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Over the last 2 decades, echocardiography has created a tremendous impact in healthcare. Much of the success of echocardiography is due to its ability to provide “live” moving images that can be reviewed and easily understood by all sorts of health care providers and patients alike. Yet this ability has been only minimally exploited in the past, given the limitations of analog technology. Meanwhile, other areas of medical imaging have adopted digital recording as the standard. The first efforts in digital echocardiography occurred in the early 1980s. Given storage capacity and processing speed limitation, digital echo was limited to stress testing and evaluation of co ronary artery disease, using a quad screen format and grayscale images. New technological advances in echocardiography today permit to register moving images in digital format, allowing logical archival, rapid data retrieval, copy and transfer, off-line quantitative analysis, and side-by-side comparison with superior image resolution. The American Society of Echocardiography first established in 1992 a task force to educate the echocardiographic community on the promise and pitfalls of digital echocardiography and advise the Digital Images and Communications in Medicine (DICOM) committee on a standard image format for echocardiography.

New! Approaches to Digital Study Acquisition in the Echocardiography Laboratory The problems associated with videotaping echocardiography studies are well known.“Digital echo” enables productivity gains through improved workflow by eliminating videotape and its associated problems, improving access to current and prior exams, and streamlining study review. Download PDF of this article provided by Camtronics.

Analog vs. Digital Imaging - The principal feature of analog data is its continuous nature. Their elect ronic transmission is accomplished by adding signals of varying frequency or amplitude to carrier waves of a given frequency of alternating electromagnetic current. Analog data is typically represented as a series of sine waves

Data Acquisition - Cardiac ultrasound imaging equipment obtains initially analog data from the imaging transducer, where ultrasonic reflections stimulate a piezo-electric crystal to produce electrical impulses. In order to convert these electrical impulses into images, they need to be processed by a computer that analyzes time delay, signal intensity and frequency shifts in order to determine the location, density and velocity of each cardiac structure.

Data Compression - A single frame echocardiographic image has a resolution of 640 horizontal ´ 480 vertical pixels ´ 24-bits per pixel, equalling 922 KB. Thus, at an average frame rate of 30 Hz, a 15 min uncompressed echocardiography study requires about 25 GB. Handling uncompressed data therefore becomes impractical, given current storage and transfer speed limitations.

Data Storage - Once a digital echocardiographic study is acquired and transferred, it will require some type of storage. In general terms, it is best to think of storage at different levels. Storage for immediate review of current studies needs to be rapidly accessible, while long term storage for older studies already reviewed and interpreted requires higher capacity and not necessarily fast speed. There is an inverse relationship between capacity and access speed and a direct relationship between speed and cost.

. Data Transfer Network transfer is the most efficient method to deliver echocardiographic studies from the acquisition to the interpretation and to the final storage location. A network is a series of nodes (input and output devices) interconnected by communication paths. Networks can be characterized in terms of spatial distance as local area networks (LAN), metropolitan area networks (MAN), and wide area networks (WAN).

Remote access - One useful feature of the digital echo lab is remote access capability. In theory, a client can be located at any remote location as long as an Internet location is in place. There are, however, 2 practical limitations: remote access speed and data confidentiality. Data encryption should be implemented for data transmission outside the hospital “firewall”in order to protect patient confidentiality and to comply with State and Federal regulations.