PACS development in Asia.

First, history of PACS in Japan from 1982 to 2002 has been investigated. By 2002 total of 1468 PACS units have been installed. Of these, 1174 are small-size PACS with less than four image display terminals, 203 are medium-size with 5-14 terminals, and 91 are large-size with 15 up to 1300 terminals. The main nine large-size PACS of 91 have been retrospectively investigated from 1984 for PACS experiments and from 1989 for PACS operation. Most of these nine hospitals have increased the number of PACS terminals by installing additional PACS units, instead of reinforcing the existing single PACS. The use of DICOM interfaces has increased the number of modalities connected to PACS and influenced the spreading of PACS installations in Japan. The status of HIS and RIS coupling to PACS, and the use of PACS in primary diagnosis or in image referral are discussed. Assessment of PACS is now in an early stage. Baseline studies of HIS/RIS/PACS effectiveness have been carried out to assess quantitatively the PACS merit. Second, history of PACS development in Korea is described. Very acute climbing up of filmless PACS diffusion was observed from 2000 to 2002. The reasons seem to be lack of domestic X-ray film industry, economic crisis in 1997 and PACS Reimbursement Act in health insurance in Korea. Third, the Hong Kong Wide Area Image Distribution/PACS Project is reported. It is now under phase 1 of design and partial implementation employing the latest and the highest ends of advanced technology such as failure resilience.