Sharing patient radiological imaging studies and pathological samples: standards, protocols and practices

This paper discusses some of the problems experienced in sharing radiological images and pathological samples between hospitals. Despite the introduction of DICOM standards for medical imaging, difference are reported in the adoption of this standard by different vendors. Furthermore the standard is under constant review and is being continually updated. These updates mean that imaging conducted under the newer standards are sometimes not readable in older systems, and vice versa. Transmission of images, while theoretically possible, is not practically implemented because of shortcomings in networks, deterioration of resolution on transmitted images and problems of maintaining text or voice based records with an associated image. There are also many obstacles to sharing because of differences in local imaging protocols. While digital imaging is not in widespread use for pathology samples, local processing protocols and techniques regularly prove obstacles to sharing patient pathological data. Co-ordination of both radiology and pathology samples is the most important challenge to sharing this information among hospitals and institutions. This paper describes work in progress to make a comprehensive list of obstacles to sharing radiological image sets and pathological material between referring doctors and specialists. Issues of standards, protocols, procedures and techniques in pathology and radiology are explained.