Pediatric digital echocardiography: a study of the analog-to-digital transition

Limited information is available that describes the practical conversion of a pediatric echocardiography laboratory from videotape to a primarily digital format. To help pediatric echocardiographers begin to make the analog-to-digital transition, we report our pediatric digital acquisition protocol and the acquisition and storage parameters of 1000 unselected, consecutive digitally acquired studies of pediatric patients with known or suspected congenital or acquired heart disease. With the use of our acquisition protocol, a complete normal study requires 46 moving clips and 12 still-frame images. Five hundred consecutive patient studies acquired with "high" JPEG (Joint Photographers Experts Group) compression (group 1) were compared with the next 500 examinations acquired using "medium" JPEG compression (group 2) for number of moving clips, still images, and megabytes of storage space. No intergroup difference was found in the number of moving clips or still images. When JPEG compression was decreased from high to medium, the average clip storage requirement per patient increased, and the number of patients stored per 230-MB magneto optical disk decreased significantly. Non-ECG-triggered timed single-plane clips and still images required significantly more storage space than ECG-triggered single-beat clips and still images. The frequency of multiplane sweeps was.03% and was independent of diagnosis. With the use of high JPEG compression, the digital storage cost per patient was $1.90, which was 6.0 times greater than that for simultaneously recorded 120-minute VHS videotape. Many features of the digital paradigm, including decreased MOD storage space, enhanced serial study comparisons, random image access, and improved image quality, mitigate this cost differential.