Experience with a DICOM-compatible digital pediatric echocardiography laboratory

A digital pediatric echocardiography laboratory, without videotape redundancy was established at Children's Hospital of Wisconsin in December 1998. To characterize the experience, 1198 consecutive patient studies were reviewed-50% from the first 2 months after establishing the digital protocol and 50% from the last 2 months available. Each study was stored using a protocol that was based on capture of single beat clips of relevant two-dimensional/color Doppler imaging and static frame spectral Doppler tracings. Studies were digitally compressed using a DICOM-compatible JPEG algorithm at 20:1 and edited with deletions of redundant clips to minimize archival storage needs. Study quality was uniformly excellent, and no errors were attributable to the digital protocol or compression-related loss of information. The average study required 21.5 +/- 11.4 MB of storage space with 35.4 +/- 12.3 total clips/study captured. Studies reviewed from the earlier experience were not significantly larger (23.6 +/- 14 vs 19.7 +/- 8.1 MB, 35.6 +/- 12.5 vs 35.2 +/- 12 clips) than those done recently. Studies in patients with isolated ventricular septal defect used comparable storage (23.7 +/- 8.9 MB, 42.8 +/- 11.5 clips) to that of the group as a whole. More complex congenital heart disease studies were slightly larger-tetralogy of Fallot (28.2 +/- 19.5 MB, 43.4 +/- 13.9 clips), transposition of the great arteries (30.6 +/- 17.4 MB, 40.3 +/- 16.7 clips), and single ventricle (29.7 +/- 19.6 MB, 39.9 +/- 12 clips)--although this trend was not significant. This study suggests that digital pediatric echo is feasible using a DICOM-compatible protocol with maintenance of diagnostic integrity despite compression of study size to allow rapid archival storage and retrieval.