  The compilation and analysis of radiological images poses numerous challenges
for researchers. The sheer volume of data as well as the computational needs of
algorithms capable of operating on images are extensive. Additionally, the
assembly of these images alone is difficult, as these exams may differ widely
in terms of clinical context, structured annotation available for model
training, modality, and patient identifiers. In this paper, we describe our
experiences and challenges in establishing a trusted collection of radiology
images linked to the United States Department of Veterans Affairs (VA)
electronic health record database. We also discuss implications in making this
repository research-ready for medical investigators. Key insights include
uncovering the specific procedures required for transferring images from a
clinical to a research-ready environment, as well as roadblocks and bottlenecks
in this process that may hinder future efforts at automation.
