Scanning thin, reading thick . . .

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. . . and storing how, exactly? That was the question that kicked off this afternoon's session on workflow and image processing. Jeffrey Mendel, MD, began his presentation by observing that to believe the New York Times and the Wall Street Journal, imaging is currently awash in exciting, amazing new technology. "But somehow that great new technology that I see on the cover of the times never seems to make it to me," he said. Why? Well, 3D image reconstruction and analysis are all well and good, but issues remain when it comes to storage of all those thin slices. Where should all the thin slices go? The answer probably changes depending on who you ask. As Mendel delineated, clinicians are not a homogenous group: some are report-centric, others image-centric, and any storage strategy you implement should accommodate both. Mendel explained that there are three models for thin section storage. The first, sending thick data to PACS and thin data to the 3D workstation, requires separate data storage and management, and leads to complications when integrating 3D tools in PACS hanging protocols. The second, storing all data on the PACS forever, strains the system, making storage management and image distribution difficult. The third is a blended model -- and everyone loves a compromise. The blended model involves storing thick data and key images in all cases, then selectively storing thin data in the long term. All that's required is a robust but flexible set of rules to maintain what is stored where and why. (No problem, right?) Mendel also outlined some PACS storage myths, like that spinning disc storage is cheap -- boy howdy, is it not -- or that purging, compression or streaming video from server clusters will fix everything. So . . . what will fix everything? According to Mendel, the only perfect solution would be to store all thin data indefinitely, and we're still a ways off from that. But you can get ready now by examining your resources and clinical needs -- and by making sure your 3D and PACS vendors work well together and have scalable, flexible solutions.