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BioMed Research International
Volume 2014 (2014), Article ID 657417, 9 pages
Research Article

Performance Enhancement of a Web-Based Picture Archiving and Communication System Using Commercial Off-the-Shelf Server Clusters

1Institute of Nuclear Engineering and Science, National Tsing Hua University, Hsinchu 30013, Taiwan
2Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu 30013, Taiwan
3Department of Management Information Systems, Central Taiwan University of Science and Technology, Taichung 40202, Taiwan
4Health Physics Division, Institute of Nuclear Energy Research, Atomic Energy Council, Taoyuan 32500, Taiwan
5Department of Biomedical Imaging and Radiological Science, China Medical University, No. 91 Hsueh-Shih Road, Taichung 40202, Taiwan

Received 3 October 2013; Revised 29 December 2013; Accepted 14 January 2014; Published 20 February 2014

Academic Editor: Bassam Hassan

Copyright © 2014 Yan-Lin Liu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The rapid development of picture archiving and communication systems (PACSs) thoroughly changes the way of medical informatics communication and management. However, as the scale of a hospital’s operations increases, the large amount of digital images transferred in the network inevitably decreases system efficiency. In this study, a server cluster consisting of two server nodes was constructed. Network load balancing (NLB), distributed file system (DFS), and structured query language (SQL) duplication services were installed. A total of 1 to 16 workstations were used to transfer computed radiography (CR), computed tomography (CT), and magnetic resonance (MR) images simultaneously to simulate the clinical situation. The average transmission rate (ATR) was analyzed between the cluster and noncluster servers. In the download scenario, the ATRs of CR, CT, and MR images increased by 44.3%, 56.6%, and 100.9%, respectively, when using the server cluster, whereas the ATRs increased by 23.0%, 39.2%, and 24.9% in the upload scenario. In the mix scenario, the transmission performance increased by 45.2% when using eight computer units. The fault tolerance mechanisms of the server cluster maintained the system availability and image integrity. The server cluster can improve the transmission efficiency while maintaining high reliability and continuous availability in a healthcare environment.