(PACS) A system used to communicate and archive medical imaging data, mostly images and associated textural data generated in a radiology department, and disseminated throughout the hospital. A PACS is usually based on the DICOM (Digital Imaging and Communications in Medicine) standard.
The main components in the PACS are:
Acquisition devices, which acquire their data in direct digital format, like a MRI system, are most easily integrated into a PACS.
Short term archives need to have rapid access, such as provided by a RAID (redundant array of independent disks), whereas long term archives need not have such rapid access and can be consigned, e.g. to optical disks or a magnetic.
High speed networks are necessary for rapid transmission of imaging data from the short term archive to the diagnostic workstations. Optical fiber, ATM (asynchronous transfer mode), fast or switched Ethernet, are examples of high speed transmission networks, whereas demographic textural data may be transmitted along conventional Ethernet.
Sophisticated software is a major element in any hospital-wide PACS. The software concepts include: preloading or prefetching of historical images pertinent to current examinations, worklists and folders to subdivide the vast mass of data acquired in a PACS in a form, which is easy and practical to access, default display protocols whereby images are automatically displayed on workstation monitors in a prearranged clinically logical order and format, and protocols radiologists can rapidly report worklists of undictated examinations, using a minimum of computer manipulation.

(LE) Myocardial late enhancement in contrast enhanced cardiac MRI has the ability to precisely delineate myocardial scar associated with coronary artery disease. Viability imaging implies evaluating infarcted myocardium to see whether there is enough viable tissue available for revascularization. The reversal of myocardial dysfunction is particularly relevant in patients with depressed ventricular function because revascularization improves long-term survival. In comparison to SPECT and PET imaging, myocardial late enhancement MRI demonstrates areas of delayed enhancement exactly in correlation with the infarcted region.
Viability on cardiac MRI (CMR) is based on the fact that all infarcts enhance vividly 10-15 minutes after the administration of intravenous paramagnetic contrast agents. This enhancement represents the accumulation of gadolinium in the extracellular space, due to the loss of membrane integrity in the infarcted tissue. This phenomenon of delayed hyperenhancement has been proven to correlate with the actual extent of the infarct.
MRI myocardial late enhancement can quantify the size, location and transmural extent of the infarct. If the transmural extent of the infarct (region of enhancement on MRI) is less than 50% of the wall thickness, there will be improved contractility in that segment following revascularization. In areas of hypokinesia, if there is a rim of "black" or non-infarcted myocardium that is not contracting well, it indicates the presence of hibernating myocardium, which is likely to improve after revascularization of the artery supplying that particular territory.
The total duration of a myocardial late enhancement MR imaging protocol for viability is approximately 30 minutes, including scout images, first-pass images, cine images in two planes, and delayed myocardial enhancement images. In order to assess viable myocardium, the gadolinium contrast agent is injected at a dose of 0.15 to 0.2 mmol/kg. After about 10 minutes, short axis and long axis views (see cardiac axes) of the heart are obtained using an inversion prepared ECG gated gradient echo sequence. The inversion pulse is adjusted to suppress normal myocardium. Areas of nonviable myocardium retain extremely high signal intensity, black areas show normal tissue.

For Ultrasound Imaging (USI) see Myocardial Contrast Echocardiography at Medical-Ultrasound-Imaging.com.

(DE FGRE, Dual/FFE, DE FFE) Simultaneously acquired in and out of phase TE gradient echo images. To quantitatively measure the signal intensity differences between out of phase and in phase images the parameters should be the same except for the TE.
The chemical shift artifact appearing on the out-of-phase image allows for the detection of lipids in the liver or adrenal gland, such as diffuse fatty infiltration, focal fatty infiltration, focal fatty sparing, benign adrenocortical masses and intracellular lipids within a hepatocellar neoplasm, where spin echo and fat suppression techniques are not as sensitive. Specific pathologies that have been reported include liver lipoma, angiomyolipoma, myelolipoma, metastatic liposarcoma, teratocarcinoma, melanoma, haemorrhagic neoplasm and metastatic choriocarcinoma.

The definition of imaging is the visual representation of an object. Medical imaging began after the discovery of x-rays by Konrad Roentgen 1896. The first fifty years of radiological imaging, pictures have been created by focusing x-rays on the examined body part and direct depiction onto a single piece of film inside a special cassette. The next development involved the use of fluorescent screens and special glasses to see x-ray images in real time.
A major development was the application of contrast agents for a better image contrast and organ visualization. In the 1950s, first nuclear medicine studies showed the up-take of very low-level radioactive chemicals in organs, using special gamma cameras. This medical imaging technology allows information of biologic processes in vivo. Today, PET and SPECT play an important role in both clinical research and diagnosis of biochemical and physiologic processes. In 1955, the first x-ray image intensifier allowed the pick up and display of x-ray movies.
In the 1960s, the principals of sonar were applied to diagnostic imaging. Ultrasonic waves generated by a quartz crystal are reflected at the interfaces between different tissues, received by the ultrasound machine, and turned into pictures with the use of computers and reconstruction software. Ultrasound imaging is an important diagnostic tool, and there are great opportunities for its further development. Looking into the future, the grand challenges include targeted contrast agents, real-time 3D ultrasound imaging, and molecular imaging.
Digital imaging techniques were implemented in the 1970s into conventional fluoroscopic image intensifier and by Godfrey Hounsfield with the first computed tomography. Digital images are electronic snapshots sampled and mapped as a grid of dots or pixels. The introduction of x-ray CT revolutionised medical imaging with cross sectional images of the human body and high contrast between different types of soft tissue. These developments were made possible by analog to digital converters and computers. The multislice spiral CT technology has expands the clinical applications dramatically.
The first MRI devices were tested on clinical patients in 1980. The spread of CT machines is the spur to the rapid development of MRI imaging and the introduction of tomographic imaging techniques into diagnostic nuclear medicine. With technological improvements including higher field strength, more open MRI magnets, faster gradient systems, and novel data-acquisition techniques, MRI is a real-time interactive imaging modality that provides both detailed structural and functional information of the body.
Today, imaging in medicine has advanced to a stage that was inconceivable 100 years ago, with growing medical imaging modalities:
All this type of scans are an integral part of modern healthcare. Because of the rapid development of digital imaging modalities, the increasing need for an efficient management leads to the widening of radiology information systems (RIS) and archival of images in digital form in picture archiving and communication systems (PACS). In telemedicine, healthcare professionals are linked over a computer network. Using cutting-edge computing and communications technologies, in videoconferences, where audio and visual images are transmitted in real time, medical images of MRI scans, x-ray examinations, CT scans and other pictures are shareable.
See also Hybrid Imaging.

See also the related poll results: 'In 2010 your scanner will probably work with a field strength of', 'MRI will have replaced 50% of x-ray exams by'

Otsuka Maryland Research Institute, Inc. (OMRI), a new affiliated company, was established to further Otsuka Pharmaceutical Co., Ltd.'s goal of globalizing core clinical R&D activities, while Otsuka America Pharmaceutical, Inc. (OAPI) focuses on product commercialization.

MRI Contrast Agents: