Stupid Pet, I Mean PACS Tricks

Image credit: http://www.skateboardingbulldog.com

It's amazing that a little glitch can cause a big pain. What's even more amusing is the fact that this particular glitch is shared by Impax 6.x and GE Centricity 2.x.

Here's the scenario...I'm looking at a CT, cine'ing through the slices. I want to change window settings, say from a mediastinal window to a bone window. Shouldn't be a problem, especially if I have the window/level preset to a keyboard shortcut. BUT...sometimes, only the slice that is on the screen will have the parameters changed, with all other slices remaining at the original level. And just why does this happen only sometimes?

Our Agfa PACS-admin actually figured this one out, and it turns out to be the explanation for Centricity's bad behaviour as well. If you did nothing else to the scan other than change with W/L settings, there is no problem, and such changes apply to all slices. However, if you happened to stop and measure something, then all bets are off. In their infinite wisdom, the programmers decided that a measurement should only apply to the slice on the screen. That makes sense, I guess, but their solution was to switch the tool application mode (my term, but it works) from applying a change to all slices to applying it to just one. And, it doesn't return to the "all slice" mode when you go back to the window/level control. This makes me do it, which as a lazy slug, I resent, and I don't even realize that I have to make this change until I'm flipping through the images and see one slice at lung windows and the rest at a different setting altogether.

I have to throw in one more little trick from Impax. At the bottom of the viewer, if you right-click on an UNMARKED point (even my Agfa PACS-Admin didn't know about this tool), you get a little sub-menu with three selections. The first is a limited history, which will bring up a list of the last 20 studies that were marked as Dictated. (This, of course, doesn't help if you lost something that was marked "Dictation started".) The second entry on this secret menu allows one to auto hide the toolbars, which I have never seen anyone use. The final entry, "Show Navigation Toolbar at the top of the screen" does just that. Sadly, there is a significant lag in the activation of any of the items, and the grouping is unintuitive enough that when I go after the history, I accidentally hit the "Show Toolbar at top" as often as not. I don't want the toolbar up there, and worse yet, it often disrupts the position of the other buttons at the top of the viewer, requiring me to log off and back on again to fix it. Really fun trick, guys.

How did we get these stupid PACS tricks? I will guarantee you that the developers didn't demo or test these options in an actual production environment. I'm sure these functions made perfect sense on paper, but they yield yet another hinderance to my workflow, out here in the real world of private practice.

Would you guys at GE and Agfa mind fixing this stuff, please?