Medical Ultrasound Imaging
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Picture Archiving and Communication System
(PACS) A system used to communicate and archive medical imaging data, mostly images and associated textural data generated in a radiology department, and disseminated throughout the hospital. A PACS is usually based on the DICOM (Digital Imaging and Communications in Medicine) standard.

The main components in the PACS are: acquisition devices where the images are acquired;
short and longer term archives for storage of digital and textural data;
a database and database management;
diagnostic and review workstations;
software to run the system;
a communication network linking the system components;
interfaces with other networks (hospital and radiological information systems).

Acquisition devices, which acquire their data in direct digital format, like a MRI system, are most easily integrated into a PACS.
Short term archives need to have rapid access, such as provided by a RAID (redundant array of independent disks), whereas long term archives need not have such rapid access and can be consigned, e.g. to optical disks or a magnetic.
High speed networks are necessary for rapid transmission of imaging data from the short term archive to the diagnostic workstations. Optical fibre, ATM (asynchronous transfer mode), fast or switched Ethernet, are examples of high speed transmission networks, whereas demographic textural data may be transmitted along conventional Ethernet.
Sophisticated software is a major element in any hospital-wide PACS. The software concepts include: preloading or prefetching of historical images pertinent to current examinations, worklists and folders to subdivide the vast mass of data acquired in a PACS in a form, which is easy and practical to access, default display protocols whereby images are automatically displayed on workstation monitors in a prearranged clinically logical order and format, and protocols radiologists can rapidly report worklists of undictated examinations, using a minimum of computer manipulation.
History of Ultrasound
The earliest introduction of vascular ultrasound contrast agents (USCA) was by Gramiak and Shah in 1968, when they injected agitated saline into the ascending aorta and cardiac chambers during echocardiographic to opacify the left heart chamber. Strong echoes were produced within the heart, due to the acoustic mismatch between free air microbubbles in the saline and the surrounding blood.
In 1880 the Curie brothers discovered the piezoelectric effect in quartz. Converse piezoelectricity was mathematically deduced from fundamental thermodynamic principles by Lippmann in 1881.
In 1917, Paul Langevin (France) and his coworkers developed an underwater sonar system (called hydrophone) that uses the piezoelectric effect to detect submarines through echo location.
In 1935, the first RADAR system was produced by the British physicist Robert Watson-Wat. Also about 1935, developments began with the objective to use ultrasonic power therapeutically, utilizing its heating and disruptive effects on living tissues. In 1936, Siemens markets the first ultrasonic therapeutic machine, the Sonostat.
Shortly after the World War II, researchers began to explore medical diagnostic capabilities of ultrasound. Karl Theo Dussik (Austria) attempted to locate the cerebral ventricles by measuring the transmission of ultrasound beam through the skull. Other researchers try to use ultrasound to detect gallstones, breast masses, and tumors. These first investigations were performed with A-mode.
Shortly after the World War II, researchers in Europe, the United States and Japan began to explore medical diagnostic capabilities of ultrasound. Karl Theo Dussik (Austria) attempted to locate the cerebral ventricles by measuring the transmission of ultrasound beam through the skull. Other researchers, e.g. George Ludwig (United States) tried to use ultrasound to detect gallstones, breast masses, and tumors. This first experimentally investigations were performed with A-mode. Ultrasound pioneers contributed innovations and important discoveries, for example the velocity of sound transmission in animal soft tissues with a mean value of 1540 m/sec (still in use today), and determined values of the optimal scanning frequency of the ultrasound transducer.
In the early 50`s the first B-mode images were obtained. Images were static, without gray-scale information in simple black and white and compound technique. Carl Hellmuth Hertz and Inge Edler (Sweden) made in 1953 the first scan of heart activity. Ian Donald and Colleagues (Scotland) were specialized on obstetric and gynecologic ultrasound research. By continuous development it was possible to study pregnancy and diagnose possible complications.
After about 1960 two-dimensional compound procedures were developed. The applications in obstetric and gynecologic ultrasound boomed worldwide from the mid 60's with both, A-scan and B-scan equipment. In the late 60's B-mode ultrasonography replaced A-mode in wide parts.
In the 70's gray scale imaging became available and with progress of computer technique ultrasonic imaging gets better and faster.
After continuous work, in the 80's fast realtime B-mode gray-scale imaging was developed. Electronic focusing and duplex flow measurements became popular. A wider range of applications were possible.
In the 90's, high resolution scanners with digital beamforming, high transducer frequencies, multi-channel focus and broad-band transducer technology became state of the art. Optimized tissue contrast and improved diagnostic accuracy lead to an important role in breast imaging and cancer detection. Color Doppler and Duplex became available and sensitivity for low flow was continuously improved.
Actually, machines with advanced ultrasound system performance are equipped with realtime compound imaging, tissue harmonic imaging, contrast harmonic imaging, vascular assessment, matrix array transducers, pulse inversion imaging, 3D and 4D ultrasound with panoramic view.

Medical Imaging
The definition of imaging is the visual representation of an object. Medical imaging is a broad term that encompasses various imaging modalities and techniques used in the field of medicine to visualize and study the body's anatomy and physiology. It includes both diagnostic and non-diagnostic imaging procedures, where diagnostic imaging specifically refers to the subset of medical imaging techniques that are primarily focused on diagnosing diseases or conditions. Medical imaging techniques are employed to obtain images or visual representations of the internal organs, tissues, and structures, aiding in the diagnosis, treatment, and monitoring of medical conditions.
The field of medical imaging has significantly evolved since the discovery of X-rays by Konrad Roentgen in 1896. Initially, radiological imaging involved focusing X-rays on the body and capturing the images on a single piece of film within a specialized cassette. Subsequent advancements introduced the use of fluorescent screens and special glasses for real-time visualization of X-ray images.
A significant breakthrough came with the application of contrast agents, enhancing image contrast and improving organ visualization. In the 1950s, nuclear medicine studies utilizing gamma cameras demonstrated the uptake of low-level radioactive chemicals in organs, enabling the observation of biological processes in vivo. Currently, positron emission tomography (PET) and single photon emission computed tomography (SPECT) technologies play pivotal roles in clinical research and the diagnosis of biochemical and physiological processes. Additionally, the advent of the x-ray image intensifier in 1955 facilitated the capture and display of x-ray movies.
In the 1960s, diagnostic imaging incorporated the principles of sonar, using ultrasonic waves generated by a quartz crystal. These waves, reflecting at the interfaces between different tissues, were received by ultrasound machines and translated into images through computer algorithms and reconstruction software. Ultrasound (ultrasonography) has become an indispensable diagnostic tool across various medical specialties, with immense potential for further advancements such as targeted contrast imaging, real-time 3D or 4D ultrasound, and molecular imaging. The first use of ultrasound contrast agents (USCA) dates back to 1968.
Digital imaging techniques were introduced in the 1970s, revolutionizing conventional fluoroscopic image intensifiers. Godfrey Hounsfield's pioneering work led to the development of the first computed tomography (CT) scanner. Digital images are now electronic snapshots represented as grids of dots or pixels. X-ray CT brought about a breakthrough in medical imaging by providing cross-sectional images of the human body with high contrast between different types of soft tissue. These advancements were made possible by analog-to-digital converters and computers. The introduction of multislice spiral CT technology dramatically expanded the clinical applications of CT scans.
The first magnetic resonance imaging (MRI) devices were tested on clinical patients in 1980. With technological improvements, such as higher field strength, more open MRI magnets, faster gradient systems, and novel data-acquisition techniques, MRI has emerged as a real-time interactive imaging modality capable of providing detailed structural and functional information of the body.
Today, imaging in medicine offers a wide range of modalities, including:
X-ray projection imaging;
Fluoroscopy;
Computed tomography (CT / CAT);
Single photon emission computed tomography (SPECT);
Positron emission tomography (PET);
Mammography.

These imaging modalities have become integral components of modern healthcare. With the rapid advancement of digital imaging, efficient management has become important, leading to the expansion of radiology information systems (RIS) and the adoption of Picture Archiving and Communication Systems (PACS) for digital image archiving. In telemedicine, real-time transmission of all medical image modalities from MRI to X-ray, CT and ultrasound has become the standard. The field of medical imaging continues to evolve, promising further innovations and advancements in the future, ultimately contributing to improved patient care and diagnostics.

See also History of Ultrasound Contrast Agents, and History of Ultrasound.
Medison Co.,Ltd.
www.medison.com 'Founded in Seoul in 1985 by a team of research scientists from Korea's leading technology research institute, Medison rapidly established a reputation for innovation in digital imaging technology. By 1994, the company had attained ISO 9001 certification for its ultrasound systems and had established a worldwide distribution network covering more than 80 countries'

In 1998 Medison established a strategic alliance with Philips (formerly ATL, USA).

Samsung Electronics acquired Medison in December 2010 on its way to become a top tier medical equipment manufacturer. In March 2011 the company got renamed to Samsung Medison.

Ultrasound Systems:

Philips Medical Systems
www.medical.philips.com/main/products/mri/products/ In 1918, Philips started with their first medical X-ray tube. Philips Medical Systems now is a global leader in diagnostic imaging systems, healthcare information technology solutions, and patient monitoring and cardiac devices. Philips also provides customer services such as financing, consultancy and maintenance & repair.
Philips lacked in the field of ultrasound till 1998. By buying ATL (Bothell, Washington) in this year Philips establishing itself as an important player in ultrasound. In 2001 Philips also acquired Agilent (formerly Hewlett-Packard; Andover, Massachusetts), a market leader in the cardiology and vascular ultrasound systems (HP2000 to HP5500, now Sonos 2000 to Sonos 5500).

Philips Medical System is the diagnostics business of Royal Philips Electronics of the Netherlands, one of the world's biggest electronics companies and Europe's largest. Philips is quoted on the NYSE (symbol: PHG), London, Frankfurt, Amsterdam and other stock exchanges. On October 19, 2001, Philips Medical Systems completed a 3-year acquisition strategy through its purchase of Marconi Medical Systems. Marconi Medical Systems offered leading multislice CT, MRI, and Nuclear Gamma Camera systems to medical institutions around the world. As well as new 3.0T developments, Philips is also in collaboration with researchers at the University of Nottingham, with the intention of developing an ultrahigh field strength clinical 7.0T whole body MR system.


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