Introduction
Typically a PACS network consists of a central PACS server which stores a database containing the images, and of multiple clients that can retrieve and display these images on medical imaging software. The images are stored in DICOM format. The modalities (MRI, CT, PET, Ultrasounds, ...) send the images to the PACS Server by using a DICOM "push" (DICOM C-Store). The server and the clients communicates by using the DICOM protocol (DICOM C-Store or Query & Retrieve). The clients display the images by using a medical imaging software: a DICOM viewer.
Each computer in a PACS network are identified by their network address (IP address), a communication port (TCP/IP port) and a name (AETitle): each computer is a DICOM Node in the PACS network. IP address, TCP/IP port number and AETitle are the informations required to connect each DICOM Node to the PACS network. These informations can be found in the Preferences - Listener window in OsiriX.
Hence, to build a PACS, you need:
- A PACS Server: a computer with a lot of hard disk space and a PACS Server software, like dcm4chee. The PACS Server software needs to be robust, working flawlessly 24/7, with a powerfull database engine, capable of storing millions of DICOM images.
- PACS Clients: a computer with a DICOM viewer software, like OsiriX. These PACS Clients can query and retrieve the DICOM images from the PACS server, by using the DICOM network protocol (DICOM C-Move, C-Store, C-Find, ...). The important qualities of a DICOM viewer:
- Fast transferring time (limited by the network bandwith)
- Fast loading time to be able to load and browse 1'000 images in less than 1 minute
- Complete DICOM protocol supports to handle all different types of DICOM images
- Powerfull 2D imaging functions to analyze the images (ROIs, window levels, zooming, ....)
- 3D post-processing functions to view the datasets in volume rendering, MPR or MIP
- Image fusion support to analyze PET-CT studies
Today, thanks to multiple open-source projects, it is possible to build a complete PACS network for free (you still have to pay for the hardware...). To build our free and open-source PACS network, we will use OsiriX, as the DICOM viewer, and dcm4chee as the PACS server.
Set-up
Hardware
- For the PACS Server: choose a MacPro with 2TB of storage to store up to 3 millions of CT images, depending on your RAID configuration. By using Xsan you can even build unlimited PACS storage.
- For the PACS clients: choose an iMac or a MacPro, depending if you need to do 3D post-processing or only 2D viewing.
Software
- For the PACS Server: there are currently a great open-source DICOM server software: dcm4chee.
- For the PACS clients: choose OsiriX, it's a bloody great DICOM Viewer!
Installation of dcm4chee
A step-by-step installation procedure : dcm4chee steps-by-steps
To manage your server:
Enter http://localhost:8080/dcm4chee-web/ in your web browser
Default account and password: admin / admin
To be able to Send or Retrieve an exam from/to your new PACS Server, you need to declare it on each PACS Clients:
Run OsiriX, select Preferences - Locations and add your DICOM PACS Server:
Add each PACS Clients (DICOM Nodes) on your PACS Server:
You can find the DICOM Node informations of your OsiriX workstation in the Preferences - Listener window.
More informations about dcm4chee:
Informations
Exchange images between OsiriX and your PACS Server (dcm4chee)
If you want to retrieve specific studies from your PACS server, you can now open the Query & Retrieve window in OsiriX:
Select the source, dcm4chee, enter a patient's name and click Query.
You can also send new studies from OsiriX to the PACS Server by using the DICOM Send function of OsiriX.
Conclusion
You just created and installed a complete PACS Network: PACS Server (dcm4chee) and PACS Workstations (OsiriX) for free, based on open-source and unlimited powerfull database engine (MySQL) components.
Problems? Support?
If you have any problems with the set-up of this open-source PACS, join our mailing list to find answers: OsiriX mailing list.
Are you looking for a 24/7 experts support to manage your PACS network and your OsiriX workstations? Check our parnters area.
Deploy a JPEG2000 PACS
Starting with OsiriX 3.6 and higher, you can build an efficient and robust DICOM JPEG2000 PACS. Read this document for more informations: OsiriX JPEG2000.pdf
Importante notice:
If you use C-GET/C-MOVE Query And Retrieve, be sure to activate JPEG2000 syntax in DICOM Listener on BOTH sides!
If you use WADO Query And Retrieve, be sure to compress the images in JPEG2000 on the server side, and activate the 'original' retrieve syntax, on the client side.
Installing a MacOS & OsiriX compatible RIS
(Radiology Information System)
- Blackbird RIS, based on FileMaker Pro, compatible with MacOS & Windows, integrated with OsiriX.
- Turyon : Tuyon.com releases HoruX, the First and Exclusively "made for OsiriX" RIS (Cocoa-based). Free version available (HoruXFree).
- ICOGEM RIS, web-based RIS system, fully compatible with MacOS and OsiriX
- Do you distribute a MacOS & OsiriX compatible RIS? Send us an email !
Security Protocols with OsiriX
More informations about certificates, ssl, https, ... are available here: Security Page
