Technical Developments in Radiology: Enhancing Research Workflows with PACScrawler

Efficiently identifying and retrieving imaging studies to create research cohorts is often hindered by the segregated storage of medical imaging data and radiological reports. To address this, we developed PACScrawler, an open-source tool designed to streamline cohort assembly by enabling efficient search and access to imaging studies across Picture Archiving and Communication Systems (PACS) and Radiology Information Systems (RIS). The system features a backend crawler module that regularly collects DICOM and RIS metadata and radiology reports from newly acquired studies and stores them in a local Apache Solr/Lucene index. A web-based interface enables multi-parameter search across the indexed database, and a retrieval module downloads the corresponding imaging data on demand. Between 2012 and 2024, PACScrawler indexed 2,327,317 examinations from 316,310 patients at our institution. In our local setup, routine indexing of 1079 examinations on a representative day required 26.5 min, corresponding to a median of 1.4 s per study. In a batch retrieval benchmark, ten head MRI examinations comprising 325 series were retrieved in 16 min 08 s using PACScrawler compared with 31 min 45 s by manual sequential PACS export. For LLM-assisted query construction, 17 of 20 generated Solr queries were usable with no or limited manual adjustment. As an illustrative use case, the index enabled longitudinal monitoring of local imaging volumes and examination complexity. PACScrawler lowers the technical barrier for clinical imaging research by providing an open-source, regularly updated local search index for selected PACS/RIS metadata and radiology reports. It supports retrospective cohort identification, on-demand retrieval of imaging data, and longitudinal monitoring of institutional imaging trends while routine indexing is limited to metadata and report text. As a DICOM-based tool, PACScrawler may be adapted to other clinical environments after local PACS/RIS integration and validation; source code is available at https://github.com/pacs-ris-crawler/pacs-ris-crawler .