For many doctors, specialists, hospitals, health care practices and medical facilities, the cloud holds a lot of promise for storing and  accessing medical imaging studies by physicians and patients alike. Luckily, virtual cloud storage can typically find an application for nearly every type of medical imaging modality, from CT scanners to MRI machines and everything in between. 

This is great news for radiologists. The caveat to this is if you’re a practice that primarily handles large medical imaging files or research data sets and has limited internet bandwidth. If bandwidth is not a concern, however, large file sizes become less of a roadblock on your journey to using software for cloud-based medical record storage. 

Let's discuss a few of the more challenging use cases around cloud storage for medical records and images.

Tomosynthesis and Cloud Storage

In recent years, digital breast tomosynthesis (DBT) has taken the place of traditional mammography examinations at some practices, due to the cutting-edge results it can provide. Where mammography affords 2-D breast imaging, the tomosynthesis format produces a more comprehensive 3-D image of the breast, with fewer gaps in medical imaging data.

As a result, tomosynthesis imaging studies are much larger in size - with over 100 images per breast in many cases, as opposed to only two in a standard mammogram. With the increased file size comes increased latency issues in load time. While some of this challenge can be overcome by selecting to push the imaging data to the cloud during off hours, another layer of complexity is that tomosynthesis imaging studies use special viewing software to visualize those data sets, and not all cloud vendors and servers can support this requirement.

It’s not, however, that the use of the cloud is out of the question for those practices and providers who are embracing tomosynthesis, but it does present a unique set of demands. In fact, even mammography isn’t exempt from hurdles with cloud storage as mammography viewers must also meet Mammography and Quality Standards Act (MQSA) and FDA standards for compliance.

Taking this into account, it's important to make sure you are working with a cloud vendor who is sophisticated enough to understand these intricacies and who can also offer an FDA-approved viewer cleared for mammography and tomosynthesis diagnosis that also protects patient privacy. 

Prohibitively Large File Sizes

Tomosynthesis isn't the only type of medical imaging with files sizes that challenge connectivity to the cloud online. There are many other use cases where the size of data sets are so great, even the fastest of internet connections won’t enable effective use of the cloud.

Dense research studies, are an example of where you may experience latency with the cloud, especially around uploading and viewing. We have seen incredibly large file sizes from these type of research projects since they are typically scanning patients or animals that are deceased, and thus have no issue with longer radiation exposure times than are possible with living patients. This in turn, generates higher resolution images with larger file sizes.

For example, recently we spoke with someone who was in the process of taking computed tomography (CT) scans of every species in the world of a particular type of animal. It’s an exciting project, but as it is intended to be a reference tool for researchers around the world, the level of detail desired in the images leads to a very large CT scan file size.

Each of the CT scan data sets is at least 20-30 gigabytes (GB) in size. A cloud storage and visualization system was not the right choice for them because uploading and retrieval times would take too long. 

Generally, It Comes Down to a Bandwidth Discussion

Putting these exceptions to the side, common clinical studies used in diagnosis and delivery of patient care — ultrasounds, x-rays, magnetic resonance imaging (MRI), CT scans, echocardiography, mammography etc. - are well-suited for securely storing and accessing this kind of patient data in a cloud platform. In general, your healthcare practice shouldn't have an issue with MRI file size, DICOM file, or the other formats listed here when transitioning to the cloud.

That said, restrictions on use of the cloud has less to do with the particular modality and more to do with the file sizes generated and your practice's bandwidth speeds. When considering whether or not cloud storage is appropriate for your modality, the answer is dependent on your specific use case and the size of the studies you are producing. Some studies, such as dense research scans, simply won’t play well with slower internet connections. 

However, the vast majority of clinical imaging studies should be well within appropriate file size ranges to leverage a cloud PACS solution, regardless of modality type.