To date, most of the U.S. Army's medical imaging requirements for combat care have been satisfied by conventional x-ray techniques. While effective, units employing such techniques require extensive logistics support and provide somewhat limited capabilities in the combat zone. Digital technology may offer an opportunity to improve capabilities while reducing the logistical support for field radiology. This paper provides a top-down perspective of the Army's medical digital imaging needs with an eye towards promoting further discussions on the role, operations, and evaluation of a Digital Imaging Network System (DINS). A DINS is an automated and integrated information management system for processing, storing, retrieving, and displaying radiological images and related clinical information. This report was first published in November 1987 and has been revised to reflect the sponsor's subsequent review. Keywords: RA II; Filmless radiology; Digital imaging; Digital x-ray; Filmless x-ray; Teleradiology; Volunteers. (kt).

Medical images generated by radiological procedures typically result in the generation of film-based images. In 1986, the U.S. Army Medical Research and Development Command contracted with the MITRE Corporation to investigate the use of filmless radiology in both its fixed facility and battlefield medical systems. To support this evaluation, commercially available Digital Imaging Network System (DINS) equipment was competitively procured and installed at two university medical centers, which competed for the opportunity to participate in this evaluation. Equipment provided by AT & T was installed at Georgetown University and equipment provided by Philips Medical Systems was installed at the University of Washington. In parallel, a prototype battlefield DINS was developed by MITRE, using commercially available workstation technology, to support concept exploration of DINS in the battlefield environment. This document summarizes and presents the results of the systems engineering studies and technical evaluations that were conducted as part of this four-year study. Keywords: Radiological information management; Digital data communications; Digital images; Filmless radiology; Picture Archiving & Communication Systems(PACS); Medical imaging.

This document describes evaluation studies and technical investigations proposed for the three-year Digital Imaging Network System (DINS) prototype project, sponsored by the U.S. Army Medical Research and Development Command, Ft. Detrick, Maryland. The project has three overall goals. The first is to install and operate a prototype DINS at each of two University-based hospitals for test purposes. The second is to evaluate key aspects of each prototype system once it is in full operation. The third is to develop guidelines and specifications for an operational DINS suitable for use by the military and others developing systems of the future. This document defines twelve overall evaluative questions for use in meeting the second and third objectives of the project and proposes studies that will answer these questions. Keywords: RA II; Radiological information management; Data communications; Digital images; Digital radiography; Teleradiology; Volunteers; Filmless x-ray; Communications network models. (kt).

THE STORY: In August of 1937, in a small town in eastern North Carolina, we meet the Avery family. Roma Avery is the widowed matriarch who still maintains a hold on her recently married son, Neal. He and his wife, Taw, a former school teacher, rent a room