-footprint PACS with web-based forms may offer unique benefits to several research and educational tasks. Additionally, universal compatibility among desktop and handheld devices could facilitate studies or educational tasks tailored for mobile computing and more general applications.
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Integration of Forms with Cloud-based PACS
Cloud-based PACS
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TABLE 1
DICOM Tags That Are Anonymized
DICOM Tag Name of DICOM Tag 0008,0030–0033 Study, series, acquisition, content time 0008,0050 Accession number 0008,0080–1010 Institution name, address, referrer, station name 0008,1040–1070 Institution department, physician of record, operator’s name 0010,0010–2154 Patient’s name, ID, issuer of patient ID, birth date, sex, other patient’s ID, patient’s age, patient’s size and weight, ethnic group, pregnancy status, telephone number, religious preference, military rank, branch of service 0020,3404 Modifying device manufacturer 0020,4000 Image comments 0028,4000 Image presentation comments All tags starting with the following group numbers are removed: 0019, 0029, 0031–0033, 0035, 0038, 0043, 0045, 0049, 0051, 0053, 0060, 0070, 0073, 4008 All private, nonstandard tags are removed (any group number starting with an odd number)
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Integration of Web Forms
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Case Studies
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Case Study: MRMC Research Study Evaluating a New Imaging Technique
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Case Study: Multireader Research Study Evaluating Imaging Features of a Specific Disease Process
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Case Study: Educational Assessment
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Case Study: Online Teaching File
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Limitations
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Conclusions
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