Foreword With the advancement of picture archiving and communications systems(PACs)into mainstream use in healthcare facilities. there is a natural transition from the dis- ciplines of engineering research and technology assessment to clinical operations While much research in PACS-related areas continues, commercial systems are widely available. The burgeoning use of PACs in a range of healthcare facility sizes has created entirely new employment opportunities for"PACS managers, " modality managers,""interface analysts, and others who are needed to get these systems implemented, keep them operating, and expand them as necessary. The field of medical imaging informatics is often described as the discipline encompassing the subject areas that these new specialists need to understand. As the Society of Imaging Infor matics in Medicine(SliM)defines it Imaging informatics is a relatively new multidisciplinary field that intersects with the biological sciences, health services, information sciences and com- puting, medical physics, and engineering. Imaging informatics touches every aspect of the imaging chain and forms a bridge with imaging and other medical disciplines. Because the technology of PACS continues to evolve, imaging informatics is also important for the researcher. Each of the areas comprising the field of imaging infor- matics has aspects that make for challenging research topics. Absent the research these challenges foster and PACs would stagnate For the student of medical imaging informatics, there is a wealth of literature available for study. However, much of this is written for trainees in a particular discipline Anatomy, for example, is typically aimed at medical, dental, veterinary, and physical therapy students, not at engineers. Texts on networks or storage systems are not designed for physicians. Even primers on such topics tend not to provide a cross- disciplinary perspective of the subject The authors of Medical Imaging Informatics have accepted the challenge of creating a textbook that provides the student of medical imaging informatics with the broad range of topical areas necessary for the field and doing so without being superficial Unusual for a text on informatics, the book contains a chapter, A Primer on Imaging Anatomy and Physiology, subject material this writer knows is important, but is often lacking in the knowledge-base of the information technology (IT) people he works with. Similarly, many informatics-oriented physicians this writer knows do not have the in-depth understanding of information systems and components that IT experts have. Such is the subject matter of the"middle chapters of the book -Chapter 3. Information Systems Architectures, Chapter 4: Medical Data Visualization: Toward Integrated Clinical Workstations, and Chapter 5. Characterizing Imaging Data. The succeeding chapters are directed towards integrating IT theory and infrastructure with medical practice topics-Chapter 6: Natural Language Processing of Medical Reports, Chapter 7: Organizing Observations: Data Models, Chapter 8: Disease Models, Part 1. Graphical Models, and Chapter 9: Disease Models, Part 1 Querying Applications Finally, because a practitioner of medical imaging informatics is expected to keep up with the current literature and to know the bases of decision making. the authors have included a chapter on Evaluation. With the statistical methods and technology assess- ment areas covered, the reader will gain the understanding needed to be a critical iSocietyofImagingiNformaticsinMedicinewebsitehttp://nwwsimmveb.orgviii Foreword With the advancement of picture archiving and communications systems (PACS) into “mainstream” use in healthcare facilities, there is a natural transition from the dis￾ciplines of engineering research and technology assessment to clinical operations. While much research in PACS-related areas continues, commercial systems are widely available. The burgeoning use of PACS in a range of healthcare facility sizes has created entirely new employment opportunities for “PACS managers,” “modality managers,” “interface analysts,” and others who are needed to get these systems implemented, keep them operating, and expand them as necessary. The field of medical imaging informatics is often described as the discipline encompassing the subject areas that these new specialists need to understand. As the Society of Imaging Infor￾matics in Medicine (SIIM) defines it: Imaging informatics is a relatively new multidisciplinary field that intersects with the biological sciences, health services, information sciences and com￾puting, medical physics, and engineering. Imaging informatics touches every aspect of the imaging chain and forms a bridge with imaging and other medical disciplines.1 Because the technology of PACS continues to evolve, imaging informatics is also important for the researcher. Each of the areas comprising the field of imaging infor￾matics has aspects that make for challenging research topics. Absent the research these challenges foster and PACS would stagnate. For the student of medical imaging informatics, there is a wealth of literature available for study. However, much of this is written for trainees in a particular discipline. Anatomy, for example, is typically aimed at medical, dental, veterinary, and physical therapy students, not at engineers. Texts on networks or storage systems are not designed for physicians. Even primers on such topics tend not to provide a cross￾disciplinary perspective of the subject. The authors of Medical Imaging Informatics have accepted the challenge of creating a textbook that provides the student of medical imaging informatics with the broad range of topical areas necessary for the field and doing so without being superficial. Unusual for a text on informatics, the book contains a chapter, A Primer on Imaging Anatomy and Physiology, subject material this writer knows is important, but is often lacking in the knowledge-base of the information technology (IT) people he works with. Similarly, many informatics-oriented physicians this writer knows do not have the in-depth understanding of information systems and components that IT experts have. Such is the subject matter of the “middle” chapters of the book – Chapter 3: Information Systems & Architectures, Chapter 4: Medical Data Visualization: Toward Integrated Clinical Workstations, and Chapter 5: Characterizing Imaging Data. The succeeding chapters are directed towards integrating IT theory and infrastructure with medical practice topics – Chapter 6: Natural Language Processing of Medical Reports, Chapter 7: Organizing Observations: Data Models, Chapter 8: Disease Models, Part I: Graphical Models, and Chapter 9: Disease Models, Part II: Querying & Applications. Finally, because a practitioner of medical imaging informatics is expected to keep up with the current literature and to know the bases of decision making, the authors have included a chapter on Evaluation. With the statistical methods and technology assess￾ment areas covered, the reader will gain the understanding needed to be a critical 1 Society of Imaging Informatics in Medicine website: http://www.siimweb.org