The "Tara Teleradiology System" (TTS) is a network modular designed product allowing management of analog images in a variety of radiology applications. It has the following capabilities:  

• It can network the output from various modalities in a busy hospital setting for real time and direct supervision, either within a department or from a remote location. 
  (such as from a doctor's home, as pictured below)  
• It can be expanded to provide direct supervision from multiple remote sites.  
• It can tie together operations at multiple imaging centers from one control center.  
• It's robust teleradiology component allows sending both black/white, color and cine data. 

The design of this system is modular and utilizes, as an input function, the video output of any image modality including MR, CT, Nuclear Medicine, Ultrasound, Digital Fluoro, Special Procedures, Computed Radiography and Non-digital fluoroscopy. 
Interface to existing networks and network software allows communication using existing lines.  The options for communication between facilities include T1, ISDN, and conventional phone line.

HOW THE TELERADIOLOGY SYSTEM WORKS

The images are captured from the video image on the video network. The technologist performs the capture and send functions from a terminal located at each scanner. The software has an intuitive interface and the status of transmissions and of the video network can be verified from the user monitors. Virtually any scanner can be interfaced to the TTS. There are several options for sending images to the home, including telephone, ISDN and T1 lines. An ADSL interface is presently in development. Typical transmission time for a CT of the brain without bone windows is 11 minutes using conventional phone lines and 3 minutes using ISDN lines.

The TTS receiving software can be loaded on a conventional personal computer using either the Windows NT, Windows 95 or Windows 98 operating system.

Multiple functions are available:

• The images can be viewed in formats ranging from a single image displayed full screen, to viewing an entire study on one screen. Adjustments for brightness, contrast, and hue are included. Electronic calipers are available for calibration and measurement of findings.  The technologist has the option of sending electronic notes with the images. 
• The interpreting radiologist can type in an interpretation which is associated with the image. A log of all studies sent and their interpretations can then be printed out or stored on the computer for future use.  
• There is a robust cine viewing capability which is helpful for a variety of studies including Gated Heart Studies. The images can be sent and received in either black/white or color.

Three options are available to notify the radiologist a study has been received: a telephone call on a separate line, a pop-up notification on the screen, or to have the computer beep. Any combination of these options can be selected by the user.

One study can be reviewed while other studies are being received. The PC can have both ISDN and analog modules.

The TTS capture software allows multiple users to simultaneously capture studies. The studies to be sent are placed in a queue which may be reviewed at any time. If there are several studies in the queue to be sent, there is an option to tag a study as a priority and it is placed at the front of the transmission queue.

There are multiple compression algorithms available. Some of the algorithms are lossy and some are lossless. The user can use the standard default algorithms or select from a library of algorithms. Four different levels of image quality are available for the transmission of the images and these can be selected on a study by study basis. The four default options are:

1. Best (no compression) 
2. High resolution (lossless compression) 
3. Normal (lossy compression with no clinically significant image degradation) 
4. Survey (lossy compression with discernible image degradation, only used for extremely rapid transmission of large studies)

At the time of image capture, the technologist can send a note along with each image. Clinical information can be sent using the note function as well.

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VIDEO NETWORK 

The core of the system is the TTS video network. The video output from each of the scanners is sampled and sent to a central server where the images are converted to standard, high resolution video signal. There is a TTS terminal at each of the input modalities to allow control of all the functionalities of the video network.

The video network can be controlled remotely using any computer on the network. This feature is very helpful in many situations, for example, when selecting video output from monitors in a reading room. The video output to a particular monitor can be from any of the multiple sites on the video network.

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OTHER FEATURES 

1) Image Capture for Slides There is an option in the capture software which allows an image to be selected for packaging into any standard image output including TIFF, PCX, GIF or BIT MAP. These images may be stored on the video network server and, at any later time, a software utility can be used which sends these captured images either to floppy disc for import to presentation software or to a peripheral device such as a slide maker. 

2) Images-on-Report There is also an image capture function which provides designated images for printing in a transcribed radiology report.

There are two options for Images-on-Report. The first is to print the captured image to a dedicated high resolution printer. The second is an integrated module which formats the image into the text file of a transcribed radiology report and makes a single page report including both text and the captured image.

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