A CT scanner finishes a chest study. Somewhere between that moment and the radiologist's first click, a surprising amount happens, and most of the "the PACS is slow" complaints live in that gap. Here is the path a study takes through a modern archive, and what each step costs.
0–5 s: the scanner sends
The modality pushes the series over DICOM C-STORE to the archive's receiving node. On a local network this is fast; across sites it depends on the gateway. RadImages uses a DICOM Uploader gateway at each site that accepts the study immediately, stores it locally and forwards it to the central archive in the background, so the scanner is never waiting on a WAN link.
5–15 s: the archive indexes
Every instance is parsed, the patient is matched against the index (this is where a wrong ID or a mistyped birth date is caught), the study is registered, and the worklist entry created at ordering time is closed via MPPS. A good archive does this per instance as they arrive, not after the last one, so the study is readable while it is still being sent.
15–30 s: pre-processing
This is the step that decides how fast the viewer feels later. The archive builds a compressed streaming representation of each series, pre-computes thumbnails and, for large volumes, prepares the data the server-side renderer will need for MPR and 3D. Done now, once, it saves seconds on every open afterwards.
30–45 s: routing
Rules decide who else gets a copy: an AI triage service, the regional archive, a partner hospital for second opinion, a teaching file. Each destination is a queue with retries and an audit entry, so nothing is lost if a link is down.
45–60 s: the worklist
The study appears on the reader's list, prioritised by rules: stroke protocol first, outpatient follow-up later. Prior studies are pre-fetched so comparison is instant. If an AI result has already come back it is attached, and the flag is visible before the study is even opened.
Then the first click
Because everything above happened once, centrally, the viewer only needs to stream the pre-built representation. First image in well under a second, full series in the background, reconstructions on demand.
When a department says the PACS is slow, the fix is rarely a faster PC. It is usually one of these five steps happening late, serially, or not at all. RadImages PACS is built so that each of them runs as the data arrives, and each is visible in the monitoring console when it does not.