Orthanc to access exams from other PACS

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1

Hello all,

TL;DR

Can Orthanc be used to access exams stored on another PACS without importing them ?

Alternatively, can Orthanc be used to access exams stored on a NAS (storage of another PACS system) without importing them ?

Long version :

I have been in charge of the IT in a charity hospital for a few months.

I am new to the medical domain, but I am trying to improve the workflow in the hospital by using a PACS server for the radiology department.

We are already using a proprietary software (EchoPAC) for echography with its storage on a NAS.

So far, I have setup an Orthanc server for tests. I am able to send and receive exams from different modalities and everything look very promising!

Ideally I would like to have one single user interface for the medical staff to access all the exams stored in both the Orthanc PACS (x-ray, CT, etc.) and the EchoPAC (echo).

I currently have problems communicating with the EchoPAC (I’m not sure if it is a licence limitation or it was not installed properly, but that’s another topic). I am looking for new solutions.

I was wondering if it would be possible to use Orthanc as a “gateway” to the EchoPAC or its storage.

By gateway, I mean to use Orthanc to index the exams stored from the EchoPAC but without importing them and to view the exams stored on the NAS.

Alternatively, I could also settle to add the NAS as an external storage in Orthanc. However, I don’t know if the file structure used to store the images would be a problem.

I have very limited storage here so it is out of the question to import a copy in Orthanc. I would also prefer to keep the two PACS separated as much as possible (the users are used to one system and it will be hard to change it).

Is there any way to do setup one of the above-mentioned option? Is there a better alternative I didn’t consider (except moving everything in Orthanc) ?

Thank you in advance for your help !

Massimo

2

Hi Massimo –

I have been thinking about how to do this as well for a while, but haven’t come up with any very good solutions.

I haven’t done this, but I imagine that you could set up an automatic script that would stream data in from the PACS into a separate Orthanc instance, and then expire/delete the studies after the report shows up in the EHR (or it reaches a time limit). It’s not exactly what you are thinking, but it may solve the problem of getting the rads a single point of access for the studies without maintaining multiple copies on multiple systems.

You would probably also have to think about automatically pulling prior studies from the same patient when a new study shows up and expiring them when the new study gets dropped. I will think about this some more. Do post again if you come up with a good solution.

Derek-

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This is what we do in practice.

When the PACS cooperates, we just have it sync the data on its own.

When it doesn't, we poll using C-FIND via /modalities and retrieve
studies we don't already have by matching UIDs against a local list.

Other processes enforce the retention policy.

4

Hello,

Have you considered setting the “StoreDicom” configuration option of Orthanc to “false”?
http://book.orthanc-server.com/users/configuration.html

In this case, Orthanc would run in “index-only” mode: The raw DICOM files received by Orthanc from the acquisition modalities would not be stored within the Orthanc storage area. Orthanc would only store a summary of the DICOM tags as JSON files.

To further reduce disk space, make sure to enable the “StorageCompression” configuration option.

HTH,
Sébastien-