[The presentation of a picture archiving and communication system (PACS) and the initial experiences with its use]

The use of computers has yielded new diagnostic techniques (US, CT, MRI and computed radiography) that can successfully replace conventional film in data acquisition, image display and image interpretation. Thanks to the Picture Archiving and Communication System (PACS), we can now manage the whole of diagnostic data because the images are acquired, coupled to the patient data stored in the Radiology Information System (RIS), sent to display workstations and finally sent to the archives.

To present the configuration and functions of a new PACS used in radiology and nuclear medicine departments and to evaluate its efficacy one year after implementation. Particular attention is paid to the objective difficulties radiologists found in approaching the system.

Secretarial work reduction and a more rational archiving organization are two of the advantages of automation. PACS permits rapid image display, retrieval nd archiving for both scientific and statistical purposes; however, its correct use is hindered by a series of problems, namely: a) reluctance to use PACS by many members of the medical staff, due to the complexity of its procedures; b) lack of panoramicity on the display monitor in multi-image examinations and c) underuse of viewing workstations in several wards of our institution due to lack of know-how.

Although the use of PACS has improved the workload management in our departments, the system still needs to be customized to the radiologist to optimize its use. Workstations must be user-friendly, with simultaneous display of more images. On the other hand, radiologists need to expand their knowledge of new techniques, thus modifying obsolete working procedures.