Unlocking the PACS DICOM Domain for its Use in Clinical Research Data Warehouses

Area of Science:

• Medical Informatics
• Health Services Research

Background:

• Clinical Data Warehouses (DWHs) facilitate researcher access to pseudonymized clinical data.
• Integrating medical imaging data, specifically from Picture Archiving and Communication Systems (PACS), into DWHs is not well-established.

Purpose of the Study:

• To assess the feasibility of integrating a production PACS with a research DWH.
• To enable DWH queries that combine clinical and medical imaging metadata.
• To allow ad hoc display and download of images directly from the DWH.

Main Methods:

• Developed an application interface for querying a production PACS from a clinical research DWH.
• Evaluated performance of bulk metadata extraction from PACS to DWH.
• Assessed performance of ad hoc image retrieval (display and download) from PACS via DWH.

Main Results:

• The system integration was successful and utilized in four research use cases.
• Bulk metadata extraction times varied significantly based on the approach (median 0.09 to 12.52 seconds per patient).
• Ad hoc image retrieval took a median of 2.57 seconds for download and 5.55 to 40.77 seconds for display.

Conclusions:

• Full integration of production PACS with research DWHs is feasible and supports diverse research applications.
• Bulk extraction of basic imaging metadata is achievable; comprehensive metadata extraction is best suited for specific patient subgroups.