1. A Picture Archiving and Communications System, comprising: an imaging modality subsystem configured to produce medical images; a PACS workstation communicatively coupled with the imaging modality subsystem to process data corresponding to the medical images; and a database subsystem communicatively coupled with the imaging modality subsystem and the PACS workstation, the database subsystem including a processor configured to process the medical images and the data corresponding to the medical images, wherein the database subsystem is a relational database that uses two-phase commit processing to store the medical images in a storage medium, wherein two-phase commit processing includes storing multiple instances of an image and images of the same body part, and further wherein the database subsystem is configured to ensure transactional integrity of the medical images and the data corresponding to the medical images by use of commit/rollback processing in which a transaction results in commit processing if possible and rollback processing if commit processing fails.