Open-source, low-cost, high-reliability solutions for digital imaging systems: example of a "dicom router"

Area of Science:

• Medical Physics
• Radiotherapy Technology
• Health Informatics

Background:

• Modern radiotherapy divisions face challenges in managing digital imaging data from various sources.
• Integrating diverse Digital Imaging and Communications in Medicine (DICOM) data streams with complex routing policies is a significant technical hurdle.

Purpose of the Study:

• To demonstrate how a radiotherapy department can overcome digital imaging integration challenges by developing in-house expertise.
• To showcase the use of free and open-source resources for cost-effective solutions in radiotherapy IT infrastructure.

Main Methods:

• Implemented a DICOM router using free, stable technologies: PHP, Apache, MySQL, DCMTK, and Linux.
• Utilized low-cost hardware and considered integration with existing electronic clinical records.
• Incorporated hardware redundancy for enhanced system stability.

Main Results:

• Developed a functional DICOM router supporting both manual and automatic image routing.
• Successfully linked acquired images with electronic clinical records.
• The system has operated reliably for one year, validating the chosen technologies.

Conclusions:

• Acquiring in-house IT knowledge is crucial for managing multi-provider integration issues in healthcare.
• Open-source technologies provide accessible, well-documented solutions for small-to-medium scale IT challenges in healthcare.
• In-house development using open-source tools offers a cost-effective alternative to expensive commercial IT solutions.