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FAQ: Can I get copies of the measurement marks, annotations or regions of interest that a radiologist has drawn in the iSite PACS?

Radiologists and other imaging personnel are able to use the IntelliSpace PACS to create "annotations" on clinical images. These annotations are often measurements denoting the location and size of lesions or suspicious abnormalities. They may also be notes made by a radiologist or technologist. Radiologists and research personnel often use this method to draw regions of interest (ROIs) around various lesions or abnormalities depicted on images so they can be easily identified for further review or research.

Previously, there was no way to extract these annotations for research use, as they were saved as proprietary metadata within the PACS internal database and there was no officially support method of exporting them. Beginning in 2023, the PACS began supporting the option of exporting some of these annotations as DICOM presentation state objects and DICOM key image objects. The HIRO is able to export these DICOM files and include them with the image files as part of your image data request if desired. If you would like this data to be included with your image data requests, please mention this within the comments of your request.

If you have questions about this issue, or if you would like help identifying alternate methods for creating image annotations, please contact the HIRO (hirohelp [at]

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