Local electronic storage of radiological studies for radiosurgery

Although radiosurgical practice mandates meticulous radiological follow-up, even the most efficient radiology department can be overwhelmed by the large number of radiosurgical patients who have undergone diagnostic studies for many years at many different institutions to follow many separate lesions. Although the task of assembling these studies is theoretically possible, because they are spread out in time and space, it is often impractical. We therefore sought to construct a computer-based system that could store images from multiple sources and present them instantly for review.

We attached a flatbed film scanner to a standard desktop computer in our clinic and scanned selected sheets of film into an image database at each visit of a radiosurgical patient. "Low-tech" solutions were deliberately chosen-that is, to enhance ease and software compatibility, we used the operating system's directory structure for organization of data instead of proprietary software. Standard commercially available software was used to review studies that had been previously scanned.

During a 2- to 3-year period, images were scanned from 1129 studies performed on 435 patients. Images could be reviewed instantly and compared with current studies, and scanning a single piece of film required approximately 30 seconds. We estimate that the current capacity of our computer memory will satisfy our needs for approximately 12 years.

Assembly of an efficient and inexpensive system for image storage and retrieval suitable for radiosurgical practice is feasible and straightforward. Although our system is not a substitute for a radiology department, it obviates the constant frustration of "finding the films" and has become an essential part of our radiosurgical practice.