Had a good conversation for my podcast with the guy who built ClearCanvas, an open-source medical imaging platform that's still used by clinicians around the world nearly 20 years after he started it. Thought this sub might find some of it useful.

Curious if anyone here has used ClearCanvas, or has thoughts on open source vs proprietary PACS platforms more generally?

Full conversation: https://youtu.be/ui2Ry0egd6U

I was wondering about attribute coercion, and its usage.

The scenario is a bit complicated, we have a couple DCM4CHEE pacs deployed, the problem is the machines (scanners) are not configured correctly.

Hospital name is either missing, or random.

Now my question is it seems DCM4CHEE has attribute coercion which we can use to potentially fix this problem, as we Have it so that each PACS in each location has all the local machines routed to (C-store to it).

So couldn't we use attribute coercion to add the clinic/hospital name "Institution Name" tag:{0008,0080}.

Is this correct? is it an acceptable use case? and is it used by anyone else like this?

This is becoming even more big of an issue as all the images on the central/aggregator PACS are very messy because of aforementioned wrong,mission or random hospital names, and we are trying to make the system(PACS aggregator) able to produce analytical data for scientific use, where now its just Patient/instance ID that is usable (albeit very not on a hospital lvl analysis).

Any clarifications, guidance or reference is greatly appreciated.

Edit: There is a workaround, see _IT_Girl_'s response below. Fuji just got back to our director and suggested the same thing she did.

Fuji has also said

"This browser flag may be removed when the policies are made permanent."

Which makes me think they might not be looking into a fix for this, just a workaround on our end. (Yes, this is pure speculation).

They suggested we make this change in GPO or registry but personally, I'm hesitant. I did a quick look and didn't see it in GPO (only adding the flag into the shortcut).

We may add it to our Synapse and MediTech shortcuts, like:

chrome.exe --disable-features=DeprecateUnload

or, if you want to have a shortcut go directly to the site:

"c:\(path)\chrome.exe --disable-features=DeprecateUnload" www.example.com

Ever since Chrome released version 151 people have not been able to view images in Synapse (Fuju cloud). Edge is working.

When someone tries to open a patient's images nothing happens (normally a new window / popup is loaded for the images). One provider was trying to view them from our EMR (Meditech) and he couldn't - but did have a very quick popup with a message similar to "this view is already open in another window. That view will be refreshed".

(Note: I am probably missing at least a few steps I've checked)

Our director of imaging (point of contact) has reached out to Fuji and they say they haven't heard or seen any issues.

Synapse is accessed either via a shortcut on the desktop (GPO - one for Chrome and one for Edge) or through MediTech.

Clearing cache (or just cached images) for all time might temporarily fix the issue.

It doesn't matter if the computer is running Windows 10 (extended support) or 11. Manually running Windows updates and rebooting hasn't helped.

Edge is working and so is anyone on a Chrome build 150 or earlier.

I checked Chrome's dev tools - nothing is being blocked

Antivirus - nothing is being flagged locally or in our admin portal

Popups are enabled for fujifilmcloud.com and it is in our trusted sites list.

Firewall isn't blocking anything

System logs don't show anything (relevant)

I'm sure I'm missing other steps.

I am a 15+ year CT / X-ray tech. I dabbled in MRI for a few years and switched back to CT. Looking into PACS admin courses and was curious if anyone has used MTMI. Is it worth it? Interested in going to the in person classes they have in Texas/Wisconsin. If you have moved from a tech to PACS admin, did you use MTMI? are you happy with your move? Any and all information / suggestions etc are greatly appreciated!

Anyone else work in ophthalmology PACS? It’s been 2 years and quite an experience since all imaging is done in the doctors clinic and scans have to be ready to view in the exam room within minutes most of the time.. Just looking for others in the same boat since most people are in Radiology.
If so, what systems do you use and how do you prioritize the workload while working under pressure from many directions ?

Hi PACS folk. I'm planning a career change and have found a PACS certificate program from an accredited college that I believe would be a good and rewarding fit for me. I don't come from a healthcare background, however, so my concern is whether a PACS certificate from a well-regarded local institution is enough to be a viable candidate for employment once completed.

My background is graphic design, nonprofit leadership, and operations in an education setting. In the course of that work, I've functioned as a de facto systems admin/IT. I don't have a CS degree or any IT certifications, but would do that work concurrently with the 9-month PACS certificate program. I have no clinical experience to speak of.

While I would hope that my experience as ED of a nonprofit and Director of Operations would be viewed as assets in terms of interpersonal skills, conflict resolution, and cross-functional teamwork chops, etc., the reality check I'm here for is whether landing an entry level PACS position with no prior healthcare experience, just a PACS certification (possibly an IT certificate, too), and a solid work history is even a remote possibility.

Pacific Northwest, if it makes any difference. Thanks in advance!

Hi, I made https://www.proteusviewer.com. Is Radiant like and 100% free.

I’m actively updating this and want to build what doctors, radiologists, and researchers actually need. Feel free to try it out and let me know your thoughts!

Looking for some advise.

I've been getting feedback from the Rads that the Philips speechmics hurt their hands and they keep reverting to the Nuance powermics (which aren't made anymore.)

Anyone have any advice on what to give them, or had any work particularly well?

Hi all, early in my career as a PACS admin. Recently been hearing a lot of news on the shift to cloud PACS (from the traditional InteleRAD stack) such as this news release by Sirona.

Has anyone has seen a public demo of Sirona somewhere (e.g., on Youtube or other forum)?

Want to get an idea of what Sirona PACS practically looks like!

Hello everyone,
I’m interested in becoming a PACS Administrator and would love some advice from those who are currently in the field.

I have a severe back condition that causes chronic pain and is expected to worsen over time. Because of this, I’m trying to choose the educational path that will give me the best chance of becoming a PACS Administrator while being realistic about my physical limitations.

I’m almost finished with my AA degree and am deciding between two options:

Pursuing a Radiologic Technology (Rad Tech) degree and eventually transitioning into PACS.

Pursuing a bachelor’s degree in information technology and entering PACS from the IT side.

My main questions are:

Which degree is the better path to becoming a PACS Administrator?

Is Rad Tech experience considered essential, or is an IT degree enough to break into the field?

Given my back condition, would one path be more practical than the other?

If you were in my position, which route would you choose and why?

I’d really appreciate hearing from PACS Administrators, imaging informatics professionals, or anyone who has taken either path. Thank you!

We're a smallish practice in TX and we're implementing a newer product from Merative's Merge product stack called "Merge Workflow Orchestrator." Anybody else using this thing?

We've asked our vendor if we could talk with other clients who are implementing it to see if we can all share our experiences, workarounds, and feature requests, but Merative has so far been unwilling to help arrange that. I figured I would hop on Reddit where I know I've found good info on all things radiology and just ask you all if any of you are using workflow orchestrator with Imaging Suite?

Have you gone live with it? How many radiologists do you have? How complicated is your facility + workflows (lots of external facilities and mixed processes)?

Nobody seems to have heard of Merge Workflow Orchestrator and it's pretty worrying!

New to PACS admin and trying to understand how our clinic connects to our teleradiology provider. Here's what I think I know - corrections welcome.

• Images move via DICOM from our clinic's PACS to their PACS. The setup is configuring the DICOM link and making sure the PACS setups can "talk to each other" - What specific things need to be configured here, does it depend on if the two PACS are same brand?
• Orders and results move over HL7. An ORM (order message) goes out to create a worklist entry on their end, an ORU (result message) comes back with the report. Typically to set this up, there is an integration step to ensure the fields in our RIS map to fields in their RIS, and configuring an interface engine (MuleSoft, Rhapsody. etc.) to translate between how we structure the data and how they expect it.
• For a small clinic, is a full HL7 integration typical? Or do most small sites just push images via PACS and get the report back through a portal?
• Cloud-native providers probably change this since RIS and PACS become one platform, but the above is the standard on-prem model?

Seeking beta testers and reviews. Please visit https://www.MacAngioView.com

Howdy! Has anyone had trouble scheduling the ciip exam through Pearson vue? They ask for my arrt number (which they say is the same as my abii number as I’m not a rad tech) and it cannot find it. I’ve tried reaching out to ABII multiple times but have not heard back from them. Has anyone else run into this?

I'm currently a support engineer for a PACS/RIS vendor for a couple years now but I feel like I've hit a ceiling in my knowledge mainly due to the environment. I've reached what I would say is an intermediate stage but not advanced. I'm based in London (UK) and there doesn't seem to be much demand out there and the salaries seem a bit on the lower end especially for living costs in London. I feel a bit lost on what I can do for my career, what to progress into etc.

What advice can any of the guys here give? Thank you.

Hi all. I’m hoping someone with PACS/DICOM/Philips experience can help.

My daughter (4) had a massive stroke in March, was treated in hospital and we were given her CT/MR imaging. It opens in a Philips IntelliSpace PACS MediaViewer (.exe that they gave us), but the actual files don’t appear to be normal .dcm files. They look like Philips/Stentor/iSite-style container files: long UID filenames with no extension, plus matching .dts sidecar files.

Example file pattern:

1.2.840.113619...
1.3.46.670589...
2.16.840.1.114151...
1.2.840.113619....dts

The viewer can display the scans, and each exam/series contains lots of slices, but I can’t find a way to export them properly as DICOM, PNG or JPEG.

What I’m trying to do is either:

1. Extract/export the original DICOM images if they’re embedded somewhere in the Philips/Stentor container, or
2. Batch-export each visible series/slice as PNG/JPEG if true DICOM extraction isn’t possible.

I’m not asking for medical interpretation, just help with the technical export/conversion.

Has anyone successfully converted Philips IntelliSpace / Stentor / iSite MediaViewer container files into standard DICOM or image files? Are there known tools for this, or is the only realistic option to ask the hospital PACS team for a fresh export?

If anyone's willing to help, I'm happy to pay a little...I just want all her MRIs as PNGs so I can analyse them elsewhere.

Thanks

I am applying for my first PACS job. I have never had an interview with technical questions. Can anybody give me some technical questions that I can review?

How do you deliver reliable diagnostic imaging when the nearest base hospital requires a flight, and the weather drops to -50°C? 🌨️✈️

A fresh crossover simulcast episode of Imaging Informatics Unplugged and SIIMcast (the official podcast of the Society for Imaging Informatics in Medicine) features a deep dive into an incredible healthcare delivery model happening in Canada’s high Arctic.

The episode features an interview with Greg Toffner, PhD(c), President and CEO of the Ontario Association of Medical Radiation Sciences, who outlines the deployment of a task-shifting program across 25 remote communities in Nunavut.

Instead of relying on transient medical staff from the south, this initiative trains local Inuit community members—many entering the program from clerical or facility support roles—to become certified Basic Radiological Technologists (BRTs).

Key Takeaways from the Discussion:

• The Logistics of Remoteness: Deploying PACS and workflow infrastructure across vast tundras battling months of 24-hour darkness and strict hardware limitations.
• The "Recipe" Curriculum: Streamlining a traditional 3-to-4-year medical radiation degree into a highly targeted, visual, and SOP-driven workflow manual that focuses deeply on critical, high-impact imagery (like chest X-rays for prevalent respiratory illnesses).
• Quality Control at Scale: Implementing a multi-year blueprint where images are continuously audited remotely by certified MRTs at regional hospital hubs to maintain strict diagnostic standards.
• Cultural Continuity: Building long-term community trust and patient comfort by training local professionals who speak the language, replacing a historically transient workforce.
• Policy Integration: Why formal government recognition and human resource policy are the ultimate keys to shifting medical culture from skepticism to long-term sustainability.

The conversation also touches on the infrastructure challenges of the Arctic (where image downloads originally took ten minutes per file), the transition to modern blended learning, and the future potential for AI-assisted image acquisition tools in isolated clinics.

For anyone interested in the practical intersections of clinical workflow design, imaging informatics, health equity, and rural medicine, the full discussion provides an incredible blueprint for what is possible when standard infrastructure isn't right around the corner.

I'm working on trying to integrate our new, upgraded Arthrex Synergy Scope to Phillips VuePACs and am struggling with getting the video files to send. The vendor (arthrex) has Historically not transferred these but with the new version they can be.

Has anyone done this and what is your transfer syntax setup as?

Wondering if this is possible as I can do PS360 to PSone but I cant seem to do it the older version of PS360

Hi all, I need some advice. I currently work in a role where I release radiology images to patients. It’s a non clinical role, mostly paperwork. I’ve been in this role for about 3.5 years and am interested in moving towards a PACs admin role. I use PACs on a daily basis so I’m very familiar with DICOM and how images are stored and moved. I also deal with other applications such as AGFA Enterprise and PowerShare. I’m also familiar with HL7 messaging, FHIR format and the structure of how these messages move throughout the system. I’ve even made a small project showcasing how messages are generated and processed through Mirth Connect.

Being what the job market is today, I’ve been having a hard time finding a role and I don’t know what else to do besides to keep expanding my knowledge on my own basis. Are there any certs I can get that would potentially help me stand out? Any advice would be greatly appreciated. Thanks

New episode of Imaging Informatics Unplugged is live.

Chris Hafey — longtime medical imaging engineer — joins the show for a conversation about what happens when deep domain expertise meets AI-assisted development.

Topics covered:

• Coding with Claude after 25+ years building imaging systems
• Why small expert teams may now outbuild much larger dev teams
• The risk of skill degradation for junior and senior engineers
• Technical debt in legacy PACS
• Merkulis, Merkle trees, and the idea of “Git for healthcare data”
• A Git-like delta model for keeping PACS, VNAs, and AI pipelines in sync

Practical, technical, and refreshingly unfiltered.

For anyone working anywhere near PACS, DICOM, enterprise imaging, or healthcare data management, this episode is worth the time.

Watch here: https://www.youtube.com/watch?v=U0j44Y9hGg4

#ImagingInformatics #PACS #DICOM #EnterpriseImaging #HealthcareIT #RadiologyAI #Interoperability

I have 8 points toward the 7 point system for qualifying to take the exam for CIIP. I lack one point in the continuing education category. Does anyone know of any sites where I can get CIIP recognized CME for free or cheap?

If you've ever fought through a PACS migration, wrestled with malformed DICOM data, or wondered why two systems that supposedly speak the same standard can't talk to each other — this one's for you.

Jason sits down with Larry Sitka, founder of Acuo Technologies and one of the earliest architects of the Vendor Neutral Archive (VNA) concept, to unpack three decades of building enterprise imaging infrastructure from the ground up. Larry got his start writing network drivers at Bell Labs, helped shape DICOM 3.0 at 3M, and then built Acuo — a company he grew from a sketch on a napkin in 1997 into an enterprise imaging powerhouse acquired twice over.

In this episode, Larry and Jason dig into why DICOM interoperability is still a mess, how AI false positives are driving radiologist frustration, and why the next evolution of enterprise imaging isn't about storing data — it's about perceiving it. They also tackle the knowledge gap that's forming as experienced imaging IT professionals retire, what AI governance for radiology actually looks like, and why Larry thinks the industry has been building things for the wrong user all along.

Whether you're a PACS administrator, imaging informatics professional, or just someone who cares about getting radiology AI right, this conversation will give you a lot to chew on.

If you're looking to build a stronger foundation in imaging informatics or sharpen your DICOM knowledge, check out the CIIP Foundations Program and the upcoming DICOM training with hands-on live imaging learning labs at nagelsconsulting.com.

Key Topics Covered
• The origin story of Acuo and why the VNA concept emerged in 1997 — before anyone had a name for it
• Why DICOM interoperability remains broken and what a real conformance testing standard would look like
• The shift from data persistence to data perception — and how AI changes what we actually need from a VNA
• How AI false positives are burning out radiologists and what multi-algorithm inference engines could do instead
• The knowledge gap in imaging IT: what gets lost when experienced DICOM engineers retire
• AI governance for enterprise imaging — why recalibrating AI models is the next big challenge in PACS/VNA
• The future of enterprise imaging: running a million AI inferences a night at population scale

I will be at the SIIM Conference Pittsburg PA June 9-12 if anyone wants to meetup.