Dear AuntMinnie Member,
Will PACS survive as an independent discipline? Or will it be taken over by hospital IT departments, with radiology personnel losing control and influence over how the technology is used?
These are the questions asked by PACS consultant Mike Cannavo in a new installation of his Straight Talk From the PACSman column. In the article, Mike talks about the evolution of PACS, from its origins as a standalone system that pioneered the digitization of healthcare to its current status as a component of the integrated electronic health record.
While PACS faces major challenges to its independence, Mike believes it can still survive if some steps are taken. Find out what they are by clicking here, or visit our Imaging Informatics Community at informatics.auntminnie.com.
While you're in the community, check out a recent article on changes to physician licensing practices that could make it easier for doctors to get medical licenses across state lines -- providing a boon to teleradiology and telemedicine.
Boston Marathon imaging
Last year's Boston Marathon bombings highlighted the vital role that medical imaging plays in the treatment of trauma victims. This week, we're featuring an article that describes exactly how imaging exams guided the management of bombing victims.
Three people were killed and more than 260 were injured in the attacks, with survivors treated at 27 hospitals in the Boston area. Triage was complicated by the arrival of so many patients in such a short period of time, according to the researchers from Massachusetts General Hospital.
In the article, they report on the types of injuries and their presentation on CT and radiography exams. The group found that injuries varied depending on the impact of different blast waves from the explosion.
Learn more by clicking here, or visit the CT Digital Community at ct.auntminnie.com.
Tennis elbow and sonographers
Finally, we continue our popular Making a Difference as a Sonographer column with part 2 of a series of articles on tennis elbow.
In the new column, Doug Wuebben and Mark Roozen describe exercises that sonographers can perform to improve their stability and strength to relieve elbow pain. If you're a sonographer who is scanning in pain, you don't want to perform another study without reading this.
You'll find the article by clicking here, or visit our Ultrasound Digital Community at ultrasound.auntminnie.com.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
