Generation of complete electronic nuclear medicine reports including static, dynamic and gated images

Aim: To develop a procedure for the creation of nuclear medicine reports containing static and dynamic images. The reason for implementing this technique is the lack of adequate solutions for an electronic format of nuclear medicine results allowing for rapid transmission via e-mail, specially in the case of dynamic and gated SPECT studies, since functional data is best presented in dynamic mode. Material and Methods: Clinical images were acquired in static, whole body, dynamic and gated mode, corresponding to bone studies, diuretic renogram, radionuclide cystography and gated perfusion SPECT, as well as respective time-activity curves. Image files were imported from a dedicated nuclear medicine computer system (Elscint XPert) to a Windows-based PC through a standard ethernet network with TCP-IP communications protocol, using a software developed by us which permits the conversion from the manufacturer's original format into a bitmap format (.bmp) compatible with commercially available PC software. For cardiac perfusion studies, background was subtracted prior to transferring to reduce the amount of information in the file; this was not done for other type of studies because useful data could be eliminated. Dynamic images were then processed using commercial software to create animated files and stored in .gif format. Static images were re-sized and stored in .jpg format. Original color or gray scale was always preserved. All the graphic material was then merged with a previously prepared report text using HTML format. The report also contained reference diagrams to facilitate interpretation. The whole report was then compressed into a self-extractable file, ready to be sent by electronic mail. Reception of the material was visually checked for data integrity including image quality by two experienced nuclear medicine physicians. Results: The report presented allows for simultaneous visualization of the text, diagrams and images either static, dynamic, gated or time-activity curves. File sizes were between 150 and 300 Kbytes. Electronic transmission of the data took about one minute for gated SPECT studies and less than 2 minutes for other dynamic studies, considering connection at 33,6 KB/s. Data format was preserved and image quality suffered no degradation along the process. Conclusion: The proposed method is suitable to prepare and electronically deliver complete, high-quality nuclear medicine reports on a daily practical basis. Although image processing is not allowed, it can be of benefit for referring physicians, consultants and students/tutors in distance-learning courses