For many health care practices and facilities, the cloud holds a lot of promise for the storage and access of medical imaging studies, by physicians and patients alike. The good news is that cloud storage can typically find an application for nearly every type of medical imaging modality, from CT scanners to MRI machines and everything in between.
The caveat to this is if you’re a practice that primarily handles large medical imaging or research data sets and has limited internet bandwidth. If bandwidth is not a concern, however, large file sizes become less of a roadblock on your journey to the cloud.
Let's discuss a few of the more challenging use cases.
Tomosynthesis and Cloud Storage
In recent years, digital breast tomosynthesis (DBT) has taken the place of traditional mammography examinations at some practices, due to the cutting-edge results it can provide. Where mammography affords 2-D breast imaging, tomosynthesis produces a more comprehensive 3-D image of the breast, with fewer gaps in medical imaging data.
As a result, tomosynthesis imaging studies are understandably much larger in size - with over 100 images per breast in many cases, as opposed to only two in a standard mammogram. With the increased file size comes increased latency issues in load time. While some of this challenge can be overcome by selecting to push the imaging data to the cloud during off hours, another layer of complexity is that tomosynthesis imaging studies use special viewing software to visualize those data sets, and not all cloud vendors can support this requirement.
It’s not, however, that the use of the cloud is out of the question for those practices who are embracing tomosynthesis, but it does present a unique set of demands. In fact, even mammography isn’t exempt from hurdles with cloud storage as mammography viewers must also meet Mammography and Quality Standards Act (MQSA) and FDA standards.
Taking this into account, it's important to make sure you are working with a cloud vendor who is sophisticated enough to understand these intricacies and who can also offer an FDA-approved viewer cleared for mammography and tomosynthesis diagnosis.
Prohibitively Large File Sizes
Tomosynthesis isn't the only type of medical imaging with files sizes that challenge connectivity to the cloud. There are many other use cases where the size of data sets are so great, even the fastest of internet connections won’t enable effective use of the cloud.
Dense research studies, are an example of where you may experience latency with the cloud, especially around uploading and viewing. We have seen incredibly large file sizes from these type of research projects since they are typically scanning patients or animals that are deceased, and thus have no issue with longer radiation exposure times than are possible with living patients. This in turn, generates higher resolution images with larger file sizes.
For example, recently we spoke with someone who was in the process of taking computed tomography (CT) scans of every species in the world of a particular type of animal. It’s an exciting project, but as it is intended to be a reference tool for researchers around the world, the level of detail desired in the images leads to very large imaging files.
Each of the CT scan data sets is at least 20 to 30 gigabytes (GB) in size, meaning cloud storage and visualization were not the optimal choice for this use case as upload and retrieval times would be prohibitive.
Generally, It Comes Down to a Bandwidth Discussion
Putting these exceptions to the side, common clinical studies used in diagnosis and delivery of patient care - ultrasounds, x-rays, magnetic resonance imaging (MRI), CT scans, echocardiography, mammography etc. - are well-suited for storage and access in the cloud.
That said, restrictions on use of the cloud has less to do with the particular modality and more to do with the file sizes generated and your practice's bandwidth speeds. When considering whether or not cloud storage is appropriate for your modality, the answer is dependent on your specific use case and the size of the studies you are producing. Some studies, such as dense research scans, simply won’t play well with slower internet connections.
However, the vast majority of clinical imaging studies should be well within appropriate file size ranges to leverage a cloud PACS solution, regardless of modality type.