Hanging protocol and viewers for a dental full patient archiving and communication system

Objectives: Study objectives were: to develop a hanging protocol for displaying digital transmission radiographic images of oral and maxillofacial regions using a dental DICOM (digital imaging and communication in medicine) viewer and a dental Web viewer; and to give information on a system that allows patients and health professionals to share image information. Methods: For the hanging protocol, alphanumeric tags were defined and used in a DICOM modality worklist. These tags consisted of layout information to display images on monitors by the type of projection method and assignment information to display images of template for intraoral full-mouth survey that were numbered and slotted according to tooth position. Tooth code and algorithm for assignment of images for intraoral full-mouth survey were determined. Expanded correspondence for viewers was used for modalities without tags. Images could be edited by quality control system. An electronic medical record (EMR) system, a radiological information system (RIS) and a picture archiving and communication system (PACS) with servers, terminals and viewers were set up in a patient-centred hospital environment. Results: Using the hanging protocol, the viewers displayed digital transmission radiographic images automatically on display areas on one or multiple monitors showing intraoral, panoramic and extraoral views produced during various examinations. The images were also displayed using the coupling function of EMR and RIS. Users can compare the images taken at various times more efficiently. Conclusion: The new system using a dental DICOM viewer and a dental Web viewer is the most advanced for examining oral and maxillofacial regions compared with medical viewers. Our local but clinically operational hanging protocol should be a good model for DICOM Working Group 22.