Integration of Computer-Aided Diagnosis (CAD) with PACS

In this chapter we present two CAD applications that accomplished their ultimate goal of becoming integrated into daily clinical practice. The two CAD applications are for detection of multiple sclerosis on brain MRI with informatics output, and bone age assessment of children from hand radiographs. The rationale behind the CAD system’s development and the validation and evaluation processes will be reviewed, the same as in Chapter 25, but with an additional important component not discussed in Chapter 25, which is its integration with PACS for daily operation. For convenience, Figure 20.9 is reproduced here as Figure 26.1 to show how this chapter (in orange color) corresponds as well to other chapters of Part IV.

CAD-PACS integration requires new concepts and additional technical background. Hence we introduce in this chapter DICOM screen capture and structured reporting framework, some specific IHE (integrating the healthcare enterprise) workflow profiles, and CAD-PACS toolkit.


The main purpose in integrating CAD with PACS for daily clinical operation is to utilize CAD as a second reader. To recap our discussion in Chapter 25, CAD software can be implemented within a stand-alone CAD workstation (WS), a CAD server, or be integrated in PACS as PACS-based CAD. Currently several PACS and CAD companies have successfully integrated their CAD applications within the PACS operation, ...

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