Computer Aided Detection/Diagnosis (CAD) can greatly assist in the clinical decision making process, and therefore, has drawn tremendous research efforts. However, integrating independent CAD workstation results with the clinical diagnostic workflow still remains challenging. We have presented a CAD-PACS integration toolkit that complies with DICOM standard and IHE profiles. One major issue in CAD-PACS integration is the security of the images used in CAD post-processing and the corresponding CAD result images. In this paper, we present a method for assuring the integrity of both DICOM images used in CAD post-processing and the CAD image results that are in BMP or JPEG format. The method is evaluated in a PACS simulator that simulates clinical PACS workflow. It can also be applied to multiple CAD applications that are integrated with the PACS simulator. The successful development and evaluation of this method will provide a useful approach for assuring image integrity of the CAD-PACS integration in clinical diagnosis.
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