RSNA/AAPM 2001 Notes

I was last at an RSNA in 1997. I expected a bigger meeting this year. In fact attendance was down by at least 13% compared to 2000. This was very noticeable as the halls and corridors were much more open than in past years.

My primary purpose in attending the RSNA was to participate in the AAPM Board meetings on Wednesday afternoon and Thursday morning. Of course Chicago is a great city to visit so some opera and fine dining was definitely going to happen. Missed the highly recommended exhibition at The Art Institute of Chicago on Van Gogh and Gauguin – The Studio of the South I brought too much work with me and had to give up something. Maybe I should have given up some time at the RSNA?

RSNA lived up to my expectations of a tremendously useful educational resource and a weak science resource. It was enlightening to wander the Exhibition Halls looking for things relevant to nuclear medicine.

DICOM was not so much in-your-face this year as in 1997. The new hype was for the IHE – Integrated Health Enterprise. More on this below.


Arrive in the morning and found subway into the city and to my hotel. Started on that work I brought. Went to complete registration. Nothing happening at McCormick yet. Work late into the night.


Work. Went to AAPM committee meetings. The nuclear medicine committee has Task Group #11 trying to get comparative performance data on gamma camera PET machines. It has become difficult and expensive to carry out this work at institutions that do not have on site cyclotrons. We need and angel. More work in hotel.

Course 130: Categorical Course in Diagnostic Radiology: Thoracic Imaging-Chest and Cardiac: Lung Cancer—Screening. NL Mueller, Vancouver, TM Grist, Madison

A. ELCAP Experience: Screening Technique. CI Henschke, New York

B. ACRIN Experience: Diagnostic Strategies. DR Aberle, Los Angeles

C. Mayo Clinic Experience: Ancillary Findings. SJ Swenson, Rochester

D. Moffitt Experience Cost Effectiveness. RA Clark, Tampa

E. Conclusions. NL Muller, Vancouver

All throughout the meeting there was talk of screening with CT. Doses, technique, whether it is efficacious, etc. This was a good set of presentations by the ones who have been advocating and researching the issues. Conclusions – Still gathering data.


Course 229: Tumor Angiogenesis: Basic Pathophysilogy and Molecular Probes. AA Bogdanov, Boston, Moderator

A. Microcirculation in Tumors. F Yuan, Durham

C. MR Imaging of Angiogenesis. ZM Bujwalla, Baltimore

B. Targeted Echogenic Probes for Angiogenesis Imaging. AL Klibanov, Charlottesville

This was a nice exposition of some of the things that Folkman alluded to in his featured lecture in the afternoon.

Angiogenesis-Dependent Imaging. Judah Folkman, Boston

Eugene P. Pendergrass New Horizons Lecture

A very good talk pointing out the ubiquitous nature of angiogenesis – the development of new vessels, in many phases of health and disease. His take home message: When you drain the Pacific Ocean don't be surprised that the islands are connected.

Special Focus Session F02: Digital Imaging /Informatics: Current Status. RL Arenson, Moderator

PACS in the Enterprise (Outside 0f Radiology). KJ Dryer, Boston, P Skaruls(sp?), Chicago, (subbing for JP Glaser, Boston)

Dryer pointed out that DICOM does not hold up when there are 1000s of users to be serviced, e.g. in a modern hospital of any significant size where information (images and text) are to be delivered to the enterprise. Something better is needed. He sees the future based around Web distribution using compression of up to 20:1. He sees a move to tighten the integration of Web based services with the Radiology Department PACS system

Skaruls pointed out the move toward canned software and the move away from home grown software as a strong trend. The institution has to provide the network, help desk and public machines.

Workflow in Radiology (Department Efficiency/Hospital Efficiency). DS Channin Chicago, Eliot L. Siegel, Baltimore

Siegel used his time to extol the vision of the seamlessly integrated health enterprise. he gave a dramatic example of cutting a request and delivery of an X-ray exam from 59 steps to 9 steps. Dramatic monetary savings and improved delivery of services can result from from this integration. The VA system will be easy, he says because of its relative simplicity and uniformity.

Channin pointed out that in a general hospital such an effort will require a lot of planning and education. Hence the IHE program fostered by RSNA and others. IHE is not a standard but an initiative and movement to foster improved efficiency by responsible integration. Fine- just so we don't end up with another DICOM fiasco.

Computer-aided Diagnosis (CAD) (Radiologist Being Replaced by Computer) DE Arvin, San Francisco, D P Harrington, Stony Brook

Harrington pointed out that Radiology is in a state of crisis. Complexity is increasing, radiologists are decreasing, turnaround is decreasing, volumes are increasing, funding is decreasing, and turf battles abound. The need for more productivity is obvious. We need help he said. Arvin pointed out that computer-aided diagnosis (CAD) is ready to help. More work is needed but it is ALMOST HERE.


Course No. 330: Categorical Course in Diagnostic Radiology: Thoracic Imaging – Chest and Cardiac: Pulmonary Embolism. NL Mueller, Vancouver, TM Grist, Madison

What amazes me so much is that when radiologists talk with each other about PE is that they can talk for hours without ever mentioning nuclear medicine perfusion/ventilation scans. Still used at our hospital.

A. Acute Pulmonary embolism: Spiral CT. JR Mayo, Vancouver

CT is now at 1-2 mm slice thickness, 120 KVP and 200-300 mAs. Must review on a workstation because there is too much data for film. Studies of efficacy are flawed but sensitivity lies between 53-100%. Later studies with better equipment have higher sensitivity. Latest 85-90% sensitivity with 90-95% specificity for segmental with subsegmental lower. He think that pulmonary angoigram as the gold standard is a flawed.

B. Chronic Pulmonary Embolism: CTMJ Remy-Jardin, Lille

Remy-Jardin advocated CT over angio in cases of chronic PE and selection of candidates for surgery.

C. Pulmonary Embolism: MR Imaging. WB Gefter Philadelphia

William B. Gefter told us that MRA is the coming thing for PE with 2-3 mm slice thickness, performed in a breath hold with Gd contrast. Sens and Spec get better every year. Both in the 80s in 1999. The technique fails for small vessels, he says. There are Gd aerosols coming out. Soon there will be blood pool agents. Clearly all the modalities are moving forward on PE.

Course No. 417A: PET and US Techniques in the Evaluation of Tumor angiogenesis. RL Wahl, Baltimore, PL Carson, Ann Arbor

That PET can image angiogenesis may not be so surprising but using US? Yes. There are contrast agents soon to be available that will contribute to the imaging of angiogenesis.


AAPM board meeting in PM. Left at 7 PM (scheduled to end at 6 PM) for dinner date.


AAPM strategic planning meeting for the Board in AM. Left for Boston in PM.

Technical Exhibits

The commercial exhibits took up north and south halls and a good piece of the infoRAD space. infoRAD was only a bit less commercial than the North and South halls. I have very narrow interests compared to the scope of the meeting, I decided to walk around the floor and compare nuclear medicine floor space in the various booths. The winner was Trionix who had a large amount of floor space totally devoted to NM and with their whole product line being shown. The loser was GE who barely had a NM showing. Something about PET but no other NM hardware on the floor.

Philips had a lot of nuclear medicine space but it was fractionated between the ADAC corner and the Marconi (Picker) corner. They were definitely trying hard to impress with the seriousness of their return to NM. It was impressive and I was positively impressed. The Allegro is a PET (GSO) with a top of the line Marconi CT. I was sure that it was a Philips CT in June. Maybe this product is in flux. Or maybe I just get confused with the marketing words. I have since confirmed that GEMINI is the name of the combined PET/CT and Allegro is the name for the new PET alone.

Siemens was certainly present with a NM showing but there was little emphasis relative to the rest of their display. The only new item was a PET workstation as a works-in-progress.

Smaller booths that I spent time at:


Jerome Champetier de Ribes, Directeur General, CEO

Have various DIOCM software packages that run under Windows.

DICOM Valet DICOM Izer – a type of DICOM gateway that puts various image files, and captured images to a storage device or to a print device. ~$2500

DIOCM Eye – the Swiss Army Knife for DICO. Acquires, reads, browses, displays, processes, converts, prints, stores and digitizes your every desire.

DICOM Toaster – burns CDs

Nuclear Fields

Cast collimators for your gamma camera – Kara Finnegan Marketing and Sales. Fanbeam 350 for brains on an

Thinking Systems Corporation

Xiaoyi Wang Pres. Represented by Mid-Atlantic Imaging, Columbia MD

NuGateway takes proprietary files from your camera and sends them to a PACS. $5000 not $10000 to $20000 that we have seen from the big guys.

NuWEB puts your nuc med data on the WEB so you do not have to come into the office to read.

DOME Imaging Systems and image SYSTEMS Corporation.

These two were teamed up in infoRAD. and displays and flat panel displays. I was surprised at the really bright LCD screens on view. Some impressive QC software for displays was being demoed, too.

Sensor Systems

Has MEDx software, an all purpose brain visualization and analysis software package for UNIX systems.

TomoTherapy Inc.

A linear accelerator for helical treatments. Came out of U Wisconsin projects, I think.

RMD Instruments, LLC

Lots of detectors, currently featuring structured CsI

Nuclear Diagnostics LTD.

Featuring Hermes Medical Solutions. Workstations for quantitation, esp. nuc med.

Voxar, Inc.

3D software plug-ins for PACS workstations.


There was 482 posters but a significant fraction of the them were no shows. Here are the ones that caught my eye.

222HS-p - A Fault Tolerant 300 GB RAID server and 2 TB Tape Jukebox PACS archive for $20k. GJ Wendt, PG Nagy, WW Peppler, C Kahn, K Ehlers, Madison

No, they do not really use it for PACS, but for a teaching file. It does to show how overpriced the commercial PACS systems are.

237HS-p - Acute Cerebral Infarction: Effect of JPEG Compression on Detection at CT. Y. Ohgiya, T Gokan, H Fujisawa, K. Hamamizu, K Tanno, H Munechika, Tokyo

They found that 10:1 and 20:1 were tolerated. But their data showed that at 20:1 ROC curve was worse. Not significant, they say.

243PH-p - The Use of Erbium Filtration for Routine Diagnostic X-ray investigations. LA Rainford, JP Stack, PC Brennan, Dublin

They found decreased doses and increased or same image quality with erbium as opposed to aluminum filters.

247PH-p - Consistency of Image Quality Measurements of Computed Radiography Systems with Implications for a Quality Control Program. KA Fetterly, TM Peterson, TR Daly, BA Schueler, Rochester, MN

They followed several CR systems for 15 mos. QC program took 1 hr to perform which could be automated to be accomplished in less time. Small changes in performance can be detected. A formal QC program will be initiated as image quality measurements are a good thing.

255PH-p - Hand Images: Comparison of a Flat Panel Digital Detector to Screen-Film and Computed Radiography Detectors. H Pauls, T Pollak, R Friedberg, U Gunl, A kogel, K Kohler, Dresden

Authors found that 200 ìm pixel DR (GE) gave best image quality compared to CR (Agfa) and SF (Agfa) which were about the same.

257PH-p - Comparison of Computed Radiography and Film/Screen Combination Using a Contrast-Detail Phantom. Z Lu, EL Nickoloff, JC So, AK Dutta, New York

Authors wanted to minimize patient dose, optimize technique using a contrast-detail phantom as criteria. CR seems to want a higher kVp setting and more filtration to reduce patient dose and maintain image quality as measured with the contrast-detail phantom.

261PH-p - Spreadsheets for Automated Data Collection, Analysis and Report Generation for Diagnostic Medical Physics. SG Langer, KM Kanal, Seattle

Authors have tried to automate record keeping with spreadsheets. Designed with 1 day/sheet. Provides for time savings in collection and distribution. Langer shares and you can see more at

264PH-p - CT Lung Nodule Size: Effects of Scanners and reconstruction filters. PF Judy, FL Jacobson, B Zaho, DA Israel, C Del Frate, Boston

Using a lung nodule phantom authors measured visual and computer size measurements from 2 scanners and 4 different reconstruction filters. Above 4 mm no effect was seen with filters. Scanners had essentially the same performance.

270PH-p - Comparison of Time Requirements in 2D vs 3D Radiotherapy Planning. A Kuten, S Lippa, R Bar Dermona, E Gez, S Dijkhuis, D Gaitini, Haifa

An Industrial Management Engineer studied planning of 2D vs 3D. 2D takes 2X longer to plan and physics staffing has to be increased.

277PH-p - DICOM can be Extended by Defining an Otology Incorporating Dynamic Behavior Such as Involved in Medical Image Processing. F Aubry, AE Todd-Pokropek, London

Authors want to extend DICOM to include Categories, allowing for more versatility in sharing and distributing more complex images.

286PH-p - Linearity of Recovery Coefficients in PET. L Geworski, BO Knoop, WH Knapp, DL Munz, Berlin

The authors premise was that if scatter and attenuation were accurate then recovery coefficients would be the same for hot and cold sources. Tested for Exact 922 in 2D and 3D mode. Evaluated using IEC procedures and found support for their premise. They propose this as a test of linearity and correction accuracy. This work was with spheres. Would other shapes be the same?

287PH-p - Absolute calibration of Positron Emission Tomographs: A Multicentric Comparative Evaluation. L Geworski, V Ivancevic, M de Wit, R Bares, DL Munz, Berlin

Authors checked dose calibrators and PET scanner calibration. 23 tomographs were tested. 65% were within 5% of the mean, 85% within 10%. Rest were far out. Absolute calibration cannot be trusted without investigation.

289PH-p - Set-up and Calibrations of Color Cathode Ray Tube Displays for the Purpose of Board Examinations. H Roehrig, WH Hartmann, RJ Rovenelli, MP Capp, MG Evanoff, EA Krupinski, Tuscon

Authors demonstrated that they successfully controlled 88 CRTs for purposes of Pathology and Radiology exams. More work is required on objective color accuracy calibration.

Scientific papers

There were 1670 abstract in the program. There was plenty of productive things to do in Chicago so the "obligation" I felt to go to the weak nuclear medicine physics papers was easy to avoid. However I did struggle to find SOMETHING of utility. The following caught my attention.

287 - Functional Mapping of Regional Liver Asialoglycoprotein Receptor Amount from Single Blood Sample and SPECT N Shuke, A Okizaki, J Sato, Y Ishikawa, K Takahashi, T Aburano et al, Asahikawa, Japan

GSA albumin is an approved agent in Japan. Dynamic SPECT results in low-count high-noise numbers so authors attempted to validate a static SPECT method using a 2 compartment model. They were able to validate the approach and provide a quantitative receptor image with a static SPECT acquisition.

288 - Revolutionary Nuclear Medicine Diagnostic Images Through Pixon Post-Processing: Enhanced Contrast, Resolution and Order of Magnitude Increase in Signal-to-Noise Ratio. DL Gilday, A Yahil, R Puetter, PS Babyn, R McFadden, Toronto

I am not sure how revolutionary this image processing is but it caused some interest in the members of the audience. You can maybe judge for yourself by checking out It was described to us as deriving from astrophysics work and based on some sort of adaptive smoothing. They were not revealing much.

289 - Efficacy of Triple Energy Window (TES) Method in the Simultaneous Acquisition of Ga-67 and Tc-99m. I Fukunaga, N Yamazaki, K Ishikawa, Y Ozaki, Y Sumi. Urayasa, Japan

A phantom study to try to test the efficacy of simultaneous bone scan and Ga-67 scan. Not convincing.

1027 - Lesion Detection and Classification for ENT- and GI Tumors with PET-CT Fusion in an In-line System Compared to PET Alone. TF Hany, GW Goerres, A Kaim, K Mosna-Firlejczyk, KD Stumpe, GK Von Schulthess, Zurich

The authors presentation prompted a spirited discussion. They are true believers that CT and PET should be on the same gantry. Some in the audience did not fully agree.

1029 - Evaluation of Parotid Tumors with FDG-PET. S Hamaguchi, Noriuchi, T Inoue, N Satou, J Aoki, K Endo, Maebashi, Japan.

FDG images not definitive in most parotid tumors.

1030 - Dual-Phase Whole Body PET FDG Imaging: A Novel Way to Improve Specificity and Sensitivity in Oncology. LM Lamki, NA Mullani, BJ Barron, E Kim, Houston

In 100 patients early phase images at 2 min/body position starting 2 min after injection then delayed phase within ½ hr at 6 min/body position. They found the early phase images reduced false positives and negatives.

1028 - Comparison of Diagnostic Accuracy between CT and FDG-PET in the Evaluation of Primary Tumor and Nodal Metastases in Patients with Surgically Resected Esophageal Cancer: A Prospective Study. KS Lee, YC Yoon, Y Shim, T Kim, K Kim, B Kim et al, Seoul

In 48 patients PET significantly better for staging and nodal involvement, less so for primary evaluation. Comment from audience: PET-CT would be even better!

1032 - The Accuracy of 18FDG-PET vs 67Ga SPECT for Detecting Splenic Involvement in Hodgkin's Disease. JN Rini, E Manalili, MB Tomas, I Melder, G Karayalcin, CJ Palestro. New Hyde Park, NY

Using gamma camera PET they found FDG best.

1033 - Insights into Explaining Apparent Discrepancies between PET and CT Findings. RB Hoffman, M Parver, Torrance CA

Used Exact 47 and Lightspeed. Most likely causes are improved PET contrast and delay between the two scans in aggressive disease.

Education Exhibits

There were 1107 such exhibits. These are posters. Some are very good. Others are so bad they should not be there at all.

051CEMS-e - New Software for Management of Radiological Images: Medical Images Organizer (MIO) V Panebianco, V Campanella, C Catalano, A Laghi, I Sansoni, R Passariello, Rome

Uses 4D Engine in a DB for teaching

073CEPH-e - Computer-based Image Quality Evaluation of Digital Radiography Systems. L Wang, KA Fetterly, TM Peterson, Rochester MN

Good teaching content on MTF, noise power function

0402NM-e - Breast Lymphoscintigraphy: Promise and Controversy, MT Chou, R Powsner, E Levin, Boston

Good description of the process and technique.

0406NM-e - Pictorial Review of Gamma Camera Coincidence Imaging of Lung Nodules with FDG. AJ Minotti, LM Shah, Cleveland

Good intro to the subject and controversies.

0408NM-e - Radioimmunotherapy (RIT) of Leptomeningeal (LM) Neoplasm with Intraventricular (Ivent) 131-I-3F8: Patient Imaging and Dosimetry. K Kramer, NV Cheung, JL Humm, R Finn, SD Yeh, SM Larson et al, New York.

Some progress is being made in RIT.

0410NM-e - User Requirements and Benefits of Tele-medicine for Use in Nuclear Medicine in Particular in Developing Countries: A Solution Looking for a Problem? R Chanachai, AE Todd-Pokropek, London.

Trials in Thailand and Morocco were used to illustrate issues specific to developing countries. It can be made to work but....??

0412NM-e: - PET/CT and PET/MR Image Fusion: Updated 3D Registration and Visualization Techniques for Primary Tumor Staging. GS Lin, I Habboush, M Thomas, SJ Swerdloff , Fremont CA.

A brief review of registration. with emphasis on IMRT. and RTP

0415NM-e - Evaluation of Cerebral Radiation Necrosis vs Tumor Recurrence with [18F] FDG Using a Hybrid Dual Detector PET/SPECT Camera. AF Fernandez-Abril, GN Stakiankis, Miami

Sens=100%, Spec=83% with 15 pts.

0420NM-e - Thallium Scintigraphy in Bone and Soft-Tissue Tumors: Usefulness, Pitfalls, and Additional Value of Dynamic Scan in Differentiating Malignant from Benign Tumors. Y Sugawara, T Kikuchi, T Mochizuki, S Nakata, J Ikezoe, Onsen, Japan

They found high sensitivity but significant uptake in benign tumors. There is probably no serious role for Tl-201 in this application.

0566PP-e - A Multidisciplinary Approach to the Development of User-centered Interfaces of Radiological Workstations Used for Navigation through Large Imaging Data Sets. MH Verschoor, M Van der Geer, PO Passenier, HA Vrooman, PM Pattynama, Rotterdam

This was pretty good. Discussed the factors from cognitive viewpoint. But are the companies listening?

0574MS-e - Practical Use of a New Watermarking Technique for Medical Image Communication and Archive. T Umeda, H Tachibana, T Ikeda, Y Yuminaka, H Harauchi, K Inamura, Sagamihara, Japan

Why watermarks on digital images? I think it is for authentication. Is this important? Maybe to some it is?

0578MS-e - High-Resolution Computed Tomography of Unique Miniature Sculptures: Antique Japanese Netsuke. SA Sirr, M Bernstein, C Stephenson, Minneapolis

Netsuke is the wooden adornment on a woman's kimono sash. They have become art objects and here is away to verify and study them.

0644PH-e - PACS Simulator: A Standalone Educational Tool. HK Hunag, F Cao, BJ Liu, MZ Zhou, J Zhang, GT Mogel, Los Angeles.

But is it needed?

0646PH-e - Equalization Processing for Digital Chest Radiographs. MJ Flynn, WR Eyler, M Couwenhoven, RM Slone, E Samei, BR Whiting et al, Detroit

This was very rich in educational material. I wish I had time to digest it or take it home to read and study.

0647PH-e - Scale-based Maximum Intensity Projection (MIP) Rendering. PK Saha, JK Udupa, T Lei, JM Abrahams, Philadelphia

With MR images. Filtering to remove noise before MIP is very helpful.

0648PH-e - A Framework for Evaluating Image Segmentation Algorithms. JK Udapa. Philadelphia

In MR.

0649PH-e - Choosing the Optimal Monitor for PACS and Teleradiology: The Importance of the Phosphor. EA Krupinski, H Roehrig, Tucson

Phosphor should be critical. P45 and P104 showed very slight differences in performance, however.

0650PH-e - Image Quality Characterization of Medical Imaging Monochrome Active-Matrix Liquid Crystal Displays. A Bandano, S Martin, J Kanicki, Rockville

Good research on comparing suitability of LCD displays. Looks like they have arrived.

0651PH-e - Radiation Risks from Lung Cancer Screening Using CT. PF Judy, FL Jacobson, VJ Rodrigues, RD Nawfel. Boston


0655PH-e - Design and Construction of a Liver Phantom for CT Imaging and Interventions that Simulates Liver Motion Seen During Respiration. F Banovac, KR Cleary, EB Levy, DJ Lindisch, S Onda, D Tanaka. Washington DC

They used a rather standard liver phantom, added movement and a tracking device. Could this be used in evaluation of new PET/CT machines?

0658PH-e - Evaluation of Diagnostic Information Yield Obtained from Tuned-Aperture Computed Tomography and Conventional Dento-alveolar Imaging Modalities for Assessing Impacted Teeth. K Yamamoto, H Sekiguchi, Y Kousuge, T Mori, Y Hayakawa, AG Farman et al, Chiba

TACT slightly improved the dental x-rays.

0661PH-e - Quality Control of Digital Radiography in Comparison to Conventional Film Radiography. F Van Der Meer, JF Veenland, JL Grashuis, Rotterdam

Came with a handout. Very nice work with lots of detail. More in the books?

0663PH-e - Quantitative Evaluation Method for Image Display Technologies. MR Bruesewitz, KA Fetterly, NJ Hangiandreou, JP Taubel. Rochester, MN

As an example they applied this to two films: their current film and a new one. Seems elaborate. Do they really do this?

0665PH-e - Understanding Mach Bands: Physical Principles and Clinical Examples. MS Rzeszotarski, LM Shah, AJ Minotti. Cleveland

A very instructive poster.

0681PH-e Building a Teaching Server Out of the PACS. My Law, FH Tang, F Cao, Kowloon, HK

There were several of these type of projects. This one pulled interesting cases from PACS to a Web server. Seemed overly complex.

0683PH-e - Establishing a Small-Animal Phase-Contrast Radiography Imaging System. EF Donnelly, RR Price, DR Pickens, Nashville

Sensitive to soft tissue with inherent edge enhancement. Applications?

infoRAD Exhibits

These exhibits were hands on workstation-based educational exhibits. Some were very well done.

926ED-i - Digital Archiving of Lectures: An Overview of Techniques. EP Tamm, RB Iyer, KW McEnery, Houston

This was both good and useful. I wish I could take it home with me. Very practical advice on how to save and distribute voice/graphics.

9401IMA-i - Remote Image Processing through the Internet: Hands-on Demonstration of the EU Project Novice. E Neri, D Caramella, A Jackson, N John, A Sadarjoen, C Bartolozzi, Pisa.

This is worth a follow-up. This describes an Internet resource for image processing. and

9402IMA-i - How to Create a Movie from Serial 2D Medical Images Conveniently: A Step-by-Step Tutorial on the PC. J Liou, Y Sun, R Lee, MM Teng, W Guo, C Chang, Taipei

I wish this exhibit had been working. I could have learned something, I think.

9603PACS-i - DicomWorks: A DICOM Converter, Archiving and Transfer Software. PA Puech, L Boussel, FE Cotton, PC Douek, Lyon

I would really like to spend more time with this one. It sounds too good to be true. And its FREE!

9606PACS-i - A Detailed Evaluation of 20 Different DICOM Viewers That are Available on the Internet: Free Trials or Free Licenses. M Chang, Y Sun, AJ Liou, C Wu, MM Teng, C Chang, Taipei.

This was always busy. I finally got on and it is a very useful compilation. Try

9609PACS-i - PACSPULSE: A Web-based DICOM Network Traffic Monitor and Analysis Tool. PG Nagy, CE Kahn, K Ehlers, J Rehm, GJ Wendt. Milwaukee

This sounds like a useful tool.

9614PACS-i - Image Quality Control and Image Quality Measurements for Display Systems. H Roehrig, H Blume, BM Hemminger, J Fan, M Arthur. Tucson

ACR/NEMA Working Group 11: Display Function Standard. A tutorial and hands on demo of tools.