From archives to picture archiving and communications systems

Keeping organised and consistent film archives is a well-known problem in the radiological world. With the introduction of digital modalities (CT, MR,...) the idea of archiving the image data in a non common way was born. The aim is to keep the information in digital form from acquisition to destination, e.g. archives, viewing station, teleradiology, a task that was not as easy as some people believed, due to bare technical possibilities and to the lack of standards concerning medical image data. These reasons made it not so common to integrate components of different origins into a digital Picture Archiving and Communication environment. How should we attempt to integrate the analogue examinations? It is ridiculous to exclude the conventional XR-examination that accounts for more than 70% of the total production. We believe that there will be a migration to light-stimulable phosphor plates, but these are not yet user friendly and certainly not cost effective. We have similar problems of immature technology as we had for the digital modalities. In a first attempt the bridge can be crossed, between the two worlds by means of converters (laser scanner, CCD camera). PACS will become a reality in the future as almost all examinations will be digitalized. We are now in a transition period with its inconveniences, but we will gain a lot soon. The migration from piles of films through a computer assisted radiological archiving system to a full digital environment is sketched in a historical survey.