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The large volumes of digital images produced by digital imaging modalities in Radiology have
provided the motivation for the development of picture archiving and communication systems
(PACS) in an effort to provide an organized mechanism for digital image management. The
development of more sophisticated methods of digital image acquisition (Multislice CT and Digital
Mammography, for example), as well as the implementation and performance of PACS and
Teleradiology systems in a health care environment, have created challenges in the area of image
compression with respect to storing and transmitting digital images.
Image compression can be reversible (lossless) or irreversible (lossy). While in the former, there is
no loss of information, the latter presents concerns since there is a loss of information. This loss of
information from diagnostic medical images is of primary concern not only to radiologists, but also
to patients and their physicians. In 1997, Goldberg pointed out that "there is growing evidence that
lossy compression can be applied without significantly affecting the diagnostic content of images...
there is growing consensus in the radiologic community that some forms of lossy compression are
acceptable".
The purpose of this study was to explore the opinions of expert radiologists, and related
professional organizations on the use of irreversible compression in routine practice
The opinions of notable radiologists in the US and Canada are varied indicating no consensus of
opinion on the use of irreversible compression in primary diagnosis, however, they are
generally positive on the notion of the image storage and transmission advantages. Almost all
radiologists are concerned with the litigation potential of an incorrect diagnosis based on
irreversible compressed images. The survey of several radiology professional and related organizations reveals that no professional
practice standards exist for the use of irreversible compression. Currently, the only standard for
image compression is stated in the ACR's Technical Standards for Teleradiology and Digital Image
Management.
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