§16§The term picture archiving and communications system (PACS) was initiated during the first International conference and workshop on the topic sponsored by The International Society for Optical Engineering (SPIE) in Newport Beach, California in 1982. The research and development (R〓16§Hokkaido University, Japan; Hammersmith Hospital, United Kingdom; Social and Medical Center East (SMZO), Vienna, Austria; the U.S. Armed Force Medical Diagnostic Imaging Support (MDIS) project; and the UCLA Medical Plaza ambulatory care center. Another phenomenon is the organization of the EC-countries which provides a tremendous impetus for the European PACS R〓04§1 Introduction, Definition, and Historical Background of Picture Archiving and Communication Systems.- 1.1 Background.- 1.2 Description.- 1.3 Genesis.- 1.4 PACS Research.- 1.5 Clinical Implementation and Evaluation.- 1.6 Organizations and Conferences.- References.- 2 Medical Requirements for Clinical Integration.- 2.1 Introduction.- 2.2 The Structure of Imaging Activities Within the Hospital.- 2.3 Medical Requirements in Terms of Access to Images.- 2.4 Medical Needs in Terms of Spatial Resolution.- 2.5 Medical Needs in Terms of User Friendliness.- 2.6 Medical Needs in Terms of Patient Data Consistency.- 2.7 Medical Need for Image Manipulation: Image Compression.- References.- 3 Looking for Indicators of a Reference Hospital.- 3.1 Introduction.- 3.2 Questionnaire.- 3.3 Basic Schema of Possible Indicators.- 3.4 Preliminary Results.- 3.5 Indications for Further Inquiries.- References.- 4 Communication Between Hospital and Radiology Information Systems and Picture Archiving and Commun §04§ication Systems.- 4.1 Integrated Information Systems in the Hospital.- 4.2 Radiology Information Systems.- 4.3 Integration of PACS, RIS, and HIS.- References.- 5 Networking.- 5.1 Image Network Technology.- 5.2 Network Management.- 5.3 Potential Benefits and Critical Issues of Prefetching.- References.- 6 Digital Image Workstations.- 6.1 Workstation Design Considerations.- 6.2 Adaptive User Interfaces for PACS Image Workstations.- References.- 7 Data Bases.- 7.1 Distributed Multimedia Data Base Systems.- 7.2 Distributed Image Archival.- 7.3 Image Indexing by Content.- References.- 8 Standardization.- 8.1 Trends.- 8.2 Formal European Standardization Bodies.- 8.3 European Bodies Promoting Standardization.- 8.4 Standardization Actions Related to Medical Informatics and Imaging.- 8.5 StandardizationActions for Medical Image Interchange.- 8.6 Conclusion.- References.- 9 Second Generation PACS Concept: A Global View.- 9.1 The First Generation PACS: Reasons for Their Failure.- 9.2 The New §04§ Generation: Medically Determined PACS Concept.- 9.3 Adaptive User Interface.- 9.4 Distributed Data Base.- 9.5 Integrated PACS/HIS/RIS Environment.- 9.6 Prefetching.- 9.7 Intelligent Distribution of Images: Knowledge-Based Networking.- 9.8 Modular Architecture; Phased Approach.- 9.9 Conclusion.