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Re: [Gnumed-devel] Re: DICOM viewers (was Feedback)

From: James Busser
Subject: Re: [Gnumed-devel] Re: DICOM viewers (was Feedback)
Date: Sun, 30 Dec 2007 14:16:31 -0800

On 30-Dec-07, at 10:05 AM, Karsten Hilbert wrote:

Our wiki lists PIL which I assumed might have been built into Sebastian's
bundled Mac GNUmed app... should Osirix also be needed,
No. Only if you want to use it. GNUmed uses a bit of
heuristics and looks for a bunch of different DICOM viewers.

If the Tools > DICOM menu option simply provides a link to an external application (viewer) --- which the user can *optionally* choose to install --- then can I conclude correctly that Python Imaging Library (PIL) is needed for something unrelated to DICOM, perhaps to assist GNUmed to open non-DICOM image formats like TIFFs, GIFs, PNGs and JPEGs etc? Or does some non-GNUmed application need to be installed on every computer in order to be able to view these and is this to be mapped using the Setup plugin?

Also, if we work through the use-cases *storing* a patient's images... given that most doctors desire to receive and store (only) the radiologists' interpretations (text file reports), preferring to avoid having to save copies of the images in their own EMRs, but even if this is true...

1) If another copy of the original may be impossible, or difficult, or simply inconvenient to try to access if it may be needed in the future (for example if the patient obtained the study and the CD while on a trip in another country) might a doctor wish to save these 0.5 MB to 10 MB files in GNUmed and would they do this through "Patient > import documents"? It seems that these modest file sizes are well within the 1GB maximum per document "part" suggested at

2) if the local, regional or national medical system supports local storage of a pointer to the image, the ability to save and manage this could make it much easier to later re-access the same image. This could be implemented as an extra field in the "Document" and "Import Documents" notebook tabs as soon as any host imaging systems would provide and handle permalinks.

ps - I found links online to a medical journal paper from 2004 that reviewed free viewers for Mac but has possible generally useful information such as typical DICOM file sizes (Table 2), and to a study that assessed the acceptability of working with JPEG Web- converted DICOM images:: 1747-4949.2007.00092.x?cookieSet=1

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