In today’s radiology environment, DICOM routers do much more than store and forward studies from one station to the next. In fact, DICOM routers are at the heart of what keeps a radiology practice running. Recent advancements in routing technology have paved the way for improvements in security, performance, data integrity, quality control, and storage management. Why do these essential components often become an afterthought in architecture and workflow design? If your organization is not currently capitalizing on today’s latest routing technology, take the time to read this article closely.
1. Secure Connections without VPNs
The Internet has revolutionized radiology as we know it. It’s not at all uncommon for DICOM studies to be routed to a cloud PACS, or to a central server located at an off-site location. Historically, VPNs were needed to send studies securely over the Internet. However, challenges with VPN setup, maintenance, and downtime have taken DICOM routing in a new direction:
- Many radiology practices utilize DICOM router and PACS technology that is capable of leveraging TLS protocols for encryption, authentication, and data integrity.
- Secure connections that utilize 256-bit SSL certificates can commonly be found pushing DICOM studies over the Internet without the need for VPNs.
These security improvements have allowed enterprise hospitals, imaging centers, and teleradiology practices to thrive in recent years.
2. Improved Performance
DICOM routers are the engines that keep the radiology practice running. As with any engine, performance is key. Taking advantage of the following improvements in performance-related routing technology will ensure that your radiology practice runs like a well-oiled machine:
- Today’s DICOM routers utilize optimized transfer protocols that can minimize the overhead that can cause network congestion and slowness.
- Many high-volume organizations utilize multi-threading techniques to stream multiple images or studies simultaneously across the network.
- DICOM routers today can leverage compression algorithms that sometimes are not achievable when sending from the modality to the PACS directly.
- Smart-prefetch of relevant priors is a recent feature that’s gaining the interest of PACS admins and radiologists. The feature enables automatic pre-fetching of the most relevant priors based on any user-defined criteria, such as study description (partial/ full match), Study UID, facility, etc. This improves the quality of reads, increases productivity for radiologists, and reduces turn-around time.
All of these performance-boosting advancements have helped radiology practices reach new heights in efficiency and speed.
3. Data Integrity
Since the dawning of PACS in the early 80s, administrators have been playing the role of janitors, cleaning up messy studies and getting rid of junk in the system. In recent years however, DICOM routers have come a long way in reducing the amount of clean-up work necessary in the system, such as:
- Features such as field mapping, which is able to move values from incorrect DICOM tags into their proper place before studies hit the PACS.
- Tools for normalization of data such as placing clean facility names, modalities, study descriptions, and body parts on every study received to keep data consistent and allow PACS hanging protocols to work correctly.
- Some routers include the ability to run custom scripts on each study received before forwarding it on to the PACS. This key functionality has enabled organizations to solve data integrity challenges which were historically inconceivable.
These improvements in data integrity trickle down to improvements in study access control, hanging protocols, worklist configuration, routing capabilities, and much more.
4. Archiving
New advancements in routing technology have combined the DICOM services of a router with the storage model of a Vendor Neutral Archive (VNA) to produce a hybrid solution which has changed the way many radiology practices operate.
- Upgrading a DICOM router to include VNA capabilities has helped numerous organizations consolidate and manage their storage environment, while increasing redundancy and retrieval capabilities. For many sites that ship their studies somewhere else for reading, a high-powered DICOM router with archiving capabilities is all they need for a PACS.
- Advanced DICOM routers now also include image viewing capabilities, which has allowed for technologist QC of the studies before they get routed off-site for interpretation.
It’s clear that DICOM routers today do much more than send and receive studies. Radiology practices that are able to act on the latest advancements in routing technology will surely benefit from the added functionality and initiate a positive transformation of their operation.
