Office Based Digital Radiology (Repost)

X-rays, MRIs and The Mac

Digitization of Radiology Film

Osirix Image
Osirix Image

There has been a trend to the increasing digitization of radiology information. This works great on  Mac computers since Osirix Imaging Software has been a global favorite of radiologists for several years. In fact a 2007 white paper detailing the integration of this open source software at a hospital in Mannheim is available at:

Osirix works wonderfully for 2D and 3D information. It is a 2D viewer, 3D viewer, 4d viewer (time dimension) and a 5D viewer (3D data + temporal and functional data) It can integrate images derived from 2 sources such as Cardiac PET/CT angiogram. X-rays, bone scans, pet scans, cat scans and more are readily viewable.  I’ve used Osirix for about 3 years and find it reliable and helpful. It is great for MRIs. I’ve found clinical problems, such as a torn plantar plate, that had previously been mistakenly read as normal. (Of course a physical examination should go a long way in leading one to suspect a plantar plate injury.)

The standard file format DICOM and over 20 other file formats are easily read using Osirix. The DICOM standard allows physicians using software and systems from different vendors to rapidly share imaging information. The only time Osirix will not work is if a proprietary format is used. The disks are sometimes hostilely marked “not compatible with Apple Macintosh computers”.  Since every radiology center has the capability of outputting a standard format file, and it is readable by their own Microsoft Explorer based software, I don’t know why anyone would limit the readability of the disk. In fact, there is no good reason not to use DICOM format. But if by chance a radiology center near you has made the mistake of not using DICOM, that error is quickly remedied with a call requesting a standard format “DICCOM” disk. Osirix development is open source and distributed under the GNU Lesser General Public License.

What is DICOM?

DICOM is a radiological information standard file format. It is the de facto standard used in all hospitals worldwide. The file format was developed in 1993 and used for a variety of medical image types including MRI, CT, and Pet scan. The image is compressible. The National Electrical manufacturers Association (NEMA) created the standard and these same manufacturers embed the capability of creating these standard file formats for cross platform interoperability.

DICOM can even store information on radiation exposure for examinations. It is dependent on the device manufacturer to properly implement this using the current addendum to the standard called the “Radiation Dose Structured Report“. Phillips and GE create a separate image with the total exposure listed. For more details see David Clunie’s Blog.

MEDX3D format is a new format with ongoing work to incorporate the upcoming format in the DICOM standard and in OSIRIX.

The NEMA online brochure explains the format in simple English:


Osirix Imaging Software

Osirix for iPhone/iPod Touch

Radscaper – Dicom viewer via browser that doesn’t use ActiveX for windows and Linux. Uses a Java applet.

Windows DICOM Viewer: DICOMWorks 1.3.5

DICOM – Latest Standard (doc and pdf formats)

Future of DICOM –

What Going Digital Will Mean For the Dentist’s Office – from J Am Dent Assoc

Dave’s Places In Radiology – Extremely thorough site for radiology professionals

David Clunie’s Blog (also see his Medical Image Format Site) – discussions and many links to sites with technical details.

MRI View of Big Mac (