Revolution in medical imaging systems generate high-resolution images. This revolution has created new challenges in accessing, sharing, archiving and protecting medical images. The number of these images has also increased significantly over the past decade, which is creating another challenge. Recently, the health care industry has started noticing cloud computing as a solution because of its elasticity and scalability, which contribute to avoiding hardware obsolescence, providing universal access to medical images anywhere and anytime, and increasing their availability. This paper introduces the main characteristics of the cloud-based picture and communication system (PACS) and highlights its technical and nontechnical advantages. Moreover, this paper illustrates challenges in cloud-based medical image exchange, regulation, and interoperability as well as how medical image existence can affect cloud users. Furthermore, the paper concludes with directions for future research in medical imaging.

Keywords
PACS, DICOM, HL7, medical imaging, cloud computing.