Home teleradiology system

NASA Astrophysics Data System (ADS)

Komo, Darmadi; Garra, Brian S.; Freedman, Matthew T.; Mun, Seong K.

1997-05-01

The Home Teleradiology Server system has been developed and installed at the Department of Radiology, Georgetown University Medical Center. The main purpose of the system is to provide a service for on-call physicians to view patients' medical images at home during off-hours. This service will reduce the overhead time required by on-call physicians to travel to the hospital, thereby increasing the efficiency of patient care and improving the total quality of the health care. Typically when a new case is conducted, the medical images generated from CT, US, and/or MRI modalities are transferred to a central server at the hospital via DICOM messages over an existing hospital network. The server has a DICOM network agent that listens to DICOM messages sent by CT, US, and MRI modalities and stores them into separate DICOM files for sending purposes. The server also has a general purpose, flexible scheduling software that can be configured to send image files to specific user(s) at certain times on any day(s) of the week. The server will then distribute the medical images to on- call physicians' homes via a high-speed modem. All file transmissions occur in the background without human interaction after the scheduling software is pre-configured accordingly. At the receiving end, the physicians' computers consist of high-end workstations that have high-speed modems to receive the medical images sent by the central server from the hospital, and DICOM compatible viewer software to view the transmitted medical images in DICOM format. A technician from the hospital, and DICOM compatible viewer software to view the transmitted medical images in DICOM format. A technician from the hospital will notify the physician(s) after all the image files have been completely sent. The physician(s) will then examine the medical images and decide if it is necessary to travel to the hospital for further examination on the patients. Overall, the Home Teleradiology system provides the on-call physicians with a cost-effective and convenient environment for viewing patients' medical images at home.

Telemedicine with integrated data security in ATM-based networks

NASA Astrophysics Data System (ADS)

Thiel, Andreas; Bernarding, Johannes; Kurth, Ralf; Wenzel, Rudiger; Villringer, Arno; Tolxdorff, Thomas

1997-05-01

Telemedical services rely on the digital transfer of large amounts of data in a short time. The acceptance of these services requires therefore new hard- and software concepts. The fast exchange of data is well performed within a high- speed ATM-based network. The fast access to the data from different platforms imposes more difficult problems, which may be divided into those relating to standardized data formats and those relating to different levels of data security across nations. For a standardized access to the formats and those relating to different levels of data security across nations. For a standardized access to the image data, a DICOM 3.0 server was implemented.IMages were converted into the DICOM 3.0 standard if necessary. The access to the server is provided by an implementation of DICOM in JAVA allowing access to the data from different platforms. Data protection measures to ensure the secure transfer of sensitive patient data are not yet solved within the DICOM concept. We investigated different schemes to protect data using the DICOM/JAVA modality with as little impact on data transfer speed as possible.

Toward the First Data Acquisition Standard in Synthetic Biology.

PubMed

Sainz de Murieta, Iñaki; Bultelle, Matthieu; Kitney, Richard I

2016-08-19

This paper describes the development of a new data acquisition standard for synthetic biology. This comprises the creation of a methodology that is designed to capture all the data, metadata, and protocol information associated with biopart characterization experiments. The new standard, called DICOM-SB, is based on the highly successful Digital Imaging and Communications in Medicine (DICOM) standard in medicine. A data model is described which has been specifically developed for synthetic biology. The model is a modular, extensible data model for the experimental process, which can optimize data storage for large amounts of data. DICOM-SB also includes services orientated toward the automatic exchange of data and information between modalities and repositories. DICOM-SB has been developed in the context of systematic design in synthetic biology, which is based on the engineering principles of modularity, standardization, and characterization. The systematic design approach utilizes the design, build, test, and learn design cycle paradigm. DICOM-SB has been designed to be compatible with and complementary to other standards in synthetic biology, including SBOL. In this regard, the software provides effective interoperability. The new standard has been tested by experiments and data exchange between Nanyang Technological University in Singapore and Imperial College London.

Lossless compression of grayscale medical images: effectiveness of traditional and state-of-the-art approaches

NASA Astrophysics Data System (ADS)

Clunie, David A.

2000-05-01

Proprietary compression schemes have a cost and risk associated with their support, end of life and interoperability. Standards reduce this cost and risk. The new JPEG-LS process (ISO/IEC 14495-1), and the lossless mode of the proposed JPEG 2000 scheme (ISO/IEC CD15444-1), new standard schemes that may be incorporated into DICOM, are evaluated here. Three thousand, six hundred and seventy-nine (3,679) single frame grayscale images from multiple anatomical regions, modalities and vendors, were tested. For all images combined JPEG-LS and JPEG 2000 performed equally well (3.81), almost as well as CALIC (3.91), a complex predictive scheme used only as a benchmark. Both out-performed existing JPEG (3.04 with optimum predictor choice per image, 2.79 for previous pixel prediction as most commonly used in DICOM). Text dictionary schemes performed poorly (gzip 2.38), as did image dictionary schemes without statistical modeling (PNG 2.76). Proprietary transform based schemes did not perform as well as JPEG-LS or JPEG 2000 (S+P Arithmetic 3.4, CREW 3.56). Stratified by modality, JPEG-LS compressed CT images (4.00), MR (3.59), NM (5.98), US (3.4), IO (2.66), CR (3.64), DX (2.43), and MG (2.62). CALIC always achieved the highest compression except for one modality for which JPEG-LS did better (MG digital vendor A JPEG-LS 4.02, CALIC 4.01). JPEG-LS outperformed existing JPEG for all modalities. The use of standard schemes can achieve state of the art performance, regardless of modality, JPEG-LS is simple, easy to implement, consumes less memory, and is faster than JPEG 2000, though JPEG 2000 will offer lossy and progressive transmission. It is recommended that DICOM add transfer syntaxes for both JPEG-LS and JPEG 2000.

Enterprise-scale image distribution with a Web PACS.

PubMed

Gropper, A; Doyle, S; Dreyer, K

1998-08-01

The integration of images with existing and new health care information systems poses a number of challenges in a multi-facility network: image distribution to clinicians; making DICOM image headers consistent across information systems; and integration of teleradiology into PACS. A novel, Web-based enterprise PACS architecture introduced at Massachusetts General Hospital provides a solution. Four AMICAS Web/Intranet Image Servers were installed as the default DICOM destination of 10 digital modalities. A fifth AMICAS receives teleradiology studies via the Internet. Each AMICAS includes: a Java-based interface to the IDXrad radiology information system (RIS), a DICOM autorouter to tape-library archives and to the Agfa PACS, a wavelet image compressor/decompressor that preserves compatibility with DICOM workstations, a Web server to distribute images throughout the enterprise, and an extensible interface which permits links between other HIS and AMICAS. Using wavelet compression and Internet standards as its native formats, AMICAS creates a bridge to the DICOM networks of remote imaging centers via the Internet. This teleradiology capability is integrated into the DICOM network and the PACS thereby eliminating the need for special teleradiology workstations. AMICAS has been installed at MGH since March of 1997. During that time, it has been a reliable component of the evolving digital image distribution system. As a result, the recently renovated neurosurgical ICU will be filmless and use only AMICAS workstations for mission-critical patient care.

Informatics in radiology: web-based preliminary reporting system for radiology residents with PACS integration.

PubMed

O'Connell, Timothy; Chang, Debra

2012-01-01

While on call, radiology residents review imaging studies and issue preliminary reports to referring clinicians. In the absence of an integrated reporting system at the training sites of the authors' institution, residents were typing and faxing preliminary reports. To partially automate the on-call resident workflow, a Web-based system for resident reporting was developed by using the free open-source xAMP Web application framework and an open-source DICOM (Digital Imaging and Communications in Medicine) software toolkit, with the goals of reducing errors and lowering barriers to education. This reporting system integrates with the picture archiving and communication system to display a worklist of studies. Patient data are automatically entered in the preliminary report to prevent identification errors and simplify the report creation process. When the final report for a resident's on-call study is available, the reporting system queries the report broker for the final report, and then displays the preliminary report side by side with the final report, thus simplifying the review process and encouraging review of all of the resident's reports. The xAMP Web application framework should be considered for development of radiology department informatics projects owing to its zero cost, minimal hardware requirements, ease of programming, and large support community.

An automated DICOM database capable of arbitrary data mining (including radiation dose indicators) for quality monitoring.

PubMed

Wang, Shanshan; Pavlicek, William; Roberts, Catherine C; Langer, Steve G; Zhang, Muhong; Hu, Mengqi; Morin, Richard L; Schueler, Beth A; Wellnitz, Clinton V; Wu, Teresa

2011-04-01

The U.S. National Press has brought to full public discussion concerns regarding the use of medical radiation, specifically x-ray computed tomography (CT), in diagnosis. A need exists for developing methods whereby assurance is given that all diagnostic medical radiation use is properly prescribed, and all patients' radiation exposure is monitored. The "DICOM Index Tracker©" (DIT) transparently captures desired digital imaging and communications in medicine (DICOM) tags from CT, nuclear imaging equipment, and other DICOM devices across an enterprise. Its initial use is recording, monitoring, and providing automatic alerts to medical professionals of excursions beyond internally determined trigger action levels of radiation. A flexible knowledge base, aware of equipment in use, enables automatic alerts to system administrators of newly identified equipment models or software versions so that DIT can be adapted to the new equipment or software. A dosimetry module accepts mammography breast organ dose, skin air kerma values from XA modalities, exposure indices from computed radiography, etc. upon receipt. The American Association of Physicists in Medicine recommended a methodology for effective dose calculations which are performed with CT units having DICOM structured dose reports. Web interface reporting is provided for accessing the database in real-time. DIT is DICOM-compliant and, thus, is standardized for international comparisons. Automatic alerts currently in use include: email, cell phone text message, and internal pager text messaging. This system extends the utility of DICOM for standardizing the capturing and computing of radiation dose as well as other quality measures.

Automated DICOM metadata and volumetric anatomical information extraction for radiation dosimetry

NASA Astrophysics Data System (ADS)

Papamichail, D.; Ploussi, A.; Kordolaimi, S.; Karavasilis, E.; Papadimitroulas, P.; Syrgiamiotis, V.; Efstathopoulos, E.

2015-09-01

Patient-specific dosimetry calculations based on simulation techniques have as a prerequisite the modeling of the modality system and the creation of voxelized phantoms. This procedure requires the knowledge of scanning parameters and patients’ information included in a DICOM file as well as image segmentation. However, the extraction of this information is complicated and time-consuming. The objective of this study was to develop a simple graphical user interface (GUI) to (i) automatically extract metadata from every slice image of a DICOM file in a single query and (ii) interactively specify the regions of interest (ROI) without explicit access to the radiology information system. The user-friendly application developed in Matlab environment. The user can select a series of DICOM files and manage their text and graphical data. The metadata are automatically formatted and presented to the user as a Microsoft Excel file. The volumetric maps are formed by interactively specifying the ROIs and by assigning a specific value in every ROI. The result is stored in DICOM format, for data and trend analysis. The developed GUI is easy, fast and and constitutes a very useful tool for individualized dosimetry. One of the future goals is to incorporate a remote access to a PACS server functionality.

Informatics in radiology (infoRAD): free DICOM image viewing and processing software for the Macintosh computer: what's available and what it can do for you.

PubMed

Escott, Edward J; Rubinstein, David

2004-01-01

It is often necessary for radiologists to use digital images in presentations and conferences. Most imaging modalities produce images in the Digital Imaging and Communications in Medicine (DICOM) format. The image files tend to be large and thus cannot be directly imported into most presentation software, such as Microsoft PowerPoint; the large files also consume storage space. There are many free programs that allow viewing and processing of these files on a personal computer, including conversion to more common file formats such as the Joint Photographic Experts Group (JPEG) format. Free DICOM image viewing and processing software for computers running on the Microsoft Windows operating system has already been evaluated. However, many people use the Macintosh (Apple Computer) platform, and a number of programs are available for these users. The World Wide Web was searched for free DICOM image viewing or processing software that was designed for the Macintosh platform or is written in Java and is therefore platform independent. The features of these programs and their usability were evaluated. There are many free programs for the Macintosh platform that enable viewing and processing of DICOM images. (c) RSNA, 2004.

DICOM Data Warehouse: Part 2.

PubMed

Langer, Steve G

2016-06-01

In 2010, the DICOM Data Warehouse (DDW) was launched as a data warehouse for DICOM meta-data. Its chief design goals were to have a flexible database schema that enabled it to index standard patient and study information, modality specific tags (public and private), and create a framework to derive computable information (derived tags) from the former items. Furthermore, it was to map the above information to an internally standard lexicon that enables a non-DICOM savvy programmer to write standard SQL queries and retrieve the equivalent data from a cohort of scanners, regardless of what tag that data element was found in over the changing epochs of DICOM and ensuing migration of elements from private to public tags. After 5 years, the original design has scaled astonishingly well. Very little has changed in the database schema. The knowledge base is now fluent in over 90 device types. Also, additional stored procedures have been written to compute data that is derivable from standard or mapped tags. Finally, an early concern is that the system would not be able to address the variability DICOM-SR objects has been addressed. As of this writing the system is indexing 300 MR, 600 CT, and 2000 other (XA, DR, CR, MG) imaging studies per day. The only remaining issue to be solved is the case for tags that were not prospectively indexed-and indeed, this final challenge may lead to a noSQL, big data, approach in a subsequent version.

Using IHE and HL7 conformance to specify consistent PACS interoperability for a large multi-center enterprise.

PubMed

Henderson, Michael L; Dayhoff, Ruth E; Titton, Csaba P; Casertano, Andrew

2006-01-01

As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic imaging procedures at 141 medical centers and 850 outpatient clinics. VHA's VistA Imaging Package provides a full archival, display, and communications infrastructure and interfaces to radiology and other HIS modules as well as modalities and a worklist provider In addition, various medical center entities within VHA have elected to install commercial picture archiving and communications systems to enable image organization and interpretation. To evaluate interfaces between commercial PACS, the VistA hospital information system, and imaging modalities, VHA has built a fully constrained specification that is based on the Radiology Technical Framework (Rad-TF) Integrating the Healthcare Enterprise. The Health Level Seven normative conformance mechanism was applied to the IHE Rad-TF and agency requirements to arrive at a baseline set of message specifications. VHA provides a thorough implementation and testing process to promote the adoption of standards-based interoperability by all PACS vendors that want to interface with VistA Imaging.

Dose Monitoring in Radiology Departments: Status Quo and Future Perspectives.

PubMed

Boos, J; Meineke, A; Bethge, O T; Antoch, G; Kröpil, P

2016-05-01

The number of computed tomography examinations has continuously increased over the last decades and accounts for a major part of the collective radiation dose from medical investigations. For purposes of quality assurance in modern radiology a systematic monitoring and analysis of dose related data from radiological examinations is mandatory. Various ways of collecting dose data are available today, for example the Digital Imaging and Communication in Medicine - Structured Report (DICOM-SR), optical character recognition and DICOM-modality performed procedure steps (MPPS). The DICOM-SR is part of the DICOM-standard and provides the DICOM-Radiation Dose Structured Report, which is an easily applicable and comprehensive solution to collect radiation dose parameters. This standard simplifies the process of data collection and enables comprehensive dose monitoring. Various commercial dose monitoring software devices with varying characteristics are available today. In this article, we discuss legal obligations, various ways to monitor dose data, current dose monitoring software solutions and future perspectives in regard to the EU Council Directive 2013/59/EURATOM. • Automated, systematic dose monitoring is an important element in quality assurance of radiology departments. • DICOM-RDSR-capable CT scanners facilitate the monitoring of dose data. • A variety of commercial and non-commercial dose monitoring software tools are available today. • Successful dose monitoring requires comprehensive infrastructure for monitoring, analysing and optimizing radiation exposure. Citation Format: • Boos J, Meineke A, Bethge OT et al. Dose Monitoring in Radiology Departments: Status Quo and Future Perspectives. Fortschr Röntgenstr 2016; 188: 443 - 450. © Georg Thieme Verlag KG Stuttgart · New York.

Poster - Thur Eve - 77: Coordinate transformation from DICOM to DOSXYZnrc.

PubMed

Zhan, L; Jiang, R; Osei, E K

2012-07-01

DICOM format is the de facto standard for communications between therapeutic and diagnostic modalities. A plan generated by a treatment planning system (TPS) is often exported to DICOM format. BEAMnrc/DOSXYZnrc is a widely used Monte Carlo (MC) package for beam and dose simulations in radiotherapy. It has its own definition for beam orientation, which is not in compliance with the one defined in DICOM standard. Dose simulations using TPS generated plans require transformation of beam orientations to DOSXYZnrc coordinate system (c.s.) after extracting the necessary parameters from DICOM RP files. The transformation is nontrivial. There have been two studies for the coordinate transformations. The transformation equation sets derived have been helpful to BEAMnrc/DOSXYZnrc users. However, both the transformation equation sets are complex mathematically and not easy to program. In this study, we derive a new set of transformation equations, which are more compact, better understandable, and easier for computational implementation. The derivation of polar angle θ and azimuthal angle φ is similar to the existing studies by applying a series of rotations to a vector in DICOM patient c.s. The derivation of beam rotation Φ col for DOSXYZnrc, however, is different. It is obtained by a direct combination of the actual collimator rotation with the projection of the couch rotation to the collimator rotating plane. Verification of the transformation has been performed using clinical plans created with Eclipse. The comparison between Eclipse and MC results show exact geometrical agreement for field placements, together with good agreement in dose distributions. © 2012 American Association of Physicists in Medicine.

De-identification of Medical Images with Retention of Scientific Research Value

PubMed Central

Maffitt, David R.; Smith, Kirk E.; Kirby, Justin S.; Clark, Kenneth W.; Freymann, John B.; Vendt, Bruce A.; Tarbox, Lawrence R.; Prior, Fred W.

2015-01-01

Online public repositories for sharing research data allow investigators to validate existing research or perform secondary research without the expense of collecting new data. Patient data made publicly available through such repositories may constitute a breach of personally identifiable information if not properly de-identified. Imaging data are especially at risk because some intricacies of the Digital Imaging and Communications in Medicine (DICOM) format are not widely understood by researchers. If imaging data still containing protected health information (PHI) were released through a public repository, a number of different parties could be held liable, including the original researcher who collected and submitted the data, the original researcher’s institution, and the organization managing the repository. To minimize these risks through proper de-identification of image data, one must understand what PHI exists and where that PHI resides, and one must have the tools to remove PHI without compromising the scientific integrity of the data. DICOM public elements are defined by the DICOM Standard. Modality vendors use private elements to encode acquisition parameters that are not yet defined by the DICOM Standard, or the vendor may not have updated an existing software product after DICOM defined new public elements. Because private elements are not standardized, a common de-identification practice is to delete all private elements, removing scientifically useful data as well as PHI. Researchers and publishers of imaging data can use the tools and process described in this article to de-identify DICOM images according to current best practices. ©RSNA, 2015 PMID:25969931

Informatics in radiology: use of CouchDB for document-based storage of DICOM objects.

PubMed

Rascovsky, Simón J; Delgado, Jorge A; Sanz, Alexander; Calvo, Víctor D; Castrillón, Gabriel

2012-01-01

Picture archiving and communication systems traditionally have depended on schema-based Structured Query Language (SQL) databases for imaging data management. To optimize database size and performance, many such systems store a reduced set of Digital Imaging and Communications in Medicine (DICOM) metadata, discarding informational content that might be needed in the future. As an alternative to traditional database systems, document-based key-value stores recently have gained popularity. These systems store documents containing key-value pairs that facilitate data searches without predefined schemas. Document-based key-value stores are especially suited to archive DICOM objects because DICOM metadata are highly heterogeneous collections of tag-value pairs conveying specific information about imaging modalities, acquisition protocols, and vendor-supported postprocessing options. The authors used an open-source document-based database management system (Apache CouchDB) to create and test two such databases; CouchDB was selected for its overall ease of use, capability for managing attachments, and reliance on HTTP and Representational State Transfer standards for accessing and retrieving data. A large database was created first in which the DICOM metadata from 5880 anonymized magnetic resonance imaging studies (1,949,753 images) were loaded by using a Ruby script. To provide the usual DICOM query functionality, several predefined "views" (standard queries) were created by using JavaScript. For performance comparison, the same queries were executed in both the CouchDB database and a SQL-based DICOM archive. The capabilities of CouchDB for attachment management and database replication were separately assessed in tests of a similar, smaller database. Results showed that CouchDB allowed efficient storage and interrogation of all DICOM objects; with the use of information retrieval algorithms such as map-reduce, all the DICOM metadata stored in the large database were searchable with only a minimal increase in retrieval time over that with the traditional database management system. Results also indicated possible uses for document-based databases in data mining applications such as dose monitoring, quality assurance, and protocol optimization. RSNA, 2012

Providing integrity, authenticity, and confidentiality for header and pixel data of DICOM images.

PubMed

Al-Haj, Ali

2015-04-01

Exchange of medical images over public networks is subjected to different types of security threats. This has triggered persisting demands for secured telemedicine implementations that will provide confidentiality, authenticity, and integrity for the transmitted images. The medical image exchange standard (DICOM) offers mechanisms to provide confidentiality for the header data of the image but not for the pixel data. On the other hand, it offers mechanisms to achieve authenticity and integrity for the pixel data but not for the header data. In this paper, we propose a crypto-based algorithm that provides confidentially, authenticity, and integrity for the pixel data, as well as for the header data. This is achieved by applying strong cryptographic primitives utilizing internally generated security data, such as encryption keys, hashing codes, and digital signatures. The security data are generated internally from the header and the pixel data, thus a strong bond is established between the DICOM data and the corresponding security data. The proposed algorithm has been evaluated extensively using DICOM images of different modalities. Simulation experiments show that confidentiality, authenticity, and integrity have been achieved as reflected by the results we obtained for normalized correlation, entropy, PSNR, histogram analysis, and robustness.

Image storage in radiation oncology: What did we learn from diagnostic radiology?

NASA Astrophysics Data System (ADS)

Blodgett, Kurt; Luick, Marc; Colonias, Athanasios; Gayou, Olivier; Karlovits, Stephen; Werts, E. Day

2009-02-01

The Digital Imaging and Communications in Medicine (DICOM) standard was developed by the National Electrical Manufacturers Association (NEMA) and the American College of Radiology (ACR) for medical image archiving and retrieval. An extension to this implemented a standard named DICOM-RT for use in Radiation Oncology. There are currently seven radiotherapy-specific DICOM objects which include: RT Structure Set, RT Plan, RT Dose, RT Image, RT Beams Treatment Record, RT Brachy Treatment Record, and RT Treatment Summary Record. The type of data associated with DICOM-RT includes (1) Radiation treatment planning datasets (CT, MRI, PET) with radiation treatment plans showing beam arrangements, isodose distributions, and dose volume histograms of targets/normal tissues and (2) Image-guided radiation modalities such as Siemens MVision mega-voltage cone beam CT (MV-CBCT). With the advent of such advancing technologies, there has been an exponential increase in image data collected for each patient, and the need for reliable and accessible image storage has become critical. A potential solution is a Radiation Oncology specific picture archiving and communication systems (PACS) that would allow data storage from multiple vendor devices and support the storage and retrieval needs not only of a single site but of a large, multi-facility network of radiation oncology clinics. This PACS system must be reliable, expandable, and cost-effective to operate while protecting sensitive patient image information in a Health Insurance Portability and Accountability Act (HIPAA) compliant environment. This paper emphasizes the expanding DICOM-RT storage requirements across our network of 8 radiation oncology clinics and the initiatives we undertook to address the increased volume of data by using the ImageGrid (CANDELiS Inc, Irvine CA) server and the IGViewer license (CANDELiS Inc, Irvine CA) to create a DICOM-RT compatible PACS system.

A DICOM-RT radiation oncology ePR with decision support utilizing a quantified knowledge base from historical data

NASA Astrophysics Data System (ADS)

Documet, Jorge R.; Liu, Brent; Le, Anh; Law, Maria

2008-03-01

During the last 2 years we have been working on developing a DICOM-RT (Radiation Therapy) ePR (Electronic Patient Record) with decision support that will allow physicists and radiation oncologists during their decision-making process. This ePR allows offline treatment dose calculations and plan evaluation, while at the same time it compares and quantifies treatment planning algorithms using DICOM-RT objects. The ePR framework permits the addition of visualization, processing, and analysis tools, which combined with the core functionality of reporting, importing and exporting of medical studies, creates a very powerful application that can improve the efficiency while planning cancer treatments. Usually a Radiation Oncology department will have disparate and complex data generated by the RT modalities as well as data scattered in RT Information/Management systems, Record & Verify systems, and Treatment Planning Systems (TPS) which can compromise the efficiency of the clinical workflow since the data crucial for a clinical decision may be time-consuming to retrieve, temporarily missing, or even lost. To address these shortcomings, the ACR-NEMA Standards Committee extended its DICOM (Digital Imaging & Communications in Medicine) standard from Radiology to RT by ratifying seven DICOM RT objects starting in 1997 [1,2]. However, they are not broadly used yet by the RT community in daily clinical operations. In the past, the research focus of an RT department has primarily been developing new protocols and devices to improve treatment process and outcomes of cancer patients with minimal effort dedicated to integration of imaging and information systems. Our attempt is to show a proof-of-concept that a DICOM-RT ePR system can be developed as a foundation to perform medical imaging informatics research in developing decision-support tools and knowledge base for future data mining applications.

Beam coordinate transformations from DICOM to DOSXYZnrc

NASA Astrophysics Data System (ADS)

Zhan, Lixin; Jiang, Runqing; Osei, Ernest K.

2012-12-01

Digital imaging and communications in medicine (DICOM) format is the de facto standard for communications between therapeutic and diagnostic modalities. A plan generated by a treatment planning system (TPS) is often exported in DICOM format. BEAMnrc/DOSXYZnrc is a widely used Monte Carlo (MC) package for modelling the Linac head and simulating dose delivery in radiotherapy. It has its own definition of beam orientation, which is not in compliance with the one defined in the DICOM standard. MC dose calculations using information from TPS generated plans require transformation of beam orientations to the DOSXYZnrc coordinate system (c.s.) and the transformation is non-trivial. There have been two studies on the coordinate transformations. The transformation equation sets derived have been helpful to BEAMnrc/DOSXYZnrc users. However, the transformation equation sets are complex mathematically and not easy to program. In this study, we derive a new set of transformation equations, which are more compact, easily understandable, and easier for computational implementation. The derivation of the polar angle θ and the azimuthal angle φ used by DOSXYZnrc is similar to the existing studies by applying a series of rotations to a vector in DICOM patient c.s. The derivation of the beam rotation ϕcol for DOSXYZnrc, however, is different. It is obtained by a direct combination of the actual collimator rotation with the projection of the couch rotation to the collimator rotating plane. Verification of the transformation has been performed using clinical plans. The comparisons between TPS and MC results show very good geometrical agreement for field placements, together with good agreement in dose distributions.

Indexing and retrieving DICOM data in disperse and unstructured archives.

PubMed

Costa, Carlos; Freitas, Filipe; Pereira, Marco; Silva, Augusto; Oliveira, José L

2009-01-01

This paper proposes an indexing and retrieval solution to gather information from distributed DICOM documents by allowing searches and access to the virtual data repository using a Google-like process. The medical imaging modalities are becoming more powerful and less expensive. The result is the proliferation of equipment acquisition by imaging centers, including the small ones. With this dispersion of data, it is not easy to take advantage of all the information that can be retrieved from these studies. Furthermore, many of these small centers do not have large enough requirements to justify the acquisition of a traditional PACS. A peer-to-peer PACS platform to index and query DICOM files over a set of distributed repositories that are logically viewed as a single federated unit. The solution is based on a public domain document-indexing engine and extends traditional PACS query and retrieval mechanisms. This proposal deals well with complex searching requirements, from a single desktop environment to distributed scenarios. The solution performance and robustness were demonstrated in trials. The characteristics of presented PACS platform make it particularly important for small institutions, including educational and research groups.

Enterprise-class Digital Imaging and Communications in Medicine (DICOM) image infrastructure.

PubMed

York, G; Wortmann, J; Atanasiu, R

2001-06-01

Most current picture archiving and communication systems (PACS) are designed for a single department or a single modality. Few PACS installations have been deployed that support the needs of the hospital or the entire Integrated Delivery Network (IDN). The authors propose a new image management architecture that can support a large, distributed enterprise.

DICOM implementation on online tape library storage system

NASA Astrophysics Data System (ADS)

Komo, Darmadi; Dai, Hailei L.; Elghammer, David; Levine, Betty A.; Mun, Seong K.

1998-07-01

The main purpose of this project is to implement a Digital Image and Communications (DICOM) compliant online tape library system over the Internet. Once finished, the system will be used to store medical exams generated from U.S. ARMY Mobile ARMY Surgical Hospital (MASH) in Tuzla, Bosnia. A modified UC Davis implementation of DICOM storage class is used for this project. DICOM storage class user and provider are implemented as the system's interface to the Internet. The DICOM software provides flexible configuration options such as types of modalities and trusted remote DICOM hosts. Metadata is extracted from each exam and indexed in a relational database for query and retrieve purposes. The medical images are stored inside the Wolfcreek-9360 tape library system from StorageTek Corporation. The tape library system has nearline access to more than 1000 tapes. Each tape has a capacity of 800 megabytes making the total nearline tape access of around 1 terabyte. The tape library uses the Application Storage Manager (ASM) which provides cost-effective file management, storage, archival, and retrieval services. ASM automatically and transparently copies files from expensive magnetic disk to less expensive nearline tape library, and restores the files back when they are needed. The ASM also provides a crash recovery tool, which enable an entire file system restore in a short time. A graphical user interface (GUI) function is used to view the contents of the storage systems. This GUI also allows user to retrieve the stored exams and send the exams to anywhere on the Internet using DICOM protocols. With the integration of different components of the system, we have implemented a high capacity online tape library storage system that is flexible and easy to use. Using tape as an alternative storage media as opposed to the magnetic disk has the great potential of cost savings in terms of dollars per megabyte of storage. As this system matures, the Hospital Information Systems/Radiology Information Systems (HIS/RIS) or other components can be developed potentially as interfaces to the outside world thus widen the usage of the tape library system.

Interpretation of the rainbow color scale for quantitative medical imaging: perceptually linear color calibration (CSDF) versus DICOM GSDF

NASA Astrophysics Data System (ADS)

Chesterman, Frédérique; Manssens, Hannah; Morel, Céline; Serrell, Guillaume; Piepers, Bastian; Kimpe, Tom

2017-03-01

Medical displays for primary diagnosis are calibrated to the DICOM GSDF1 but there is no accepted standard today that describes how display systems for medical modalities involving color should be calibrated. Recently the Color Standard Display Function3,4 (CSDF), a calibration using the CIEDE2000 color difference metric to make a display as perceptually linear as possible has been proposed. In this work we present the results of a first observer study set up to investigate the interpretation accuracy of a rainbow color scale when a medical display is calibrated to CSDF versus DICOM GSDF and a second observer study set up to investigate the detectability of color differences when a medical display is calibrated to CSDF, DICOM GSDF and sRGB. The results of the first study indicate that the error when interpreting a rainbow color scale is lower for CSDF than for DICOM GSDF with statistically significant difference (Mann-Whitney U test) for eight out of twelve observers. The results correspond to what is expected based on CIEDE2000 color differences between consecutive colors along the rainbow color scale for both calibrations. The results of the second study indicate a statistical significant improvement in detecting color differences when a display is calibrated to CSDF compared to DICOM GSDF and a (non-significant) trend indicating improved detection for CSDF compared to sRGB. To our knowledge this is the first work that shows the added value of a perceptual color calibration method (CSDF) in interpreting medical color images using the rainbow color scale. Improved interpretation of the rainbow color scale may be beneficial in the area of quantitative medical imaging (e.g. PET SUV, quantitative MRI and CT and doppler US), where a medical specialist needs to interpret quantitative medical data based on a color scale and/or detect subtle color differences and where improved interpretation accuracy and improved detection of color differences may contribute to a better diagnosis. Our results indicate that for diagnostic applications involving both grayscale and color images, CSDF should be chosen over DICOM GSDF and sRGB as it assures excellent detection for color images and at the same time maintains DICOM GSDF for grayscale images.

DICOM image secure communications with Internet protocols IPv6 and IPv4.

PubMed

Zhang, Jianguo; Yu, Fenghai; Sun, Jianyong; Yang, Yuanyuan; Liang, Chenwen

2007-01-01

Image-data transmission from one site to another through public network is usually characterized in term of privacy, authenticity, and integrity. In this paper, we first describe a general scenario about how image is delivered from one site to another through a wide-area network (WAN) with security features of data privacy, integrity, and authenticity. Second, we give the common implementation method of the digital imaging and communication in medicine (DICOM) image communication software library with IPv6/IPv4 for high-speed broadband Internet by using open-source software. Third, we discuss two major security-transmission methods, the IP security (IPSec) and the secure-socket layer (SSL) or transport-layer security (TLS), being used currently in medical-image-data communication with privacy support. Fourth, we describe a test schema of multiple-modality DICOM-image communications through TCP/IPv4 and TCP/IPv6 with different security methods, different security algorithms, and operating systems, and evaluate the test results. We found that there are tradeoff factors between choosing the IPsec and the SSL/TLS-based security implementation of IPv6/IPv4 protocols. If the WAN networks only use IPv6 such as in high-speed broadband Internet, the choice is IPsec-based security. If the networks are IPv4 or the combination of IPv6 and IPv4, it is better to use SSL/TLS security. The Linux platform has more security algorithms implemented than the Windows (XP) platform, and can achieve better performance in most experiments of IPv6 and IPv4-based DICOM-image communications. In teleradiology or enterprise-PACS applications, the Linux operating system may be the better choice as peer security gateways for both the IPsec and the SSL/TLS-based secure DICOM communications cross public networks.

Integrating research and clinical neuroimaging for the evaluation of traumatic brain injury recovery

NASA Astrophysics Data System (ADS)

Senseney, Justin; Ollinger, John; Graner, John; Lui, Wei; Oakes, Terry; Riedy, Gerard

2015-03-01

Advanced MRI research and other imaging modalities may serve as biomarkers for the evaluation of traumatic brain injury (TBI) recovery. However, these advanced modalities typically require off-line processing which creates images that are incompatible with radiologist viewing software sold commercially. AGFA Impax is an example of such a picture archiving and communication system(PACS) that is used by many radiology departments in the United States Military Health System. By taking advantage of Impax's use of the Digital Imaging and Communications in Medicine (DICOM) standard, we developed a system that allows for advanced medical imaging to be incorporated into clinical PACS. Radiology research can now be conducted using existing clinical imaging display platforms resources in combination with image processingtechniques that are only available outside of the clinical scanning environment. We extracted the spatial and identification elements of theDICOM standard that are necessary to allow research images to be incorporatedinto a clinical radiology system, and developed a tool that annotates research images with the proper tags. This allows for the evaluation of imaging representations of biological markers that may be useful in theevaluation of TBI and TBI recovery.

Paperless protocoling of CT and MRI requests at an outpatient imaging center.

PubMed

Bassignani, Matthew J; Dierolf, David A; Roberts, David L; Lee, Steven

2010-04-01

We created our imaging center (IC) to move outpatient imaging from our busy inpatient imaging suite off-site to a location that is more inviting to ambulatory patients. Nevertheless, patients scanned at our IC still represent the depth and breadth of illness complexity seen with our tertiary care population. Thus, we protocol exams on an individualized basis to ensure that the referring clinician's question is fully answered by the exam performed. Previously, paper based protocoling was a laborious process for all those involved where the IC business office would fax the requests to various reading rooms for protocoling by the subspecialist radiologists who are 3 miles away at the main hospital. Once protocoled, reading room coordinators would fax back the protocoled request to the IC technical area in preparation for the next day's scheduled exams. At any breakdown in this process (e.g., lost paperwork), patient exams were delayed and clinicians and patients became upset. To improve this process, we developed a paper free process whereby protocoling is accomplished through scanning of exam requests into our PACS. Using the common worklist functionality found in most PACS, we created "protocoling worklists" that contain these scanned documents. Radiologists protocol these studies in the PACS worklist (with the added benefit of having all imaging and report data available), and subsequently, the technologists can see and act on the protocols they find in PACS. This process has significantly decreased interruptions in our busy reading rooms and decreased rework of IC staff.

Overview of PACS

NASA Astrophysics Data System (ADS)

Vanden Brink, John A.

1995-08-01

Development of the DICOM standard and incremental developments in workstation, network, compression, archiving, and digital x-ray technology have produced cost effective image communication possibilities for selected medical applications. The emerging markets include modality PACS, mini PACS, and teleradiology. Military and VA programs lead the way in the move to adopt PACS technology. Commercial markets for PACS components and PAC systems are at LR400 million growing to LR500 million in 1996.

Integration of XNAT/PACS, DICOM, and Research Software for Automated Multi-modal Image Analysis.

PubMed

Gao, Yurui; Burns, Scott S; Lauzon, Carolyn B; Fong, Andrew E; James, Terry A; Lubar, Joel F; Thatcher, Robert W; Twillie, David A; Wirt, Michael D; Zola, Marc A; Logan, Bret W; Anderson, Adam W; Landman, Bennett A

2013-03-29

Traumatic brain injury (TBI) is an increasingly important public health concern. While there are several promising avenues of intervention, clinical assessments are relatively coarse and comparative quantitative analysis is an emerging field. Imaging data provide potentially useful information for evaluating TBI across functional, structural, and microstructural phenotypes. Integration and management of disparate data types are major obstacles. In a multi-institution collaboration, we are collecting electroencephalogy (EEG), structural MRI, diffusion tensor MRI (DTI), and single photon emission computed tomography (SPECT) from a large cohort of US Army service members exposed to mild or moderate TBI who are undergoing experimental treatment. We have constructed a robust informatics backbone for this project centered on the DICOM standard and eXtensible Neuroimaging Archive Toolkit (XNAT) server. Herein, we discuss (1) optimization of data transmission, validation and storage, (2) quality assurance and workflow management, and (3) integration of high performance computing with research software.

Integration of XNAT/PACS, DICOM, and research software for automated multi-modal image analysis

NASA Astrophysics Data System (ADS)

Gao, Yurui; Burns, Scott S.; Lauzon, Carolyn B.; Fong, Andrew E.; James, Terry A.; Lubar, Joel F.; Thatcher, Robert W.; Twillie, David A.; Wirt, Michael D.; Zola, Marc A.; Logan, Bret W.; Anderson, Adam W.; Landman, Bennett A.

2013-03-01

Traumatic brain injury (TBI) is an increasingly important public health concern. While there are several promising avenues of intervention, clinical assessments are relatively coarse and comparative quantitative analysis is an emerging field. Imaging data provide potentially useful information for evaluating TBI across functional, structural, and microstructural phenotypes. Integration and management of disparate data types are major obstacles. In a multi-institution collaboration, we are collecting electroencephalogy (EEG), structural MRI, diffusion tensor MRI (DTI), and single photon emission computed tomography (SPECT) from a large cohort of US Army service members exposed to mild or moderate TBI who are undergoing experimental treatment. We have constructed a robust informatics backbone for this project centered on the DICOM standard and eXtensible Neuroimaging Archive Toolkit (XNAT) server. Herein, we discuss (1) optimization of data transmission, validation and storage, (2) quality assurance and workflow management, and (3) integration of high performance computing with research software.

Integration of XNAT/PACS, DICOM, and Research Software for Automated Multi-modal Image Analysis

PubMed Central

Gao, Yurui; Burns, Scott S.; Lauzon, Carolyn B.; Fong, Andrew E.; James, Terry A.; Lubar, Joel F.; Thatcher, Robert W.; Twillie, David A.; Wirt, Michael D.; Zola, Marc A.; Logan, Bret W.; Anderson, Adam W.; Landman, Bennett A.

2013-01-01

Traumatic brain injury (TBI) is an increasingly important public health concern. While there are several promising avenues of intervention, clinical assessments are relatively coarse and comparative quantitative analysis is an emerging field. Imaging data provide potentially useful information for evaluating TBI across functional, structural, and microstructural phenotypes. Integration and management of disparate data types are major obstacles. In a multi-institution collaboration, we are collecting electroencephalogy (EEG), structural MRI, diffusion tensor MRI (DTI), and single photon emission computed tomography (SPECT) from a large cohort of US Army service members exposed to mild or moderate TBI who are undergoing experimental treatment. We have constructed a robust informatics backbone for this project centered on the DICOM standard and eXtensible Neuroimaging Archive Toolkit (XNAT) server. Herein, we discuss (1) optimization of data transmission, validation and storage, (2) quality assurance and workflow management, and (3) integration of high performance computing with research software. PMID:24386548

A DICOM-based 2nd generation Molecular Imaging Data Grid implementing the IHE XDS-i integration profile.

PubMed

Lee, Jasper; Zhang, Jianguo; Park, Ryan; Dagliyan, Grant; Liu, Brent; Huang, H K

2012-07-01

A Molecular Imaging Data Grid (MIDG) was developed to address current informatics challenges in archival, sharing, search, and distribution of preclinical imaging studies between animal imaging facilities and investigator sites. This manuscript presents a 2nd generation MIDG replacing the Globus Toolkit with a new system architecture that implements the IHE XDS-i integration profile. Implementation and evaluation were conducted using a 3-site interdisciplinary test-bed at the University of Southern California. The 2nd generation MIDG design architecture replaces the initial design's Globus Toolkit with dedicated web services and XML-based messaging for dedicated management and delivery of multi-modality DICOM imaging datasets. The Cross-enterprise Document Sharing for Imaging (XDS-i) integration profile from the field of enterprise radiology informatics was adopted into the MIDG design because streamlined image registration, management, and distribution dataflow are likewise needed in preclinical imaging informatics systems as in enterprise PACS application. Implementation of the MIDG is demonstrated at the University of Southern California Molecular Imaging Center (MIC) and two other sites with specified hardware, software, and network bandwidth. Evaluation of the MIDG involves data upload, download, and fault-tolerance testing scenarios using multi-modality animal imaging datasets collected at the USC Molecular Imaging Center. The upload, download, and fault-tolerance tests of the MIDG were performed multiple times using 12 collected animal study datasets. Upload and download times demonstrated reproducibility and improved real-world performance. Fault-tolerance tests showed that automated failover between Grid Node Servers has minimal impact on normal download times. Building upon the 1st generation concepts and experiences, the 2nd generation MIDG system improves accessibility of disparate animal-model molecular imaging datasets to users outside a molecular imaging facility's LAN using a new architecture, dataflow, and dedicated DICOM-based management web services. Productivity and efficiency of preclinical research for translational sciences investigators has been further streamlined for multi-center study data registration, management, and distribution.

Performance and function of a high-speed multiple star topology image management system at Mayo Clinic Scottsdale.

PubMed

Pavlicek, W; Zavalkovskiy, B; Eversman, W G

1999-05-01

Mayo Clinic Scottsdale (MCS) is a busy outpatient facility (150,000 examinations per year) connected via asynchronous transfer mode (ATM; OC-3 155 MB/s) to a new Mayo Clinic Hospital (178 beds) located more than 12 miles distant. A primary care facility staffed by radiology lies roughly halfway between the hospital and clinic connected to both. Installed at each of the three locations is a high-speed star topology image network providing direct fiber connection (160 MB/s) from the local image storage unit (ISU) to the local radiology and clinical workstations. The clinic has 22 workstations in its star, the hospital has 13, and the primary care practice has two. In response to Mayo's request for a seamless service among the three locations, the vendor (GE Medical Systems, Milwaukee, WI) provided enhanced connectivity capability in a two-step process. First, a transfer gateway (TGW) was installed, tested, and implemented to provide the needed communication of the examinations generated at the three sites. Any examinations generated at either the hospital or the primary care facility (specified as the remote stars) automatically transfer their images to the ISU at the clinic. Permanent storage (Kodak optical jukebox, Rochester, NY) is only connected to the hub (Clinic) star. Thus, the hub ISU is provided with a copy of all examinations, while the two remote ISUs maintain local exams. Prefetching from the archive is intelligently accomplished during the off hours only to the hub star, thus providing the remote stars with network dependent access to comparison images. Image transfer is possible via remote log-on. The second step was the installation of an image transfer server (ITS) to replace the slower Digital Imaging and Communications in Medicine (DICOM)-based TGW, and a central higher performance database to replace the multiple database environment. This topology provides an enterprise view of the images at the three locations, while maintaining the high-speed performance of the local star connection to what is now called the short-term storage (STS). Performance was measured and 25 chest examinations (17 MB each) transferred in just over 4 minutes. Integration of the radiology information management system (RIMS) was modified to provide location-specific report and examination interfaces, thereby allowing local filtering of the worklist to remote and near real-time consultation, and remote examination monitoring of modalities are addressed with this technologic approach. The installation of the single database ITS environment has occurred for testing prior to implementation.

Content-based image retrieval in medical applications for picture archiving and communication systems

NASA Astrophysics Data System (ADS)

Lehmann, Thomas M.; Guld, Mark O.; Thies, Christian; Fischer, Benedikt; Keysers, Daniel; Kohnen, Michael; Schubert, Henning; Wein, Berthold B.

2003-05-01

Picture archiving and communication systems (PACS) aim to efficiently provide the radiologists with all images in a suitable quality for diagnosis. Modern standards for digital imaging and communication in medicine (DICOM) comprise alphanumerical descriptions of study, patient, and technical parameters. Currently, this is the only information used to select relevant images within PACS. Since textual descriptions insufficiently describe the great variety of details in medical images, content-based image retrieval (CBIR) is expected to have a strong impact when integrated into PACS. However, existing CBIR approaches usually are limited to a distinct modality, organ, or diagnostic study. In this state-of-the-art report, we present first results implementing a general approach to content-based image retrieval in medical applications (IRMA) and discuss its integration into PACS environments. Usually, a PACS consists of a DICOM image server and several DICOM-compliant workstations, which are used by radiologists for reading the images and reporting the findings. Basic IRMA components are the relational database, the scheduler, and the web server, which all may be installed on the DICOM image server, and the IRMA daemons running on distributed machines, e.g., the radiologists" workstations. These workstations can also host the web-based front-ends of IRMA applications. Integrating CBIR and PACS, a special focus is put on (a) location and access transparency for data, methods, and experiments, (b) replication transparency for methods in development, (c) concurrency transparency for job processing and feature extraction, (d) system transparency at method implementation time, and (e) job distribution transparency when issuing a query. Transparent integration will have a certain impact on diagnostic quality supporting both evidence-based medicine and case-based reasoning.

Integration, acceptance testing, and clinical operation of the Medical Information, Communication and Archive System, phase II.

PubMed

Smith, E M; Wandtke, J; Robinson, A

1999-05-01

The Medical Information, Communication and Archive System (MICAS) is a multivendor incremental approach to picture archiving and communications system (PACS). It is a multimodality integrated image management system that is seamlessly integrated with the radiology information system (RIS). Phase II enhancements of MICAS include a permanent archive, automated workflow, study caches, Microsoft (Redmond, WA) Windows NT diagnostic workstations with all components adhering to Digital Information Communications in Medicine (DICOM) standards. MICAS is designed as an enterprise-wide PACS to provide images and reports throughout the Strong Health healthcare network. Phase II includes the addition of a Cemax-Icon (Fremont, CA) archive, PACS broker (Mitra, Waterloo, Canada), an interface (IDX PACSlink, Burlington, VT) to the RIS (IDXrad) plus the conversion of the UNIX-based redundant array of inexpensive disks (RAID) 5 temporary archives in phase I to NT-based RAID 0 DICOM modality-specific study caches (ImageLabs, Bedford, MA). The phase I acquisition engines and workflow management software was uninstalled and the Cemax archive manager (AM) assumed these functions. The existing ImageLabs UNIX-based viewing software was enhanced and converted to an NT-based DICOM viewer. Installation of phase II hardware and software and integration with existing components began in July 1998. Phase II of MICAS demonstrates that a multivendor open-system incremental approach to PACS is feasible, cost-effective, and has significant advantages over a single-vendor implementation.

Cardiology-oriented PACS

NASA Astrophysics Data System (ADS)

Silva, Augusto F. d.; Costa, Carlos; Abrantes, Pedro; Gama, Vasco; Den Boer, Ad

1998-07-01

This paper describes an integrated system designed to provide efficient means for DICOM compliant cardiac imaging archival, transmission and visualization based on a communications backbone matching recent enabling telematic technologies like Asynchronous Transfer Mode (ATM) and switched Local Area Networks (LANs). Within a distributed client-server framework, the system was conceived on a modality based bottom-up approach, aiming ultrafast access to short term archives and seamless retrieval of cardiac video sequences throughout review stations located at the outpatient referral rooms, intensive and intermediate care units and operating theaters.

SU-E-T-99: Design and Development of Isocenter Parameter System for CT Simulation Laser Based On DICOM RT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Luo, G

2014-06-01

Purpose: In order to receive DICOM files from treatment planning system and generate patient isocenter positioning parameter file for CT laser system automatically, this paper presents a method for communication with treatment planning system and calculation of isocenter parameter for each radiation field. Methods: Coordinate transformation and laser positioning file formats were analyzed, isocenter parameter was calculated via data from DICOM CT Data and DICOM RTPLAN file. An in-house software-DicomGenie was developed based on the object-oriented program platform-Qt with DCMTK SDK (Germany OFFIS company DICOM SDK) . DicomGenie was tested for accuracy using Philips CT simulation plan system (Tumor LOC,more » Philips) and A2J CT positioning laser system (Thorigny Sur Marne, France). Results: DicomGenie successfully established DICOM communication between treatment planning system, DICOM files were received by DicomGenie and patient laser isocenter information was generated accurately. Patient laser parameter data files can be used for for CT laser system directly. Conclusion: In-house software DicomGenie received and extracted DICOM data, isocenter laser positioning data files were created by DicomGenie and can be use for A2J laser positioning system.« less

XML-based scripting of multimodality image presentations in multidisciplinary clinical conferences

NASA Astrophysics Data System (ADS)

Ratib, Osman M.; Allada, Vivekanand; Dahlbom, Magdalena; Marcus, Phillip; Fine, Ian; Lapstra, Lorelle

2002-05-01

We developed a multi-modality image presentation software for display and analysis of images and related data from different imaging modalities. The software is part of a cardiac image review and presentation platform that supports integration of digital images and data from digital and analog media such as videotapes, analog x-ray films and 35 mm cine films. The software supports standard DICOM image files as well as AVI and PDF data formats. The system is integrated in a digital conferencing room that includes projections of digital and analog sources, remote videoconferencing capabilities, and an electronic whiteboard. The goal of this pilot project is to: 1) develop a new paradigm for image and data management for presentation in a clinically meaningful sequence adapted to case-specific scenarios, 2) design and implement a multi-modality review and conferencing workstation using component technology and customizable 'plug-in' architecture to support complex review and diagnostic tasks applicable to all cardiac imaging modalities and 3) develop an XML-based scripting model of image and data presentation for clinical review and decision making during routine clinical tasks and multidisciplinary clinical conferences.

Comparative performance investigation of DICOM C-STORE and DICOM HTTP-based requests.

PubMed

Le Maitre, Amandine; Fernando, Jude; Morvan, Yannick; Mevel, Gilles; Cordonnier, Emmanuel

2014-01-01

Increasingly, physicians have to access clinical images distributed over multiple healthcare organizations. To this end, two DICOM protocols may be used: a regular DICOM C-STORE transaction or an HTTP-based DICOM request such as WADO or STOW. A major problem of the DICOM C-STORE transaction is that it is inefficient to transfer DICOM data sets that consist of thousands of DICOM objects (such as functional MRI data set) because of the large number of negotiations involved in the transfer. We compare the performances of C-STORE transactions with the STOW HTTP-based protocol, and show that the STOW protocol can divide the transfer time by about 50 when compared to a DICOM C-STORE transaction for studies that consists of thousands of DICOM objects.

PET/CT (and CT) instrumentation, image reconstruction and data transfer for radiotherapy planning.

PubMed

Sattler, Bernhard; Lee, John A; Lonsdale, Markus; Coche, Emmanuel

2010-09-01

The positron emission tomography in combination with CT in hybrid, cross-modality imaging systems (PET/CT) gains more and more importance as a part of the treatment-planning procedure in radiotherapy. Positron emission tomography (PET), as a integral part of nuclear medicine imaging and non-invasive imaging technique, offers the visualization and quantification of pre-selected tracer metabolism. In combination with the structural information from CT, this molecular imaging technique has great potential to support and improve the outcome of the treatment-planning procedure prior to radiotherapy. By the choice of the PET-Tracer, a variety of different metabolic processes can be visualized. First and foremost, this is the glucose metabolism of a tissue as well as for instance hypoxia or cell proliferation. This paper comprises the system characteristics of hybrid PET/CT systems. Acquisition and processing protocols are described in general and modifications to cope with the special needs in radiooncology. This starts with the different position of the patient on a special table top, continues with the use of the same fixation material as used for positioning of the patient in radiooncology while simulation and irradiation and leads to special processing protocols that include the delineation of the volumes that are subject to treatment planning and irradiation (PTV, GTV, CTV, etc.). General CT acquisition and processing parameters as well as the use of contrast enhancement of the CT are described. The possible risks and pitfalls the investigator could face during the hybrid-imaging procedure are explained and listed. The interdisciplinary use of different imaging modalities implies a increase of the volume of data created. These data need to be stored and communicated fast, safe and correct. Therefore, the DICOM-Standard provides objects and classes for this purpose (DICOM RT). Furthermore, the standard DICOM objects and classes for nuclear medicine (NM, PT) and computed tomography (CT) are used to communicate the actual image data created by the modalities. Care must be taken for data security, especially when transferring data across the (network-) borders of different hospitals. Overall, the most important precondition for successful integration of functional imaging in RT treatment planning is the goal orientated as well as close and thorough communication between nuclear medicine and radiotherapy departments on all levels of interaction (personnel, imaging protocols, GTV delineation, and selection of the data transfer method). Copyright 2010 European Society for Therapeutic Radiology and Oncology and European Association of Nuclear Medicine. Published by Elsevier Ireland Ltd.. All rights reserved.

Development of a DICOM library

NASA Astrophysics Data System (ADS)

Kim, Dongsun; Shin, Dongkyu M.; Kim, Dongyoun M.

2001-08-01

Object-oriented DICOM decoding library was developed as a type of DLL for MS-Windows environment development. It supports all DICOM standard Transfer Syntaxes, multi-frame images, RLE decoding and window level adjusting. Image library for medical application was also developed as a type of DLL and ActiveX Control using proposed DICOM library. It supports display of DICOM image, cine mode and basic manipulations. For an application of a proposed image library, a couple of DICOM viewers were developed. One can be used as an off-line DICOM Workstation, and the other can be used for browsing the local DICOM files.

Informatics in radiology: an information model of the DICOM standard.

PubMed

Kahn, Charles E; Langlotz, Curtis P; Channin, David S; Rubin, Daniel L

2011-01-01

The Digital Imaging and Communications in Medicine (DICOM) Standard is a key foundational technology for radiology. However, its complexity creates challenges for information system developers because the current DICOM specification requires human interpretation and is subject to nonstandard implementation. To address this problem, a formally sound and computationally accessible information model of the DICOM Standard was created. The DICOM Standard was modeled as an ontology, a machine-accessible and human-interpretable representation that may be viewed and manipulated by information-modeling tools. The DICOM Ontology includes a real-world model and a DICOM entity model. The real-world model describes patients, studies, images, and other features of medical imaging. The DICOM entity model describes connections between real-world entities and the classes that model the corresponding DICOM information entities. The DICOM Ontology was created to support the Cancer Biomedical Informatics Grid (caBIG) initiative, and it may be extended to encompass the entire DICOM Standard and serve as a foundation of medical imaging systems for research and patient care. RSNA, 2010

Request redirection paradigm in medical image archive implementation.

PubMed

Dragan, Dinu; Ivetić, Dragan

2012-08-01

It is widely recognized that the JPEG2000 facilitates issues in medical imaging: storage, communication, sharing, remote access, interoperability, and presentation scalability. Therefore, JPEG2000 support was added to the DICOM standard Supplement 61. Two approaches to support JPEG2000 medical image are explicitly defined by the DICOM standard: replacing the DICOM image format with corresponding JPEG2000 codestream, or by the Pixel Data Provider service, DICOM supplement 106. The latest one supposes two-step retrieval of medical image: DICOM request and response from a DICOM server, and then JPIP request and response from a JPEG2000 server. We propose a novel strategy for transmission of scalable JPEG2000 images extracted from a single codestream over DICOM network using the DICOM Private Data Element without sacrificing system interoperability. It employs the request redirection paradigm: DICOM request and response from JPEG2000 server through DICOM server. The paper presents programming solution for implementation of request redirection paradigm in a DICOM transparent manner. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Development of a methodology for structured reporting of information in echocardiography.

PubMed

Homorodean, Călin; Olinic, Maria; Olinic, Dan

2012-03-01

In order to conduct research relying on ultrasound images, it is necessary to access a large number of relevant cases represented by images and their interpretation. DICOM standard defines the structured reporting information object. Templates are tree-like structures which offer structural guidance in report construction. Laying the foundations of a structured reporting methodology in echocardiography, through the generation of a consistent set of DICOM templates. We developed an information system with the ability of managing echocardiographic images and structured reports. In order to perform a complete description of the cardiac structures, we used 1900 coded concepts organized into 344 contexts by their semantic meaning in a variety of cardiac diseases. We developed 30 templates, with up to 10 nesting levels. The list of templates has a pyramid-like architecture. Two templates are used for reporting every measurement and description: "EchoMeasurement" and "EchoDescription". Intermediate level templates specify how to report the features of echoDoppler findings: "Spectral Curve", "Color Jet", "Intracardiac mass". Templates for every cardiovascular structure include the previous ones. "Echocardiography Procedure Report" includes all other templates. The templates were tested in reporting echo features of 100 patients by analyzing 500 DICOM images. The benefits of these templates has been proven during the testing process, through the quality of the echocardiography report, the ability to argue and to link every diagnostic feature to a defining image and by opening up opportunities for education, research. In the future, our template-based reporting methodology might be extended to other imaging modalities.

Use Rubrics and Reach ALL Learners.

ERIC Educational Resources Information Center

Active Learner: A Foxfire Journal for Teachers, 1998

1998-01-01

Describes the use of student-developed rubrics, conferencing, and reflective journaling to improve writing skills in a third-grade classroom. A rubric--a written tool used to authentically assess a piece of work--lists criteria for the work and includes a system for evaluating each criteria. Rubrics enabled the students to evaluate their own work…

RIS integrated IMAC system

NASA Astrophysics Data System (ADS)

Angelhed, Jan-Erik; Carlsson, Goeran; Gustavsson, Staffan; Karlsson, Anders; Larsson, Lars E. G.; Svensson, Sune; Tylen, Ulf

1998-07-01

An Image Management And Communication (IMAC) system adapted to the X-ray department at Sahlgrenska University Hospital has been developed using standard components. Two user demands have been considered primary: Rapid access to (display of) images and an efficient worklist management. To fulfil these demands a connection between the IMAC system and the existing Radiological Information System (RIS) has been implemented. The functional modules are: check of information consistency in data exported from image sources, a (logically) central storage of image data, viewing facility for high speed-, large volume-, clinical work, and an efficient interface to the RIS. Also, an image related database extension has been made to the RIS. The IMAC system has a strictly modular design with a simple structure. The image archive and short term storage are logically the same and acts as a huge disk. Through NFS all image data is available to all the connected workstations. All patient selection for viewing is through worklists, which are created by selection criteria in the RIS, by the use of barcodes, or, in singular cases, by entering the patient ID by hand.

Integration of DICOM and openEHR standards

NASA Astrophysics Data System (ADS)

Wang, Ying; Yao, Zhihong; Liu, Lei

2011-03-01

The standard format for medical imaging storage and transmission is DICOM. openEHR is an open standard specification in health informatics that describes the management and storage, retrieval and exchange of health data in electronic health records. Considering that the integration of DICOM and openEHR is beneficial to information sharing, on the basis of XML-based DICOM format, we developed a method of creating a DICOM Imaging Archetype in openEHR to enable the integration of DICOM and openEHR. Each DICOM file contains abundant imaging information. However, because reading a DICOM involves looking up the DICOM Data Dictionary, the readability of a DICOM file has been limited. openEHR has innovatively adopted two level modeling method, making clinical information divided into lower level, the information model, and upper level, archetypes and templates. But one critical challenge posed to the development of openEHR is the information sharing problem, especially in imaging information sharing. For example, some important imaging information cannot be displayed in an openEHR file. In this paper, to enhance the readability of a DICOM file and semantic interoperability of an openEHR file, we developed a method of mapping a DICOM file to an openEHR file by adopting the form of archetype defined in openEHR. Because an archetype has a tree structure, after mapping a DICOM file to an openEHR file, the converted information is structuralized in conformance with openEHR format. This method enables the integration of DICOM and openEHR and data exchange without losing imaging information between two standards.

JavaScript Access to DICOM Network and Objects in Web Browser.

PubMed

Drnasin, Ivan; Grgić, Mislav; Gogić, Goran

2017-10-01

Digital imaging and communications in medicine (DICOM) 3.0 standard provides the baseline for the picture archiving and communication systems (PACS). The development of Internet and various communication media initiated demand for non-DICOM access to PACS systems. Ever-increasing utilization of the web browsers, laptops and handheld devices, as opposed to desktop applications and static organizational computers, lead to development of different web technologies. The DICOM standard officials accepted those subsequently as tools of alternative access. This paper provides an overview of the current state of development of the web access technology to the DICOM repositories. It presents a different approach of using HTML5 features of the web browsers through the JavaScript language and the WebSocket protocol by enabling real-time communication with DICOM repositories. JavaScript DICOM network library, DICOM to WebSocket proxy and a proof-of-concept web application that qualifies as a DICOM 3.0 device were developed.

DICOM Standard Conformance in Veterinary Medicine in Germany: a Survey of Imaging Studies in Referral Cases.

PubMed

Brühschwein, Andreas; Klever, Julius; Wilkinson, Tom; Meyer-Lindenberg, Andrea

2018-02-01

In 2016, the recommendations of the DICOM Standards Committee for the use of veterinary identification DICOM tags had its 10th anniversary. The goal of our study was to survey veterinary DICOM standard conformance in Germany regarding the specific identification tags veterinarians should use in veterinary diagnostic imaging. We hypothesized that most veterinarians in Germany do not follow the guidelines of the DICOM Standards Committee. We analyzed the metadata of 488 imaging studies of referral cases from 115 different veterinary institutions in Germany by computer-aided DICOM header readout. We found that 25 (5.1%) of the imaging studies fully complied with the "veterinary DICOM standard" in this survey. The results confirmed our hypothesis that the recommendations of the DICOM Standards Committee for the consistent and advantageous use of veterinary identification tags have found minimal acceptance amongst German veterinarians. DICOM does not only enable connectivity between machines, DICOM also improves communication between veterinarians by sharing correct and valuable metadata for better patient care. Therefore, we recommend that lecturers, universities, societies, authorities, vendors, and other stakeholders should increase their effort to improve the spread of the veterinary DICOM standard in the veterinary world.

Common object request broker architecture (CORBA)-based security services for the virtual radiology environment.

PubMed

Martinez, R; Cole, C; Rozenblit, J; Cook, J F; Chacko, A K

2000-05-01

The US Army Great Plains Regional Medical Command (GPRMC) has a requirement to conform to Department of Defense (DoD) and Army security policies for the Virtual Radiology Environment (VRE) Project. Within the DoD, security policy is defined as the set of laws, rules, and practices that regulate how an organization manages, protects, and distributes sensitive information. Security policy in the DoD is described by the Trusted Computer System Evaluation Criteria (TCSEC), Army Regulation (AR) 380-19, Defense Information Infrastructure Common Operating Environment (DII COE), Military Health Services System Automated Information Systems Security Policy Manual, and National Computer Security Center-TG-005, "Trusted Network Interpretation." These documents were used to develop a security policy that defines information protection requirements that are made with respect to those laws, rules, and practices that are required to protect the information stored and processed in the VRE Project. The goal of the security policy is to provide for a C2-level of information protection while also satisfying the functional needs of the GPRMC's user community. This report summarizes the security policy for the VRE and defines the CORBA security services that satisfy the policy. In the VRE, the information to be protected is embedded into three major information components: (1) Patient information consists of Digital Imaging and Communications in Medicine (DICOM)-formatted fields. The patient information resides in the digital imaging network picture archiving and communication system (DIN-PACS) networks in the database archive systems and includes (a) patient demographics; (b) patient images from x-ray, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US); and (c) prior patient images and related patient history. (2) Meta-Manager information to be protected consists of several data objects. This information is distributed to the Meta-Manager nodes and includes (a) radiologist schedules; (b) modality worklists; (c) routed case information; (d) DIN-PACS and Composite Health Care system (CHCS) messages, and Meta-Manager administrative and security information; and (e) patient case information. (3) Access control and communications security is required in the VRE to control who uses the VRE and Meta-Manager facilities and to secure the messages between VRE components. The CORBA Security Service Specification version 1.5 is designed to allow up to TCSEC's B2-level security for distributed objects. The CORBA Security Service Specification defines the functionality of several security features: identification and authentication, authorization and access control, security auditing, communication security, nonrepudiation, and security administration. This report describes the enhanced security features for the VRE and their implementation using commercial CORBA Security Service software products.

Building a gateway with open source software for secure-DICOM communication over insecure networks

NASA Astrophysics Data System (ADS)

Emmel, Dirk; Ricke, Jens; Stohlmann, Lutz; Haderer, Alexander; Felix, Roland

2002-05-01

For Teleradiology the exchange of DICOM-images is needed for several purposes. Existing solutions often don't consider about the needs for data security and data privacy. Communication is done without any encryption over insecure networks or with encryption using proprietary solutions, which reduces the data communication possibilities to partners with the same equipment. Our goal was to build a gateway, which offers a transparent solution for secure DICOM-communication in a heterogeneous environment We developed a PC-based gateway system with DICOM-communication to the in-house network and secure DICOM communication for the communication over the insecure network. One gateway installed at each location is responsible for encryption/decryption. The sender just transfers the image data over the DICOM protocol to the local gateway. The gateway forwards the data to the gateway on the destination site using the secure DICOM protocol, which is part of the DICOM standard. The receiving gateway forwards the image data to the final destination again using the DICOM-Protocol. The gateway is based on Open Source software and runs under several operating systems. Our experience shows a reliable solution, which solves security issues for DICOM communication of image data and integrates seamless into a heterogeneous DICOM environment.

DICOM image quantification secondary capture (DICOM IQSC) integrated with numeric results, regions, and curves: implementation and applications in nuclear medicine

NASA Astrophysics Data System (ADS)

Cao, Xinhua; Xu, Xiaoyin; Voss, Stephan

2017-03-01

In this paper, we describe an enhanced DICOM Secondary Capture (SC) that integrates Image Quantification (IQ) results, Regions of Interest (ROIs), and Time Activity Curves (TACs) with screen shots by embedding extra medical imaging information into a standard DICOM header. A software toolkit of DICOM IQSC has been developed to implement the SC-centered information integration of quantitative analysis for routine practice of nuclear medicine. Primary experiments show that the DICOM IQSC method is simple and easy to implement seamlessly integrating post-processing workstations with PACS for archiving and retrieving IQ information. Additional DICOM IQSC applications in routine nuclear medicine and clinic research are also discussed.

DICOM: key concepts--part I.

PubMed

Kabachinski, Jeff

2005-01-01

In this issue and next, we're investigating different sections of the DICOM Standard to get a grip on what it's all about. The bottom line is to facilitate communication and DICOM addresses all the technical aspects to allow complying OEMs to talk to one another. In part 2, IT World completes its overview on DICOM by exploring UID, networking with DICOM, conformance, and conformance statements.

Implementing a DICOM-HL7 interface application

NASA Astrophysics Data System (ADS)

Fritz, Steven L.; Munjal, Sunita; Connors, James; Csipo, Deszu

1995-05-01

The DICOM standard, in addition to resolving certain problems with the ACR-NEMA 2.0 standard regarding network support and the clinical data dictionary, added new capabilities, in the form of study content notification and patient, study and results management services, intended to assist in interfacing between PACS and HIS or RIS systems. We have defined and implemented a mechanism that allows a DICOM application entity (AE) to interrogate an HL7 based RIS using DICOM services. The implementation involved development of a DICOM- HL7 gateway which converted between DICOM and HL7 messages to achieve the desired retrieval capability. This mechanism, based on the DICOM query/retrieve service, was used to interface a DeJarnette Research film digitizer to an IDXrad RIS at the University of Maryland Medical Systems hospital in Baltimore, Maryland. A C++ class library was developed for both DICOM and HL7 massaging, with several constructors used to convert between the two standards.

Clinical experience with a high-performance ATM-connected DICOM archive for cardiology

NASA Astrophysics Data System (ADS)

Solomon, Harry P.

1997-05-01

A system to archive large image sets, such as cardiac cine runs, with near realtime response must address several functional and performance issues, including efficient use of a high performance network connection with standard protocols, an architecture which effectively integrates both short- and long-term mass storage devices, and a flexible data management policy which allows optimization of image distribution and retrieval strategies based on modality and site-specific operational use. Clinical experience with such as archive has allowed evaluation of these systems issues and refinement of a traffic model for cardiac angiography.

Information object definition-based unified modeling language representation of DICOM structured reporting: a case study of transcoding DICOM to XML.

PubMed

Tirado-Ramos, Alfredo; Hu, Jingkun; Lee, K P

2002-01-01

Supplement 23 to DICOM (Digital Imaging and Communications for Medicine), Structured Reporting, is a specification that supports a semantically rich representation of image and waveform content, enabling experts to share image and related patient information. DICOM SR supports the representation of textual and coded data linked to images and waveforms. Nevertheless, the medical information technology community needs models that work as bridges between the DICOM relational model and open object-oriented technologies. The authors assert that representations of the DICOM Structured Reporting standard, using object-oriented modeling languages such as the Unified Modeling Language, can provide a high-level reference view of the semantically rich framework of DICOM and its complex structures. They have produced an object-oriented model to represent the DICOM SR standard and have derived XML-exchangeable representations of this model using World Wide Web Consortium specifications. They expect the model to benefit developers and system architects who are interested in developing applications that are compliant with the DICOM SR specification.

Novel Algorithm for Classification of Medical Images

NASA Astrophysics Data System (ADS)

Bhushan, Bharat; Juneja, Monika

2010-11-01

Content-based image retrieval (CBIR) methods in medical image databases have been designed to support specific tasks, such as retrieval of medical images. These methods cannot be transferred to other medical applications since different imaging modalities require different types of processing. To enable content-based queries in diverse collections of medical images, the retrieval system must be familiar with the current Image class prior to the query processing. Further, almost all of them deal with the DICOM imaging format. In this paper a novel algorithm based on energy information obtained from wavelet transform for the classification of medical images according to their modalities is described. For this two types of wavelets have been used and have been shown that energy obtained in either case is quite distinct for each of the body part. This technique can be successfully applied to different image formats. The results are shown for JPEG imaging format.

Information Object Definition–based Unified Modeling Language Representation of DICOM Structured Reporting

PubMed Central

Tirado-Ramos, Alfredo; Hu, Jingkun; Lee, K.P.

2002-01-01

Supplement 23 to DICOM (Digital Imaging and Communications for Medicine), Structured Reporting, is a specification that supports a semantically rich representation of image and waveform content, enabling experts to share image and related patient information. DICOM SR supports the representation of textual and coded data linked to images and waveforms. Nevertheless, the medical information technology community needs models that work as bridges between the DICOM relational model and open object-oriented technologies. The authors assert that representations of the DICOM Structured Reporting standard, using object-oriented modeling languages such as the Unified Modeling Language, can provide a high-level reference view of the semantically rich framework of DICOM and its complex structures. They have produced an object-oriented model to represent the DICOM SR standard and have derived XML-exchangeable representations of this model using World Wide Web Consortium specifications. They expect the model to benefit developers and system architects who are interested in developing applications that are compliant with the DICOM SR specification. PMID:11751804

PACS and electronic health records

NASA Astrophysics Data System (ADS)

Cohen, Simona; Gilboa, Flora; Shani, Uri

2002-05-01

Electronic Health Record (EHR) is a major component of the health informatics domain. An important part of the EHR is the medical images obtained over a patient's lifetime and stored in diverse PACS. The vision presented in this paper is that future medical information systems will convert data from various medical sources -- including diverse modalities, PACS, HIS, CIS, RIS, and proprietary systems -- to HL7 standard XML documents. Then, the various documents are indexed and compiled to EHRs, upon which complex queries can be posed. We describe the conversion of data retrieved from PACS systems through DICOM to HL7 standard XML documents. This enables the EHR system to answer queries such as 'Get all chest images of patients at the age of 20-30, that have blood type 'A' and are allergic to pine trees', which a single PACS cannot answer. The integration of data from multiple sources makes our approach capable of delivering such answers. It enables the correlation of medical, demographic, clinical, and even genetic information. In addition, by fully indexing all the tagged data in DICOM objects, it becomes possible to offer access to huge amounts of valuable data, which can be better exploited in the specific radiology domain.

DICOM structured report to track patient's radiation dose to organs from abdominal CT exam

NASA Astrophysics Data System (ADS)

Morioka, Craig; Turner, Adam; McNitt-Gray, Michael; Zankl, Maria; Meng, Frank; El-Saden, Suzie

2011-03-01

The dramatic increase of diagnostic imaging capabilities over the past decade has contributed to increased radiation exposure to patient populations. Several factors have contributed to the increase in imaging procedures: wider availability of imaging modalities, increase in technical capabilities, rise in demand by patients and clinicians, favorable reimbursement, and lack of guidelines to control utilization. The primary focus of this research is to provide in depth information about radiation doses that patients receive as a result of CT exams, with the initial investigation involving abdominal CT exams. Current dose measurement methods (i.e. CTDIvol Computed Tomography Dose Index) do not provide direct information about a patient's organ dose. We have developed a method to determine CTDIvol normalized organ doses using a set of organ specific exponential regression equations. These exponential equations along with measured CTDIvol are used to calculate organ dose estimates from abdominal CT scans for eight different patient models. For each patient, organ dose and CTDIvol were estimated for an abdominal CT scan. We then modified the DICOM Radiation Dose Structured Report (RDSR) to store the pertinent patient information on radiation dose to their abdominal organs.

Application of XML in DICOM

NASA Astrophysics Data System (ADS)

You, Xiaozhen; Yao, Zhihong

2005-04-01

As a standard of communication and storage for medical digital images, DICOM has been playing a very important role in integration of hospital information. In DICOM, tags are expressed by numbers, and only standard data elements can be shared by looking up Data Dictionary while private tags can not. As such, a DICOM file's readability and extensibility is limited. In addition, reading DICOM files needs special software. In our research, we introduced XML into DICOM, defining an XML-based DICOM special transfer format, XML-DCM, a DICOM storage format, X-DCM, as well as developing a program package to realize format interchange among DICOM, XML-DCM, and X-DCM. XML-DCM is based on the DICOM structure while replacing numeric tags with accessible XML character string tags. The merits are as following: a) every character string tag of XML-DCM has explicit meaning, so users can understand standard data elements and those private data elements easily without looking up the Data Dictionary. In this way, the readability and data sharing of DICOM files are greatly improved; b) According to requirements, users can set new character string tags with explicit meaning to their own system to extend the capacity of data elements; c) User can read the medical image and associated information conveniently through IE, ultimately enlarging the scope of data sharing. The application of storage format X-DCM will reduce data redundancy and save storage memory. The result of practical application shows that XML-DCM does favor integration and share of medical image data among different systems or devices.

SU-E-T-211: Peer Review System for Ensuring Quality of Radiation Therapy Treatments.

PubMed

Kapoor, R; Kapur, P; Kumar, S A; Alex, D; Ranka, S; Palta, J

2012-06-01

To demonstrate a Web-based electronic peer review system that has the potential to improve quality of care for radiation therapy patients. The system provides tools that allow radiation oncologists to seek peer review of target and critical structure delineation, treatment plans, and share clinical data with peers to optimize radiation therapy treatments. Peer review of radiation therapy treatment planning data prior to its initiation improves the quality of radiation therapy and clinical outcomes. Web-based access to radiation therapy treatment planning data and medical records mitigate existing geographical and temporal constraints. With internet access, the healthcare provider can access the data from any location and review it in an interactive and collaborative manner. Interoperability standard like DICOM-RT and IHE-RO compliant RT Systems have facilitated the design and implementation of PRS with Silverlight Web technology, .net Framework and SQL Server. Local DICOM-RT archive and cloud based services are deployed to facilitate remote peer reviews. To validate the PRS system, we tested the system for 100 patients with Philips Pinnacle v 9.0 and Varian Eclipse v 8.9 treatment planning system (TPS). We transmitted the DICOM RT data from the TPS to the cloud based services via the PRS local DICOM RT Archive. Various CT simulation based parameters such as orientation of CT, properties of RT structures etc. were compared between the TPS and PRS system. Data integrity of other parameters such as patient demographics (patient name, ID, attending physician etc.) and dose volume related parameters were also evaluated. Such rigorous testing allowed us to optimize the functionalities and clinical implementation of the PRS. We believe that the PRS will improve the quality and safety of a broad spectrum of radiation therapy patients treated in underserved areas while discouraging the overutilization of expensive radiation treatment modalities. This research and development project is supported by the James and Ester King Biomedical Research Program grant # RC1-09KW-09-26829. © 2012 American Association of Physicists in Medicine.

Extraction of CT dose information from DICOM metadata: automated Matlab-based approach.

PubMed

Dave, Jaydev K; Gingold, Eric L

2013-01-01

The purpose of this study was to extract exposure parameters and dose-relevant indexes of CT examinations from information embedded in DICOM metadata. DICOM dose report files were identified and retrieved from a PACS. An automated software program was used to extract from these files information from the structured elements in the DICOM metadata relevant to exposure. Extracting information from DICOM metadata eliminated potential errors inherent in techniques based on optical character recognition, yielding 100% accuracy.

Mapping DICOM to OpenDocument format

NASA Astrophysics Data System (ADS)

Yu, Cong; Yao, Zhihong

2009-02-01

In order to enhance the readability, extensibility and sharing of DICOM files, we have introduced XML into DICOM file system (SPIE Volume 5748)[1] and the multilayer tree structure into DICOM (SPIE Volume 6145)[2]. In this paper, we proposed mapping DICOM to ODF(OpenDocument Format), for it is also based on XML. As a result, the new format realizes the separation of content(including text content and image) and display style. Meanwhile, since OpenDocument files take the format of a ZIP compressed archive, the new kind of DICOM files can benefit from ZIP's lossless compression to reduce file size. Moreover, this open format can also guarantee long-term access to data without legal or technical barriers, making medical images accessible to various fields.

MO-F-16A-06: Implementation of a Radiation Exposure Monitoring System for Surveillance of Multi-Modality Radiation Dose Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stewart, B; Kanal, K; Dickinson, R

2014-06-15

Purpose: We have implemented a commercially available Radiation Exposure Monitoring System (REMS) to enhance the processes of radiation dose data collection, analysis and alerting developed over the past decade at our sites of practice. REMS allows for consolidation of multiple radiation dose information sources and quicker alerting than previously developed processes. Methods: Thirty-nine x-ray producing imaging modalities were interfaced with the REMS: thirteen computed tomography scanners, sixteen angiography/interventional systems, nine digital radiography systems and one mammography system. A number of methodologies were used to provide dose data to the REMS: Modality Performed Procedure Step (MPPS) messages, DICOM Radiation Dose Structuredmore » Reports (RDSR), and DICOM header information. Once interfaced, the dosimetry information from each device underwent validation (first 15–20 exams) before release for viewing by end-users: physicians, medical physicists, technologists and administrators. Results: Before REMS, our diagnostic physics group pulled dosimetry data from seven disparate databases throughout the radiology, radiation oncology, cardiology, electrophysiology, anesthesiology/pain management and vascular surgery departments at two major medical centers and four associated outpatient clinics. With the REMS implementation, we now have one authoritative source of dose information for alerting, longitudinal analysis, dashboard/graphics generation and benchmarking. REMS provides immediate automatic dose alerts utilizing thresholds calculated through daily statistical analysis. This has streamlined our Closing the Loop process for estimated skin exposures in excess of our institutional specific substantial radiation dose level which relied on technologist notification of the diagnostic physics group and daily report from the radiology information system (RIS). REMS also automatically calculates the CT size-specific dose estimate (SSDE) as well as provides two-dimensional angulation dose maps for angiography/interventional procedures. Conclusion: REMS implementation has streamlined and consolidated the dosimetry data collection and analysis process at our institutions while eliminating manual entry error and providing immediate alerting and access to dosimetry data to both physicists and physicians. Brent Stewart has funded research through GE Healthcare.« less

Kleene Algebra and Bytecode Verification

DTIC Science & Technology

2016-04-27

computing the star (Kleene closure) of a matrix of transfer functions. In this paper we show how this general framework applies to the problem of Java ...bytecode verification. We show how to specify transfer functions arising in Java bytecode verification in such a way that the Kleene algebra operations...potentially improve the performance over the standard worklist algorithm when a small cutset can be found. Key words: Java , bytecode, verification, static

System integration and DICOM image creation for PET-MR fusion.

PubMed

Hsiao, Chia-Hung; Kao, Tsair; Fang, Yu-Hua; Wang, Jiunn-Kuen; Guo, Wan-Yuo; Chao, Liang-Hsiao; Yen, Sang-Hue

2005-03-01

This article demonstrates a gateway system for converting image fusion results to digital imaging and communication in medicine (DICOM) objects. For the purpose of standardization and integration, we have followed the guidelines of the Integrated Healthcare Enterprise technical framework and developed a DICOM gateway. The gateway system combines data from hospital information system, image fusion results, and the information generated itself to constitute new DICOM objects. All the mandatory tags defined in standard DICOM object were generated in the gateway system. The gateway system will generate two series of SOP instances of each PET-MR fusion result; SOP (Service Object Pair) one for the reconstructed magnetic resonance (MR) images and the other for position emission tomography (PET) images. The size, resolution, spatial coordinates, and number of frames are the same in both series of SOP instances. Every new generated MR image exactly fits with one of the reconstructed PET images. Those DICOM images are stored to the picture archiving and communication system (PACS) server by means of standard DICOM protocols. When those images are retrieved and viewed by standard DICOM viewing systems, both images can be viewed at the same anatomy location. This system is useful for precise diagnosis and therapy.

DICOM relay over the cloud.

PubMed

Silva, Luís A Bastião; Costa, Carlos; Oliveira, José Luis

2013-05-01

Healthcare institutions worldwide have adopted picture archiving and communication system (PACS) for enterprise access to images, relying on Digital Imaging Communication in Medicine (DICOM) standards for data exchange. However, communication over a wider domain of independent medical institutions is not well standardized. A DICOM-compliant bridge was developed for extending and sharing DICOM services across healthcare institutions without requiring complex network setups or dedicated communication channels. A set of DICOM routers interconnected through a public cloud infrastructure was implemented to support medical image exchange among institutions. Despite the advantages of cloud computing, new challenges were encountered regarding data privacy, particularly when medical data are transmitted over different domains. To address this issue, a solution was introduced by creating a ciphered data channel between the entities sharing DICOM services. Two main DICOM services were implemented in the bridge: Storage and Query/Retrieve. The performance measures demonstrated it is quite simple to exchange information and processes between several institutions. The solution can be integrated with any currently installed PACS-DICOM infrastructure. This method works transparently with well-known cloud service providers. Cloud computing was introduced to augment enterprise PACS by providing standard medical imaging services across different institutions, offering communication privacy and enabling creation of wider PACS scenarios with suitable technical solutions.

An automated distinction of DICOM images for lung cancer CAD system

NASA Astrophysics Data System (ADS)

Suzuki, H.; Saita, S.; Kubo, M.; Kawata, Y.; Niki, N.; Nishitani, H.; Ohmatsu, H.; Eguchi, K.; Kaneko, M.; Moriyama, N.

2009-02-01

Automated distinction of medical images is an important preprocessing in Computer-Aided Diagnosis (CAD) systems. The CAD systems have been developed using medical image sets with specific scan conditions and body parts. However, varied examinations are performed in medical sites. The specification of the examination is contained into DICOM textual meta information. Most DICOM textual meta information can be considered reliable, however the body part information cannot always be considered reliable. In this paper, we describe an automated distinction of DICOM images as a preprocessing for lung cancer CAD system. Our approach uses DICOM textual meta information and low cost image processing. Firstly, the textual meta information such as scan conditions of DICOM image is distinguished. Secondly, the DICOM image is set to distinguish the body parts which are identified by image processing. The identification of body parts is based on anatomical structure which is represented by features of three regions, body tissue, bone, and air. The method is effective to the practical use of lung cancer CAD system in medical sites.

Operational experience with DICOM for the clinical specialties in the healthcare enterprise

NASA Astrophysics Data System (ADS)

Kuzmak, Peter M.; Dayhoff, Ruth E.

2004-04-01

A number of clinical specialties routinely use images in treating patients, for example ophthalmology, dentistry, cardiology, endoscopy, and surgery. These images are captured by a variety of commercial digital image acquisition systems. The US Department of Veterans Affairs has been working for several years on advancing the use of the Digital Imaging and Communications in Medicine (DICOM) Standard in these clinical specialties. This is an effort that has involved several facets: (1) working with the vendors to ensure that they satisfy existing DICOM requirements, (2) developing interface software to the VistA hospital information system (HIS), (3) field testing DICOM systems, (4) deploying these DICOM interfaces nation-wide to all VA medical centers, (5) working with the healthcare providers using the system, and (6) participating in the DICOM working groups to improve the standard. The VA is now beginning to develop clinical applications that make use of the DICOM interfaces in the clinical specialties. The first of these will be in ophthalmology to remotely screen patients for diabetic retinopathy.

Reengineering Workflow for Curation of DICOM Datasets.

PubMed

Bennett, William; Smith, Kirk; Jarosz, Quasar; Nolan, Tracy; Bosch, Walter

2018-06-15

Reusable, publicly available data is a pillar of open science and rapid advancement of cancer imaging research. Sharing data from completed research studies not only saves research dollars required to collect data, but also helps insure that studies are both replicable and reproducible. The Cancer Imaging Archive (TCIA) is a global shared repository for imaging data related to cancer. Insuring the consistency, scientific utility, and anonymity of data stored in TCIA is of utmost importance. As the rate of submission to TCIA has been increasing, both in volume and complexity of DICOM objects stored, the process of curation of collections has become a bottleneck in acquisition of data. In order to increase the rate of curation of image sets, improve the quality of the curation, and better track the provenance of changes made to submitted DICOM image sets, a custom set of tools was developed, using novel methods for the analysis of DICOM data sets. These tools are written in the programming language perl, use the open-source database PostgreSQL, make use of the perl DICOM routines in the open-source package Posda, and incorporate DICOM diagnostic tools from other open-source packages, such as dicom3tools. These tools are referred to as the "Posda Tools." The Posda Tools are open source and available via git at https://github.com/UAMS-DBMI/PosdaTools . In this paper, we briefly describe the Posda Tools and discuss the novel methods employed by these tools to facilitate rapid analysis of DICOM data, including the following: (1) use a database schema which is more permissive, and differently normalized from traditional DICOM databases; (2) perform integrity checks automatically on a bulk basis; (3) apply revisions to DICOM datasets on an bulk basis, either through a web-based interface or via command line executable perl scripts; (4) all such edits are tracked in a revision tracker and may be rolled back; (5) a UI is provided to inspect the results of such edits, to verify that they are what was intended; (6) identification of DICOM Studies, Series, and SOP instances using "nicknames" which are persistent and have well-defined scope to make expression of reported DICOM errors easier to manage; and (7) rapidly identify potential duplicate DICOM datasets by pixel data is provided; this can be used, e.g., to identify submission subjects which may relate to the same individual, without identifying the individual.

Open-Source, Web-Based Dashboard Components for DICOM Connectivity.

PubMed

Bustamante, Catalina; Pineda, Julian; Rascovsky, Simon; Arango, Andres

2016-08-01

The administration of a DICOM network within an imaging healthcare institution requires tools that allow for monitoring of connectivity and availability for adequate uptime measurements and help guide technology management strategies. We present the implementation of an open-source widget for the Dashing framework that provides basic dashboard functionality allowing for monitoring of a DICOM network using network "ping" and DICOM "C-ECHO" operations.

Using Java to generate globally unique identifiers for DICOM objects.

PubMed

Kamauu, Aaron W C; Duvall, Scott L; Avrin, David E

2009-03-01

Digital imaging and communication in medicine (DICOM) specifies that all DICOM objects have globally unique identifiers (UIDs). Creating these UIDs can be a difficult task due to the variety of techniques in use and the requirement to ensure global uniqueness. We present a simple technique of combining a root organization identifier, assigned descriptive identifiers, and JAVA generated unique identifiers to construct DICOM compliant UIDs.

Development of a web-based DICOM-SR viewer for CAD data of multiple sclerosis lesions in an imaging informatics-based efolder

NASA Astrophysics Data System (ADS)

Ma, Kevin; Wong, Jonathan; Zhong, Mark; Zhang, Jeff; Liu, Brent

2014-03-01

In the past, we have presented an imaging-informatics based eFolder system for managing and analyzing imaging and lesion data of multiple sclerosis (MS) patients, which allows for data storage, data analysis, and data mining in clinical and research settings. The system integrates the patient's clinical data with imaging studies and a computer-aided detection (CAD) algorithm for quantifying MS lesion volume, lesion contour, locations, and sizes in brain MRI studies. For compliance with IHE integration protocols, long-term storage in PACS, and data query and display in a DICOM compliant clinical setting, CAD results need to be converted into DICOM-Structured Report (SR) format. Open-source dcmtk and customized XML templates are used to convert quantitative MS CAD results from MATLAB to DICOM-SR format. A web-based GUI based on our existing web-accessible DICOM object (WADO) image viewer has been designed to display the CAD results from generated SR files. The GUI is able to parse DICOM-SR files and extract SR document data, then display lesion volume, location, and brain matter volume along with the referenced DICOM imaging study. In addition, the GUI supports lesion contour overlay, which matches a detected MS lesion with its corresponding DICOM-SR data when a user selects either the lesion or the data. The methodology of converting CAD data in native MATLAB format to DICOM-SR and displaying the tabulated DICOM-SR along with the patient's clinical information, and relevant study images in the GUI will be demonstrated. The developed SR conversion model and GUI support aim to further demonstrate how to incorporate CAD post-processing components in a PACS and imaging informatics-based environment.

DICOM-compatible format for analytical cytology data

NASA Astrophysics Data System (ADS)

Leif, Robert C.; Leif, Suzanne B.

1998-04-01

The addition of a list mode data type to the Digital Imaging and Communications in Medicine standard, DICOM will enhance the storage and transmission of digital microscopy data and extend DICOM to include flow cytometry data. This would permit the present International Society for analytical Cytology Flow Cytometry Standard to be retired. DICOM includes: image graphics objects, specifications for describing: studies, reports, the acquisition of the data, work list management, and the individuals involved (physician, patient, etc.) The glossary of terms (objects) suitable for use with DICOM has been extended to include the collaborative effort of Logical Observation Identifier Names and Codes (LOINC) and Systematized Nomenclature of Human and Veterinary Medicine (SNOMED) to create a consistent, unambiguous clinical reference terminology. It also appears that DICOM will be a significant part of the Common Object Request Broker Architecture, CORBA.

Free DICOM de-identification tools in clinical research: functioning and safety of patient privacy.

PubMed

Aryanto, K Y E; Oudkerk, M; van Ooijen, P M A

2015-12-01

To compare non-commercial DICOM toolkits for their de-identification ability in removing a patient's personal health information (PHI) from a DICOM header. Ten DICOM toolkits were selected for de-identification tests. Tests were performed by using the system's default de-identification profile and, subsequently, the tools' best adjusted settings. We aimed to eliminate fifty elements considered to contain identifying patient information. The tools were also examined for their respective methods of customization. Only one tool was able to de-identify all required elements with the default setting. Not all of the toolkits provide a customizable de-identification profile. Six tools allowed changes by selecting the provided profiles, giving input through a graphical user interface (GUI) or configuration text file, or providing the appropriate command-line arguments. Using adjusted settings, four of those six toolkits were able to perform full de-identification. Only five tools could properly de-identify the defined DICOM elements, and in four cases, only after careful customization. Therefore, free DICOM toolkits should be used with extreme care to prevent the risk of disclosing PHI, especially when using the default configuration. In case optimal security is required, one of the five toolkits is proposed. • Free DICOM toolkits should be carefully used to prevent patient identity disclosure. • Each DICOM tool produces its own specific outcomes from the de-identification process. • In case optimal security is required, using one DICOM toolkit is proposed.

Fast processing of digital imaging and communications in medicine (DICOM) metadata using multiseries DICOM format.

PubMed

Ismail, Mahmoud; Philbin, James

2015-04-01

The digital imaging and communications in medicine (DICOM) information model combines pixel data and its metadata in a single object. There are user scenarios that only need metadata manipulation, such as deidentification and study migration. Most picture archiving and communication system use a database to store and update the metadata rather than updating the raw DICOM files themselves. The multiseries DICOM (MSD) format separates metadata from pixel data and eliminates duplicate attributes. This work promotes storing DICOM studies in MSD format to reduce the metadata processing time. A set of experiments are performed that update the metadata of a set of DICOM studies for deidentification and migration. The studies are stored in both the traditional single frame DICOM (SFD) format and the MSD format. The results show that it is faster to update studies' metadata in MSD format than in SFD format because the bulk data is separated in MSD and is not retrieved from the storage system. In addition, it is space efficient to store the deidentified studies in MSD format as it shares the same bulk data object with the original study. In summary, separation of metadata from pixel data using the MSD format provides fast metadata access and speeds up applications that process only the metadata.

Fast processing of digital imaging and communications in medicine (DICOM) metadata using multiseries DICOM format

PubMed Central

Ismail, Mahmoud; Philbin, James

2015-01-01

Abstract. The digital imaging and communications in medicine (DICOM) information model combines pixel data and its metadata in a single object. There are user scenarios that only need metadata manipulation, such as deidentification and study migration. Most picture archiving and communication system use a database to store and update the metadata rather than updating the raw DICOM files themselves. The multiseries DICOM (MSD) format separates metadata from pixel data and eliminates duplicate attributes. This work promotes storing DICOM studies in MSD format to reduce the metadata processing time. A set of experiments are performed that update the metadata of a set of DICOM studies for deidentification and migration. The studies are stored in both the traditional single frame DICOM (SFD) format and the MSD format. The results show that it is faster to update studies’ metadata in MSD format than in SFD format because the bulk data is separated in MSD and is not retrieved from the storage system. In addition, it is space efficient to store the deidentified studies in MSD format as it shares the same bulk data object with the original study. In summary, separation of metadata from pixel data using the MSD format provides fast metadata access and speeds up applications that process only the metadata. PMID:26158117

[A solution for display and processing of DICOM images in web PACS].

PubMed

Xue, Wei-jing; Lu, Wen; Wang, Hai-yang; Meng, Jian

2009-03-01

Use the technique of Java Applet to realize the supporting of DICOM image in ordinary Web browser, thereby to expand the processing function of medical image. First analyze the format of DICOM file and design a class which can acquire the pixels, then design two Applet classes, of which one is used to disposal the DICOM image, the other is used to display DICOM image that have been disposaled in the first Applet. They all embedded in the View page, and they communicate by Applet Context object. The method designed in this paper can make users display and process DICOM images directly by using ordinary Web browser, which makes Web PACS not only have the advantages of B/S model, but also have the advantages of the C/S model. Java Applet is the key for expanding the Web browser's function in Web PACS, which provides a guideline to sharing of medical images.

Authentication, integrity, and confidentiality in DICOM-structured reporting: concept and implementation

NASA Astrophysics Data System (ADS)

Riesmeier, Joerg; Eichelberg, Marco; Kleber, Klaus; Groenemeyer, Dietrich H.; Oosterwijk, Herman J.; Jensch, Peter F.

2002-05-01

With the release of 'DICOM Structured Reporting' (SR) as an official extension of the standard about two years ago, DICOM has entered a new domain that is only indirectly related to medical imaging. Basically, DICOM SR is a general model allowing to encode medical reports in a structured manner in DICOM's tag-based format. Therefore, the existing DICOM infrastructure can be used to archive and communicate structured reports, with only relatively small changes to existing systems. As a consequence of the introduction of medical reports in a digital form, the relevance of security measures increases significantly. We have developed a prototype implementation of DICOM structured reporting together with the new security extensions for secure transport connections and digital signatures. The application allows to create, read and modify any SR document, to digitally sign an SR document in whole or part and to transmit such documents over a network. While the secure transport connection protects data from modifications or unauthorized access only during transmission, digital signatures provide a lifetime integrity check and, therefore, maintain the legal document status of structured reports. The application has been successfully demonstrated at RSNA 2000 and ECR 2001, and is freely available on the Internet.

Integrating DICOM structure reporting (SR) into the medical imaging informatics data grid

NASA Astrophysics Data System (ADS)

Lee, Jasper; Le, Anh; Liu, Brent

2008-03-01

The Medical Imaging Informatics (MI2) Data Grid developed at the USC Image Processing and Informatics Laboratory enables medical images to be shared securely between multiple imaging centers. Current applications include an imaging-based clinical trial setting where multiple field sites perform image acquisition and a centralized radiology core performs image analysis, often using computer-aided diagnosis tools (CAD) that generate a DICOM-SR to report their findings and measurements. As more and more CAD tools are being developed in the radiology field, the generated DICOM Structure Reports (SR) holding key radiological findings and measurements that are not part of the DICOM image need to be integrated into the existing Medical Imaging Informatics Data Grid with the corresponding imaging studies. We will discuss the significance and method involved in adapting DICOM-SR into the Medical Imaging Informatics Data Grid. The result is a MI2 Data Grid repository from which users can send and receive DICOM-SR objects based on the imaging-based clinical trial application. The services required to extract and categorize information from the structured reports will be discussed, and the workflow to store and retrieve a DICOM-SR file into the existing MI2 Data Grid will be shown.

Preliminary DICOM acceptance testing using the central test node

NASA Astrophysics Data System (ADS)

Chimiak, William J.

1996-05-01

The Bowman Gray School of Medicine of Wake Forest University (BGSM) is installing clinical DICOM workstations and DICOM film digitizers for use in a telemedicine trial over the North Carolina ATM infrastructure. Acquiring equipment thought to be DICOM compliant, but which does not live up to expectations and possibly fails to interoperate with other DICOM equipment, is a concern. In cooperation with RSNA and the Mallinckrodt Institute of Radiology of the Washington University School of Medicine (MIR), BGSM made acceptance of the CEMAX workstations for the telemedicine trial contingent upon a satisfactory test with the MIR central test node (CTN). During the test, both engineers never left their hospitals during the tests drastically cutting travel and per diem costs and valuable time. The successful results exceeded expectations. Images were not only passed back and forth to the CTN by both the CEMAX clinical workstation and the quality assurance workstation, but images arriving from the CTN were entered into the CEMAX clinical database without operator intervention. It was expected that the images would transfer, but the placement into the database, although reasonable to expect, actually occurred. This live test from an independent test source exhibited the ease with which the CEMAX workstations handled the DICOM images in their systems. In the test, the CEMAX workstations were configured as an exporter of DICOM images at BGSM. The CTN was entered in the configuration of the CEMAX workstations as a source of DICOM images. The test was to ensure that plain film, computed tomography, and magnetic resonance images could be easily exchanged between workstations electronically. This paper describes the procedure for using the CTN to provide preliminary testing of DICOM equipment.

Towards a semantic PACS: Using Semantic Web technology to represent imaging data.

PubMed

Van Soest, Johan; Lustberg, Tim; Grittner, Detlef; Marshall, M Scott; Persoon, Lucas; Nijsten, Bas; Feltens, Peter; Dekker, Andre

2014-01-01

The DICOM standard is ubiquitous within medicine. However, improved DICOM semantics would significantly enhance search operations. Furthermore, databases of current PACS systems are not flexible enough for the demands within image analysis research. In this paper, we investigated if we can use Semantic Web technology, to store and represent metadata of DICOM image files, as well as linking additional computational results to image metadata. Therefore, we developed a proof of concept containing two applications: one to store commonly used DICOM metadata in an RDF repository, and one to calculate imaging biomarkers based on DICOM images, and store the biomarker values in an RDF repository. This enabled us to search for all patients with a gross tumor volume calculated to be larger than 50 cc. We have shown that we can successfully store the DICOM metadata in an RDF repository and are refining our proof of concept with regards to volume naming, value representation, and the applications themselves.

[The design and implementation of DICOM self-help film printing system].

PubMed

Wang, Xiaodong; Jiang, Mowen

2013-09-01

This article focuses on the design and implementation of self-help film printing system which based on DICOM standard. According to DICOM standard and the working process of the radiology department, the system realizes self-help printing film as well as monitoring and managing the film printing business.

The DICOM Standard: A Brief Overview

NASA Astrophysics Data System (ADS)

Gibaud, Bernard

The DICOM standard has now become the uncontested standard for the exchange and management of biomedical images. Everyone acknowledges its prominent role in the emergence of multi-vendor Picture Archiving and Communication Systems (PACS), and their successful integration with Hospital Information Systems and Radiology Information Systems, thanks to the Integrating the Healthcare Enterprise (IHE) initiative. We introduce here the basic concepts retained for the definition of objects and services in DICOM, with the hope that it will help the reader to find his or her way in the vast DICOM documentation available on the web.

Image Viewer using Digital Imaging and Communications in Medicine (DICOM)

NASA Astrophysics Data System (ADS)

Baraskar, Trupti N.

2010-11-01

Digital Imaging and Communications in Medicine is a standard for handling, storing, printing, and transmitting information in medical imaging. The National Electrical Manufacturers Association holds the copyright to this standard. It was developed by the DICOM Standards committee. The other image viewers cannot collectively store the image details as well as the patient's information. So the image may get separated from the details, but DICOM file format stores the patient's information and the image details. Main objective is to develop a DICOM image viewer. The image viewer will open .dcm i.e. DICOM image file and also will have additional features such as zoom in, zoom out, black and white inverter, magnifier, blur, B/W inverter, horizontal and vertical flipping, sharpening, contrast, brightness and .gif converter are incorporated.

TME10/380: Remote Transmission of Radiological Images by means of Intranet/Internet Technology

PubMed Central

Sicurello, F; Pizzi, R

1999-01-01

At the Istituto Nazionale Neurologico C. Besta in Milano a network architecture has been developed to connect computers and diagnostic modalities, based on Intranet technology in order to allow the hospital to have an external access through the Internet. The Internet technology has become the "glue" that allows to link different computers and to develop applications able to work independently from the hardware/software platform. Using a PACS (Picture Archiving and Communication System) system integrated to the diagnostic modalities by means of the standardized DICOM image format, the digital radiological images can be transferred, displayed and processed on special visualization workstations all around the hospital. From the workstations the same images can be transferred in DICOM format to a teleconsulting workstation. In fact the hospital is involved in a national project for the remote connection between many Italian hospitals. This national network is linked to already developed regional networks like the Toscana MAN and the ATM Sirius Network. Some links are performed directly in ATM (155 Mbps), others are based on CDN (Direct Numerical Connection, 2Mbps), others are simply based on ISDN connections. The system allows to make it simpler and faster the already established daily exchange of radiological reports between the involved hospitals, especially from Istituto Nazionale Neurologico and Istituto Nazionale deiTumori. All the actions performed by the radiologist are translated by the software into "events" and replied to the remote workstation and vice-versa. In this way the radiologists can see each others, speak together and act in real time on a common "board" of diagnostic images, each one with his own pointer. The adopted technology is evolving on a system based on a web architecture and Java applications, useful for small clinical centers not endowed with expensive information systems. These centers will be able to get consulting performances by the excellence centers, making available accurate diagnoses and therapy protocols.

SU-E-J-93: Development of Pre-Contoured Human Model Library in DICOM-RT Format for the Epidemiological Study of the Radiotherapy Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pyakuryal, A; Lee, C; Lee, C

Purpose: Prior to 3D conformal radiation therapy planning, patient anatomy information was mostly limited to 2D beams-eye-view from the conventional simulator. To analyze the outcomes of such treatments for radiation late effects, 3D computational human models are often used in commercial treatment planning systems (TPSs). However, several underlying difficulties such as time-consuming manual delineation procedures of a large number of structures in the model have always limited its applications. Primary objective of this work was to develop a human model library for the epidemiological study by converting 3D-surface model organs to DICOM-RT format (DICOM-RT structure) using an in-house built software.more » We converted the ICRP reference human models to DICOM-RT models, which can be readily adopted for various dose calculations. Methods: MATLAB based code were utilized to convert the contour drawings extracted in text-format from the 3D graphic-tool, Rhinoceros into DICOM-RT structure format for 50 different organs of each model using a 16GB dual-core processor. The conversion periods were measured for each DICOM-RT models, and the reconstructed structure volumes were validated against the original 3D-surface models in the TPS. Ten reference hybrid whole-body models (8-pediatric and 2-adults) were automatically processed to create DICOM-RT computational human model library. Results: Mean contour conversion period was found to be 580 (N=2) and 394.5 (N=8) seconds for 50 organs in the adult and pediatric models respectively. A good agreement for large organs (NRMSD <1.0%) and small organs (NRMSD <7.7%) was also observed between the original volumes and corresponding DICOM-RT structure volumes of the organs. Conclusion: The ICRP reference human models were converted into DICOM-RT format to support the epidemiological study using a large cohort of conventional radiotherapy patients. Due to its DICOM-compatibility, the library may be implemented to many other different applications. We also expect to develop the library by including additional models in future.« less

MineScan: non-image data monitoring and mining from imaging modalities

NASA Astrophysics Data System (ADS)

Zaidi, Shayan M.; Huff, Dov; Bhalodia, Pankit; Mongkolwat, Pattanasak; Channin, David S.

2003-05-01

This project is intended to capture and interactively display non-image information routinely generated by imaging modalities. This information relates to the device's performance of the individual procedures and is not necessarily available in other information streams such as DICOM headers. While originally intended for use in servicing the modalities, this information can also be presented to radiologists and administrators within the department for both micro- and macro-management purposes. This data can help hospital administrators and radiologists manage available resources and discover clues to indicate what modifications in hospital operations might significantly improve its ability to provide efficient patient care. Data is collected from a departmental CT scanner. The data consists of a running record of exams followed by a list of processing records logged over a 24-hour period. MineScan extracts information from these records and stores it into a database. A statistical program is run once a day to collect relevant metrics. MineScan can be accessed via a Web browser or through an advanced prototype PACS workstation. This information, if provided in real-time, can be used to manage operations in a busy department. Even when provided historically, the data can be used to assess current activity, analyze trends and plan future operations.

Integrating TRENCADIS components in gLite to share DICOM medical images and structured reports.

PubMed

Blanquer, Ignacio; Hernández, Vicente; Salavert, José; Segrelles, Damià

2010-01-01

The problem of sharing medical information among different centres has been tackled by many projects. Several of them target the specific problem of sharing DICOM images and structured reports (DICOM-SR), such as the TRENCADIS project. In this paper we propose sharing and organizing DICOM data and DICOM-SR metadata benefiting from the existent deployed Grid infrastructures compliant with gLite such as EGEE or the Spanish NGI. These infrastructures contribute with a large amount of storage resources for creating knowledge databases and also provide metadata storage resources (such as AMGA) to semantically organize reports in a tree-structure. First, in this paper, we present the extension of TRENCADIS architecture to use gLite components (LFC, AMGA, SE) on the shake of increasing interoperability. Using the metadata from DICOM-SR, and maintaining its tree structure, enables federating different but compatible diagnostic structures and simplifies the definition of complex queries. This article describes how to do this in AMGA and it shows an approach to efficiently code radiology reports to enable the multi-centre federation of data resources.

New DICOM extensions for softcopy and hardcopy display consistency.

PubMed

Eichelberg, M; Riesmeier, J; Kleber, K; Grönemeyer, D H; Oosterwijk, H; Jensch, P

2000-01-01

The DICOM standard defines in detail how medical images can be communicated. However, the rules on how to interpret the parameters contained in a DICOM image which deal with the image presentation were either lacking or not well defined. As a result, the same image frequently looks different when displayed on different workstations or printed on a film from various printers. Three new DICOM extensions attempt to close this gap by defining a comprehensive model for the display of images on softcopy and hardcopy devices: Grayscale Standard Display Function, Grayscale Softcopy Presentation State and Presentation Look Up Table.

CytometryML: a markup language for analytical cytology

NASA Astrophysics Data System (ADS)

Leif, Robert C.; Leif, Stephanie H.; Leif, Suzanne B.

2003-06-01

Cytometry Markup Language, CytometryML, is a proposed new analytical cytology data standard. CytometryML is a set of XML schemas for encoding both flow cytometry and digital microscopy text based data types. CytometryML schemas reference both DICOM (Digital Imaging and Communications in Medicine) codes and FCS keywords. These schemas provide representations for the keywords in FCS 3.0 and will soon include DICOM microscopic image data. Flow Cytometry Standard (FCS) list-mode has been mapped to the DICOM Waveform Information Object. A preliminary version of a list mode binary data type, which does not presently exist in DICOM, has been designed. This binary type is required to enhance the storage and transmission of flow cytometry and digital microscopy data. Index files based on Waveform indices will be used to rapidly locate the cells present in individual subsets. DICOM has the advantage of employing standard file types, TIF and JPEG, for Digital Microscopy. Using an XML schema based representation means that standard commercial software packages such as Excel and MathCad can be used to analyze, display, and store analytical cytometry data. Furthermore, by providing one standard for both DICOM data and analytical cytology data, it eliminates the need to create and maintain special purpose interfaces for analytical cytology data thereby integrating the data into the larger DICOM and other clinical communities. A draft version of CytometryML is available at www.newportinstruments.com.

CytometryML, an XML format based on DICOM and FCS for analytical cytology data.

PubMed

Leif, Robert C; Leif, Suzanne B; Leif, Stephanie H

2003-07-01

Flow Cytometry Standard (FCS) was initially created to standardize the software researchers use to analyze, transmit, and store data produced by flow cytometers and sorters. Because of the clinical utility of flow cytometry, it is necessary to have a standard consistent with the requirements of medical regulatory agencies. We extended the existing mapping of FCS to the Digital Imaging and Communications in Medicine (DICOM) standard to include list-mode data produced by flow cytometry, laser scanning cytometry, and microscopic image cytometry. FCS list-mode was mapped to the DICOM Waveform Information Object. We created a collection of Extensible Markup Language (XML) schemas to express the DICOM analytical cytologic text-based data types except for large binary objects. We also developed a cytometry markup language, CytometryML, in an open environment subject to continuous peer review. The feasibility of expressing the data contained in FCS, including list-mode in DICOM, was demonstrated; and a preliminary mapping for list-mode data in the form of XML schemas and documents was completed. DICOM permitted the creation of indices that can be used to rapidly locate in a list-mode file the cells that are members of a subset. DICOM and its coding schemes for other medical standards can be represented by XML schemas, which can be combined with other relevant XML applications, such as Mathematical Markup Language (MathML). The use of XML format based on DICOM for analytical cytology met most of the previously specified requirements and appears capable of meeting the others; therefore, the present FCS should be retired and replaced by an open, XML-based, standard CytometryML. Copyright 2003 Wiley-Liss, Inc.

Medical Applications of the PHITS Code (3): User Assistance Program for Medical Physics Computation.

PubMed

Furuta, Takuya; Hashimoto, Shintaro; Sato, Tatsuhiko

2016-01-01

DICOM2PHITS and PSFC4PHITS are user assistance programs for medical physics PHITS applications. DICOM2PHITS is a program to construct the voxel PHITS simulation geometry from patient CT DICOM image data by using a conversion table from CT number to material composition. PSFC4PHITS is a program to convert the IAEA phase-space file data to PHITS format to be used as a simulation source of PHITS. Both of the programs are useful for users who want to apply PHITS simulation to verification of the treatment planning of radiation therapy. We are now developing a program to convert dose distribution obtained by PHITS to DICOM RT-dose format. We also want to develop a program which is able to implement treatment information included in other DICOM files (RT-plan and RT-structure) as a future plan.

DICOM static and dynamic representation through unified modeling language

NASA Astrophysics Data System (ADS)

Martinez-Martinez, Alfonso; Jimenez-Alaniz, Juan R.; Gonzalez-Marquez, A.; Chavez-Avelar, N.

2004-04-01

The DICOM standard, as all standards, specifies in generic way the management in network and storage media environments of digital medical images and their related information. However, understanding the specifications for particular implementation is not a trivial work. Thus, this work is about understanding and modelling parts of the DICOM standard using Object Oriented methodologies, as part of software development processes. This has offered different static and dynamic views, according with the standard specifications, and the resultant models have been represented through the Unified Modelling Language (UML). The modelled parts are related to network conformance claim: Network Communication Support for Message Exchange, Message Exchange, Information Object Definitions, Service Class Specifications, Data Structures and Encoding, and Data Dictionary. The resultant models have given a better understanding about DICOM parts and have opened the possibility of create a software library to develop DICOM conformable PACS applications.

Application of Multiprotocol Medical Imaging Communications and an Extended DICOM WADO Service in a Teleradiology Architecture

PubMed Central

Koutelakis, George V.; Anastassopoulos, George K.; Lymberopoulos, Dimitrios K.

2012-01-01

Multiprotocol medical imaging communication through the Internet is more flexible than the tight DICOM transfers. This paper introduces a modular multiprotocol teleradiology architecture that integrates DICOM and common Internet services (based on web, FTP, and E-mail) into a unique operational domain. The extended WADO service (a web extension of DICOM) and the other proposed services allow access to all levels of the DICOM information hierarchy as opposed to solely Object level. A lightweight client site is considered adequate, because the server site of the architecture provides clients with service interfaces through the web as well as invulnerable space for temporary storage, called as User Domains, so that users fulfill their applications' tasks. The proposed teleradiology architecture is pilot implemented using mainly Java-based technologies and is evaluated by engineers in collaboration with doctors. The new architecture ensures flexibility in access, user mobility, and enhanced data security. PMID:22489237

Digital Imaging and Communications in Medicine Whole Slide Imaging Connectathon at Digital Pathology Association Pathology Visions 2017.

PubMed

Clunie, David; Hosseinzadeh, Dan; Wintell, Mikael; De Mena, David; Lajara, Nieves; Garcia-Rojo, Marcial; Bueno, Gloria; Saligrama, Kiran; Stearrett, Aaron; Toomey, David; Abels, Esther; Apeldoorn, Frank Van; Langevin, Stephane; Nichols, Sean; Schmid, Joachim; Horchner, Uwe; Beckwith, Bruce; Parwani, Anil; Pantanowitz, Liron

2018-01-01

As digital pathology systems for clinical diagnostic work applications become mainstream, interoperability between these systems from different vendors becomes critical. For the first time, multiple digital pathology vendors have publicly revealed the use of the digital imaging and communications in medicine (DICOM) standard file format and network protocol to communicate between separate whole slide acquisition, storage, and viewing components. Note the use of DICOM for clinical diagnostic applications is still to be validated in the United States. The successful demonstration shows that the DICOM standard is fundamentally sound, though many lessons were learned. These lessons will be incorporated as incremental improvements in the standard, provide more detailed profiles to constrain variation for specific use cases, and offer educational material for implementers. Future Connectathon events will expand the scope to include more devices and vendors, as well as more ambitious use cases including laboratory information system integration and annotation for image analysis, as well as more geographic diversity. Users should request DICOM features in all purchases and contracts. It is anticipated that the growth of DICOM-compliant manufacturers will likely also ease DICOM for pathology becoming a recognized standard and as such the regulatory pathway for digital pathology products.

Digital pathology: DICOM-conform draft, testbed, and first results.

PubMed

Zwönitzer, Ralf; Kalinski, Thomas; Hofmann, Harald; Roessner, Albert; Bernarding, Johannes

2007-09-01

Hospital information systems are state of the art nowadays. Therefore, Digital Pathology, also labelled as Virtual Microscopy, has gained increased attention. Triggered by radiology, standardized information models and workflows were world-wide defined based on DICOM. However, DICOM-conform integration of Digital Pathology into existing clinical information systems imposes new problems requiring specific solutions concerning the huge amount of data as well as the special structure of the data to be managed, transferred, and stored. We implemented a testbed to realize and evaluate the workflow of digitized slides from acquisition to archiving. The experiences led to the draft of a DICOM-conform information model that accounted for extensions, definitions, and technical requirements necessary to integrate digital pathology in a hospital-wide DICOM environment. Slides were digitized, compressed, and could be viewed remotely. Real-time transfer of the huge amount of data was optimized using streaming techniques. Compared to a recent discussion in the DICOM Working Group for Digital Pathology (WG26) our experiences led to a preference of a JPEG2000/JPIP-based streaming of the whole slide image. The results showed that digital pathology is feasible but strong efforts by users and vendors are still necessary to integrate Digital Pathology into existing information systems.

A collaborative framework for contributing DICOM RT PHI (Protected Health Information) to augment data mining in clinical decision support

NASA Astrophysics Data System (ADS)

Deshpande, Ruchi; Thuptimdang, Wanwara; DeMarco, John; Liu, Brent J.

2014-03-01

We have built a decision support system that provides recommendations for customizing radiation therapy treatment plans, based on patient models generated from a database of retrospective planning data. This database consists of relevant metadata and information derived from the following DICOM objects - CT images, RT Structure Set, RT Dose and RT Plan. The usefulness and accuracy of such patient models partly depends on the sample size of the learning data set. Our current goal is to increase this sample size by expanding our decision support system into a collaborative framework to include contributions from multiple collaborators. Potential collaborators are often reluctant to upload even anonymized patient files to repositories outside their local organizational network in order to avoid any conflicts with HIPAA Privacy and Security Rules. We have circumvented this problem by developing a tool that can parse DICOM files on the client's side and extract de-identified numeric and text data from DICOM RT headers for uploading to a centralized system. As a result, the DICOM files containing PHI remain local to the client side. This is a novel workflow that results in adding only relevant yet valuable data from DICOM files to the centralized decision support knowledge base in such a way that the DICOM files never leave the contributor's local workstation in a cloud-based environment. Such a workflow serves to encourage clinicians to contribute data for research endeavors by ensuring protection of electronic patient data.

DataViewer3D: An Open-Source, Cross-Platform Multi-Modal Neuroimaging Data Visualization Tool

PubMed Central

Gouws, André; Woods, Will; Millman, Rebecca; Morland, Antony; Green, Gary

2008-01-01

Integration and display of results from multiple neuroimaging modalities [e.g. magnetic resonance imaging (MRI), magnetoencephalography, EEG] relies on display of a diverse range of data within a common, defined coordinate frame. DataViewer3D (DV3D) is a multi-modal imaging data visualization tool offering a cross-platform, open-source solution to simultaneous data overlay visualization requirements of imaging studies. While DV3D is primarily a visualization tool, the package allows an analysis approach where results from one imaging modality can guide comparative analysis of another modality in a single coordinate space. DV3D is built on Python, a dynamic object-oriented programming language with support for integration of modular toolkits, and development of cross-platform software for neuroimaging. DV3D harnesses the power of the Visualization Toolkit (VTK) for two-dimensional (2D) and 3D rendering, calling VTK's low level C++ functions from Python. Users interact with data via an intuitive interface that uses Python to bind wxWidgets, which in turn calls the user's operating system dialogs and graphical user interface tools. DV3D currently supports NIfTI-1, ANALYZE™ and DICOM formats for MRI data display (including statistical data overlay). Formats for other data types are supported. The modularity of DV3D and ease of use of Python allows rapid integration of additional format support and user development. DV3D has been tested on Mac OSX, RedHat Linux and Microsoft Windows XP. DV3D is offered for free download with an extensive set of tutorial resources and example data. PMID:19352444

Standardized access, display, and retrieval of medical video

NASA Astrophysics Data System (ADS)

Bellaire, Gunter; Steines, Daniel; Graschew, Georgi; Thiel, Andreas; Bernarding, Johannes; Tolxdorff, Thomas; Schlag, Peter M.

1999-05-01

The system presented here enhances documentation and data- secured, second-opinion facilities by integrating video sequences into DICOM 3.0. We present an implementation for a medical video server extended by a DICOM interface. Security mechanisms conforming with DICOM are integrated to enable secure internet access. Digital video documents of diagnostic and therapeutic procedures should be examined regarding the clip length and size necessary for second opinion and manageable with today's hardware. Image sources relevant for this paper include 3D laparoscope, 3D surgical microscope, 3D open surgery camera, synthetic video, and monoscopic endoscopes, etc. The global DICOM video concept and three special workplaces of distinct applications are described. Additionally, an approach is presented to analyze the motion of the endoscopic camera for future automatic video-cutting. Digital stereoscopic video sequences are especially in demand for surgery . Therefore DSVS are also integrated into the DICOM video concept. Results are presented describing the suitability of stereoscopic display techniques for the operating room.

Separation of metadata and pixel data to speed DICOM tag morphing.

PubMed

Ismail, Mahmoud; Philbin, James

2013-01-01

The DICOM information model combines pixel data and metadata in single DICOM object. It is not possible to access the metadata separately from the pixel data. There are use cases where only metadata is accessed. The current DICOM object format increases the running time of those use cases. Tag morphing is one of those use cases. Tag morphing includes deletion, insertion or manipulation of one or more of the metadata attributes. It is typically used for order reconciliation on study acquisition or to localize the issuer of patient ID (IPID) and the patient ID attributes when data from one domain is transferred to a different domain. In this work, we propose using Multi-Series DICOM (MSD) objects, which separate metadata from pixel data and remove duplicate attributes, to reduce the time required for Tag Morphing. The time required to update a set of study attributes in each format is compared. The results show that the MSD format significantly reduces the time required for tag morphing.

Performance evaluation of secured DICOM image communication with next generation internet protocol IPv6

NASA Astrophysics Data System (ADS)

Yu, Fenghai; Zhang, Jianguo; Chen, Xiaomeng; Huang, H. K.

2005-04-01

Next Generation Internet (NGI) technology with new communication protocol IPv6 emerges as a potential solution for low-cost and high-speed networks for image data transmission. IPv6 is designed to solve many of the problems of the current version of IP (known as IPv4) with regard to address depletion, security, autoconfiguration, extensibility, and more. We choose CTN (Central Test Node) DICOM software developed by The Mallinckrodt Institute of Radiology to implement IPv6/IPv4 enabled DICOM communication software on different operating systems (Windows/Linux), and used this DICOM software to evaluate the performance of the IPv6/IPv4 enabled DICOM image communication with different security setting and environments. We compared the security communications of IPsec with SSL/TLS on different TCP/IP protocols (IPv6/IPv4), and find that there are some trade-offs to choose security solution between IPsec and SSL/TLS in the security implementation of IPv6/IPv4 communication networks.

Image Acquisition Context

PubMed Central

Bidgood, W. Dean; Bray, Bruce; Brown, Nicolas; Mori, Angelo Rossi; Spackman, Kent A.; Golichowski, Alan; Jones, Robert H.; Korman, Louis; Dove, Brent; Hildebrand, Lloyd; Berg, Michael

1999-01-01

Objective: To support clinically relevant indexing of biomedical images and image-related information based on the attributes of image acquisition procedures and the judgments (observations) expressed by observers in the process of image interpretation. Design: The authors introduce the notion of “image acquisition context,” the set of attributes that describe image acquisition procedures, and present a standards-based strategy for utilizing the attributes of image acquisition context as indexing and retrieval keys for digital image libraries. Methods: The authors' indexing strategy is based on an interdependent message/terminology architecture that combines the Digital Imaging and Communication in Medicine (DICOM) standard, the SNOMED (Systematized Nomenclature of Human and Veterinary Medicine) vocabulary, and the SNOMED DICOM microglossary. The SNOMED DICOM microglossary provides context-dependent mapping of terminology to DICOM data elements. Results: The capability of embedding standard coded descriptors in DICOM image headers and image-interpretation reports improves the potential for selective retrieval of image-related information. This favorably affects information management in digital libraries. PMID:9925229

Image acquisition context: procedure description attributes for clinically relevant indexing and selective retrieval of biomedical images.

PubMed

Bidgood, W D; Bray, B; Brown, N; Mori, A R; Spackman, K A; Golichowski, A; Jones, R H; Korman, L; Dove, B; Hildebrand, L; Berg, M

1999-01-01

To support clinically relevant indexing of biomedical images and image-related information based on the attributes of image acquisition procedures and the judgments (observations) expressed by observers in the process of image interpretation. The authors introduce the notion of "image acquisition context," the set of attributes that describe image acquisition procedures, and present a standards-based strategy for utilizing the attributes of image acquisition context as indexing and retrieval keys for digital image libraries. The authors' indexing strategy is based on an interdependent message/terminology architecture that combines the Digital Imaging and Communication in Medicine (DICOM) standard, the SNOMED (Systematized Nomenclature of Human and Veterinary Medicine) vocabulary, and the SNOMED DICOM microglossary. The SNOMED DICOM microglossary provides context-dependent mapping of terminology to DICOM data elements. The capability of embedding standard coded descriptors in DICOM image headers and image-interpretation reports improves the potential for selective retrieval of image-related information. This favorably affects information management in digital libraries.

Digital Imaging and Communications in Medicine Whole Slide Imaging Connectathon at Digital Pathology Association Pathology Visions 2017

PubMed Central

Clunie, David; Hosseinzadeh, Dan; Wintell, Mikael; De Mena, David; Lajara, Nieves; Garcia-Rojo, Marcial; Bueno, Gloria; Saligrama, Kiran; Stearrett, Aaron; Toomey, David; Abels, Esther; Apeldoorn, Frank Van; Langevin, Stephane; Nichols, Sean; Schmid, Joachim; Horchner, Uwe; Beckwith, Bruce; Parwani, Anil; Pantanowitz, Liron

2018-01-01

As digital pathology systems for clinical diagnostic work applications become mainstream, interoperability between these systems from different vendors becomes critical. For the first time, multiple digital pathology vendors have publicly revealed the use of the digital imaging and communications in medicine (DICOM) standard file format and network protocol to communicate between separate whole slide acquisition, storage, and viewing components. Note the use of DICOM for clinical diagnostic applications is still to be validated in the United States. The successful demonstration shows that the DICOM standard is fundamentally sound, though many lessons were learned. These lessons will be incorporated as incremental improvements in the standard, provide more detailed profiles to constrain variation for specific use cases, and offer educational material for implementers. Future Connectathon events will expand the scope to include more devices and vendors, as well as more ambitious use cases including laboratory information system integration and annotation for image analysis, as well as more geographic diversity. Users should request DICOM features in all purchases and contracts. It is anticipated that the growth of DICOM-compliant manufacturers will likely also ease DICOM for pathology becoming a recognized standard and as such the regulatory pathway for digital pathology products. PMID:29619278

Toward uniform implementation of parametric map Digital Imaging and Communication in Medicine standard in multisite quantitative diffusion imaging studies.

PubMed

Malyarenko, Dariya; Fedorov, Andriy; Bell, Laura; Prah, Melissa; Hectors, Stefanie; Arlinghaus, Lori; Muzi, Mark; Solaiyappan, Meiyappan; Jacobs, Michael; Fung, Maggie; Shukla-Dave, Amita; McManus, Kevin; Boss, Michael; Taouli, Bachir; Yankeelov, Thomas E; Quarles, Christopher Chad; Schmainda, Kathleen; Chenevert, Thomas L; Newitt, David C

2018-01-01

This paper reports on results of a multisite collaborative project launched by the MRI subgroup of Quantitative Imaging Network to assess current capability and provide future guidelines for generating a standard parametric diffusion map Digital Imaging and Communication in Medicine (DICOM) in clinical trials that utilize quantitative diffusion-weighted imaging (DWI). Participating sites used a multivendor DWI DICOM dataset of a single phantom to generate parametric maps (PMs) of the apparent diffusion coefficient (ADC) based on two models. The results were evaluated for numerical consistency among models and true phantom ADC values, as well as for consistency of metadata with attributes required by the DICOM standards. This analysis identified missing metadata descriptive of the sources for detected numerical discrepancies among ADC models. Instead of the DICOM PM object, all sites stored ADC maps as DICOM MR objects, generally lacking designated attributes and coded terms for quantitative DWI modeling. Source-image reference, model parameters, ADC units and scale, deemed important for numerical consistency, were either missing or stored using nonstandard conventions. Guided by the identified limitations, the DICOM PM standard has been amended to include coded terms for the relevant diffusion models. Open-source software has been developed to support conversion of site-specific formats into the standard representation.

An imaging informatics-based system utilizing DICOM objects for treating pain in spinal cord injury patients utilizing proton beam radiotherapy

NASA Astrophysics Data System (ADS)

Verma, Sneha K.; Liu, Brent J.; Chun, Sophia; Gridley, Daila S.

2014-03-01

Many US combat personnel have sustained nervous tissue trauma during service, which often causes Neuropathic pain as a side effect and is difficult to manage. However in select patients, synapse lesioning can provide significant pain control. Our goal is to determine the effectiveness of using Proton Beam radiotherapy for treating spinal cord injury (SCI) related neuropathic pain as an alternative to invasive surgical lesioning. The project is a joint collaboration of USC, Spinal Cord Institute VA Healthcare System, Long Beach, and Loma Linda University. This is first system of its kind that supports integration and standardization of imaging informatics data in DICOM format; clinical evaluation forms outcomes data and treatment planning data from the Treatment planning station (TPS) utilized to administer the proton therapy in DICOM-RT format. It also supports evaluation of SCI subjects for recruitment into the clinical study, which includes the development, and integration of digital forms and tools for automatic evaluation and classification of SCI pain. Last year, we presented the concept for the patient recruitment module based on the principle of Bayesian decision theory. This year we are presenting the fully developed patient recruitment module and its integration to other modules. In addition, the DICOM module for integrating DICOM and DICOM-RT-ION data is also developed and integrated. This allows researchers to upload animal/patient study data into the system. The patient recruitment module has been tested using 25 retrospective patient data and DICOM data module is tested using 5 sets of animal data.

DICOM for quantitative imaging biomarker development: a standards based approach to sharing clinical data and structured PET/CT analysis results in head and neck cancer research.

PubMed

Fedorov, Andriy; Clunie, David; Ulrich, Ethan; Bauer, Christian; Wahle, Andreas; Brown, Bartley; Onken, Michael; Riesmeier, Jörg; Pieper, Steve; Kikinis, Ron; Buatti, John; Beichel, Reinhard R

2016-01-01

Background. Imaging biomarkers hold tremendous promise for precision medicine clinical applications. Development of such biomarkers relies heavily on image post-processing tools for automated image quantitation. Their deployment in the context of clinical research necessitates interoperability with the clinical systems. Comparison with the established outcomes and evaluation tasks motivate integration of the clinical and imaging data, and the use of standardized approaches to support annotation and sharing of the analysis results and semantics. We developed the methodology and tools to support these tasks in Positron Emission Tomography and Computed Tomography (PET/CT) quantitative imaging (QI) biomarker development applied to head and neck cancer (HNC) treatment response assessment, using the Digital Imaging and Communications in Medicine (DICOM(®)) international standard and free open-source software. Methods. Quantitative analysis of PET/CT imaging data collected on patients undergoing treatment for HNC was conducted. Processing steps included Standardized Uptake Value (SUV) normalization of the images, segmentation of the tumor using manual and semi-automatic approaches, automatic segmentation of the reference regions, and extraction of the volumetric segmentation-based measurements. Suitable components of the DICOM standard were identified to model the various types of data produced by the analysis. A developer toolkit of conversion routines and an Application Programming Interface (API) were contributed and applied to create a standards-based representation of the data. Results. DICOM Real World Value Mapping, Segmentation and Structured Reporting objects were utilized for standards-compliant representation of the PET/CT QI analysis results and relevant clinical data. A number of correction proposals to the standard were developed. The open-source DICOM toolkit (DCMTK) was improved to simplify the task of DICOM encoding by introducing new API abstractions. Conversion and visualization tools utilizing this toolkit were developed. The encoded objects were validated for consistency and interoperability. The resulting dataset was deposited in the QIN-HEADNECK collection of The Cancer Imaging Archive (TCIA). Supporting tools for data analysis and DICOM conversion were made available as free open-source software. Discussion. We presented a detailed investigation of the development and application of the DICOM model, as well as the supporting open-source tools and toolkits, to accommodate representation of the research data in QI biomarker development. We demonstrated that the DICOM standard can be used to represent the types of data relevant in HNC QI biomarker development, and encode their complex relationships. The resulting annotated objects are amenable to data mining applications, and are interoperable with a variety of systems that support the DICOM standard.

Technical Note: Development and validation of an open data format for CT projection data.

PubMed

Chen, Baiyu; Duan, Xinhui; Yu, Zhicong; Leng, Shuai; Yu, Lifeng; McCollough, Cynthia

2015-12-01

Lack of access to projection data from patient CT scans is a major limitation for development and validation of new reconstruction algorithms. To meet this critical need, this work developed and validated a vendor-neutral format for CT projection data, which will further be employed to build a library of patient projection data for public access. A digital imaging and communication in medicine (DICOM)-like format was created for CT projection data (CT-PD), named the DICOM-CT-PD format. The format stores attenuation information in the DICOM image data block and stores parameters necessary for reconstruction in the DICOM header under various tags (51 tags to store the geometry and scan parameters and 9 tags to store patient information). To validate the accuracy and completeness of the new format, CT projection data from helical scans of the ACR CT accreditation phantom were acquired from two clinical CT scanners (Somatom Definition Flash, Siemens Healthcare, Forchheim, Germany and Discovery CT750 HD, GE Healthcare, Waukesha, WI). After decoding (by the authors for Siemens, by the manufacturer for GE), the projection data were converted to the DICOM-CT-PD format. Off-line CT reconstructions were performed by internal and external reconstruction researchers using only the information stored in the DICOM-CT-PD files and the DICOM-CT-PD field definitions. Compared with the commercially reconstructed CT images, the off-line reconstructed images created using the DICOM-CT-PD format are similar in terms of CT numbers (differences of 5 HU for the bone insert and -9 HU for the air insert), image noise (±1 HU), and low contrast detectability (6 mm rods visible in both). Because of different reconstruction approaches, slightly different in-plane and cross-plane high contrast spatial resolution were obtained compared to those reconstructed on the scanners (axial plane: GE off-line, 7 lp/cm; GE commercial, 7 lp/cm; Siemens off-line, 8 lp/cm; Siemens commercial, 7 lp/cm. Coronal plane: Siemens off-line, 6 lp/cm; Siemens commercial, 8 lp/cm). A vendor-neutral extended DICOM format has been developed that enables open sharing of CT projection data from third-generation CT scanners. Validation of the format showed that the geometric parameters and attenuation information in the DICOM-CT-PD file were correctly stored, could be retrieved with use of the provided instructions, and contained sufficient data for reconstruction of CT images that approximated those from the commercial scanner.

North by Northwestern: initial experience with PACS at Northwestern Memorial Hospital

NASA Astrophysics Data System (ADS)

Channin, David S.; Hawkins, Rodney C.; Enzmann, Dieter R.

2000-05-01

This paper describes the initial phases and configuration of the Picture Archive and Communication System (PACS) deployed at Northwestern Memorial Hospital. The primary goals of the project were to improve service to patients, improve service to referring physicians, and improve the process of radiology. Secondary goals were to enhance the academic mission, and modernize institutional information systems. The system consists of a large number of heterogeneous imaging modalities sending imaging studies via DICOM to a GE medical Systems PathSpeed PACS. The radiology department workflow is briefly described. The system is currently storing approximately 140,000 studies and over 5 million images, growing by approximately 600 studies and 25,000 images per day. Data reflecting use of the short term and long term storage is provided.

[Construction of DICOM-WWW gateway by open source, and application to PDAs using the high-speed mobile communications network].

PubMed

Yokohama, Noriya

2003-09-01

The author constructed a medical image network system using open source software that took security into consideration. This system was enabled for search and browse with a WWW browser, and images were stored in a DICOM server. In order to realize this function, software was developed to fill in the gap between the DICOM protocol and HTTP using PHP language. The transmission speed was evaluated by the difference in protocols between DICOM and HTTP. Furthermore, an attempt was made to evaluate the convenience of medical image access with a personal information terminal via the Internet through the high-speed mobile communication terminal. Results suggested the feasibility of remote diagnosis and application to emergency care.

Development of a high-performance image server using ATM technology

NASA Astrophysics Data System (ADS)

Do Van, Minh; Humphrey, Louis M.; Ravin, Carl E.

1996-05-01

The ability to display digital radiographs to a radiologist in a reasonable time has long been the goal of many PACS. Intelligent routing, or pre-fetching images, has become a solution whereby a system uses a set of rules to route the images to a pre-determined destination. Images would then be stored locally on a workstation for faster display times. Some PACS use a large, centralized storage approach and workstations retrieve images over high bandwidth connections. Another approach to image management is to provide a high performance, clustered storage system. This has the advantage of eliminating the complexity of pre-fetching and allows for rapid image display from anywhere within the hospital. We discuss the development of such a storage device, which provides extremely fast access to images across a local area network. Among the requirements for development of the image server were high performance, DICOM 3.0 compliance, and the use of industry standard components. The completed image server provides performance more than sufficient for use in clinical practice. Setting up modalities to send images to the image server is simple due to the adherence to the DICOM 3.0 specification. Using only off-the-shelf components allows us to keep the cost of the server relatively inexpensive and allows for easy upgrades as technology becomes more advanced. These factors make the image server ideal for use as a clustered storage system in a radiology department.

Retrospective evaluation of dosimetric quality for prostate carcinomas treated with 3D conformal, intensity modulated and volumetric modulated arc radiotherapy

PubMed Central

Crowe, Scott B; Kairn, Tanya; Middlebrook, Nigel; Hill, Brendan; Christie, David R H; Knight, Richard T; Kenny, John; Langton, Christian M; Trapp, Jamie V

2013-01-01

Introduction This study examines and compares the dosimetric quality of radiotherapy treatment plans for prostate carcinoma across a cohort of 163 patients treated across five centres: 83 treated with three-dimensional conformal radiotherapy (3DCRT), 33 treated with intensity modulated radiotherapy (IMRT) and 47 treated with volumetric modulated arc therapy (VMAT). Methods Treatment plan quality was evaluated in terms of target dose homogeneity and organs at risk (OAR), through the use of a set of dose metrics. These included the mean, maximum and minimum doses; the homogeneity and conformity indices for the target volumes; and a selection of dose coverage values that were relevant to each OAR. Statistical significance was evaluated using two-tailed Welch's T-tests. The Monte Carlo DICOM ToolKit software was adapted to permit the evaluation of dose metrics from DICOM data exported from a commercial radiotherapy treatment planning system. Results The 3DCRT treatment plans offered greater planning target volume dose homogeneity than the other two treatment modalities. The IMRT and VMAT plans offered greater dose reduction in the OAR: with increased compliance with recommended OAR dose constraints, compared to conventional 3DCRT treatments. When compared to each other, IMRT and VMAT did not provide significantly different treatment plan quality for like-sized tumour volumes. Conclusions This study indicates that IMRT and VMAT have provided similar dosimetric quality, which is superior to the dosimetric quality achieved with 3DCRT. PMID:26229621

Comparison between DICOM-calibrated and uncalibrated consumer grade and 6-MP displays under different lighting conditions in panoramic radiography

PubMed Central

Haapea, M; Liukkonen, E; Huumonen, S; Tervonen, O; Nieminen, M T

2015-01-01

Objectives: To compare observer performance in the detection of anatomical structures and pathology in panoramic radiographs using consumer grade with and without digital imaging and communication in medicine (DICOM)-calibration and 6-megapixel (6-MP) displays under different lighting conditions. Methods: 30 panoramic radiographs were randomly evaluated on three displays under bright (510 lx) and dim (16 lx) ambient lighting by two observers with different years of experience. Dentinoenamel junction, dentinal caries and periapical inflammatory lesions, visibility of cortical border of the floor and pathological lesions in maxillary sinus were evaluated. Consensus between the observers was considered as reference. Intraobserver agreement was determined. Proportion of equivalent ratings and weighted kappa were used to assess reliability. The level of significance was set to p < 0.05. Results: The proportion of equivalent ratings with consensus differed between uncalibrated and DICOM-calibrated consumer grade displays in dentinal caries in the lower molar in dim lighting (p = 0.021) and between DICOM-calibrated consumer grade and 6-MP display in bright lighting (p = 0.038) for an experienced observer. Significant differences were found between uncalibrated and DICOM-calibrated consumer grade displays in dentinal caries in bright lighting (p = 0.044) and periapical lesions in the upper molar in dim lighting (p = 0.008) for a less experienced observer. Intraobserver reliability was better at detecting dentinal caries than at detecting periapical and maxillary sinus pathology. Conclusions: DICOM calibration may improve observer performance in panoramic radiography in different lighting conditions. Therefore, a DICOM-calibrated consumer grade display can be used instead of a medical display in dental practice without compromising the diagnostic quality. PMID:25564888

Emerging Trends in the Volume and Format of Outside Examinations Submitted for Secondary Interpretation

PubMed Central

Hunt, Christopher H.; Wood, Christopher P.; Diehn, Felix E.; Eckel, Laurence J.; Schwartz, Kara M.; Erickson, Bradley J.

2014-01-01

OBJECTIVE The purpose of this article is to describe the trends of secondary interpretations, including the total volume and format of cases. MATERIALS AND METHODS This retrospective study involved all outside neuroradiology examinations submitted for secondary interpretation from November 2006 through December 2010. This practice utilizes consistent criteria and includes all images that cover the brain, neck, and spine. For each month, the total number of outside examinations and their format (i.e., hard-copy film, DICOM CD-ROM, or non-DICOM CD-ROM) were recorded. RESULTS There was no significant change in the volume of cases (1043 ± 131 cases/month; p = 0.46, two-sided Student t test). There was a significant decrease in the volume of hard-copy films submitted, with the mean number of examinations submitted per month on hard-copy film declining from 297 in 2007 to 57 in 2010 (p < 0.0001, Student t test). This decrease was mirrored by an increase in the mean number of cases submitted on CD-ROM (753 cases/month in 2007 and 1036 cases/month in 2010; p < 0.0001). Although most were submitted in DICOM format, there was almost a doubling of the volume of cases submitted on non-DICOM CD-ROM (mean number of non-DICOM CD-ROMs, nine cases/month in 2007 and 17 cases/month in 2010; p < 0.001). CONCLUSION There has been a significant decrease in the number of hard-copy films submitted for secondary interpretation. There has been almost a doubling of the volume of cases submitted in non-DICOM formats, which is unfortunate, given the many advantages of the internationally derived DICOM standard, including ease of archiving, standardized display, efficient review, improved interpretation, and quality of patient care. PMID:22451538

Emerging trends in the volume and format of outside examinations submitted for secondary interpretation.

PubMed

Hunt, Christopher H; Wood, Christopher P; Diehn, Felix E; Eckel, Laurence J; Schwartz, Kara M; Erickson, Bradley J

2012-04-01

The purpose of this article is to describe the trends of secondary interpretations, including the total volume and format of cases. This retrospective study involved all outside neuroradiology examinations submitted for secondary interpretation from November 2006 through December 2010. This practice utilizes consistent criteria and includes all images that cover the brain, neck, and spine. For each month, the total number of outside examinations and their format (i.e., hard-copy film, DICOM CD-ROM, or non-DICOM CD-ROM) were recorded. There was no significant change in the volume of cases (1043 ± 131 cases/month; p = 0.46, two-sided Student t test). There was a significant decrease in the volume of hard-copy films submitted, with the mean number of examinations submitted per month on hard-copy film declining from 297 in 2007 to 57 in 2010 (p < 0.0001, Student t test). This decrease was mirrored by an increase in the mean number of cases submitted on CD-ROM (753 cases/month in 2007 and 1036 cases/month in 2010; p < 0.0001). Although most were submitted in DICOM format, there was almost a doubling of the volume of cases submitted on non-DICOM CD-ROM (mean number of non-DICOM CD-ROMs, nine cases/month in 2007 and 17 cases/month in 2010; p < 0.001). There has been a significant decrease in the number of hard-copy films submitted for secondary interpretation. There has been almost a doubling of the volume of cases submitted in non-DICOM formats, which is unfortunate, given the many advantages of the internationally derived DICOM standard, including ease of archiving, standardized display, efficient review, improved interpretation, and quality of patient care.

Context indexing of digital cardiac ultrasound records in PACS

NASA Astrophysics Data System (ADS)

Lobodzinski, S. Suave; Meszaros, Georg N.

1998-07-01

Recent wide adoption of the DICOM 3.0 standard by ultrasound equipment vendors created a need for practical clinical implementations of cardiac imaging study visualization, management and archiving, DICOM 3.0 defines only a logical and physical format for exchanging image data (still images, video, patient and study demographics). All DICOM compliant imaging studies must presently be archived on a 650 Mb recordable compact disk. This is a severe limitation for ultrasound applications where studies of 3 to 10 minutes long are a common practice. In addition, DICOM digital echocardiography objects require physiological signal indexing, content segmentation and characterization. Since DICOM 3.0 is an interchange standard only, it does not define how to database composite video objects. The goal of this research was therefore to address the issues of efficient storage, retrieval and management of DICOM compliant cardiac video studies in a distributed PACS environment. Our Web based implementation has the advantage of accommodating both DICOM defined entity-relation modules (equipment data, patient data, video format, etc.) in standard relational database tables and digital indexed video with its attributes in an object relational database. Object relational data model facilitates content indexing of full motion cardiac imaging studies through bi-directional hyperlink generation that tie searchable video attributes and related objects to individual video frames in the temporal domain. Benefits realized from use of bi-directionally hyperlinked data models in an object relational database include: (1) real time video indexing during image acquisition, (2) random access and frame accurate instant playback of previously recorded full motion imaging data, and (3) time savings from faster and more accurate access to data through multiple navigation mechanisms such as multidimensional queries on an index, queries on a hyperlink attribute, free search and browsing.

Automated customized retrieval of radiotherapy data for clinical trials, audit and research.

PubMed

Romanchikova, Marina; Harrison, Karl; Burnet, Neil G; Hoole, Andrew Cf; Sutcliffe, Michael Pf; Parker, Michael Andrew; Jena, Rajesh; Thomas, Simon James

2018-02-01

To enable fast and customizable automated collection of radiotherapy (RT) data from tomotherapy storage. Human-readable data maps (TagMaps) were created to generate DICOM-RT (Digital Imaging and Communications in Medicine standard for Radiation Therapy) data from tomotherapy archives, and provided access to "hidden" information comprising delivery sinograms, positional corrections and adaptive-RT doses. 797 data sets totalling 25,000 scans were batch-exported in 31.5 h. All archived information was restored, including the data not available via commercial software. The exported data were DICOM-compliant and compatible with major commercial tools including RayStation, Pinnacle and ProSoma. The export ran without operator interventions. The TagMap method for DICOM-RT data modelling produced software that was many times faster than the vendor's solution, required minimal operator input and delivered high volumes of vendor-identical DICOM data. The approach is applicable to many clinical and research data processing scenarios and can be adapted to recover DICOM-RT data from other proprietary storage types such as Elekta, Pinnacle or ProSoma. Advances in knowledge: A novel method to translate data from proprietary storage to DICOM-RT is presented. It provides access to the data hidden in electronic archives, offers a working solution to the issues of data migration and vendor lock-in and paves the way for large-scale imaging and radiomics studies.

Evaluation of DICOM viewer software for workflow integration in clinical trials

NASA Astrophysics Data System (ADS)

Haak, Daniel; Page, Charles E.; Kabino, Klaus; Deserno, Thomas M.

2015-03-01

The digital imaging and communications in medicine (DICOM) protocol is nowadays the leading standard for capture, exchange and storage of image data in medical applications. A broad range of commercial, free, and open source software tools supporting a variety of DICOM functionality exists. However, different from patient's care in hospital, DICOM has not yet arrived in electronic data capture systems (EDCS) for clinical trials. Due to missing integration, even just the visualization of patient's image data in electronic case report forms (eCRFs) is impossible. Four increasing levels for integration of DICOM components into EDCS are conceivable, raising functionality but also demands on interfaces with each level. Hence, in this paper, a comprehensive evaluation of 27 DICOM viewer software projects is performed, investigating viewing functionality as well as interfaces for integration. Concerning general, integration, and viewing requirements the survey involves the criteria (i) license, (ii) support, (iii) platform, (iv) interfaces, (v) two-dimensional (2D) and (vi) three-dimensional (3D) image viewing functionality. Optimal viewers are suggested for applications in clinical trials for 3D imaging, hospital communication, and workflow. Focusing on open source solutions, the viewers ImageJ and MicroView are superior for 3D visualization, whereas GingkoCADx is advantageous for hospital integration. Concerning workflow optimization in multi-centered clinical trials, we suggest the open source viewer Weasis. Covering most use cases, an EDCS and PACS interconnection with Weasis is suggested.

Network oriented radiological and medical archive

NASA Astrophysics Data System (ADS)

Ferraris, M.; Frixione, P.; Squarcia, S.

2001-10-01

In this paper the basic ideas of NORMA (Network Oriented Radiological and Medical Archive) are discussed. NORMA is an original project built by a team of physicists in collaboration with radiologists in order to select the best Treatment Planning in radiotherapy. It allows physicians and health physicists, working in different places, to discuss on interesting clinical cases visualizing the same diagnostic images, at the same time, and highlighting zones of interest (tumors and organs at risk). NORMA has a client/server architecture in order to be platform independent. Applying World Wide Web technologies, it can be easily used by people with no specific computer knowledge providing a verbose help to guide the user through the right steps of execution. The client side is an applet while the server side is a Java application. In order to optimize execution the project also includes a proprietary protocol, lying over TCP/IP suite, that organizes data exchanges and control messages. Diagnostic images are retrieved from a relational database or from a standard DICOM (Digital Images and COmmunications in Medicine) PACS through the DICOM-WWW gateway allowing connection of the usual Web browsers, used by the NORMA system, to DICOM applications via the HTTP protocol. Browser requests are sent to the gateway from the Web server through CGI (Common Gateway Interface). DICOM software translates the requests in DICOM messages and organizes the communication with the remote DICOM Application.

An open library of CT patient projection data

NASA Astrophysics Data System (ADS)

Chen, Baiyu; Leng, Shuai; Yu, Lifeng; Holmes, David; Fletcher, Joel; McCollough, Cynthia

2016-03-01

Lack of access to projection data from patient CT scans is a major limitation for development and validation of new reconstruction algorithms. To meet this critical need, we are building a library of CT patient projection data in an open and vendor-neutral format, DICOM-CT-PD, which is an extended DICOM format that contains sinogram data, acquisition geometry, patient information, and pathology identification. The library consists of scans of various types, including head scans, chest scans, abdomen scans, electrocardiogram (ECG)-gated scans, and dual-energy scans. For each scan, three types of data are provided, including DICOM-CT-PD projection data at various dose levels, reconstructed CT images, and a free-form text file. Several instructional documents are provided to help the users extract information from DICOM-CT-PD files, including a dictionary file for the DICOM-CT-PD format, a DICOM-CT-PD reader, and a user manual. Radiologist detection performance based on the reconstructed CT images is also provided. So far 328 head cases, 228 chest cases, and 228 abdomen cases have been collected for potential inclusion. The final library will include a selection of 50 head, chest, and abdomen scans each from at least two different manufacturers, and a few ECG-gated scans and dual-source, dual-energy scans. It will be freely available to academic researchers, and is expected to greatly facilitate the development and validation of CT reconstruction algorithms.

Performance observations based on a subset of the DICOM 3.0 draft standard

NASA Astrophysics Data System (ADS)

Moore, Stephen M.; Blaine, G. James; Jost, R. Gilbert

1993-09-01

The American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA) are defining the Digital Imaging and Communications in Medicine (DICOM) V3.0 Standard. Previous authors have investigated the performance of the ACR- NEMA V1.0 and V2.0 Standards in point to point and network applications. This paper describes an early implementation of a subset of the DICOM V3.0 Standard and presents performance results for a combination of workstation types and network technologies.

Impact of digital imaging and communications in medicine workflow on the integration of patient demographics and ophthalmic test data.

PubMed

Pandit, Ravi R; Boland, Michael V

2015-02-01

To determine the impact of a Digital Imaging and Communications in Medicine (DICOM) workflow on the linkage of demographic information to ophthalmic testing data. Evaluation of technology. Six hundred ninety-nine visual field testing encounters performed by 6 ophthalmic technicians and the transfer error queue of 37 442 ophthalmic test results. At 3 months before and 6 and 18 months after implementation of a DICOM workflow, technicians recorded the work required to enter, confirm, or edit patient demographics in each visual field device. We also determined the proportion of imaging tests sent to an error queue for manual reconciliation because of incorrect demographic information before and 3, 6, and 18 months after the DICOM workflow was established. The proportion of testing encounters for which staff had to enter, edit, or merge patient demographics and the proportion of misfiled images. Staff entered, edited, or merged data for 48% of patients before implementation (n = 237). This decreased to 24% within 6 months and 20% within 18 months of implementing the DICOM archive (n = 230 and n = 232, respectively). Staff could locate a patient in a DICOM work list for 97% of encounters at 3 months and 99% at 18 months. Before implementation, 9.2% of the images required additional intervention to be associated with the correct patient (n = 3581). This decreased by 85% over 6 months to 1.4% (n = 9979; P < 0.01). There was an increase in the percentage of misfiled images between 6 and 18 months from 1.4% to 2.2% (n = 24 549; P < 0.01), representing an overall 76% decrease over 18 months relative to the pre-DICOM period. Implementation of a DICOM-compatible workflow in an ophthalmology clinic reduced the need to enter or edit patient demographic information into imaging or testing devices by more than 50% and reduced the need to manage misfiled images by 76%. In a clinical environment that demands both efficiency and patient safety, the DICOM workflow is an important update to current practice. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Online Studies on Variation in Orthopedic Surgery: Computed Tomography in MPEG4 Versus DICOM Format.

PubMed

Mellema, Jos J; Mallee, Wouter H; Guitton, Thierry G; van Dijk, C Niek; Ring, David; Doornberg, Job N

2017-10-01

The purpose of this study was to compare the observer participation and satisfaction as well as interobserver reliability between two online platforms, Science of Variation Group (SOVG) and Traumaplatform Study Collaborative, for the evaluation of complex tibial plateau fractures using computed tomography in MPEG4 and DICOM format. A total of 143 observers started with the online evaluation of 15 complex tibial plateau fractures via either the SOVG or Traumaplatform Study Collaborative websites using MPEG4 videos or a DICOM viewer, respectively. Observers were asked to indicate the absence or presence of four tibial plateau fracture characteristics and to rate their satisfaction with the evaluation as provided by the respective online platforms. The observer participation rate was significantly higher in the SOVG (MPEG4 video) group compared to that in the Traumaplatform Study Collaborative (DICOM viewer) group (75 and 43%, respectively; P < 0.001). The median observer satisfaction with the online evaluation was seven (range, 0-10) using MPEG4 video compared to six (range, 1-9) using DICOM viewer (P = 0.11). The interobserver reliability for recognition of fracture characteristics in complex tibial plateau fractures was higher for the evaluation using MPEG4 video. In conclusion, observer participation and interobserver reliability for the characterization of tibial plateau fractures was greater with MPEG4 videos than with a standard DICOM viewer, while there was no difference in observer satisfaction. Future reliability studies should account for the method of delivering images.

A PDA study management tool (SMT) utilizing wireless broadband and full DICOM viewing capability

NASA Astrophysics Data System (ADS)

Documet, Jorge; Liu, Brent; Zhou, Zheng; Huang, H. K.; Documet, Luis

2007-03-01

During the last 4 years IPI (Image Processing and Informatics) Laboratory has been developing a web-based Study Management Tool (SMT) application that allows Radiologists, Film librarians and PACS-related (Picture Archiving and Communication System) users to dynamically and remotely perform Query/Retrieve operations in a PACS network. The users utilizing a regular PDA (Personal Digital Assistant) can remotely query a PACS archive to distribute any study to an existing DICOM (Digital Imaging and Communications in Medicine) node. This application which has proven to be convenient to manage the Study Workflow [1, 2] has been extended to include a DICOM viewing capability in the PDA. With this new feature, users can take a quick view of DICOM images providing them mobility and convenience at the same time. In addition, we are extending this application to Metropolitan-Area Wireless Broadband Networks. This feature requires Smart Phones that are capable of working as a PDA and have access to Broadband Wireless Services. With the extended application to wireless broadband technology and the preview of DICOM images, the Study Management Tool becomes an even more powerful tool for clinical workflow management.

Integration in PACS of DICOM with TCP/IP, SQL, and X Windows

NASA Astrophysics Data System (ADS)

Reijns, Gerard L.

1994-05-01

The DICOM standard (Digital Imaging and Communications in Medicine) has been developed in order to obtain compatibility at the higher OSI levels. This paper describes the implementation of DICOM into our developed low cost PACS, which uses as much as possible standard software and standard protocols such as SQL, X Windows and TCP/IP. We adopted the requirement that all messages on the communication network have to be DICOM compatible. The translation between DICOM messages and SQL commands, which drive the relational data base, has been accommodated in our PACS supervisor. The translation takes only between 10 and 20 milliseconds. Images, that will be used the current day are stored in a distributed, parallel operating image base for reasons of performance. Extensive use has been made of X Windows to visualize images. A maximum of 12 images can simultaneously be displayed, of which one selected image can be manipulated (e.g., magnified, rotated, etc.), without affecting the other displayed images. The emphasis of the future work will be on performance measurements and modeling of our PACS and bringing the results of both methods in agreement with each other.

Inaccuracies in additive manufactured medical skull models caused by the DICOM to STL conversion process.

PubMed

Huotilainen, Eero; Jaanimets, Risto; Valášek, Jiří; Marcián, Petr; Salmi, Mika; Tuomi, Jukka; Mäkitie, Antti; Wolff, Jan

2014-07-01

The process of fabricating physical medical skull models requires many steps, each of which is a potential source of geometric error. The aim of this study was to demonstrate inaccuracies and differences caused by DICOM to STL conversion in additively manufactured medical skull models. Three different institutes were requested to perform an automatic reconstruction from an identical DICOM data set of a patients undergoing tumour surgery into an STL file format using their software of preference. The acquired digitized STL data sets were assessed and compared and subsequently used to fabricate physical medical skull models. The three fabricated skull models were then scanned, and differences in the model geometries were assessed using established CAD inspection software methods. A large variation was noted in size and anatomical geometries of the three physical skull models fabricated from an identical (or "a single") DICOM data set. A medical skull model of the same individual can vary markedly depending on the DICOM to STL conversion software and the technical parameters used. Clinicians should be aware of this inaccuracy in certain applications. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

CEDIMS: cloud ethical DICOM image Mojette storage

NASA Astrophysics Data System (ADS)

Guédon, Jeanpierre; Evenou, Pierre; Tervé, Pierre; David, Sylvain; Béranger, Jérome

2012-02-01

Dicom images of patients will necessarily been stored in Clouds. However, ethical constraints must apply. In this paper, a method which provides the two following conditions is presented: 1) the medical information is not readable by the cloud owner since it is distributed along several clouds 2) the medical information can be retrieved from any sufficient subset of clouds In order to obtain this result in a real time processing, the Mojette transform is used. This paper reviews the interesting features of the Mojette transform in terms of information theory. Since only portions of the original Dicom files are stored into each cloud, their contents are not reachable. For instance, we use 4 different public clouds to save 4 different projections of each file, with the additional condition that any 3 over 4 projections are enough to reconstruct the original file. Thus, even if a cloud is unavailable when the user wants to load a Dicom file, the other 3 are giving enough information for real time reconstruction. The paper presents an implementation on 3 actual clouds. For ethical reasons, we use a Dicom image spreaded over 3 public clouds to show the obtained confidentiality and possible real time recovery.

DICOM image integration into an electronic medical record using thin viewing clients

NASA Astrophysics Data System (ADS)

Stewart, Brent K.; Langer, Steven G.; Taira, Ricky K.

1998-07-01

Purpose -- To integrate radiological DICOM images into our currently existing web-browsable Electronic Medical Record (MINDscape). Over the last five years the University of Washington has created a clinical data repository combining in a distributed relational database information from multiple departmental databases (MIND). A text-based view of this data called the Mini Medical Record (MMR) has been available for three years. MINDscape, unlike the text based MMR, provides a platform independent, web browser view of the MIND dataset that can easily be linked to other information resources on the network. We have now added the integration of radiological images into MINDscape through a DICOM webserver. Methods/New Work -- we have integrated a commercial webserver that acts as a DICOM Storage Class Provider to our, computed radiography (CR), computed tomography (CT), digital fluoroscopy (DF), magnetic resonance (MR) and ultrasound (US) scanning devices. These images can be accessed through CGI queries or by linking the image server database using ODBC or SQL gateways. This allows the use of dynamic HTML links to the images on the DICOM webserver from MINDscape, so that the radiology reports already resident in the MIND repository can be married with the associated images through the unique examination accession number generated by our Radiology Information System (RIS). The web browser plug-in used provides a wavelet decompression engine (up to 16-bits per pixel) and performs the following image manipulation functions: window/level, flip, invert, sort, rotate, zoom, cine-loop and save as JPEG. Results -- Radiological DICOM image sets (CR, CT, MR and US) are displayed with associated exam reports for referring physician and clinicians anywhere within the widespread academic medical center on PCs, Macs, X-terminals and Unix computers. This system is also being used for home teleradiology application. Conclusion -- Radiological DICOM images can be made available medical center wide to physicians quickly using low-cost and ubiquitous, thin client browsing technology and wavelet compression.

SU-F-J-174: A Series of Computational Human Phantoms in DICOM-RT Format for Normal Tissue Dose Reconstruction in Epidemiological Studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pyakuryal, A; Moroz, B; Lee, C

2016-06-15

Purpose: Epidemiological studies of second cancer risk in radiotherapy patients often require individualized dose estimates of normal tissues. Prior to 3D conformal radiation therapy planning, patient anatomy information was mostly limited to 2D radiological images or not even available. Generic patient CT images are often used in commercial radiotherapy treatment planning system (TPS) to reconstruct normal tissue doses. The objective of the current work was to develop a series of reference size computational human phantoms in DICOM-RT format for direct use in dose reconstruction in TPS. Methods: Contours of 93 organs and tissues were extracted from a series of pediatricmore » and adult hybrid computational human phantoms (newborn, 1-, 5-, 10-, 15-year-old, and adult males and females) using Rhinoceros software. A MATLAB script was created to convert the contours into the DICOM-RT structure format. The simulated CT images with the resolution of 1×1×3 mm3 were also generated from the binary phantom format and coupled with the DICOM-structure files. Accurate volumes of the organs were drawn in the format using precise delineation of the contours in converted format. Due to complex geometry of organs, higher resolution (1×1×1 mm3) was found to be more efficient in the conversion of newborn and 1-year-old phantoms. Results: Contour sets were efficiently converted into DICOM-RT structures in relatively short time (about 30 minutes for each phantom). A good agreement was observed in the volumes between the original phantoms and the converted contours for large organs (NRMSD<1.0%) and small organs (NRMSD<7.7%). Conclusion: A comprehensive series of computational human phantoms in DICOM-RT format was created to support epidemiological studies of second cancer risks in radiotherapy patients. We confirmed the DICOM-RT phantoms were successfully imported into the TPS programs of major vendors.« less

Inverse scattering and refraction corrected reflection for breast cancer imaging

NASA Astrophysics Data System (ADS)

Wiskin, J.; Borup, D.; Johnson, S.; Berggren, M.; Robinson, D.; Smith, J.; Chen, J.; Parisky, Y.; Klock, John

2010-03-01

Reflection ultrasound (US) has been utilized as an adjunct imaging modality for over 30 years. TechniScan, Inc. has developed unique, transmission and concomitant reflection algorithms which are used to reconstruct images from data gathered during a tomographic breast scanning process called Warm Bath Ultrasound (WBU™). The transmission algorithm yields high resolution, 3D, attenuation and speed of sound (SOS) images. The reflection algorithm is based on canonical ray tracing utilizing refraction correction via the SOS and attenuation reconstructions. The refraction correction reflection algorithm allows 360 degree compounding resulting in the reflection image. The requisite data are collected when scanning the entire breast in a 33° C water bath, on average in 8 minutes. This presentation explains how the data are collected and processed by the 3D transmission and reflection imaging mode algorithms. The processing is carried out using two NVIDIA® Tesla™ GPU processors, accessing data on a 4-TeraByte RAID. The WBU™ images are displayed in a DICOM viewer that allows registration of all three modalities. Several representative cases are presented to demonstrate potential diagnostic capability including: a cyst, fibroadenoma, and a carcinoma. WBU™ images (SOS, attenuation, and reflection modalities) are shown along with their respective mammograms and standard ultrasound images. In addition, anatomical studies are shown comparing WBU™ images and MRI images of a cadaver breast. This innovative technology is designed to provide additional tools in the armamentarium for diagnosis of breast disease.

Evidence and diagnostic reporting in the IHE context.

PubMed

Loef, Cor; Truyen, Roel

2005-05-01

Capturing clinical observations and findings during the diagnostic imaging process is increasingly becoming a critical step in diagnostic reporting. Standards developers-notably HL7 and DICOM-are making significant progress toward standards that enable exchanging clinical observations and findings among the various information systems of the healthcare enterprise. DICOM-like the HL7 Clinical Document Architecture (CDA) -uses templates and constrained, coded vocabulary (SNOMED, LOINC, etc.). Such a representation facilitates automated software recognition of findings and observations, intrapatient comparison, correlation to norms, and outcomes research. The scope of DICOM Structured Reporting (SR) includes many findings that products routinely create in digital form (measurements, computed estimates, etc.). In the Integrating the Healthcare Enterprise (IHE) framework, two Integration Profiles are defined for clinical data capture and diagnostic reporting: Evidence Document, and Simple Image and Numeric Report. This report describes these two DICOM SR-based integration profiles in the diagnostic reporting process.

PACS-Based Computer-Aided Detection and Diagnosis

NASA Astrophysics Data System (ADS)

Huang, H. K. (Bernie); Liu, Brent J.; Le, Anh HongTu; Documet, Jorge

The ultimate goal of Picture Archiving and Communication System (PACS)-based Computer-Aided Detection and Diagnosis (CAD) is to integrate CAD results into daily clinical practice so that it becomes a second reader to aid the radiologist's diagnosis. Integration of CAD and Hospital Information System (HIS), Radiology Information System (RIS) or PACS requires certain basic ingredients from Health Level 7 (HL7) standard for textual data, Digital Imaging and Communications in Medicine (DICOM) standard for images, and Integrating the Healthcare Enterprise (IHE) workflow profiles in order to comply with the Health Insurance Portability and Accountability Act (HIPAA) requirements to be a healthcare information system. Among the DICOM standards and IHE workflow profiles, DICOM Structured Reporting (DICOM-SR); and IHE Key Image Note (KIN), Simple Image and Numeric Report (SINR) and Post-processing Work Flow (PWF) are utilized in CAD-HIS/RIS/PACS integration. These topics with examples are presented in this chapter.

Conformance testing strategies for DICOM protocols in a heterogenous communications system

NASA Astrophysics Data System (ADS)

Meyer, Ralph; Hewett, Andrew J.; Cordonnier, Emmanuel; Piqueras, Joachim; Jensch, Peter F.

1995-05-01

The goal of the DICOM standard is to define a standard network interface and data model for imaging devices from various vendors. It shall facilitate the development and integration of information systems and picture archiving and communication systems (PACS) in a networked environment. Current activities in Oldenburg, Germany include projects to establish cooperative work applications for radiological purposes, comprising (joined) text, data, signal and image communications, based on narrowband ISDN and ATM communication for regional and Pan European applications. In such a growing and constantly changing environment it is vital to have a solid and implementable plan to bring standards in operation. A communication standard alone cannot ensure interoperability between different vendor implementations. Even DICOM does not specify implementation-specific requirements nor does it specify a testing procedure to assess an implementation's conformance to the standard. The conformance statements defined in the DICOM standard only allow a user to determine which optional components are supported by the implementation. The goal of our work is to build a conformance test suite for DICOM. Conformance testing can aid to simplify and solve problems with multivendor systems. It will check a vendor's implementation against the DICOM standard and state the found subset of functionality. The test suite will be built in respect to the ISO 9646 Standard (OSI-Conformance Testing Methodology and Framework) which is a standard devoted to the subject of conformance testing implementations of Open Systems Interconnection (OSI) standards. For our heterogeneous communication environments we must also consider ISO 9000 - 9004 (quality management and quality assurance) to give the users the confidence in evolving applications.

CytometryML: a data standard which has been designed to interface with other standards

NASA Astrophysics Data System (ADS)

Leif, Robert C.

2007-02-01

Because of the differences in the requirements, needs, and past histories including existing standards of the creating organizations, a single encompassing cytology-pathology standard will not, in the near future, replace the multiple existing or under development standards. Except for DICOM and FCS, these standardization efforts are all based on XML. CytometryML is a collection of XML schemas, which are based on the Digital Imaging and Communications in Medicine (DICOM) and Flow Cytometry Standard (FCS) datatypes. The CytometryML schemas contain attributes that link them to the DICOM standard and FCS. Interoperability with DICOM has been facilitated by, wherever reasonable, limiting the difference between CytometryML and the previous standards to syntax. In order to permit the Resource Description Framework, RDF, to reference the CytometryML datatypes, id attributes have been added to many CytometryML elements. The Laboratory Digital Imaging Project (LDIP) Data Exchange Specification and the Flowcyt standards development effort employ RDF syntax. Documentation from DICOM has been reused in CytometryML. The unity of analytical cytology was demonstrated by deriving a microscope type and a flow cytometer type from a generic cytometry instrument type. The feasibility of incorporating the Flowcyt gating schemas into CytometryML has been demonstrated. CytometryML is being extended to include many of the new DICOM Working Group 26 datatypes, which describe patients, specimens, and analytes. In situations where multiple standards are being created, interoperability can be facilitated by employing datatypes based on a common set of semantics and building in links to standards that employ different syntax.

SCAR Radiologic Technologist Survey: analysis of the impact of digital technologies on productivity.

PubMed

Reiner, Bruce I; Siegel, Eliot L; Carrino, John A; Goldburgh, Mitchell M

2002-09-01

As medical reimbursements continue to decline, increasing financial pressures are placed upon medical imaging providers. This burden is exacerbated by the existing radiologic technologist (RT) crisis, which has caused RT salaries to trend upward. One strategy to address these trends is employing technology to improve technologist productivity. While industry-wide RT productivity benchmarks have been established for film-based operation, little to date has been published in the medical literature regarding similar productivity measures for filmless operation using PACS. This study was undertaken to document the complex relationship between technologist productivity and implementation of digital radiography and digital information technologies, including PACS and hospital/radiology information systems (HIS/RIS). A nationwide survey was conducted with 112 participating institutions, in varying degrees of digital technology implementation. Technologist productivity was defined as the number of annual exams performed per technologist full-time equivalent (FTE). Productivity analyses were performed among the different demographic and technology profile groups, with a focus on general radiography, which accounts for 65-70% of imaging department volumes. When evaluating the relationship between technologist productivity and digital technology implementation, improved productivity measures were observed for institutions implementing HIS/RIS, modality worklist, and PACS. The timing of PACS implementation was found to have a significant effect on technologist productivity measures, with an initial 10.8% drop in productivity during the first year of PACS implementation, followed by a 27.8% increase in productivity beyond year one. This suggests there is a "PACS learning curve" phenomenon, which should be considered when institutions are planning for PACS implementation.

Extending the XNAT archive tool for image and analysis management in ophthalmology research

NASA Astrophysics Data System (ADS)

Wahle, Andreas; Lee, Kyungmoo; Harding, Adam T.; Garvin, Mona K.; Niemeijer, Meindert; Sonka, Milan; Abràmoff, Michael D.

2013-03-01

In ophthalmology, various modalities and tests are utilized to obtain vital information on the eye's structure and function. For example, optical coherence tomography (OCT) is utilized to diagnose, screen, and aid treatment of eye diseases like macular degeneration or glaucoma. Such data are complemented by photographic retinal fundus images and functional tests on the visual field. DICOM isn't widely used yet, though, and frequently images are encoded in proprietary formats. The eXtensible Neuroimaging Archive Tool (XNAT) is an open-source NIH-funded framework for research PACS and is in use at the University of Iowa for neurological research applications. Its use for ophthalmology was hence desirable but posed new challenges due to data types thus far not considered and the lack of standardized formats. We developed custom tools for data types not natively recognized by XNAT itself using XNAT's low-level REST API. Vendor-provided tools can be included as necessary to convert proprietary data sets into valid DICOM. Clients can access the data in a standardized format while still retaining the original format if needed by specific analysis tools. With respective project-specific permissions, results like segmentations or quantitative evaluations can be stored as additional resources to previously uploaded datasets. Applications can use our abstract-level Python or C/C++ API to communicate with the XNAT instance. This paper describes concepts and details of the designed upload script templates, which can be customized to the needs of specific projects, and the novel client-side communication API which allows integration into new or existing research applications.

Digital image envelope: method and evaluation

NASA Astrophysics Data System (ADS)

Huang, H. K.; Cao, Fei; Zhou, Michael Z.; Mogel, Greg T.; Liu, Brent J.; Zhou, Xiaoqiang

2003-05-01

Health data security, characterized in terms of data privacy, authenticity, and integrity, is a vital issue when digital images and other patient information are transmitted through public networks in telehealth applications such as teleradiology. Mandates for ensuring health data security have been extensively discussed (for example The Health Insurance Portability and Accountability Act, HIPAA) and health informatics guidelines (such as the DICOM standard) are beginning to focus on issues of data continue to be published by organizing bodies in healthcare; however, there has not been a systematic method developed to ensure data security in medical imaging Because data privacy and authenticity are often managed primarily with firewall and password protection, we have focused our research and development on data integrity. We have developed a systematic method of ensuring medical image data integrity across public networks using the concept of the digital envelope. When a medical image is generated regardless of the modality, three processes are performed: the image signature is obtained, the DICOM image header is encrypted, and a digital envelope is formed by combining the signature and the encrypted header. The envelope is encrypted and embedded in the original image. This assures the security of both the image and the patient ID. The embedded image is encrypted again and transmitted across the network. The reverse process is performed at the receiving site. The result is two digital signatures, one from the original image before transmission, and second from the image after transmission. If the signatures are identical, there has been no alteration of the image. This paper concentrates in the method and evaluation of the digital image envelope.

[Teleradiology using uncompressed DICOM format via exclusive fiber-optic system].

PubMed

Okuda, Shigeo; Kuribayashi, Sachio; Hibi, Norihumi; Matsuura, Agato; Tani, Rie; Saga, Yasushi

2005-01-01

We developed a system for teleradiology using exclusive fiber optics for transferring images formatted in uncompressed DICOM. This system was built up with commercially available machines and software provided from various companies. We are now operating the system with five remote hospitals and have had one year of experience. The current system took advantage of the security and transfer efficiency of exclusive fiber optics. Uncompressed DICOM images were useful for the identification of cases and user-friendly for viewing. The reading room is located in our university hospital, and the location is convenient for consultation and discussion of cases.

xPIPE--Reception of DICOM Data from any Sender via the Internet.

PubMed

Czwoydzinski, J; Eßeling, R; Meier, N; Heindel, W; Lenzen, H

2015-05-01

Various technologies have been established for DICOM data exchange in radiology. In addition to the patient CD, online transfers via VPN (virtual private network) or DICOM email are common practice. However, dedicated network solutions are generally not appropriate for data exchange with occasional and spontaneous partners due to missing infrastructure at the partner institutions and/or complex setup procedures. The purpose was to develop a practical solution to complement the established technologies to allow users worldwide to transfer images without registration. The development of the xPIPE system is based on Java and various software libraries. A client hosted on a website enables sending DICOM data to a receiving system of the hospital. The new xPIPE system creates a gateway to a receiving hospital which is accessible from any point worldwide, giving other hospitals, clinics and patients a simple and secure method to transmit DICOM data without intermediate storage on external servers. The system was deployed at the University Hospital Münster and subsequently widely used even without information events and training. Data protection during transfer is ensured by the use of signatures and encryption. From the user's perspective the system has only minor technical requirements and can be used with minimal setup effort. © Georg Thieme Verlag KG Stuttgart · New York.

The role of digital imaging and communications in medicine in an evolving healthcare computing environment: the model is the message.

PubMed

Bidgood, W D; alSafadi, Y; Tucker, M; Prior, F; Hagan, G; Mattison, J E

1998-02-01

The decision to use Digital Imaging and Communications in Medicine (DICOM), Health Level 7 (HL7), a common object broker such as the Common Object Request Brokering Architecture (CORBA) or ActiveX (Microsoft Corp, Redmond, WA) or any other protocol for the transfer of DICOM data depends on the requirements of a particular implementation. The selection of protocol is independent of the information model. Our goal as message standards developers is to design a data interchange infrastructure that will faithfully convey the computer-based patient record and make it available to authorized health care providers when and where it is needed for patient care. DICOM accurately and expressively represents the clinically significant properties of images and the semantics of image-related information. The DICOM data model is small and well-defined. The model can be expressed in Standard Generalized Markup Language (SGML) or Object Management Group Interface Definition Language or other common syntax-and can be implemented using any reliable communications protocol. Therefore our opinion is that the DICOM semantic data model should serve as the basis for a logically equivalent set of specifications in HL7, CORBA, ActiveX, and SGML for the interchange of biomedical images and image-related information.

DICOM for quantitative imaging biomarker development: a standards based approach to sharing clinical data and structured PET/CT analysis results in head and neck cancer research

PubMed Central

Clunie, David; Ulrich, Ethan; Bauer, Christian; Wahle, Andreas; Brown, Bartley; Onken, Michael; Riesmeier, Jörg; Pieper, Steve; Kikinis, Ron; Buatti, John; Beichel, Reinhard R.

2016-01-01

Background. Imaging biomarkers hold tremendous promise for precision medicine clinical applications. Development of such biomarkers relies heavily on image post-processing tools for automated image quantitation. Their deployment in the context of clinical research necessitates interoperability with the clinical systems. Comparison with the established outcomes and evaluation tasks motivate integration of the clinical and imaging data, and the use of standardized approaches to support annotation and sharing of the analysis results and semantics. We developed the methodology and tools to support these tasks in Positron Emission Tomography and Computed Tomography (PET/CT) quantitative imaging (QI) biomarker development applied to head and neck cancer (HNC) treatment response assessment, using the Digital Imaging and Communications in Medicine (DICOM®) international standard and free open-source software. Methods. Quantitative analysis of PET/CT imaging data collected on patients undergoing treatment for HNC was conducted. Processing steps included Standardized Uptake Value (SUV) normalization of the images, segmentation of the tumor using manual and semi-automatic approaches, automatic segmentation of the reference regions, and extraction of the volumetric segmentation-based measurements. Suitable components of the DICOM standard were identified to model the various types of data produced by the analysis. A developer toolkit of conversion routines and an Application Programming Interface (API) were contributed and applied to create a standards-based representation of the data. Results. DICOM Real World Value Mapping, Segmentation and Structured Reporting objects were utilized for standards-compliant representation of the PET/CT QI analysis results and relevant clinical data. A number of correction proposals to the standard were developed. The open-source DICOM toolkit (DCMTK) was improved to simplify the task of DICOM encoding by introducing new API abstractions. Conversion and visualization tools utilizing this toolkit were developed. The encoded objects were validated for consistency and interoperability. The resulting dataset was deposited in the QIN-HEADNECK collection of The Cancer Imaging Archive (TCIA). Supporting tools for data analysis and DICOM conversion were made available as free open-source software. Discussion. We presented a detailed investigation of the development and application of the DICOM model, as well as the supporting open-source tools and toolkits, to accommodate representation of the research data in QI biomarker development. We demonstrated that the DICOM standard can be used to represent the types of data relevant in HNC QI biomarker development, and encode their complex relationships. The resulting annotated objects are amenable to data mining applications, and are interoperable with a variety of systems that support the DICOM standard. PMID:27257542

An automatic quantification system for MS lesions with integrated DICOM structured reporting (DICOM-SR) for implementation within a clinical environment

NASA Astrophysics Data System (ADS)

Jacobs, Colin; Ma, Kevin; Moin, Paymann; Liu, Brent

2010-03-01

Multiple Sclerosis (MS) is a common neurological disease affecting the central nervous system characterized by pathologic changes including demyelination and axonal injury. MR imaging has become the most important tool to evaluate the disease progression of MS which is characterized by the occurrence of white matter lesions. Currently, radiologists evaluate and assess the multiple sclerosis lesions manually by estimating the lesion volume and amount of lesions. This process is extremely time-consuming and sensitive to intra- and inter-observer variability. Therefore, there is a need for automatic segmentation of the MS lesions followed by lesion quantification. We have developed a fully automatic segmentation algorithm to identify the MS lesions. The segmentation algorithm is accelerated by parallel computing using Graphics Processing Units (GPU) for practical implementation into a clinical environment. Subsequently, characterized quantification of the lesions is performed. The quantification results, which include lesion volume and amount of lesions, are stored in a structured report together with the lesion location in the brain to establish a standardized representation of the disease progression of the patient. The development of this structured report in collaboration with radiologists aims to facilitate outcome analysis and treatment assessment of the disease and will be standardized based on DICOM-SR. The results can be distributed to other DICOM-compliant clinical systems that support DICOM-SR such as PACS. In addition, the implementation of a fully automatic segmentation and quantification system together with a method for storing, distributing, and visualizing key imaging and informatics data in DICOM-SR for MS lesions improves the clinical workflow of radiologists and visualizations of the lesion segmentations and will provide 3-D insight into the distribution of lesions in the brain.

The benefits of the Atlas of Human Cardiac Anatomy website for the design of cardiac devices.

PubMed

Spencer, Julianne H; Quill, Jason L; Bateman, Michael G; Eggen, Michael D; Howard, Stephen A; Goff, Ryan P; Howard, Brian T; Quallich, Stephen G; Iaizzo, Paul A

2013-11-01

This paper describes how the Atlas of Human Cardiac Anatomy website can be used to improve cardiac device design throughout the process of development. The Atlas is a free-access website featuring novel images of both functional and fixed human cardiac anatomy from over 250 human heart specimens. This website provides numerous educational tutorials on anatomy, physiology and various imaging modalities. For instance, the 'device tutorial' provides examples of devices that were either present at the time of in vitro reanimation or were subsequently delivered, including leads, catheters, valves, annuloplasty rings and stents. Another section of the website displays 3D models of the vasculature, blood volumes and/or tissue volumes reconstructed from computed tomography and magnetic resonance images of various heart specimens. The website shares library images, video clips and computed tomography and MRI DICOM files in honor of the generous gifts received from donors and their families.

EIR: enterprise imaging repository, an alternative imaging archiving and communication system.

PubMed

Bian, Jiang; Topaloglu, Umit; Lane, Cheryl

2009-01-01

The enormous number of studies performed at the Nuclear Medicine Department of University of Arkansas for Medical Sciences (UAMS) generates a huge amount PET/CT images daily. A DICOM workstation had been used as "mini-PACS" to route all studies, which is historically proven to be slow due to various reasons. However, replacing the workstation with a commercial PACS server is not only cost inefficient; and more often, the PACS vendors are reluctant to take responsibility for the final integration of these components. Therefore, in this paper, we propose an alternative imaging archiving and communication system called Enterprise Imaging Repository (EIR). EIR consists of two distinguished components: an image processing daemon and a user friendly web interface. EIR not only reduces the overall waiting time of transferring a study from the modalities to radiologists' workstations, but also provides a more preferable presentation.

Documenting the information content of images.

PubMed Central

Bidgood, W. D.

1997-01-01

A standards-based message and terminology architecture has been specified to enable large-scale open and non-proprietary interchange of imaging-procedure descriptions and image-interpretation reports providing semantically-rich linkage of linguistic and non-linguistic information. The DICOM Structured Reporting Supplement, now available for trial use, embodies this interdependent message/terminology architecture. A DICOM structured report object is a self-describing information structure that can be tailored to support diverse clinical observation reporting applications by utilization of templates and context-dependent terminology from an external message/terminology mapping resource such as the SNOMED DICOM Microglossary (SDM), HL7 Vocabulary, or Terminology Resource for Message Standards (TeRMS). PMID:9357661

[Design of the image browser for PACS image workstation].

PubMed

Li, Feng; Zhou, He-Qin

2006-09-01

The design of PACS image workstation based on DICOM3.0 is introduced in the paper, then the designing method of the PACS image browser based on the control system theory is presented,focusing on two main units:DICOM analyzer and the information mapping transformer.

Comparison of sound speed measurements on two different ultrasound tomography devices

NASA Astrophysics Data System (ADS)

Sak, Mark; Duric, Neb; Littrup, Peter; Bey-Knight, Lisa; Sherman, Mark; Gierach, Gretchen; Malyarenko, Antonina

2014-03-01

Ultrasound tomography (UST) employs sound waves to produce three-dimensional images of breast tissue and precisely measures the attenuation of sound speed secondary to breast tissue composition. High breast density is a strong breast cancer risk factor and sound speed is directly proportional to breast density. UST provides a quantitative measure of breast density based on three-dimensional imaging without compression, thereby overcoming the shortcomings of many other imaging modalities. The quantitative nature of the UST breast density measures are tied to an external standard, so sound speed measurement in breast tissue should be independent of specific hardware. The work presented here compares breast sound speed measurement obtained with two different UST devices. The Computerized Ultrasound Risk Evaluation (CURE) system located at the Karmanos Cancer Institute in Detroit, Michigan was recently replaced with the SoftVue ultrasound tomographic device. Ongoing clinical trials have used images generated from both sets of hardware, so maintaining consistency in sound speed measurements is important. During an overlap period when both systems were in the same exam room, a total of 12 patients had one or both of their breasts imaged on both systems on the same day. There were 22 sound speed scans analyzed from each system and the average breast sound speeds were compared. Images were either reconstructed using saved raw data (for both CURE and SoftVue) or were created during the image acquisition (saved in DICOM format for SoftVue scans only). The sound speed measurements from each system were strongly and positively correlated with each other. The average difference in sound speed between the two sets of data was on the order of 1-2 m/s and this result was not statistically significant. The only sets of images that showed a statistical difference were the DICOM images created during the SoftVue scan compared to the SoftVue images reconstructed from the raw data. However, the discrepancy between the sound speed values could be easily handled by uniformly increasing the DICOM sound speed by approximately 0.5 m/s. These results suggest that there is no fundamental difference in sound speed measurement for the two systems and support combining data generated with these instruments in future studies.

Interobserver Variability of Radiographic Assessment Using a Mobile Messaging Application as a Teleconsultation Tool

PubMed Central

Özkan, Sezai; Mellema, Jos J.; Ring, David; Chen, Neal C.

2017-01-01

Background: To examine whether interobserver reliability, decision-making, and confidence in decision-making in the treatment of distal radius fractures changes if radiographs are viewed on a messenger application on a mobile phone compared to a standard DICOM viewer. Methods: Radiographs of distal radius fractures were presented to surgeons on either a smart phone using a mobile messenger application or a laptop using a DICOM viewer application. Twenty observers participated: 10 (50%) were randomly assigned to the DICOM viewer group and 10 (50%) to the mobile messenger group. Each observer was asked to evaluate the cases and (1) classify the fracture type according to the AO classification, (2) recommend operative or conservative treatment and (3) rate their confidence about this decision. Results: There was no significant difference in interobserver reliability for AO classification and recommendation for surgery for distal radius fractures in both groups. The percentage of recommendation for surgery was significantly higher in the messenger application group compared to the DICOM viewer group (89% versus 78%, P=0.019) and the confidence for treatment decision was significantly higher in the mobile messenger group compared to the DICOM viewer group (8.9 versus 7.9, P=0.026). Conclusion: Messenger applications on mobile phones could facilitate remote decision-making for patients with distal radius fractures, but should be used with caution. PMID:29226202

Collection of DICOM RDSR (Digital Imaging and Communication in Medicine, Radiation Dose Structured Report) Information Aimed at Reducing Patient Exposure Dose.

PubMed

Morota, Koichi; Moritake, Takashi; Sun, Lue; Ishihara, Takahiro; Kuma, Natsuyo; Murata, Satomi; Yamada, Takahiro; Okazaki, Ryuji

2016-01-01

The recent progress in angiography technology bestows benefits on patients for minimally invasive than surgery, while there has been an increase in the number of cases involving stochastic effects, such as radiation dermatitis, resulting from upgrading of the procedure because of an extension of the time for fluoroscopy and the number of shots. Recent CT equipment saves the dose data along with image data about the information management for patient exposure dose, which is used for management of individual cumulative dose and the presumed effective dose, using digital imaging and communication in medicine (DICOM). We extracted detailed information about shooting conditions and dose from the DICOM radiation dose structured report (DICOM RDSR) in the angiography area, and evaluated the trend of patient exposure dose in each procedure. As a result, we found that cases exceeding 3 Gy which needed observation in the head region were 16.7% and in the heart region were 27.3%. We also found that angiography had a higher dose of shooting than did fluoroscopy, and that the diagnosis and treatment with tumor involvement required a exposure dose than did vascular lesion. In this paper, we review the shooting conditions as a root of DICOM RDSR information and consider the possibility of planning for further reduction of the exposure dose.

Project MICAS: a multivendor open-system incremental approach to implementing an integrated enterprise-wide PACS: works in progress

NASA Astrophysics Data System (ADS)

Smith, Edward M.; Wright, Jeffrey; Fontaine, Marc T.; Robinson, Arvin E.

1998-07-01

The Medical Information, Communication and Archive System (MICAS) is a multi-vendor incremental approach to PACS. MICAS is a multi-modality integrated image management system that incorporates the radiology information system (RIS) and radiology image database (RID) with future 'hooks' to other hospital databases. Even though this approach to PACS is more risky than a single-vendor turn-key approach, it offers significant advantages. The vendors involved in the initial phase of MICAS are IDX Corp., ImageLabs, Inc. and Digital Equipment Corp (DEC). The network architecture operates at 100 MBits per sec except between the modalities and the stackable intelligent switch which is used to segment MICAS by modality. Each modality segment contains the acquisition engine for the modality, a temporary archive and one or more diagnostic workstations. All archived studies are available at all workstations, but there is no permanent archive at this time. At present, the RIS vendor is responsible for study acquisition and workflow as well as maintenance of the temporary archive. Management of study acquisition, workflow and the permanent archive will become the responsibility of the archive vendor when the archive is installed in the second quarter of 1998. The modalities currently interfaced to MICAS are MRI, CT and a Howtek film digitizer with Nuclear Medicine and computed radiography (CR) to be added when the permanent archive is installed. There are six dual-monitor diagnostic workstations which use ImageLabs Shared Vision viewer software located in MRI, CT, Nuclear Medicine, musculoskeletal reading areas and two in Radiology's main reading area. One of the major lessons learned to date is that the permanent archive should have been part of the initial MICAS installation and the archive vendor should have been responsible for image acquisition rather than the RIS vendor. Currently an archive vendor is being selected who will be responsible for the management of the archive plus the HIS/RIS interface, image acquisition, modality work list manager and interfacing to the current DICOM viewer software. The next phase of MICAS will include interfacing ultrasound, locating servers outside of the Radiology LAN to support the distribution of images and reports to the clinical floors and physician offices both within and outside of the University of Rochester Medical Center (URMC) campus and the teaching archive.

Perceptual uniformity of commonly used color spaces

NASA Astrophysics Data System (ADS)

Avanaki, Ali; Espig, Kathryn; Kimpe, Tom; Xthona, Albert; Marchessoux, Cedric; Rostang, Johan; Piepers, Bastian

2014-03-01

Use of color images in medical imaging has increased significantly the last few years. Color information is essential for applications such as ophthalmology, dermatology and clinical photography. Use of color at least brings benefits for other applications such as endoscopy, laparoscopy and digital pathology. Remarkably, as of today, there is no agreed standard on how color information needs to be visualized for medical applications. This lack of standardization results in large variability of how color images are visualized and it makes quality assurance a challenge. For this reason FDA and ICC recently organized a joint summit on color in medical imaging (CMI). At this summit, one of the suggestions was that modalities such as digital pathology could benefit from using a perceptually uniform color space (T. Kimpe, "Color Behavior of Medical Displays," CMI presentation, May 2013). Perceptually uniform spaces have already been used for many years in the radiology community where the DICOM GSDF standard provides linearity in luminance but not in color behavior. In this paper we quantify perceptual uniformity, using CIE's ΔE2000 as a color distance metric, of several color spaces that are typically used for medical applications. We applied our method to theoretical color spaces Gamma 1.8, 2.0, & 2.2, standard sRGB, and DICOM (correction LUT for gray applied to all primaries). In addition, we also measured color spaces (i.e., native behavior) of a high-end medical display (Barco Coronis Fusion 6MP DL, MDCC-6130), and a consumer display (Dell 1907FP). Our results indicate that sRGB & the native color space on the Barco Coronis Fusion exhibit the least non-uniformity within their group. However, the remaining degree of perceptual non-uniformity is still significant and there is room for improvement.

Educational utility of advanced three-dimensional virtual imaging in evaluating the anatomical configuration of the frontal recess.

PubMed

Agbetoba, Abib; Luong, Amber; Siow, Jin Keat; Senior, Brent; Callejas, Claudio; Szczygielski, Kornel; Citardi, Martin J

2017-02-01

Endoscopic sinus surgery represents a cornerstone in the professional development of otorhinolaryngology trainees. Mastery of these surgical skills requires an understanding of paranasal sinus and skull-base anatomy. The frontal sinus is associated with a wide range of variation and complex anatomical configuration, and thus represents an important challenge for all trainees performing endoscopic sinus surgery. Forty-five otorhinolaryngology trainees and 20 medical school students from 5 academic institutions were enrolled and randomized into 1 of 2 groups. Each subject underwent learning of frontal recess anatomy with both traditional 2-dimensional (2D) learning methods using a standard Digital Imaging and Communications in Medicine (DICOM) viewing software (RadiAnt Dicom Viewer Version 1.9.16) and 3-dimensional (3D) learning utilizing a novel preoperative virtual planning software (Scopis Building Blocks), with one half learning with the 2D method first and the other half learning with the 3D method first. Four questionnaires that included a total of 20 items were scored for subjects' self-assessment on knowledge of frontal recess and frontal sinus drainage pathway anatomy following each learned modality. A 2-sample Wilcoxon rank-sum test was used in the statistical analysis comparing the 2 groups. Most trainees (89%) believed that the virtual 3D planning software significantly improved their understanding of the spatial orientation of the frontal sinus drainage pathway. Incorporation of virtual 3D planning surgical software may help augment trainees' understanding and spatial orientation of the frontal recess and sinus anatomy. The potential increase in trainee proficiency and comprehension theoretically may translate to improved surgical skill and patient outcomes and in reduced surgical time. © 2016 ARS-AAOA, LLC.

VoxelMages: a general-purpose graphical interface for designing geometries and processing DICOM images for PENELOPE.

PubMed

Giménez-Alventosa, V; Ballester, F; Vijande, J

2016-12-01

The design and construction of geometries for Monte Carlo calculations is an error-prone, time-consuming, and complex step in simulations describing particle interactions and transport in the field of medical physics. The software VoxelMages has been developed to help the user in this task. It allows to design complex geometries and to process DICOM image files for simulations with the general-purpose Monte Carlo code PENELOPE in an easy and straightforward way. VoxelMages also allows to import DICOM-RT structure contour information as delivered by a treatment planning system. Its main characteristics, usage and performance benchmarking are described in detail. Copyright © 2016 Elsevier Ltd. All rights reserved.

Raspberry Pi: a 35-dollar device for viewing DICOM images.

PubMed

Paiva, Omir Antunes; Moreira, Renata de Oliveira

2014-01-01

Raspberry Pi is a low-cost computer created with educational purposes. It uses Linux and, most of times, freeware applications, particularly a software for viewing DICOM images. With an external monitor, the supported resolution (1920 × 1200 pixels) allows for the set up of simple viewing workstations at a reduced cost.

Raspberry Pi: a 35-dollar device for viewing DICOM images*

PubMed Central

Paiva, Omir Antunes; Moreira, Renata de Oliveira

2014-01-01

Raspberry Pi is a low-cost computer created with educational purposes. It uses Linux and, most of times, freeware applications, particularly a software for viewing DICOM images. With an external monitor, the supported resolution (1920 × 1200 pixels) allows for the set up of simple viewing workstations at a reduced cost. PMID:25741057

A proxy of DICOM services

NASA Astrophysics Data System (ADS)

Ribeiro, Luís S.; Costa, Carlos; Oliveira, José Luís

2010-03-01

Diagnostic tools supported by digital medical images have increasingly become an essential aid to medical decisions. However, despite its growing importance, Picture Archiving and Communication Systems (PACS) are typically oriented to support a single healthcare institution, and the sharing of medical data across institutions is still a difficult process. This paper describes a proposal to publish and control Digital Imaging Communications in Medicine (DICOM) services in a wide domain composed of several healthcare institutions. The system creates virtual bridges between intranets enabling the exchange, search and store of the medical data within the wide domain. The service provider publishes the DICOM services following a token-based strategy. The token advertisements are public and known by all system users. However, access to the DICOM service is controlled through a role association between an access key and the service. Furthermore, in medical diagnoses, time is a crucial factor. Therefore, our system is a turnkey solution, capable of exchanging medical data across firewalls and Network Address Translation (NAT), avoiding bureaucratic issues with local network security. Security is also an important concern - in any transmission across different domains, data is encrypted by Transport Layer Security (TLS).

Accuracy of templates for navigated implantation made by rapid prototyping with DICOM datasets of cone beam computer tomography (CBCT).

PubMed

Weitz, Jochen; Deppe, Herbert; Stopp, Sebastian; Lueth, Tim; Mueller, Steffen; Hohlweg-Majert, Bettina

2011-12-01

The aim of this study is to evaluate the accuracy of a surgical template-aided implant placement produced by rapid prototyping using a DICOM dataset from cone beam computer tomography (CBCT). On the basis of CBCT scans (Sirona® Galileos), a total of ten models were produced using a rapid-prototyping three-dimensional printer. On the same patients, impressions were performed to compare fitting accuracy of both methods. From the models made by impression, templates were produced and accuracy was compared and analyzed with the rapid-prototyping model. Whereas templates made by conventional procedure had an excellent accuracy, the fitting accuracy of those produced by DICOM datasets was not sufficient. Deviations ranged between 2.0 and 3.5 mm, after modification of models between 1.4 and 3.1 mm. The findings of this study suggest that the accuracy of the low-dose Sirona Galileos® DICOM dataset seems to show a high deviation, which is not useable for accurate surgical transfer for example in implant surgery.

Data-centric protection in DICOM

NASA Astrophysics Data System (ADS)

Künzi, Julien; Petkovic, M.; Koster, Paul

2009-02-01

In this paper we address the problem of privacy protection and trust enhancement in a distributed healthcare eco system. Increased trust in other parties of the eco system encourages medical entities to share data. This increases the availability of data and consequently improves the general quality of health care. We present two different solutions to the above described problem, both being developed using the DICOM standard (Digital Imaging and Communications in Medicine). The first approach, which is partially relying on legislation, uses sticky policies and commitment protocols to enhance trust. We propose to attach the access control policies to the data in the DICOM files. Furthermore, the source of data disclosure makes sure that the destination commits to enforce the policies by obtaining a signature on the policies and thus providing a proof of the commitment by the destination. The second approach aims at increasing trust by technical enforcement. For this purpose, digital rights management (DRM) technology is used. We demonstrate that it is possible to create a DICOM DRM container using the tools provided by this standard, hence still guaranteeing backward compatibility.

Summary of the white paper of DICOM WG24 'DICOM in Surgery'

NASA Astrophysics Data System (ADS)

Lemke, Heinz U.

2007-03-01

Standards for creating and integrating information about patients, equipment, and procedures are vitally needed when planning for an efficient Operating Room (OR). The DICOM Working Group 24 (WG24) has been established to develop DICOM objects and services related to Image Guided Surgery (IGS). To determine these standards, it is important to define day-to-day, step-by-step surgical workflow practices and create surgery workflow models per procedures or per variable cases. A well-defined workflow and a high fidelity patient model will be the base of activities for both, radiation therapy and surgery. Considering the present and future requirements for surgical planning and intervention, such a patient model must be n-dimensional, were n may include the spatial and temporal dimensions as well as a number of functional variables. As the boundaries between radiation therapy, surgery and interventional radiology are becoming less well-defined, precise patient models will become the greatest common denominator for all therapeutic disciplines. In addition to imaging, the focus of WG24 should, therefore, also be to serve the therapeutic disciplines by enabling modelling technology to be based on standards.

TRENCADIS--a WSRF grid MiddleWare for managing DICOM structured reporting objects.

PubMed

Blanquer, Ignacio; Hernandez, Vicente; Segrelles, Damià

2006-01-01

The adoption of the digital processing of medical data, especially on radiology, has leaded to the availability of millions of records (images and reports). However, this information is mainly used at patient level, being the extraction of information, organised according to administrative criteria, which make the extraction of knowledge difficult. Moreover, legal constraints make the direct integration of information systems complex or even impossible. On the other side, the widespread of the DICOM format has leaded to the inclusion of other information different from just radiological images. The possibility of coding radiology reports in a structured form, adding semantic information about the data contained in the DICOM objects, eases the process of structuring images according to content. DICOM Structured Reporting (DICOM-SR) is a specification of tags and sections to code and integrate radiology reports, with seamless references to findings and regions of interests of the associated images, movies, waveforms, signals, etc. The work presented in this paper aims at developing of a framework to efficiently and securely share medical images and radiology reports, as well as to provide high throughput processing services. This system is based on a previously developed architecture in the framework of the TRENCADIS project, and uses other components such as the security system and the Grid processing service developed in previous activities. The work presented here introduces a semantic structuring and an ontology framework, to organise medical images considering standard terminology and disease coding formats (SNOMED, ICD9, LOINC..).

Integration of a clinical trial database with a PACS

NASA Astrophysics Data System (ADS)

van Herk, M.

2014-03-01

Many clinical trials use Electronic Case Report Forms (ECRF), e.g., from OpenClinica. Trial data is augmented if DICOM scans, dose cubes, etc. from the Picture Archiving and Communication System (PACS) are included for data mining. Unfortunately, there is as yet no structured way to collect DICOM objects in trial databases. In this paper, we obtain a tight integration of ECRF and PACS using open source software. Methods: DICOM identifiers for selected images/series/studies are stored in associated ECRF events (e.g., baseline) as follows: 1) JavaScript added to OpenClinica communicates using HTML with a gateway server inside the hospitals firewall; 2) On this gateway, an open source DICOM server runs scripts to query and select the data, returning anonymized identifiers; 3) The scripts then collects, anonymizes, zips and transmits selected data to a central trial server; 4) Here data is stored in a DICOM archive which allows authorized ECRF users to view and download the anonymous images associated with each event. Results: All integration scripts are open source. The PACS administrator configures the anonymization script and decides to use the gateway in passive (receiving) mode or in an active mode going out to the PACS to gather data. Our ECRF centric approach supports automatic data mining by iterating over the cases in the ECRF database, providing the identifiers to load images and the clinical data to correlate with image analysis results. Conclusions: Using open source software and web technology, a tight integration has been achieved between PACS and ECRF.

A unified representation of findings in clinical radiology using the UMLS and DICOM.

PubMed

Bertaud, Valérie; Lasbleiz, Jérémy; Mougin, Fleur; Burgun, Anita; Duvauferrier, Régis

2008-09-01

Collecting and analyzing findings constitute the basis of medical activity. Computer assisted medical activity raises the problem of modelling findings. We propose a unified representation of findings integrating the representations of findings in the GAMUTS in Radiology [M.M. Reeder, B. Felson, GAMUTS in radiology Comprehensive lists of roentgen differential diagnosis, fourth ed., 2003], the Unified Medical Language System (UMLS), and the Digital Imaging and Communication in Medicine Structured Report (DICOM-SR). Starting from a corpus of findings in bone and joint radiology [M.M. Reeder, B. Felson, GAMUTS in Radiology comprehensive lists of roentgen differential diagnosis, fourth ed., 2003] (3481 words), an automated mapping to the UMLS was performed with the Metamap Program. The resulting UMLS terms and Semantic Types were analyzed in order to find a generic template in accordance with DICOM-SR structure. UMLS Concepts were missing for 45% of the GAMUTS findings. Three kinds of regularities were observed in the way the Semantic Types were combined: "pathological findings", "physiological findings" and "anatomical findings". A generic and original DICOM-SR template modelling finding was proposed. It was evaluated for representing GAMUTS jaws findings. 21% missing terms had to be picked up from Radlex (5%) or created (16%). This article shows that it is possible to represent findings using the UMLS and the DICOM SR formalism with a semi-automated method. The Metamap program helped to find a model to represent the semantic structure of free texts with standardized terms (UMLS Concepts). Nevertheless, the coverage of the UMLS is not comprehensive. This study shows that the UMLS should include more technical concepts and more concepts regarding findings, signs and symptoms to be suitable for radiology representation. The semi-automated translation of the whole GAMUTS using the UMLS concepts and the DICOM SR relations could help to create or supplement the DCMR Templates and Context Groups pertaining to the description of imaging findings.

Cloud-Based CT Dose Monitoring using the DICOM-Structured Report: Fully Automated Analysis in Regard to National Diagnostic Reference Levels.

PubMed

Boos, J; Meineke, A; Rubbert, C; Heusch, P; Lanzman, R S; Aissa, J; Antoch, G; Kröpil, P

2016-03-01

To implement automated CT dose data monitoring using the DICOM-Structured Report (DICOM-SR) in order to monitor dose-related CT data in regard to national diagnostic reference levels (DRLs). We used a novel in-house co-developed software tool based on the DICOM-SR to automatically monitor dose-related data from CT examinations. The DICOM-SR for each CT examination performed between 09/2011 and 03/2015 was automatically anonymized and sent from the CT scanners to a cloud server. Data was automatically analyzed in accordance with body region, patient age and corresponding DRL for volumetric computed tomography dose index (CTDIvol) and dose length product (DLP). Data of 36,523 examinations (131,527 scan series) performed on three different CT scanners and one PET/CT were analyzed. The overall mean CTDIvol and DLP were 51.3% and 52.8% of the national DRLs, respectively. CTDIvol and DLP reached 43.8% and 43.1% for abdominal CT (n=10,590), 66.6% and 69.6% for cranial CT (n=16,098) and 37.8% and 44.0% for chest CT (n=10,387) of the compared national DRLs, respectively. Overall, the CTDIvol exceeded national DRLs in 1.9% of the examinations, while the DLP exceeded national DRLs in 2.9% of the examinations. Between different CT protocols of the same body region, radiation exposure varied up to 50% of the DRLs. The implemented cloud-based CT dose monitoring based on the DICOM-SR enables automated benchmarking in regard to national DRLs. Overall the local dose exposure from CT reached approximately 50% of these DRLs indicating that DRL actualization as well as protocol-specific DRLs are desirable. The cloud-based approach enables multi-center dose monitoring and offers great potential to further optimize radiation exposure in radiological departments. • The newly developed software based on the DICOM-Structured Report enables large-scale cloud-based CT dose monitoring • The implemented software solution enables automated benchmarking in regard to national DRLs • The local radiation exposure from CT reached approximately 50 % of the national DRLs • The cloud-based approach offers great potential for multi-center dose analysis. © Georg Thieme Verlag KG Stuttgart · New York.

[Research and implementation of the TLS network transport security technology based on DICOM standard].

PubMed

Lu, Xiaoqi; Wang, Lei; Zhao, Jianfeng

2012-02-01

With the development of medical information, Picture Archiving and Communications System (PACS), Hospital Information System/Radiology Information System(HIS/RIS) and other medical information management system become popular and developed, and interoperability between these systems becomes more frequent. So, these enclosed systems will be open and regionalized by means of network, and this is inevitable. If the trend becomes true, the security of information transmission may be the first problem to be solved. Based on the need for network security, we investigated the Digital Imaging and Communications in Medicine (DICOM) Standard and Transport Layer Security (TLS) Protocol, and implemented the TLS transmission of the DICOM medical information with OpenSSL toolkit and DCMTK toolkit.

Electronic data capture and DICOM data management in multi-center clinical trials

NASA Astrophysics Data System (ADS)

Haak, Daniel; Page, Charles-E.; Deserno, Thomas M.

2016-03-01

Providing eligibility, efficacy and security evaluation by quantitative and qualitative disease findings, medical imaging has become increasingly important in clinical trials. Here, subject's data is today captured in electronic case reports forms (eCRFs), which are offered by electronic data capture (EDC) systems. However, integration of subject's medical image data into eCRFs is insufficiently supported. Neither integration of subject's digital imaging and communications in medicine (DICOM) data, nor communication with picture archiving and communication systems (PACS), is possible. This aggravates the workflow of the study personnel, in special regarding studies with distributed data capture in multiple sites. Hence, in this work, a system architecture is presented, which connects an EDC system, a PACS and a DICOM viewer via the web access to DICOM objects (WADO) protocol. The architecture is implemented using the open source tools OpenClinica, DCM4CHEE and Weasis. The eCRF forms the primary endpoint for the study personnel, where subject's image data is stored and retrieved. Background communication with the PACS is completely hidden for the users. Data privacy and consistency is ensured by automatic de-identification and re-labelling of DICOM data with context information (e.g. study and subject identifiers), respectively. The system is exemplarily demonstrated in a clinical trial, where computer tomography (CT) data is de-centrally captured from the subjects and centrally read by a chief radiologists to decide on inclusion of the subjects in the trial. Errors, latency and costs in the EDC workflow are reduced, while, a research database is implicitly built up in the background.

Development and evaluation of a low-cost and high-capacity DICOM image data storage system for research.

PubMed

Yakami, Masahiro; Ishizu, Koichi; Kubo, Takeshi; Okada, Tomohisa; Togashi, Kaori

2011-04-01

Thin-slice CT data, useful for clinical diagnosis and research, is now widely available but is typically discarded in many institutions, after a short period of time due to data storage capacity limitations. We designed and built a low-cost high-capacity Digital Imaging and COmmunication in Medicine (DICOM) storage system able to store thin-slice image data for years, using off-the-shelf consumer hardware components, such as a Macintosh computer, a Windows PC, and network-attached storage units. "Ordinary" hierarchical file systems, instead of a centralized data management system such as relational database, were adopted to manage patient DICOM files by arranging them in directories enabling quick and easy access to the DICOM files of each study by following the directory trees with Windows Explorer via study date and patient ID. Software used for this system was open-source OsiriX and additional programs we developed ourselves, both of which were freely available via the Internet. The initial cost of this system was about $3,600 with an incremental storage cost of about $900 per 1 terabyte (TB). This system has been running since 7th Feb 2008 with the data stored increasing at the rate of about 1.3 TB per month. Total data stored was 21.3 TB on 23rd June 2009. The maintenance workload was found to be about 30 to 60 min once every 2 weeks. In conclusion, this newly developed DICOM storage system is useful for research due to its cost-effectiveness, enormous capacity, high scalability, sufficient reliability, and easy data access.

Part II: preparing and assessing first-year radiology resident on-call readiness technical implementation.

PubMed

Yam, Chun-Shan; Kruskal, Jonathan; Pedrosa, Ivan; Kressel, Herbert

2006-06-01

The effectiveness of using a Digital Imaging and Communications in Medicine (DICOM)-based interactive examination system in evaluating the readiness of first year radiology residents before taking overnight call in the emergency department (ED) was reported in part I of this article. This report describes technical aspects for the design and implementation of this system. The examination system consists of two modules: Data Collection and Image Viewing. The Data Collection module was a personal computer (PC)-based DICOM storage server based on a free public domain software package, the Mallinckrodt Central Test Node. The Image Viewing module was a Java-based DICOM viewer created using another freeware package: zDicom ActiveX component. The examination takes place once a year at the end of the first 6-month rotation. Cases selected for the examination were actual clinical cases according to the American Society of Emergency Radiology core curriculum. In the 3-hour timed examination, each resident was required to read the cases and provide clinical findings and recommendations. Upper-level residents also participated in the examination to serve as a control. Answers were scored by two staff radiologists. We have been using this examination system successfully in our institution since 2003 to evaluate the readiness of the first-year residents before they take overnight call in the ED. This report describes a step-by-step procedure for implementing this system into a PC-based platform. This DICOM viewing software is available as freeware to other academic radiology institutions. The total cost for implementing this system is approximately 2000 US dollars.

Anonymization of DICOM Electronic Medical Records for Radiation Therapy

PubMed Central

Newhauser, Wayne; Jones, Timothy; Swerdloff, Stuart; Newhauser, Warren; Cilia, Mark; Carver, Robert; Halloran, Andy; Zhang, Rui

2014-01-01

Electronic medical records (EMR) and treatment plans are used in research on patient outcomes and radiation effects. In many situations researchers must remove protected health information (PHI) from EMRs. The literature contains several studies describing the anonymization of generic Digital Imaging and Communication in Medicine (DICOM) files and DICOM image sets but no publications were found that discuss the anonymization of DICOM radiation therapy plans, a key component of an EMR in a cancer clinic. In addition to this we were unable to find a commercial software tool that met the minimum requirements for anonymization and preservation of data integrity for radiation therapy research. The purpose of this study was to develop a prototype software code to meet the requirements for the anonymization of radiation therapy treatment plans and to develop a way to validate that code and demonstrate that it properly anonymized treatment plans and preserved data integrity. We extended an open-source code to process all relevant PHI and to allow for the automatic anonymization of multiple EMRs. The prototype code successfully anonymized multiple treatment plans in less than 1 minute per patient. We also tested commercial optical character recognition (OCR) algorithms for the detection of burned-in text on the images, but they were unable to reliably recognize text. In addition, we developed and tested an image filtering algorithm that allowed us to isolate and redact alpha-numeric text from a test radiograph. Validation tests verified that PHI was anonymized and data integrity, such as the relationship between DICOM unique identifiers (UID) was preserved. PMID:25147130

Anonymization of DICOM electronic medical records for radiation therapy.

PubMed

Newhauser, Wayne; Jones, Timothy; Swerdloff, Stuart; Newhauser, Warren; Cilia, Mark; Carver, Robert; Halloran, Andy; Zhang, Rui

2014-10-01

Electronic medical records (EMR) and treatment plans are used in research on patient outcomes and radiation effects. In many situations researchers must remove protected health information (PHI) from EMRs. The literature contains several studies describing the anonymization of generic Digital Imaging and Communication in Medicine (DICOM) files and DICOM image sets but no publications were found that discuss the anonymization of DICOM radiation therapy plans, a key component of an EMR in a cancer clinic. In addition to this we were unable to find a commercial software tool that met the minimum requirements for anonymization and preservation of data integrity for radiation therapy research. The purpose of this study was to develop a prototype software code to meet the requirements for the anonymization of radiation therapy treatment plans and to develop a way to validate that code and demonstrate that it properly anonymized treatment plans and preserved data integrity. We extended an open-source code to process all relevant PHI and to allow for the automatic anonymization of multiple EMRs. The prototype code successfully anonymized multiple treatment plans in less than 1min/patient. We also tested commercial optical character recognition (OCR) algorithms for the detection of burned-in text on the images, but they were unable to reliably recognize text. In addition, we developed and tested an image filtering algorithm that allowed us to isolate and redact alpha-numeric text from a test radiograph. Validation tests verified that PHI was anonymized and data integrity, such as the relationship between DICOM unique identifiers (UID) was preserved. Copyright © 2014 Elsevier Ltd. All rights reserved.

An open source toolkit for medical imaging de-identification.

PubMed

González, David Rodríguez; Carpenter, Trevor; van Hemert, Jano I; Wardlaw, Joanna

2010-08-01

Medical imaging acquired for clinical purposes can have several legitimate secondary uses in research projects and teaching libraries. No commonly accepted solution for anonymising these images exists because the amount of personal data that should be preserved varies case by case. Our objective is to provide a flexible mechanism for anonymising Digital Imaging and Communications in Medicine (DICOM) data that meets the requirements for deployment in multicentre trials. We reviewed our current de-identification practices and defined the relevant use cases to extract the requirements for the de-identification process. We then used these requirements in the design and implementation of the toolkit. Finally, we tested the toolkit taking as a reference those requirements, including a multicentre deployment. The toolkit successfully anonymised DICOM data from various sources. Furthermore, it was shown that it could forward anonymous data to remote destinations, remove burned-in annotations, and add tracking information to the header. The toolkit also implements the DICOM standard confidentiality mechanism. A DICOM de-identification toolkit that facilitates the enforcement of privacy policies was developed. It is highly extensible, provides the necessary flexibility to account for different de-identification requirements and has a low adoption barrier for new users.

[The compression and storage of enhanced external counterpulsation waveform based on DICOM standard].

PubMed

Hu, Ding; Xie, Shuqun; Yu, Donglan; Zheng, Zhensheng; Wang, Kuijian

2010-04-01

The development of external counterpulsation (ECP) local area network system and extensible markup language (XML)-based remote ECP medical information system conformable to digital imaging and communications in medicine (DICOM) standard has been improving the digital interchangeablity and sharability of ECP data. However, the therapy process of ECP is a continuous and longtime supervision which builds a mass of waveform data. In order to reduce the storage space and improve the transmission efficiency, the waveform data with the normative format of ECP data files have to be compressed. In this article, we introduced the compression arithmetic of template matching and improved quick fitting of linear approximation distance thresholding (LADT) in combimation with the characters of enhanced external counterpulsation (EECP) waveform signal. The DICOM standard is used as the storage and transmission standard to make our system compatible with hospital information system. According to the rules of transfer syntaxes, we defined private transfer syntax for one-dimensional compressed waveform data and stored EECP data into a DICOM file. Testing result indicates that the compressed and normative data can be correctly transmitted and displayed between EECP workstations in our EECP laboratory.

Distributing medical images with internet technologies: a DICOM web server and a DICOM java viewer.

PubMed

Fernàndez-Bayó, J; Barbero, O; Rubies, C; Sentís, M; Donoso, L

2000-01-01

With the advent of filmless radiology, it becomes important to be able to distribute radiologic images digitally throughout an entire hospital. A new approach based on World Wide Web technologies was developed to accomplish this objective. This approach involves a Web server that allows the query and retrieval of images stored in a Digital Imaging and Communications in Medicine (DICOM) archive. The images can be viewed inside a Web browser with use of a small Java program known as the DICOM Java Viewer, which is executed inside the browser. The system offers several advantages over more traditional picture archiving and communication systems (PACS): It is easy to install and maintain, is platform independent, allows images to be manipulated and displayed efficiently, and is easy to integrate with existing systems that are already making use of Web technologies. The system is user-friendly and can easily be used from outside the hospital if a security policy is in place. The simplicity and flexibility of Internet technologies makes them highly preferable to the more complex PACS workstations. The system works well, especially with magnetic resonance and computed tomographic images, and can help improve and simplify interdepartmental relationships in a filmless hospital environment.

Surgical stent planning: simulation parameter study for models based on DICOM standards.

PubMed

Scherer, S; Treichel, T; Ritter, N; Triebel, G; Drossel, W G; Burgert, O

2011-05-01

Endovascular Aneurysm Repair (EVAR) can be facilitated by a realistic simulation model of stent-vessel-interaction. Therefore, numerical feasibility and integrability in the clinical environment was evaluated. The finite element method was used to determine necessary simulation parameters for stent-vessel-interaction in EVAR. Input variables and result data of the simulation model were examined for their standardization using DICOM supplements. The study identified four essential parameters for the stent-vessel simulation: blood pressure, intima constitution, plaque occurrence and the material properties of vessel and plaque. Output quantities such as radial force of the stent and contact pressure between stent/vessel can help the surgeon to evaluate implant fixation and sealing. The model geometry can be saved with DICOM "Surface Segmentation" objects and the upcoming "Implant Templates" supplement. Simulation results can be stored using the "Structured Report". A standards-based general simulation model for optimizing stent-graft selection may be feasible. At present, there are limitations due to specification of individual vessel material parameters and for simulating the proximal fixation of stent-grafts with hooks. Simulation data with clinical relevance for documentation and presentation can be stored using existing or new DICOM extensions.

Medical Image Processing Server applied to Quality Control of Nuclear Medicine.

NASA Astrophysics Data System (ADS)

Vergara, C.; Graffigna, J. P.; Marino, E.; Omati, S.; Holleywell, P.

2016-04-01

This paper is framed within the area of medical image processing and aims to present the process of installation, configuration and implementation of a processing server of medical images (MIPS) in the Fundación Escuela de Medicina Nuclear located in Mendoza, Argentina (FUESMEN). It has been developed in the Gabinete de Tecnologia Médica (GA.TE.ME), Facultad de Ingeniería-Universidad Nacional de San Juan. MIPS is a software that using the DICOM standard, can receive medical imaging studies of different modalities or viewing stations, then it executes algorithms and finally returns the results to other devices. To achieve the objectives previously mentioned, preliminary tests were conducted in the laboratory. More over, tools were remotely installed in clinical enviroment. The appropiate protocols for setting up and using them in different services were established once defined those suitable algorithms. Finally, it’s important to focus on the implementation and training that is provided in FUESMEN, using nuclear medicine quality control processes. Results on implementation are exposed in this work.

Web-based system for surgical planning and simulation

NASA Astrophysics Data System (ADS)

Eldeib, Ayman M.; Ahmed, Mohamed N.; Farag, Aly A.; Sites, C. B.

1998-10-01

The growing scientific knowledge and rapid progress in medical imaging techniques has led to an increasing demand for better and more efficient methods of remote access to high-performance computer facilities. This paper introduces a web-based telemedicine project that provides interactive tools for surgical simulation and planning. The presented approach makes use of client-server architecture based on new internet technology where clients use an ordinary web browser to view, send, receive and manipulate patients' medical records while the server uses the supercomputer facility to generate online semi-automatic segmentation, 3D visualization, surgical simulation/planning and neuroendoscopic procedures navigation. The supercomputer (SGI ONYX 1000) is located at the Computer Vision and Image Processing Lab, University of Louisville, Kentucky. This system is under development in cooperation with the Department of Neurological Surgery, Alliant Health Systems, Louisville, Kentucky. The server is connected via a network to the Picture Archiving and Communication System at Alliant Health Systems through a DICOM standard interface that enables authorized clients to access patients' images from different medical modalities.

Intelligent ePR system for evidence-based research in radiotherapy: proton therapy for prostate cancer.

PubMed

Le, Anh H; Liu, Brent; Schulte, Reinhard; Huang, H K

2011-11-01

Proton therapy (PT) utilizes high energy particle proton beam to kill cancer cells at the target region for target cancer therapy. Due to the physical properties of the proton beam, PT delivers dose with higher precision and no exit dose compared to conventional radiotherapy. In PT, patient data are distributed among multiple systems, a hindrance to research on efficacy and effectiveness. A data mining method and a treatment plan navigator utilizing the infrastructure and data repository of a PT electronic patient record (ePR) was developed to minimize radiation toxicity and improve outcomes in prostate cancer treatment. MATERIALS/METHOD(S): The workflow of a proton therapy treatment in a radiation oncology department was reviewed, and a clinical data model and data flow were designed. A prototype PT ePR system with DICOM compliance was developed to manage prostate cancer patient images, treatment plans, and related clinical data. The ePR system consists of four main components: (1) Data Gateway; (2) ePR Server; (3) Decision Support Tools; and (4) Visualization and Display Tools. Decision support and visualization tools are currently developed based on DICOM images, DICOM-RT and DICOM-RT-ION objects data from prostate cancer patients treated with hypofractionation protocol proton therapy were used for evaluating ePR system effectiveness. Each patient data set includes a set of computed tomography (CT) DICOM images and four DICOM-RT and RT-ION objects. In addition, clinical outcomes data collected from PT cases were included to establish a knowledge base for outcomes analysis. A data mining search engine and an intelligent treatment plan navigator (ITPN) were developed and integrated with the ePR system. Evaluation was based on a data set of 39 PT patients and a hypothetical patient. The ePR system was able to facilitate the proton therapy workflow. The PT ePR system was feasible for prostate cancer patient treated with hypofractionation protocol in proton therapy. This ePR system improves efficiency in data collection and integration to facilitate outcomes analysis.

Machine Learning Interface for Medical Image Analysis.

PubMed

Zhang, Yi C; Kagen, Alexander C

2017-10-01

TensorFlow is a second-generation open-source machine learning software library with a built-in framework for implementing neural networks in wide variety of perceptual tasks. Although TensorFlow usage is well established with computer vision datasets, the TensorFlow interface with DICOM formats for medical imaging remains to be established. Our goal is to extend the TensorFlow API to accept raw DICOM images as input; 1513 DaTscan DICOM images were obtained from the Parkinson's Progression Markers Initiative (PPMI) database. DICOM pixel intensities were extracted and shaped into tensors, or n-dimensional arrays, to populate the training, validation, and test input datasets for machine learning. A simple neural network was constructed in TensorFlow to classify images into normal or Parkinson's disease groups. Training was executed over 1000 iterations for each cross-validation set. The gradient descent optimization and Adagrad optimization algorithms were used to minimize cross-entropy between the predicted and ground-truth labels. Cross-validation was performed ten times to produce a mean accuracy of 0.938 ± 0.047 (95 % CI 0.908-0.967). The mean sensitivity was 0.974 ± 0.043 (95 % CI 0.947-1.00) and mean specificity was 0.822 ± 0.207 (95 % CI 0.694-0.950). We extended the TensorFlow API to enable DICOM compatibility in the context of DaTscan image analysis. We implemented a neural network classifier that produces diagnostic accuracies on par with excellent results from previous machine learning models. These results indicate the potential role of TensorFlow as a useful adjunct diagnostic tool in the clinical setting.

Effect of display type, DICOM calibration and room illuminance in bitewing radiographs.

PubMed

Kallio-Pulkkinen, Soili; Huumonen, Sisko; Haapea, Marianne; Liukkonen, Esa; Sipola, Annina; Tervonen, Osmo; Nieminen, Miika T

2016-01-01

To compare observer performance in the detection of both anatomical structures and caries in bitewing radiographs using consumer grade displays with and without digital imaging and communications in medicine (DICOM) calibration, tablets (third generation iPad; Apple, Cupertino, CA) and 6-megapixel (MP) displays under different lighting. 30 bitewing radiographs were blindly evaluated on four displays under bright (510 lx) and dim (16 lx) ambient lighting by two observers. The dentinoenamel junction, enamel and dentinal caries, and the cortical border of the alveolar crests were evaluated. Consensus was considered as reference. Intraobserver agreement was determined. The proportion of equivalent ratings and weighted kappa were used to assess reliability. The proportion of equivalent ratings with consensus differed significantly between uncalibrated and DICOM-calibrated consumer grade display in enamel caries in upper and lower molars in bright (p = 0.013 and p = 0.003) lighting, and in dentinal caries in lower molars in both bright (p = 0.022) and dim (p = 0.004) lighting. The proportion also differed significantly between DICOM-calibrated consumer grade and 6-MP display in dentinal caries in lower molars in bright lighting (p = 0.039), tablet and consumer grade display in enamel caries in upper molars (p = 0.017) in bright lighting, tablet and 6-MP display in dentinal caries in lower molars (p = 0.003) in bright lighting and in enamel caries in lower molars (p = 0.012) in dim lighting. DICOM calibration improves the detection of enamel and dentinal caries in bitewing radiographs, particularly in bright lighting. Therefore, a calibrated consumer grade display can be recommended as a diagnostic tool for viewing bitewing radiographs.

Policies and Procedures for Reviewing Medical Images From Portable Media: Survey of Radiology Departments

PubMed Central

Kalia, Vivek; Carrino, John A.; Macura, Katarzyna J.

2015-01-01

Purpose The purpose of this study was to survey current practices for portable media (CDs and DVDs) use for medical imaging in both academic and nonacademic radiology departments in the United States. Methods This survey was a stratified, nonrandom sample, 22-question electronic survey, using SurveyMonkey, of members of the Association of Administrators in Academic Radiology, the Association for Medical Imaging Management, and the University HealthSystem Consortium, conducted in November 2009. Questions were grouped by media production and media viewing practices. Results One hundred and two individual responses to the survey were received. Ninety-eight percent of respondents said that their institutions produced Digital Imaging and Communications in Medicine (DICOM)-compliant media, with only 2.0% uncertain. Only 22.2% of respondents claimed that their institutions produced Integrating the Healthcare Enterprise (IHE) Portable Data for Imaging (PDI)-compliant media, while 71.6% were uncertain. Rates of DICOM and IHE PDI compliance did not differ between academic and nonacademic centers. As for testing digital media produced at the institutions for DICOM and IHE PDI compliance, only 16.0% of respondents’ institutions routinely did so. Conclusions Three main problem areas regarding portable media became evident from this study: (1) access, (2) importability, and (3) viewing issues, and problems with any of the 3 can delay patient care. Noncompliance and a lack of knowledge about compliance were found to be major issues in the present study, more so for IHE PDI than for DICOM, and there is much room for improvement. Recommendations include that radiology practices should routinely generate only media compliant with DICOM and IHE PDI and should test for compliance. PMID:21211763

Assuring image authenticity within a data grid using lossless digital signature embedding and a HIPAA-compliant auditing system

NASA Astrophysics Data System (ADS)

Lee, Jasper C.; Ma, Kevin C.; Liu, Brent J.

2008-03-01

A Data Grid for medical images has been developed at the Image Processing and Informatics Laboratory, USC to provide distribution and fault-tolerant storage of medical imaging studies across Internet2 and public domain. Although back-up policies and grid certificates guarantee privacy and authenticity of grid-access-points, there still lacks a method to guarantee the sensitive DICOM images have not been altered or corrupted during transmission across a public domain. This paper takes steps toward achieving full image transfer security within the Data Grid by utilizing DICOM image authentication and a HIPAA-compliant auditing system. The 3-D lossless digital signature embedding procedure involves a private 64 byte signature that is embedded into each original DICOM image volume, whereby on the receiving end the signature can to be extracted and verified following the DICOM transmission. This digital signature method has also been developed at the IPILab. The HIPAA-Compliant Auditing System (H-CAS) is required to monitor embedding and verification events, and allows monitoring of other grid activity as well. The H-CAS system federates the logs of transmission and authentication events at each grid-access-point and stores it into a HIPAA-compliant database. The auditing toolkit is installed at the local grid-access-point and utilizes Syslog [1], a client-server standard for log messaging over an IP network, to send messages to the H-CAS centralized database. By integrating digital image signatures and centralized logging capabilities, DICOM image integrity within the Medical Imaging and Informatics Data Grid can be monitored and guaranteed without loss to any image quality.

A practical approach to automate randomized design of experiments for ligand-binding assays.

PubMed

Tsoi, Jennifer; Patel, Vimal; Shih, Judy

2014-03-01

Design of experiments (DOE) is utilized in optimizing ligand-binding assay by modeling factor effects. To reduce the analyst's workload and error inherent with DOE, we propose the integration of automated liquid handlers to perform the randomized designs. A randomized design created from statistical software was imported into custom macro converting the design into a liquid-handler worklist to automate reagent delivery. An optimized assay was transferred to a contract research organization resulting in a successful validation. We developed a practical solution for assay optimization by integrating DOE and automation to increase assay robustness and enable successful method transfer. The flexibility of this process allows it to be applied to a variety of assay designs.

Image-based electronic patient records for secured collaborative medical applications.

PubMed

Zhang, Jianguo; Sun, Jianyong; Yang, Yuanyuan; Liang, Chenwen; Yao, Yihong; Cai, Weihua; Jin, Jin; Zhang, Guozhen; Sun, Kun

2005-01-01

We developed a Web-based system to interactively display image-based electronic patient records (EPR) for secured intranet and Internet collaborative medical applications. The system consists of four major components: EPR DICOM gateway (EPR-GW), Image-based EPR repository server (EPR-Server), Web Server and EPR DICOM viewer (EPR-Viewer). In the EPR-GW and EPR-Viewer, the security modules of Digital Signature and Authentication are integrated to perform the security processing on the EPR data with integrity and authenticity. The privacy of EPR in data communication and exchanging is provided by SSL/TLS-based secure communication. This presentation gave a new approach to create and manage image-based EPR from actual patient records, and also presented a way to use Web technology and DICOM standard to build an open architecture for collaborative medical applications.

Transforming Dermatologic Imaging for the Digital Era: Metadata and Standards.

PubMed

Caffery, Liam J; Clunie, David; Curiel-Lewandrowski, Clara; Malvehy, Josep; Soyer, H Peter; Halpern, Allan C

2018-01-17

Imaging is increasingly being used in dermatology for documentation, diagnosis, and management of cutaneous disease. The lack of standards for dermatologic imaging is an impediment to clinical uptake. Standardization can occur in image acquisition, terminology, interoperability, and metadata. This paper presents the International Skin Imaging Collaboration position on standardization of metadata for dermatologic imaging. Metadata is essential to ensure that dermatologic images are properly managed and interpreted. There are two standards-based approaches to recording and storing metadata in dermatologic imaging. The first uses standard consumer image file formats, and the second is the file format and metadata model developed for the Digital Imaging and Communication in Medicine (DICOM) standard. DICOM would appear to provide an advantage over using consumer image file formats for metadata as it includes all the patient, study, and technical metadata necessary to use images clinically. Whereas, consumer image file formats only include technical metadata and need to be used in conjunction with another actor-for example, an electronic medical record-to supply the patient and study metadata. The use of DICOM may have some ancillary benefits in dermatologic imaging including leveraging DICOM network and workflow services, interoperability of images and metadata, leveraging existing enterprise imaging infrastructure, greater patient safety, and better compliance to legislative requirements for image retention.

Design of an ontology for medical image manipulation: an example applied for DICOM extensions

NASA Astrophysics Data System (ADS)

Aubry, Florent; Chameroy, Virginie; Todd-Pokropek, Andrew; Di Paola, Robert

1999-07-01

Currently, various data formats are widely used for medical imags, e.g. DICOM for exchange through network and storage media, and INTERFILE for image exchange in nuclear medicine. These formats are only able partly to solve problems arising in accessing and handling imags. To solve such problems, an ontology dedicated to the description of data and knowledge involved in the handling and the management of medical images has been designed. The ontology offers a semantic frame of reference to which manipulation tools can refer. It considers various point of view on the data, related to the context of production, the content,and the data quality. It supports several levels of abstraction, going from a declarative level related to the examination type to the implementation level. Moreover, the ontology provides mechanisms allowing the creation and the description of new entities. It can, thus, act as an intermediate language ensuring accurate reuse of the entities. This paper, which presents work in progress, is focused on the description of the ontology and points out how to use it for the description of and the access to DICOM or INTERFILE entities, and for the extension of the DICOM or INTERFILE dictionaries, by adding new entities, in order to describe complex relationships between images.

The caBIG annotation and image Markup project.

PubMed

Channin, David S; Mongkolwat, Pattanasak; Kleper, Vladimir; Sepukar, Kastubh; Rubin, Daniel L

2010-04-01

Image annotation and markup are at the core of medical interpretation in both the clinical and the research setting. Digital medical images are managed with the DICOM standard format. While DICOM contains a large amount of meta-data about whom, where, and how the image was acquired, DICOM says little about the content or meaning of the pixel data. An image annotation is the explanatory or descriptive information about the pixel data of an image that is generated by a human or machine observer. An image markup is the graphical symbols placed over the image to depict an annotation. While DICOM is the standard for medical image acquisition, manipulation, transmission, storage, and display, there are no standards for image annotation and markup. Many systems expect annotation to be reported verbally, while markups are stored in graphical overlays or proprietary formats. This makes it difficult to extract and compute with both of them. The goal of the Annotation and Image Markup (AIM) project is to develop a mechanism, for modeling, capturing, and serializing image annotation and markup data that can be adopted as a standard by the medical imaging community. The AIM project produces both human- and machine-readable artifacts. This paper describes the AIM information model, schemas, software libraries, and tools so as to prepare researchers and developers for their use of AIM.

Space Spurred Computer Graphics

NASA Technical Reports Server (NTRS)

1983-01-01

Dicomed Corporation was asked by NASA in the early 1970s to develop processing capabilities for recording images sent from Mars by Viking spacecraft. The company produced a film recorder which increased the intensity levels and the capability for color recording. This development led to a strong technology base resulting in sophisticated computer graphics equipment. Dicomed systems are used to record CAD (computer aided design) and CAM (computer aided manufacturing) equipment, to update maps and produce computer generated animation.

Medical Images Remote Consultation

NASA Astrophysics Data System (ADS)

Ferraris, Maurizio; Frixione, Paolo; Squarcia, Sandro

Teleconsultation of digital images among different medical centers is now a reality. The problem to be solved is how to interconnect all the clinical diagnostic devices in a hospital in order to allow physicians and health physicists, working in different places, to discuss on interesting clinical cases visualizing the same diagnostic images at the same time. Applying World Wide Web technologies, the proposed system can be easily used by people with no specific computer knowledge providing a verbose help to guide the user through the right steps of execution. Diagnostic images are retrieved from a relational database or from a standard DICOM-PACS through the DICOM-WWW gateway allowing connection of the usual Web browsers to DICOM applications via the HTTP protocol. The system, which is proposed for radiotherapy implementation, where radiographies play a fundamental role, can be easily converted to different field of medical applications where a remote access to secure data are compulsory.

[Innovative teleradiology network: concept and experience report].

PubMed

Kämmerer, M; Bethge, O T; Antoch, G

2014-04-01

(DICOM E-MAIL provides a standardized way for exchanging DICOM objects (Digital Imaging and Communications in Medicine) and further relevant patient data for the treatment context reliably and securely via encrypted e-mails. The current version of the DICOM E-MAIL standard recommendations of the"Deutsche Röntgengesellschaft" (DRG, German Röntgen Society) defines for the first time options for setting up a special directory service for the provision and distribution of communication data of all participants in a network. By using such"telephone books", networks of any size can be operated independent of the provider. Compared to a Cross-Enterprise Document Sharing (XDS) scenario, the required infrastructure is considerably less complex and quicker to realize. Critical success factors are, in addition to the technology and an effective support, that the participants themselves contribute to the further development of the network and in this way, the network approach can be practiced.

Integrating CAD modules in a PACS environment using a wide computing infrastructure.

PubMed

Suárez-Cuenca, Jorge J; Tilve, Amara; López, Ricardo; Ferro, Gonzalo; Quiles, Javier; Souto, Miguel

2017-04-01

The aim of this paper is to describe a project designed to achieve a total integration of different CAD algorithms into the PACS environment by using a wide computing infrastructure. The aim is to build a system for the entire region of Galicia, Spain, to make CAD accessible to multiple hospitals by employing different PACSs and clinical workstations. The new CAD model seeks to connect different devices (CAD systems, acquisition modalities, workstations and PACS) by means of networking based on a platform that will offer different CAD services. This paper describes some aspects related to the health services of the region where the project was developed, CAD algorithms that were either employed or selected for inclusion in the project, and several technical aspects and results. We have built a standard-based platform with which users can request a CAD service and receive the results in their local PACS. The process runs through a web interface that allows sending data to the different CAD services. A DICOM SR object is received with the results of the algorithms stored inside the original study in the proper folder with the original images. As a result, a homogeneous service to the different hospitals of the region will be offered. End users will benefit from a homogeneous workflow and a standardised integration model to request and obtain results from CAD systems in any modality, not dependant on commercial integration models. This new solution will foster the deployment of these technologies in the entire region of Galicia.

Navigating the fifth dimension: new concepts in interactive multimodality and multidimensional image navigation

NASA Astrophysics Data System (ADS)

Ratib, Osman; Rosset, Antoine; Dahlbom, Magnus; Czernin, Johannes

2005-04-01

Display and interpretation of multi dimensional data obtained from the combination of 3D data acquired from different modalities (such as PET-CT) require complex software tools allowing the user to navigate and modify the different image parameters. With faster scanners it is now possible to acquire dynamic images of a beating heart or the transit of a contrast agent adding a fifth dimension to the data. We developed a DICOM-compliant software for real time navigation in very large sets of 5 dimensional data based on an intuitive multidimensional jog-wheel widely used by the video-editing industry. The software, provided under open source licensing, allows interactive, single-handed, navigation through 3D images while adjusting blending of image modalities, image contrast and intensity and the rate of cine display of dynamic images. In this study we focused our effort on the user interface and means for interactively navigating in these large data sets while easily and rapidly changing multiple parameters such as image position, contrast, intensity, blending of colors, magnification etc. Conventional mouse-driven user interface requiring the user to manipulate cursors and sliders on the screen are too cumbersome and slow. We evaluated several hardware devices and identified a category of multipurpose jogwheel device that is used in the video-editing industry that is particularly suitable for rapidly navigating in five dimensions while adjusting several display parameters interactively. The application of this tool will be demonstrated in cardiac PET-CT imaging and functional cardiac MRI studies.

Open source software in a practical approach for post processing of radiologic images.

PubMed

Valeri, Gianluca; Mazza, Francesco Antonino; Maggi, Stefania; Aramini, Daniele; La Riccia, Luigi; Mazzoni, Giovanni; Giovagnoni, Andrea

2015-03-01

The purpose of this paper is to evaluate the use of open source software (OSS) to process DICOM images. We selected 23 programs for Windows and 20 programs for Mac from 150 possible OSS programs including DICOM viewers and various tools (converters, DICOM header editors, etc.). The programs selected all meet the basic requirements such as free availability, stand-alone application, presence of graphical user interface, ease of installation and advanced features beyond simple display monitor. Capabilities of data import, data export, metadata, 2D viewer, 3D viewer, support platform and usability of each selected program were evaluated on a scale ranging from 1 to 10 points. Twelve programs received a score higher than or equal to eight. Among them, five obtained a score of 9: 3D Slicer, MedINRIA, MITK 3M3, VolView, VR Render; while OsiriX received 10. OsiriX appears to be the only program able to perform all the operations taken into consideration, similar to a workstation equipped with proprietary software, allowing the analysis and interpretation of images in a simple and intuitive way. OsiriX is a DICOM PACS workstation for medical imaging and software for image processing for medical research, functional imaging, 3D imaging, confocal microscopy and molecular imaging. This application is also a good tool for teaching activities because it facilitates the attainment of learning objectives among students and other specialists.

A DICOM based radiotherapy plan database for research collaboration and reporting

NASA Astrophysics Data System (ADS)

Westberg, J.; Krogh, S.; Brink, C.; Vogelius, I. R.

2014-03-01

Purpose: To create a central radiotherapy (RT) plan database for dose analysis and reporting, capable of calculating and presenting statistics on user defined patient groups. The goal is to facilitate multi-center research studies with easy and secure access to RT plans and statistics on protocol compliance. Methods: RT institutions are able to send data to the central database using DICOM communications on a secure computer network. The central system is composed of a number of DICOM servers, an SQL database and in-house developed software services to process the incoming data. A web site within the secure network allows the user to manage their submitted data. Results: The RT plan database has been developed in Microsoft .NET and users are able to send DICOM data between RT centers in Denmark. Dose-volume histogram (DVH) calculations performed by the system are comparable to those of conventional RT software. A permission system was implemented to ensure access control and easy, yet secure, data sharing across centers. The reports contain DVH statistics for structures in user defined patient groups. The system currently contains over 2200 patients in 14 collaborations. Conclusions: A central RT plan repository for use in multi-center trials and quality assurance was created. The system provides an attractive alternative to dummy runs by enabling continuous monitoring of protocol conformity and plan metrics in a trial.

Linking DICOM pixel data with radiology reports using automatic semantic annotation

NASA Astrophysics Data System (ADS)

Pathak, Sayan D.; Kim, Woojin; Munasinghe, Indeera; Criminisi, Antonio; White, Steve; Siddiqui, Khan

2012-02-01

Improved access to DICOM studies to both physicians and patients is changing the ways medical imaging studies are visualized and interpreted beyond the confines of radiologists' PACS workstations. While radiologists are trained for viewing and image interpretation, a non-radiologist physician relies on the radiologists' reports. Consequently, patients historically have been typically informed about their imaging findings via oral communication with their physicians, even though clinical studies have shown that patients respond to physician's advice significantly better when the individual patients are shown their own actual data. Our previous work on automated semantic annotation of DICOM Computed Tomography (CT) images allows us to further link radiology report with the corresponding images, enabling us to bridge the gap between image data with the human interpreted textual description of the corresponding imaging studies. The mapping of radiology text is facilitated by natural language processing (NLP) based search application. When combined with our automated semantic annotation of images, it enables navigation in large DICOM studies by clicking hyperlinked text in the radiology reports. An added advantage of using semantic annotation is the ability to render the organs to their default window level setting thus eliminating another barrier to image sharing and distribution. We believe such approaches would potentially enable the consumer to have access to their imaging data and navigate them in an informed manner.

Reconstruction of organ dose for external radiotherapy patients in retrospective epidemiologic studies

NASA Astrophysics Data System (ADS)

Lee, Choonik; Jung, Jae Won; Pelletier, Christopher; Pyakuryal, Anil; Lamart, Stephanie; Kim, Jong Oh; Lee, Choonsik

2015-03-01

Organ dose estimation for retrospective epidemiological studies of late effects in radiotherapy patients involves two challenges: radiological images to represent patient anatomy are not usually available for patient cohorts who were treated years ago, and efficient dose reconstruction methods for large-scale patient cohorts are not well established. In the current study, we developed methods to reconstruct organ doses for radiotherapy patients by using a series of computational human phantoms coupled with a commercial treatment planning system (TPS) and a radiotherapy-dedicated Monte Carlo transport code, and performed illustrative dose calculations. First, we developed methods to convert the anatomy and organ contours of the pediatric and adult hybrid computational phantom series to Digital Imaging and Communications in Medicine (DICOM)-image and DICOM-structure files, respectively. The resulting DICOM files were imported to a commercial TPS for simulating radiotherapy and dose calculation for in-field organs. The conversion process was validated by comparing electron densities relative to water and organ volumes between the hybrid phantoms and the DICOM files imported in TPS, which showed agreements within 0.1 and 2%, respectively. Second, we developed a procedure to transfer DICOM-RT files generated from the TPS directly to a Monte Carlo transport code, x-ray Voxel Monte Carlo (XVMC) for more accurate dose calculations. Third, to illustrate the performance of the established methods, we simulated a whole brain treatment for the 10 year-old male phantom and a prostate treatment for the adult male phantom. Radiation doses to selected organs were calculated using the TPS and XVMC, and compared to each other. Organ average doses from the two methods matched within 7%, whereas maximum and minimum point doses differed up to 45%. The dosimetry methods and procedures established in this study will be useful for the reconstruction of organ dose to support retrospective epidemiological studies of late effects in radiotherapy patients.

[Design and development of the DSA digital subtraction workstation].

PubMed

Peng, Wen-Xian; Peng, Tian-Zhou; Xia, Shun-Ren; Jin, Guang-Bo

2008-05-01

According to the patient examination criterion and the demands of all related departments, the DSA digital subtraction workstation has been successfully designed and is introduced in this paper by analyzing the characteristic of video source of DSA which was manufactured by GE Company and has no DICOM standard interface. The workstation includes images-capturing gateway and post-processing software. With the developed workstation, all images from this early DSA equipment are transformed into DICOM format and then are shared in different machines.

Integration of multiple DICOM Web servers into an enterprise-wide Web-based electronic medical record

NASA Astrophysics Data System (ADS)

Stewart, Brent K.; Langer, Steven G.; Martin, Kelly P.

1999-07-01

The purpose of this paper is to integrate multiple DICOM image webservers into the currently existing enterprises- wide web-browsable electronic medical record. Over the last six years the University of Washington has created a clinical data repository combining in a distributed relational database information from multiple departmental databases (MIND). A character cell-based view of this data called the Mini Medical Record (MMR) has been available for four years, MINDscape, unlike the text-based MMR. provides a platform independent, dynamic, web browser view of the MIND database that can be easily linked with medical knowledge resources on the network, like PubMed and the Federated Drug Reference. There are over 10,000 MINDscape user accounts at the University of Washington Academic Medical Centers. The weekday average number of hits to MINDscape is 35,302 and weekday average number of individual users is 1252. DICOM images from multiple webservers are now being viewed through the MINDscape electronic medical record.

A Java viewer to publish Digital Imaging and Communications in Medicine (DICOM) radiologic images on the World Wide Web.

PubMed

Setti, E; Musumeci, R

2001-06-01

The world wide web is an exciting service that allows one to publish electronic documents made of text and images on the internet. Client software called a web browser can access these documents, and display and print them. The most popular browsers are currently Microsoft Internet Explorer (Microsoft, Redmond, WA) and Netscape Communicator (Netscape Communications, Mountain View, CA). These browsers can display text in hypertext markup language (HTML) format and images in Joint Photographic Expert Group (JPEG) and Graphic Interchange Format (GIF). Currently, neither browser can display radiologic images in native Digital Imaging and Communications in Medicine (DICOM) format. With the aim to publish radiologic images on the internet, we wrote a dedicated Java applet. Our software can display radiologic and histologic images in DICOM, JPEG, and GIF formats, and provides a a number of functions like windowing and magnification lens. The applet is compatible with some web browsers, even the older versions. The software is free and available from the author.

Image Format Conversion to DICOM and Lookup Table Conversion to Presentation Value of the Japanese Society of Radiological Technology (JSRT) Standard Digital Image Database.

PubMed

Yanagita, Satoshi; Imahana, Masato; Suwa, Kazuaki; Sugimura, Hitomi; Nishiki, Masayuki

2016-01-01

Japanese Society of Radiological Technology (JSRT) standard digital image database contains many useful cases of chest X-ray images, and has been used in many state-of-the-art researches. However, the pixel values of all the images are simply digitized as relative density values by utilizing a scanned film digitizer. As a result, the pixel values are completely different from the standardized display system input value of digital imaging and communications in medicine (DICOM), called presentation value (P-value), which can maintain a visual consistency when observing images using different display luminance. Therefore, we converted all the images from JSRT standard digital image database to DICOM format followed by the conversion of the pixel values to P-value using an original program developed by ourselves. Consequently, JSRT standard digital image database has been modified so that the visual consistency of images is maintained among different luminance displays.

Informatics in radiology (infoRAD): Vendor-neutral case input into a server-based digital teaching file system.

PubMed

Kamauu, Aaron W C; DuVall, Scott L; Robison, Reid J; Liimatta, Andrew P; Wiggins, Richard H; Avrin, David E

2006-01-01

Although digital teaching files are important to radiology education, there are no current satisfactory solutions for export of Digital Imaging and Communications in Medicine (DICOM) images from picture archiving and communication systems (PACS) in desktop publishing format. A vendor-neutral digital teaching file, the Radiology Interesting Case Server (RadICS), offers an efficient tool for harvesting interesting cases from PACS without requiring modifications of the PACS configurations. Radiologists push imaging studies from PACS to RadICS via the standard DICOM Send process, and the RadICS server automatically converts the DICOM images into the Joint Photographic Experts Group format, a common desktop publishing format. They can then select key images and create an interesting case series at the PACS workstation. RadICS was tested successfully against multiple unmodified commercial PACS. Using RadICS, radiologists are able to harvest and author interesting cases at the point of clinical interpretation with minimal disruption in clinical work flow. RSNA, 2006

Standards to support information systems integration in anatomic pathology.

PubMed

Daniel, Christel; García Rojo, Marcial; Bourquard, Karima; Henin, Dominique; Schrader, Thomas; Della Mea, Vincenzo; Gilbertson, John; Beckwith, Bruce A

2009-11-01

Integrating anatomic pathology information- text and images-into electronic health care records is a key challenge for enhancing clinical information exchange between anatomic pathologists and clinicians. The aim of the Integrating the Healthcare Enterprise (IHE) international initiative is precisely to ensure interoperability of clinical information systems by using existing widespread industry standards such as Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7). To define standard-based informatics transactions to integrate anatomic pathology information to the Healthcare Enterprise. We used the methodology of the IHE initiative. Working groups from IHE, HL7, and DICOM, with special interest in anatomic pathology, defined consensual technical solutions to provide end-users with improved access to consistent information across multiple information systems. The IHE anatomic pathology technical framework describes a first integration profile, "Anatomic Pathology Workflow," dedicated to the diagnostic process including basic image acquisition and reporting solutions. This integration profile relies on 10 transactions based on HL7 or DICOM standards. A common specimen model was defined to consistently identify and describe specimens in both HL7 and DICOM transactions. The IHE anatomic pathology working group has defined standard-based informatics transactions to support the basic diagnostic workflow in anatomic pathology laboratories. In further stages, the technical framework will be completed to manage whole-slide images and semantically rich structured reports in the diagnostic workflow and to integrate systems used for patient care and those used for research activities (such as tissue bank databases or tissue microarrayers).

An efficient architecture to support digital pathology in standard medical imaging repositories.

PubMed

Marques Godinho, Tiago; Lebre, Rui; Silva, Luís Bastião; Costa, Carlos

2017-07-01

In the past decade, digital pathology and whole-slide imaging (WSI) have been gaining momentum with the proliferation of digital scanners from different manufacturers. The literature reports significant advantages associated with the adoption of digital images in pathology, namely, improvements in diagnostic accuracy and better support for telepathology. Moreover, it also offers new clinical and research applications. However, numerous barriers have been slowing the adoption of WSI, among which the most important are performance issues associated with storage and distribution of huge volumes of data, and lack of interoperability with other hospital information systems, most notably Picture Archive and Communications Systems (PACS) based on the DICOM standard. This article proposes an architecture of a Web Pathology PACS fully compliant with DICOM standard communications and data formats. The solution includes a PACS Archive responsible for storing whole-slide imaging data in DICOM WSI format and offers a communication interface based on the most recent DICOM Web services. The second component is a zero-footprint viewer that runs in any web-browser. It consumes data using the PACS archive standard web services. Moreover, it features a tiling engine especially suited to deal with the WSI image pyramids. These components were designed with special focus on efficiency and usability. The performance of our system was assessed through a comparative analysis of the state-of-the-art solutions. The results demonstrate that it is possible to have a very competitive solution based on standard workflows. Copyright © 2017 Elsevier Inc. All rights reserved.

Exemplary design of a DICOM structured report template for CBIR integration into radiological routine

NASA Astrophysics Data System (ADS)

Welter, Petra; Deserno, Thomas M.; Gülpers, Ralph; Wein, Berthold B.; Grouls, Christoph; Günther, Rolf W.

2010-03-01

The large and continuously growing amount of medical image data demands access methods with regards to content rather than simple text-based queries. The potential benefits of content-based image retrieval (CBIR) systems for computer-aided diagnosis (CAD) are evident and have been approved. Still, CBIR is not a well-established part of daily routine of radiologists. We have already presented a concept of CBIR integration for the radiology workflow in accordance with the Integrating the Healthcare Enterprise (IHE) framework. The retrieval result is composed as a Digital Imaging and Communication in Medicine (DICOM) Structured Reporting (SR) document. The use of DICOM SR provides interchange with PACS archive and image viewer. It offers the possibility of further data mining and automatic interpretation of CBIR results. However, existing standard templates do not address the domain of CBIR. We present a design of a SR template customized for CBIR. Our approach is based on the DICOM standard templates and makes use of the mammography and chest CAD SR templates. Reuse of approved SR sub-trees promises a reliable design which is further adopted to the CBIR domain. We analyze the special CBIR requirements and integrate the new concept of similar images into our template. Our approach also includes the new concept of a set of selected images for defining the processed images for CBIR. A commonly accepted pre-defined template for the presentation and exchange of results in a standardized format promotes the widespread application of CBIR in radiological routine.

Integration of implant planning workflows into the PACS infrastructure

NASA Astrophysics Data System (ADS)

Gessat, Michael; Strauß, Gero; Burgert, Oliver

2008-03-01

The integration of imaging devices, diagnostic workstations, and image servers into Picture Archiving and Communication Systems (PACS) has had an enormous effect on the efficiency of radiology workflows. The standardization of the information exchange between the devices with the DICOM standard has been an essential precondition for that development. For surgical procedures, no such infrastructure exists. With the increasingly important role computerized planning and assistance systems play in the surgical domain, an infrastructure that unifies the communication between devices becomes necessary. In recent publications, the need for a modularized system design has been established. A reference architecture for a Therapy Imaging and Model Management System (TIMMS) has been proposed. It was accepted by the DICOM Working Group 6 as the reference architecture for DICOM developments for surgery. In this paper we propose the inclusion of implant planning systems into the PACS infrastructure. We propose a generic information model for the patient specific selection and positioning of implants from a repository according to patient image data. The information models are based on clinical workflows from ENT, cardiac, and orthopedic surgery as well as technical requirements derived from different use cases and systems. We show an exemplary implementation of the model for application in ENT surgery: the selection and positioning of an ossicular implant in the middle ear. An implant repository is stored in the PACS. It makes use of an experimental implementation of the Surface Mesh Module that is currently being developed as extension to the DICOM standard.

Development and validation of RAYDOSE: a Geant4-based application for molecular radiotherapy

NASA Astrophysics Data System (ADS)

Marcatili, S.; Pettinato, C.; Daniels, S.; Lewis, G.; Edwards, P.; Fanti, S.; Spezi, E.

2013-04-01

We developed and validated a Monte-Carlo-based application (RAYDOSE) to generate patient-specific 3D dose maps on the basis of pre-treatment imaging studies. A CT DICOM image is used to model patient geometry, while repeated PET scans are employed to assess radionuclide kinetics and distribution at the voxel level. In this work, we describe the structure of this application and present the tests performed to validate it against reference data and experiments. We used the spheres of a NEMA phantom to calculate S values and total doses. The comparison with reference data from OLINDA/EXM showed an agreement within 2% for a sphere size above 2.8 cm diameter. A custom heterogeneous phantom composed of several layers of Perspex and lung equivalent material was used to compare TLD measurements of gamma radiation from 131I to Monte Carlo simulations. An agreement within 5% was found. RAYDOSE has been validated against reference data and experimental measurements and can be a useful multi-modality platform for treatment planning and research in MRT.

Benefits of an automatic patient dose registry system for interventional radiology and cardiology at five hospitals of the Madrid area.

PubMed

Fernandez-Soto, J M; Ten, J I; Sanchez, R M; España, M; Pifarre, X; Vano, E

2015-07-01

The purpose of this article is to present the results of connecting the interventional radiology and cardiology laboratories of five university hospitals to a unique server using an automatic patient dose registry system (Dose On Line for Interventional Radiology, DOLIR) developed in-house, and to evaluate its feasibility more than a year after its introduction. The system receives and stores demographic and dosimetric parameters included in the MPPS DICOM objects sent by the modalities to a database. A web service provides a graphical interface to analyse the information received. During 2013, the system processed 10 788 procedures (6874 cardiac, 2906 vascular and 1008 neuro interventional). The percentages of patients requiring clinical follow-up due to potential tissue reactions before and after the use of DOLIR are presented. The system allowed users to verify in real-time, if diagnostic (or interventional) reference levels are fulfilled. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Measuring and managing radiologist workload: application of lean and constraint theories and production planning principles to planning radiology services in a major tertiary hospital.

PubMed

MacDonald, Sharyn L S; Cowan, Ian A; Floyd, Richard; Mackintosh, Stuart; Graham, Rob; Jenkins, Emma; Hamilton, Richard

2013-10-01

We describe how techniques traditionally used in the manufacturing industry (lean management, the theory of constraints and production planning) can be applied to planning radiology services to reduce the impact of constraints such as limited radiologist hours, and to subsequently reduce delays in accessing imaging and in report turnaround. Targets for imaging and reporting were set aligned with clinical needs. Capacity was quantified for each modality and for radiologists and recorded in activity lists. Demand was quantified and forecasting commenced based on historical referral rates. To try and mitigate the impact of radiologists as a constraint, lean management processes were applied to radiologist workflows. A production planning process was implemented. Outpatient waiting times to access imaging steadily decreased. Report turnaround times improved with the percentage of overnight/on-call reports completed by a 1030 target time increased from approximately 30% to 80 to 90%. The percentage of emergency and inpatient reports completed within one hour increased from approximately 15% to approximately 50% with 80 to 90% available within 4 hours. The number of unreported cases on the radiologist work-list at the end of the working day reduced. The average weekly accuracy for demand forecasts for emergency and inpatient CT, MRI and plain film imaging was 91%, 83% and 92% respectively. For outpatient CT, MRI and plain film imaging the accuracy was 60%, 55% and 77% respectively. Reliable routine weekly and medium to longer term service planning is now possible. Tools from industry can be successfully applied to diagnostic imaging services to improve performance. They allow an accurate understanding of the demands on a service, capacity, and can reliably predict the impact of changes in demand or capacity on service delivery. © 2013 The Royal Australian and New Zealand College of Radiologists.

Reversible watermarking for authentication of DICOM images.

PubMed

Zain, J M; Baldwin, L P; Clarke, M

2004-01-01

We propose a watermarking scheme that can recover the original image from the watermarked one. The purpose is to verify the integrity and authenticity of DICOM images. We used 800x600x8 bits ultrasound (US) images in our experiment. SHA-256 of the whole image is embedded in the least significant bits of the RONI (Region of Non-Interest). If the image has not been altered, the watermark will be extracted and the original image will be recovered. SHA-256 of the recovered image will be compared with the extracted watermark for authentication.

Generic worklist handler for workflow-enabled products

NASA Astrophysics Data System (ADS)

Schmidt, Joachim; Meetz, Kirsten; Wendler, Thomas

1999-07-01

Workflow management (WfM) is an emerging field of medical information technology. It appears as a promising key technology to model, optimize and automate processes, for the sake of improved efficiency, reduced costs and improved patient care. The Application of WfM concepts requires the standardization of architectures and interfaces. A component of central interest proposed in this report is a generic work list handler: A standardized interface between a workflow enactment service and application system. Application systems with embedded work list handlers will be called 'Workflow Enabled Application Systems'. In this paper we discus functional requirements of work list handlers, as well as their integration into workflow architectures and interfaces. To lay the foundation for this specification, basic workflow terminology, the fundamentals of workflow management and - later in the paper - the available standards as defined by the Workflow Management Coalition are briefly reviewed.

Radiologic image communication and archive service: a secure, scalable, shared approach

NASA Astrophysics Data System (ADS)

Fellingham, Linda L.; Kohli, Jagdish C.

1995-11-01

The Radiologic Image Communication and Archive (RICA) service is designed to provide a shared archive for medical images to the widest possible audience of customers. Images are acquired from a number of different modalities, each available from many different vendors. Images are acquired digitally from those modalities which support direct digital output and by digitizing films for projection x-ray exams. The RICA Central Archive receives standard DICOM 3.0 messages and data streams from the medical imaging devices at customer institutions over the public telecommunication network. RICA represents a completely scalable resource. The user pays only for what he is using today with the full assurance that as the volume of image data that he wishes to send to the archive increases, the capacity will be there to accept it. To provide this seamless scalability imposes several requirements on the RICA architecture: (1) RICA must support the full array of transport services. (2) The Archive Interface must scale cost-effectively to support local networks that range from the very small (one x-ray digitizer in a medical clinic) to the very large and complex (a large hospital with several CTs, MRs, Nuclear medicine devices, ultrasound machines, CRs, and x-ray digitizers). (3) The Archive Server must scale cost-effectively to support rapidly increasing demands for service providing storage for and access to millions of patients and hundreds of millions of images. The architecture must support the incorporation of improved technology as it becomes available to maintain performance and remain cost-effective as demand rises.

Selection and implementation of a distributed phased archive for a multivendor incremental approach to PACS

NASA Astrophysics Data System (ADS)

Smith, Edward M.; Wandtke, John; Robinson, Arvin E.

1999-07-01

The selection criteria for the archive were based on the objectives of the Medical Information, Communication and Archive System (MICAS), a multi-vendor incremental approach to PACS. These objectives include interoperability between all components, seamless integration of the Radiology Information System (RIS) with MICAS and eventually other hospital databases, all components must demonstrate DICOM compliance prior to acceptance and automated workflow that can be programmed to meet changes in the healthcare environment. The long-term multi-modality archive is being implemented in 3 or more phases with the first phase designed to provide a 12 to 18 month storage solution. This decision was made because the cost per GB of storage is rapidly decreasing and the speed at which data can be retrieved is increasing with time. The open-solution selected allows incorporation of leading edge, 'best of breed' hardware and software and provides maximum jukeboxes, provides maximum flexibility of workflow both within and outside of radiology. The selected solution is media independent, supports multiple jukeboxes, provides expandable storage capacity and will provide redundancy and fault tolerance at minimal cost. Some of the required attributes of the archive include scalable archive strategy, virtual image database with global query and object-oriented database. The selection process took approximately 10 months with Cemax-Icon being the vendor selected. Prior to signing a purchase order, Cemax-Icon performed a site survey, agreed upon the acceptance test protocol and provided a written guarantee of connectivity between their archive and the imaging modalities and other MICAS components.

TU-G-BRD-02: Automated Systematic Quality Assurance Program for Radiation Oncology Information System Upgrades

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, B; Yi, B; Eley, J

Purpose: To: (1) describe an independent, automated, systematic software-based protocol for verifying clinical data accuracy/integrity for mitigation of data corruption/loss risks following radiation oncology information system (ROIS) upgrades; and (2) report on application of this approach in an academic/community practice environment. Methods: We propose a robust approach to perform quality assurance on the ROIS after an upgrade, targeting four data sources: (1) ROIS relational database; (2) ROIS DICOM interface; (3) ROIS treatment machine data configuration; and (4) ROIS-generated clinical reports. We investigated the database schema for differences between pre-/post-upgrade states. Paired DICOM data streams for the same object (such asmore » RT-Plan/Treatment Record) were compared between pre-/post-upgrade states for data corruption. We examined machine configuration and related commissioning data files for changes and corruption. ROIS-generated treatment appointment and treatment parameter reports were compared to ensure patient encounter and treatment plan accuracy. This protocol was supplemented by an end-to-end clinical workflow test to verify essential ROI functionality and integrity of components interfaced during patient care chain of activities. We describe the implementation of this protocol during a Varian ARIA system upgrade at our clinic. Results: We verified 1,638 data tables with 2.4 billion data records. For 222 under-treatment patients, 605 DICOM RT plans and 13,480 DICOM treatment records retrieved from the ROIS DICOM interface were compared, with no differences in fractions, doses delivered, or treatment parameters. We identified 82 new data tables and 78 amended/deleted tables consistent with the upgrade. Reports for 5,073 patient encounters over a 2-week horizon were compared and were identical to those before the upgrade. Content in 12,237 xml machine files was compared, with no differences identified. Conclusion: An independent QA/validation approach for ROIS upgrades was developed and implemented at our clinic. The success of this approach ensures a robust QA of ROIS upgrades without manual paper/electronic checks and associated intensive labor.« less

Average glandular dose in paired digital mammography and digital breast tomosynthesis acquisitions in a population based screening program: effects of measuring breast density, air kerma and beam quality

NASA Astrophysics Data System (ADS)

Helge Østerås, Bjørn; Skaane, Per; Gullien, Randi; Catrine Trægde Martinsen, Anne

2018-02-01

The main purpose was to compare average glandular dose (AGD) for same-compression digital mammography (DM) and digital breast tomosynthesis (DBT) acquisitions in a population based screening program, with and without breast density stratification, as determined by automatically calculated breast density (Quantra™). Secondary, to compare AGD estimates based on measured breast density, air kerma and half value layer (HVL) to DICOM metadata based estimates. AGD was estimated for 3819 women participating in the screening trial. All received craniocaudal and mediolateral oblique views of each breasts with paired DM and DBT acquisitions. Exposure parameters were extracted from DICOM metadata. Air kerma and HVL were measured for all beam qualities used to acquire the mammograms. Volumetric breast density was estimated using Quantra™. AGD was estimated using the Dance model. AGD reported directly from the DICOM metadata was also assessed. Mean AGD was 1.74 and 2.10 mGy for DM and DBT, respectively. Mean DBT/DM AGD ratio was 1.24. For fatty breasts: mean AGD was 1.74 and 2.27 mGy for DM and DBT, respectively. For dense breasts: mean AGD was 1.73 and 1.79 mGy, for DM and DBT, respectively. For breasts of similar thickness, dense breasts had higher AGD for DM and similar AGD for DBT. The DBT/DM dose ratio was substantially lower for dense compared to fatty breasts (1.08 versus 1.33). The average c-factor was 1.16. Using previously published polynomials to estimate glandularity from thickness underestimated the c-factor by 5.9% on average. Mean AGD error between estimates based on measurements (air kerma and HVL) versus DICOM header data was 3.8%, but for one mammography unit as high as 7.9%. Mean error of using the AGD value reported in the DICOM header was 10.7 and 13.3%, respectively. Thus, measurement of breast density, radiation dose and beam quality can substantially affect AGD estimates.

Estimating pediatric entrance skin dose from digital radiography examination using DICOM metadata: A quality assurance tool.

PubMed

Brady, S L; Kaufman, R A

2015-05-01

To develop an automated methodology to estimate patient examination dose in digital radiography (DR) imaging using DICOM metadata as a quality assurance (QA) tool. Patient examination and demographical information were gathered from metadata analysis of DICOM header data. The x-ray system radiation output (i.e., air KERMA) was characterized for all filter combinations used for patient examinations. Average patient thicknesses were measured for head, chest, abdomen, knees, and hands using volumetric images from CT. Backscatter factors (BSFs) were calculated from examination kVp. Patient entrance skin air KERMA (ESAK) was calculated by (1) looking up examination technique factors taken from DICOM header metadata (i.e., kVp and mA s) to derive an air KERMA (k air) value based on an x-ray characteristic radiation output curve; (2) scaling k air with a BSF value; and (3) correcting k air for patient thickness. Finally, patient entrance skin dose (ESD) was calculated by multiplying a mass-energy attenuation coefficient ratio by ESAK. Patient ESD calculations were computed for common DR examinations at our institution: dual view chest, anteroposterior (AP) abdomen, lateral (LAT) skull, dual view knee, and bone age (left hand only) examinations. ESD was calculated for a total of 3794 patients; mean age was 11 ± 8 yr (range: 2 months to 55 yr). The mean ESD range was 0.19-0.42 mGy for dual view chest, 0.28-1.2 mGy for AP abdomen, 0.18-0.65 mGy for LAT view skull, 0.15-0.63 mGy for dual view knee, and 0.10-0.12 mGy for bone age (left hand) examinations. A methodology combining DICOM header metadata and basic x-ray tube characterization curves was demonstrated. In a regulatory era where patient dose reporting has become increasingly in demand, this methodology will allow a knowledgeable user the means to establish an automatable dose reporting program for DR and perform patient dose related QA testing for digital x-ray imaging.

Estimating pediatric entrance skin dose from digital radiography examination using DICOM metadata: A quality assurance tool

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brady, S. L., E-mail: samuel.brady@stjude.org; Kaufman, R. A., E-mail: robert.kaufman@stjude.org

Purpose: To develop an automated methodology to estimate patient examination dose in digital radiography (DR) imaging using DICOM metadata as a quality assurance (QA) tool. Methods: Patient examination and demographical information were gathered from metadata analysis of DICOM header data. The x-ray system radiation output (i.e., air KERMA) was characterized for all filter combinations used for patient examinations. Average patient thicknesses were measured for head, chest, abdomen, knees, and hands using volumetric images from CT. Backscatter factors (BSFs) were calculated from examination kVp. Patient entrance skin air KERMA (ESAK) was calculated by (1) looking up examination technique factors taken frommore » DICOM header metadata (i.e., kVp and mA s) to derive an air KERMA (k{sub air}) value based on an x-ray characteristic radiation output curve; (2) scaling k{sub air} with a BSF value; and (3) correcting k{sub air} for patient thickness. Finally, patient entrance skin dose (ESD) was calculated by multiplying a mass–energy attenuation coefficient ratio by ESAK. Patient ESD calculations were computed for common DR examinations at our institution: dual view chest, anteroposterior (AP) abdomen, lateral (LAT) skull, dual view knee, and bone age (left hand only) examinations. Results: ESD was calculated for a total of 3794 patients; mean age was 11 ± 8 yr (range: 2 months to 55 yr). The mean ESD range was 0.19–0.42 mGy for dual view chest, 0.28–1.2 mGy for AP abdomen, 0.18–0.65 mGy for LAT view skull, 0.15–0.63 mGy for dual view knee, and 0.10–0.12 mGy for bone age (left hand) examinations. Conclusions: A methodology combining DICOM header metadata and basic x-ray tube characterization curves was demonstrated. In a regulatory era where patient dose reporting has become increasingly in demand, this methodology will allow a knowledgeable user the means to establish an automatable dose reporting program for DR and perform patient dose related QA testing for digital x-ray imaging.« less

Average glandular dose in paired digital mammography and digital breast tomosynthesis acquisitions in a population based screening program: effects of measuring breast density, air kerma and beam quality.

PubMed

Østerås, Bjørn Helge; Skaane, Per; Gullien, Randi; Martinsen, Anne Catrine Trægde

2018-01-25

The main purpose was to compare average glandular dose (AGD) for same-compression digital mammography (DM) and digital breast tomosynthesis (DBT) acquisitions in a population based screening program, with and without breast density stratification, as determined by automatically calculated breast density (Quantra ™ ). Secondary, to compare AGD estimates based on measured breast density, air kerma and half value layer (HVL) to DICOM metadata based estimates. AGD was estimated for 3819 women participating in the screening trial. All received craniocaudal and mediolateral oblique views of each breasts with paired DM and DBT acquisitions. Exposure parameters were extracted from DICOM metadata. Air kerma and HVL were measured for all beam qualities used to acquire the mammograms. Volumetric breast density was estimated using Quantra ™ . AGD was estimated using the Dance model. AGD reported directly from the DICOM metadata was also assessed. Mean AGD was 1.74 and 2.10 mGy for DM and DBT, respectively. Mean DBT/DM AGD ratio was 1.24. For fatty breasts: mean AGD was 1.74 and 2.27 mGy for DM and DBT, respectively. For dense breasts: mean AGD was 1.73 and 1.79 mGy, for DM and DBT, respectively. For breasts of similar thickness, dense breasts had higher AGD for DM and similar AGD for DBT. The DBT/DM dose ratio was substantially lower for dense compared to fatty breasts (1.08 versus 1.33). The average c-factor was 1.16. Using previously published polynomials to estimate glandularity from thickness underestimated the c-factor by 5.9% on average. Mean AGD error between estimates based on measurements (air kerma and HVL) versus DICOM header data was 3.8%, but for one mammography unit as high as 7.9%. Mean error of using the AGD value reported in the DICOM header was 10.7 and 13.3%, respectively. Thus, measurement of breast density, radiation dose and beam quality can substantially affect AGD estimates.

Web-based documentation system with exchange of DICOM RT for multicenter clinical studies in particle therapy

NASA Astrophysics Data System (ADS)

Kessel, Kerstin A.; Bougatf, Nina; Bohn, Christian; Engelmann, Uwe; Oetzel, Dieter; Bendl, Rolf; Debus, Jürgen; Combs, Stephanie E.

2012-02-01

Conducting clinical studies is rather difficult because of the large variety of voluminous datasets, different documentation styles, and various information systems, especially in radiation oncology. In this paper, we describe our development of a web-based documentation system with first approaches of automatic statistical analyses for transnational and multicenter clinical studies in particle therapy. It is possible to have immediate access to all patient information and exchange, store, process, and visualize text data, all types of DICOM images, especially DICOM RT, and any other multimedia data. Accessing the documentation system and submitting clinical data is possible for internal and external users (e.g. referring physicians from abroad, who are seeking the new technique of particle therapy for their patients). Thereby, security and privacy protection is ensured with the encrypted https protocol, client certificates, and an application gateway. Furthermore, all data can be pseudonymized. Integrated into the existing hospital environment, patient data is imported via various interfaces over HL7-messages and DICOM. Several further features replace manual input wherever possible and ensure data quality and entirety. With a form generator, studies can be individually designed to fit specific needs. By including all treated patients (also non-study patients), we gain the possibility for overall large-scale, retrospective analyses. Having recently begun documentation of our first six clinical studies, it has become apparent that the benefits lie in the simplification of research work, better study analyses quality and ultimately, the improvement of treatment concepts by evaluating the effectiveness of particle therapy.

Image once, print thrice? Three-dimensional printing of replacement parts.

PubMed

Rankin, Timothy M; Wormer, Blair A; Miller, John D; Giovinco, Nicholas A; Al Kassis, Salam; Armstrong, David G

2018-02-01

The last 20 years has seen an exponential increase in 3D printing as it pertains to the medical industry and more specifically surgery. Previous reviews in this domain have chosen to focus on applications within a specific field. To our knowledge, none have evaluated the broad applications of patient-specific or digital imaging and communications in medicine (DICOM) derived applications of this technology. We searched PUBMED and CINAHL from April 2012 to April 2017. 261 studies fulfilled the inclusion criteria. Proportions of articles reviewed: DICOM (5%), CT (38%), MRI (20%), Ultrasonography (28%), and Bio-printing (9%). There is level IV evidence to support the use of 3D printing for education, pre-operative planning, simulation and implantation. In order to make this technology widely applicable, it will require automation of DICOM to standard tessellation language to implant. Advances in knowledge: Recent lapses in intellectual property and greater familiarity with rapid prototyping in medicine has set the stage for the next generation of custom implants, simulators and autografts. Radiologists may be able to help establish reimbursable procedural terminology.

Developing an interactive teleradiology system for SARS diagnosis

NASA Astrophysics Data System (ADS)

Sun, Jianyong; Zhang, Jianguo; Zhuang, Jun; Chen, Xiaomeng; Yong, Yuanyuan; Tan, Yongqiang; Chen, Liu; Lian, Ping; Meng, Lili; Huang, H. K.

2004-04-01

Severe acute respiratory syndrome (SARS) is a respiratory illness that had been reported in Asia, North America, and Europe in last spring. Most of the China cases of SARS have occurred by infection in hospitals or among travelers. To protect the physicians, experts and nurses from the SARS during the diagnosis and treatment procedures, the infection control mechanisms were built in SARS hospitals. We built a Web-based interactive teleradiology system to assist the radiologists and physicians both in side and out side control area to make image diagnosis. The system consists of three major components: DICOM gateway (GW), Web-based image repository server (Server), and Web-based DICOM viewer (Viewer). This system was installed and integrated with CR, CT and the hospital information system (HIS) in Shanghai Xinhua hospital to provide image-based ePR functions for SARS consultation between the radiologists, physicians and experts inside and out side control area. The both users inside and out side the control area can use the system to process and manipulate the DICOM images interactively, and the system provide the remote control mechanism to synchronize their operations on images and display.

DICOMweb™: Background and Application of the Web Standard for Medical Imaging.

PubMed

Genereaux, Brad W; Dennison, Donald K; Ho, Kinson; Horn, Robert; Silver, Elliot Lewis; O'Donnell, Kevin; Kahn, Charles E

2018-05-10

This paper describes why and how DICOM, the standard that has been the basis for medical imaging interoperability around the world for several decades, has been extended into a full web technology-based standard, DICOMweb. At the turn of the century, healthcare embraced information technology, which created new problems and new opportunities for the medical imaging industry; at the same time, web technologies matured and began serving other domains well. This paper describes DICOMweb, how it extended the DICOM standard, and how DICOMweb can be applied to problems facing healthcare applications to address workflow and the changing healthcare climate.

Design and Implementation of A DICOM PACS With Secure Access Via Internet

DTIC Science & Technology

2001-10-25

which we have called SINFIM ( Sistema de INFormación de Imágenes Médicas). This system permits the automatic acquisition of DICOM images [2] [3...1] MA. Martínez, AJR. Jiménez, BV. Medina, LJ. Azpiroz. “Los Sistemas PACS”. [Last access 08/12/2000]. Available URL http://itzamna.uam.mx...junio, por el que se aprueba el Reglamento de medidas de seguridad de los ficheros automatizados que contengan datos de carácter personal” (Boletín Oficial del Estado, número 151, de 25 de junio de 1999)

Craniofacial Reconstruction Using Rational Cubic Ball Curves

PubMed Central

Majeed, Abdul; Mt Piah, Abd Rahni; Gobithaasan, R. U.; Yahya, Zainor Ridzuan

2015-01-01

This paper proposes the reconstruction of craniofacial fracture using rational cubic Ball curve. The idea of choosing Ball curve is based on its robustness of computing efficiency over Bezier curve. The main steps are conversion of Digital Imaging and Communications in Medicine (Dicom) images to binary images, boundary extraction and corner point detection, Ball curve fitting with genetic algorithm and final solution conversion to Dicom format. The last section illustrates a real case of craniofacial reconstruction using the proposed method which clearly indicates the applicability of this method. A Graphical User Interface (GUI) has also been developed for practical application. PMID:25880632

Magnetic resonance imaging research in sub-Saharan Africa: challenges and satellite-based networking implementation.

PubMed

Latourette, Matthew T; Siebert, James E; Barto, Robert J; Marable, Kenneth L; Muyepa, Anthony; Hammond, Colleen A; Potchen, Michael J; Kampondeni, Samuel D; Taylor, Terrie E

2011-08-01

As part of an NIH-funded study of malaria pathogenesis, a magnetic resonance (MR) imaging research facility was established in Blantyre, Malaŵi to enhance the clinical characterization of pediatric patients with cerebral malaria through application of neurological MR methods. The research program requires daily transmission of MR studies to Michigan State University (MSU) for clinical research interpretation and quantitative post-processing. An intercontinental satellite-based network was implemented for transmission of MR image data in Digital Imaging and Communications in Medicine (DICOM) format, research data collection, project communications, and remote systems administration. Satellite Internet service costs limited the bandwidth to symmetrical 384 kbit/s. DICOM routers deployed at both the Malaŵi MRI facility and MSU manage the end-to-end encrypted compressed data transmission. Network performance between DICOM routers was measured while transmitting both mixed clinical MR studies and synthetic studies. Effective network latency averaged 715 ms. Within a mix of clinical MR studies, the average transmission time for a 256 × 256 image was ~2.25 and ~6.25 s for a 512 × 512 image. Using synthetic studies of 1,000 duplicate images, the interquartile range for 256 × 256 images was [2.30, 2.36] s and [5.94, 6.05] s for 512 × 512 images. Transmission of clinical MRI studies between the DICOM routers averaged 9.35 images per minute, representing an effective channel utilization of ~137% of the 384-kbit/s satellite service as computed using uncompressed image file sizes (including the effects of image compression, protocol overhead, channel latency, etc.). Power unreliability was the primary cause of interrupted operations in the first year, including an outage exceeding 10 days.

General consumer communication tools for improved image management and communication in medicine.

PubMed

Rosset, Chantal; Rosset, Antoine; Ratib, Osman

2005-12-01

We elected to explore new technologies emerging on the general consumer market that can improve and facilitate image and data communication in medical and clinical environment. These new technologies developed for communication and storage of data can improve the user convenience and facilitate the communication and transport of images and related data beyond the usual limits and restrictions of a traditional picture archiving and communication systems (PACS) network. We specifically tested and implemented three new technologies provided on Apple computer platforms. (1) We adopted the iPod, a MP3 portable player with a hard disk storage, to easily and quickly move large number of DICOM images. (2) We adopted iChat, a videoconference and instant-messaging software, to transmit DICOM images in real time to a distant computer for conferencing teleradiology. (3) Finally, we developed a direct secure interface to use the iDisk service, a file-sharing service based on the WebDAV technology, to send and share DICOM files between distant computers. These three technologies were integrated in a new open-source image navigation and display software called OsiriX allowing for manipulation and communication of multimodality and multidimensional DICOM image data sets. This software is freely available as an open-source project at http://homepage.mac.com/rossetantoine/OsiriX. Our experience showed that the implementation of these technologies allowed us to significantly enhance the existing PACS with valuable new features without any additional investment or the need for complex extensions of our infrastructure. The added features such as teleradiology, secure and convenient image and data communication, and the use of external data storage services open the gate to a much broader extension of our imaging infrastructure to the outside world.

Integration of digital gross pathology images for enterprise-wide access.

PubMed

Amin, Milon; Sharma, Gaurav; Parwani, Anil V; Anderson, Ralph; Kolowitz, Brian J; Piccoli, Anthony; Shrestha, Rasu B; Lauro, Gonzalo Romero; Pantanowitz, Liron

2012-01-01

Sharing digital pathology images for enterprise- wide use into a picture archiving and communication system (PACS) is not yet widely adopted. We share our solution and 3-year experience of transmitting such images to an enterprise image server (EIS). Gross pathology images acquired by prosectors were integrated with clinical cases into the laboratory information system's image management module, and stored in JPEG2000 format on a networked image server. Automated daily searches for cases with gross images were used to compile an ASCII text file that was forwarded to a separate institutional Enterprise Digital Imaging and Communications in Medicine (DICOM) Wrapper (EDW) server. Concurrently, an HL7-based image order for these cases was generated, containing the locations of images and patient data, and forwarded to the EDW, which combined data in these locations to generate images with patient data, as required by DICOM standards. The image and data were then "wrapped" according to DICOM standards, transferred to the PACS servers, and made accessible on an institution-wide basis. In total, 26,966 gross images from 9,733 cases were transmitted over the 3-year period from the laboratory information system to the EIS. The average process time for cases with successful automatic uploads (n=9,688) to the EIS was 98 seconds. Only 45 cases (0.5%) failed requiring manual intervention. Uploaded images were immediately available to institution- wide PACS users. Since inception, user feedback has been positive. Enterprise- wide PACS- based sharing of pathology images is feasible, provides useful services to clinical staff, and utilizes existing information system and telecommunications infrastructure. PACS-shared pathology images, however, require a "DICOM wrapper" for multisystem compatibility.

Systematic Parameterization, Storage, and Representation of Volumetric DICOM Data.

PubMed

Fischer, Felix; Selver, M Alper; Gezer, Sinem; Dicle, Oğuz; Hillen, Walter

Tomographic medical imaging systems produce hundreds to thousands of slices, enabling three-dimensional (3D) analysis. Radiologists process these images through various tools and techniques in order to generate 3D renderings for various applications, such as surgical planning, medical education, and volumetric measurements. To save and store these visualizations, current systems use snapshots or video exporting, which prevents further optimizations and requires the storage of significant additional data. The Grayscale Softcopy Presentation State extension of the Digital Imaging and Communications in Medicine (DICOM) standard resolves this issue for two-dimensional (2D) data by introducing an extensive set of parameters, namely 2D Presentation States (2DPR), that describe how an image should be displayed. 2DPR allows storing these parameters instead of storing parameter applied images, which cause unnecessary duplication of the image data. Since there is currently no corresponding extension for 3D data, in this study, a DICOM-compliant object called 3D presentation states (3DPR) is proposed for the parameterization and storage of 3D medical volumes. To accomplish this, the 3D medical visualization process is divided into four tasks, namely pre-processing, segmentation, post-processing, and rendering. The important parameters of each task are determined. Special focus is given to the compression of segmented data, parameterization of the rendering process, and DICOM-compliant implementation of the 3DPR object. The use of 3DPR was tested in a radiology department on three clinical cases, which require multiple segmentations and visualizations during the workflow of radiologists. The results show that 3DPR can effectively simplify the workload of physicians by directly regenerating 3D renderings without repeating intermediate tasks, increase efficiency by preserving all user interactions, and provide efficient storage as well as transfer of visualized data.

Integration of digital gross pathology images for enterprise-wide access

PubMed Central

Amin, Milon; Sharma, Gaurav; Parwani, Anil V.; Anderson, Ralph; Kolowitz, Brian J; Piccoli, Anthony; Shrestha, Rasu B.; Lauro, Gonzalo Romero; Pantanowitz, Liron

2012-01-01

Background: Sharing digital pathology images for enterprise- wide use into a picture archiving and communication system (PACS) is not yet widely adopted. We share our solution and 3-year experience of transmitting such images to an enterprise image server (EIS). Methods: Gross pathology images acquired by prosectors were integrated with clinical cases into the laboratory information system's image management module, and stored in JPEG2000 format on a networked image server. Automated daily searches for cases with gross images were used to compile an ASCII text file that was forwarded to a separate institutional Enterprise Digital Imaging and Communications in Medicine (DICOM) Wrapper (EDW) server. Concurrently, an HL7-based image order for these cases was generated, containing the locations of images and patient data, and forwarded to the EDW, which combined data in these locations to generate images with patient data, as required by DICOM standards. The image and data were then “wrapped” according to DICOM standards, transferred to the PACS servers, and made accessible on an institution-wide basis. Results: In total, 26,966 gross images from 9,733 cases were transmitted over the 3-year period from the laboratory information system to the EIS. The average process time for cases with successful automatic uploads (n=9,688) to the EIS was 98 seconds. Only 45 cases (0.5%) failed requiring manual intervention. Uploaded images were immediately available to institution- wide PACS users. Since inception, user feedback has been positive. Conclusions: Enterprise- wide PACS- based sharing of pathology images is feasible, provides useful services to clinical staff, and utilizes existing information system and telecommunications infrastructure. PACS-shared pathology images, however, require a “DICOM wrapper” for multisystem compatibility. PMID:22530178

"Direct DICOM Slice Landmarking" A Novel Research Technique to Quantify Skeletal Changes in Orthognathic Surgery.

PubMed

Almukhtar, Anas; Khambay, Balvinder; Ayoub, Ashraf; Ju, Xiangyang; Al-Hiyali, Ali; Macdonald, James; Jabar, Norhayati; Goto, Tazuko

2015-01-01

The limitations of the current methods of quantifying the surgical movements of facial bones inspired this study. The aim of this study was the assessment of the accuracy and reproducibility of directly landmarking of 3D DICOM images (Digital Imaging and Communications in Medicine) to quantify the changes in the jaw bones following surgery. The study was carried out on plastic skull to simulate the surgical movements of the jaw bones. Cone beam CT scans were taken at 3mm, 6mm, and 9mm maxillary advancement; together with a 2mm, 4mm, 6mm and 8mm "down graft" which in total generated 12 different positions of the maxilla for the analysis. The movements of the maxilla were calculated using two methods, the standard approach where distances between surface landmarks on the jaw bones were measured and the novel approach where measurements were taken directly from the internal structures of the corresponding 3D DICOME slices. A one sample t-test showed that there was no statistically significant difference between the two methods of measurements for the y and z directions, however, the x direction showed a significant difference. The mean difference between the two absolute measurements were 0.34±0.20mm, 0.22±0.16mm, 0.18±0.13mm in the y, z and x directions respectively. In conclusion, the direct landmarking of 3D DICOM image slices is a reliable, reproducible and informative method for assessment of the 3D skeletal changes. The method has a clear clinical application which includes the analysis of the jaw movements "orthognathic surgery" for the correction of facial deformities.

Enhancing radiological volumes with symbolic anatomy using image fusion and collaborative virtual reality.

PubMed

Silverstein, Jonathan C; Dech, Fred; Kouchoukos, Philip L

2004-01-01

Radiological volumes are typically reviewed by surgeons using cross-sections and iso-surface reconstructions. Applications that combine collaborative stereo volume visualization with symbolic anatomic information and data fusions would expand surgeons' capabilities in interpretation of data and in planning treatment. Such an application has not been seen clinically. We are developing methods to systematically combine symbolic anatomy (term hierarchies and iso-surface atlases) with patient data using data fusion. We describe our progress toward integrating these methods into our collaborative virtual reality application. The fully combined application will be a feature-rich stereo collaborative volume visualization environment for use by surgeons in which DICOM datasets will self-report underlying anatomy with visual feedback. Using hierarchical navigation of SNOMED-CT anatomic terms integrated with our existing Tele-immersive DICOM-based volumetric rendering application, we will display polygonal representations of anatomic systems on the fly from menus that query a database. The methods and tools involved in this application development are SNOMED-CT, DICOM, VISIBLE HUMAN, volumetric fusion and C++ on a Tele-immersive platform. This application will allow us to identify structures and display polygonal representations from atlas data overlaid with the volume rendering. First, atlas data is automatically translated, rotated, and scaled to the patient data during loading using a public domain volumetric fusion algorithm. This generates a modified symbolic representation of the underlying canonical anatomy. Then, through the use of collision detection or intersection testing of various transparent polygonal representations, the polygonal structures are highlighted into the volumetric representation while the SNOMED names are displayed. Thus, structural names and polygonal models are associated with the visualized DICOM data. This novel juxtaposition of information promises to expand surgeons' abilities to interpret images and plan treatment.

SU-F-J-21: Clinical Evaluation of Surface Scanning Systems in Different Treatment Locations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moser, T; Karger, C; Stefanowicz, S

Purpose: To reduce imaging dose in fractionated IGRT, the ability of optical surface imaging systems (OSIS) to detect setup errors was tested. Therefore, clinical studies to evaluate for different treatment locations setup corrections derived by OSIS in comparison with x-ray image guidance in fractionated radiation therapy was performed. Methods: The setup correction accuracy of an OSIS system (AlignRT, VisionRT, London, UK) will be analysed for the 4 tumour locations Pelvis, Upper Abdomen, Thorax and Breast, 20 patients for each location in comparison to a different system (Sentinel, C-RAD, SE). For each patient, the setup corrections of the cone-beam computed tomographymore » (CBCT) of an Elekta Versa HD linear accelerator (Elekta, Crawley, UK) is considered as gold-standard and then compared with those of the OSIS for the first ten fractions retrospectively. There were no clinical decisions made based on the surrogate system. For the OSIS, the reference surface is highly important as it represents the actual ground truth. It can be obtained either with the system itself or the surface structure delineated in the planning CT can be imported via DICOM interface. In this paper, the first results for the treatment region thorax are presented. The reference image modalities were compared. Results: Table 1 displays the difference between the setup corrections obtained with OSIS and CBCT in lateral (LAT), longitudinal (LNG) and vertical (VRT) direction for the DICOM reference image. While the median deviations are within a few millimeters, some outliers showed large deviations. Generally, the mean deviation as well as the spread was smallest in lateral and largest in vertical direction. Conclusion: Although the system allows fast, simple and non-invasive determination of setup corrections, it should be evaluated treatment region dependant. Therefore, the study is ongoing. The application of OSIS may help to reduce the imaging dose for the patient. We gratefully acknowledge the support by our colleagues from the Radiological University Clinic Heidelberg, where the study was performed. This work was funded by the Federal Ministry of Education and Research (BMBF) Germany, grant number 01IB13001B.« less

A database paradigm for the management of DICOM-RT structure sets using a geographic information system

NASA Astrophysics Data System (ADS)

Shao, Weber; Kupelian, Patrick A.; Wang, Jason; Low, Daniel A.; Ruan, Dan

2014-03-01

We devise a paradigm for representing the DICOM-RT structure sets in a database management system, in such way that secondary calculations of geometric information can be performed quickly from the existing contour definitions. The implementation of this paradigm is achieved using the PostgreSQL database system and the PostGIS extension, a geographic information system commonly used for encoding geographical map data. The proposed paradigm eliminates the overhead of retrieving large data records from the database, as well as the need to implement various numerical and data parsing routines, when additional information related to the geometry of the anatomy is desired.

Update of the ACR-NEMA digital imaging and communications in medicine standard

NASA Astrophysics Data System (ADS)

Best, David E.; Horii, Steven C.; Bennett, William C.; Parisot, Charles R.

1992-07-01

The American College of Radiology and the National Electrical Manufacturers Association published the ACR-NEMA Digital Imaging and Communications Standard in 1985. Implementations are just now becoming available. Working groups of the committee have been very active. An expanded version of the Standard was published in 1988 and in a third version, to be known as Digital Imaging and Communications in Medicine (DICOM), is being prepared for publication in 1992. This paper briefly reviews the history of the Standard, describes the participation of the committee in international radiological imaging standards activities, and outlines the extensions planned for the DICOM Standard.

Open source tools for standardized privacy protection of medical images

NASA Astrophysics Data System (ADS)

Lien, Chung-Yueh; Onken, Michael; Eichelberg, Marco; Kao, Tsair; Hein, Andreas

2011-03-01

In addition to the primary care context, medical images are often useful for research projects and community healthcare networks, so-called "secondary use". Patient privacy becomes an issue in such scenarios since the disclosure of personal health information (PHI) has to be prevented in a sharing environment. In general, most PHIs should be completely removed from the images according to the respective privacy regulations, but some basic and alleviated data is usually required for accurate image interpretation. Our objective is to utilize and enhance these specifications in order to provide reliable software implementations for de- and re-identification of medical images suitable for online and offline delivery. DICOM (Digital Imaging and Communications in Medicine) images are de-identified by replacing PHI-specific information with values still being reasonable for imaging diagnosis and patient indexing. In this paper, this approach is evaluated based on a prototype implementation built on top of the open source framework DCMTK (DICOM Toolkit) utilizing standardized de- and re-identification mechanisms. A set of tools has been developed for DICOM de-identification that meets privacy requirements of an offline and online sharing environment and fully relies on standard-based methods.

mantisGRID: a grid platform for DICOM medical images management in Colombia and Latin America.

PubMed

Garcia Ruiz, Manuel; Garcia Chaves, Alvin; Ruiz Ibañez, Carlos; Gutierrez Mazo, Jorge Mario; Ramirez Giraldo, Juan Carlos; Pelaez Echavarria, Alejandro; Valencia Diaz, Edison; Pelaez Restrepo, Gustavo; Montoya Munera, Edwin Nelson; Garcia Loaiza, Bernardo; Gomez Gonzalez, Sebastian

2011-04-01

This paper presents the mantisGRID project, an interinstitutional initiative from Colombian medical and academic centers aiming to provide medical grid services for Colombia and Latin America. The mantisGRID is a GRID platform, based on open source grid infrastructure that provides the necessary services to access and exchange medical images and associated information following digital imaging and communications in medicine (DICOM) and health level 7 standards. The paper focuses first on the data abstraction architecture, which is achieved via Open Grid Services Architecture Data Access and Integration (OGSA-DAI) services and supported by the Globus Toolkit. The grid currently uses a 30-Mb bandwidth of the Colombian High Technology Academic Network, RENATA, connected to Internet 2. It also includes a discussion on the relational database created to handle the DICOM objects that were represented using Extensible Markup Language Schema documents, as well as other features implemented such as data security, user authentication, and patient confidentiality. Grid performance was tested using the three current operative nodes and the results demonstrated comparable query times between the mantisGRID (OGSA-DAI) and Distributed mySQL databases, especially for a large number of records.

PLACNETw: a web-based tool for plasmid reconstruction from bacterial genomes.

PubMed

Vielva, Luis; de Toro, María; Lanza, Val F; de la Cruz, Fernando

2017-12-01

PLACNET is a graph-based tool for reconstruction of plasmids from next generation sequence pair-end datasets. PLACNET graphs contain two types of nodes (assembled contigs and reference genomes) and two types of edges (scaffold links and homology to references). Manual pruning of the graphs is a necessary requirement in PLACNET, but this is difficult for users without solid bioinformatic background. PLACNETw, a webtool based on PLACNET, provides an interactive graphic interface, automates BLAST searches, and extracts the relevant information for decision making. It allows a user with domain expertise to visualize the scaffold graphs and related information of contigs as well as reference sequences, so that the pruning operations can be done interactively from a personal computer without the need for additional tools. After successful pruning, each plasmid becomes a separate connected component subgraph. The resulting data are automatically downloaded by the user. PLACNETw is freely available at https://castillo.dicom.unican.es/upload/. delacruz@unican.es. A tutorial video and several solved examples are available at https://castillo.dicom.unican.es/placnetw_video/ and https://castillo.dicom.unican.es/examples/. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Teleradiology applications with DICOM-e-mail.

PubMed

Weisser, G; Engelmann, U; Ruggiero, S; Runa, A; Schröter, A; Baur, S; Walz, M

2007-05-01

For the connection of several partners to a Dicom-e-mail based teleradiology network concepts were developed to allow the integration of different teleradiology applications. The organisational and technical needs for such an integration were analysed. More than 60 institutions including 23 hospitals in the Rhein-Neckar-Region, Germany were connected. The needed functionality was grouped in six teleradiology applications (emergency consultation, tele-guided examinations, expert consultations, cooperative work, scientific cooperations and homework with on call services) and their technical and organisational needs according to availability, speed of transfer, workflow definitions and data security needs was analysed. For the local integration of teleradiology services the setup and workflow is presented for a standalone teleradiology workstation and a server based teleradiology gateway. The line type needed for different groups of applications and users is defined. The security concept and fallback strategies are laid out, potential security problems and sources of errors are discussed. The specialties for the emergency teleradiology application are presented. The DICOM-e-mail protocol is a flexible and powerful protocol that can be used for a variety of teleradiology applications. It can meet the conditions for emergency applications but is limited if synchronous applications like teleconferences are needed.

A Framework for Integration of Heterogeneous Medical Imaging Networks

PubMed Central

Viana-Ferreira, Carlos; Ribeiro, Luís S; Costa, Carlos

2014-01-01

Medical imaging is increasing its importance in matters of medical diagnosis and in treatment support. Much is due to computers that have revolutionized medical imaging not only in acquisition process but also in the way it is visualized, stored, exchanged and managed. Picture Archiving and Communication Systems (PACS) is an example of how medical imaging takes advantage of computers. To solve problems of interoperability of PACS and medical imaging equipment, the Digital Imaging and Communications in Medicine (DICOM) standard was defined and widely implemented in current solutions. More recently, the need to exchange medical data between distinct institutions resulted in Integrating the Healthcare Enterprise (IHE) initiative that contains a content profile especially conceived for medical imaging exchange: Cross Enterprise Document Sharing for imaging (XDS-i). Moreover, due to application requirements, many solutions developed private networks to support their services. For instance, some applications support enhanced query and retrieve over DICOM objects metadata. This paper proposes anintegration framework to medical imaging networks that provides protocols interoperability and data federation services. It is an extensible plugin system that supports standard approaches (DICOM and XDS-I), but is also capable of supporting private protocols. The framework is being used in the Dicoogle Open Source PACS. PMID:25279021

A framework for integration of heterogeneous medical imaging networks.

PubMed

Viana-Ferreira, Carlos; Ribeiro, Luís S; Costa, Carlos

2014-01-01

Medical imaging is increasing its importance in matters of medical diagnosis and in treatment support. Much is due to computers that have revolutionized medical imaging not only in acquisition process but also in the way it is visualized, stored, exchanged and managed. Picture Archiving and Communication Systems (PACS) is an example of how medical imaging takes advantage of computers. To solve problems of interoperability of PACS and medical imaging equipment, the Digital Imaging and Communications in Medicine (DICOM) standard was defined and widely implemented in current solutions. More recently, the need to exchange medical data between distinct institutions resulted in Integrating the Healthcare Enterprise (IHE) initiative that contains a content profile especially conceived for medical imaging exchange: Cross Enterprise Document Sharing for imaging (XDS-i). Moreover, due to application requirements, many solutions developed private networks to support their services. For instance, some applications support enhanced query and retrieve over DICOM objects metadata. This paper proposes anintegration framework to medical imaging networks that provides protocols interoperability and data federation services. It is an extensible plugin system that supports standard approaches (DICOM and XDS-I), but is also capable of supporting private protocols. The framework is being used in the Dicoogle Open Source PACS.

UNC-Utah NA-MIC framework for DTI fiber tract analysis.

PubMed

Verde, Audrey R; Budin, Francois; Berger, Jean-Baptiste; Gupta, Aditya; Farzinfar, Mahshid; Kaiser, Adrien; Ahn, Mihye; Johnson, Hans; Matsui, Joy; Hazlett, Heather C; Sharma, Anuja; Goodlett, Casey; Shi, Yundi; Gouttard, Sylvain; Vachet, Clement; Piven, Joseph; Zhu, Hongtu; Gerig, Guido; Styner, Martin

2014-01-01

Diffusion tensor imaging has become an important modality in the field of neuroimaging to capture changes in micro-organization and to assess white matter integrity or development. While there exists a number of tractography toolsets, these usually lack tools for preprocessing or to analyze diffusion properties along the fiber tracts. Currently, the field is in critical need of a coherent end-to-end toolset for performing an along-fiber tract analysis, accessible to non-technical neuroimaging researchers. The UNC-Utah NA-MIC DTI framework represents a coherent, open source, end-to-end toolset for atlas fiber tract based DTI analysis encompassing DICOM data conversion, quality control, atlas building, fiber tractography, fiber parameterization, and statistical analysis of diffusion properties. Most steps utilize graphical user interfaces (GUI) to simplify interaction and provide an extensive DTI analysis framework for non-technical researchers/investigators. We illustrate the use of our framework on a small sample, cross sectional neuroimaging study of eight healthy 1-year-old children from the Infant Brain Imaging Study (IBIS) Network. In this limited test study, we illustrate the power of our method by quantifying the diffusion properties at 1 year of age on the genu and splenium fiber tracts.

Bio-image warehouse system: concept and implementation of a diagnosis-based data warehouse for advanced imaging modalities in neuroradiology.

PubMed

Minati, L; Ghielmetti, F; Ciobanu, V; D'Incerti, L; Maccagnano, C; Bizzi, A; Bruzzone, M G

2007-03-01

Advanced neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), chemical shift spectroscopy imaging (CSI), diffusion tensor imaging (DTI), and perfusion-weighted imaging (PWI) create novel challenges in terms of data storage and management: huge amounts of raw data are generated, the results of analysis may depend on the software and settings that have been used, and most often intermediate files are inherently not compliant with the current DICOM (digital imaging and communication in medicine) standard, as they contain multidimensional complex and tensor arrays and various other types of data structures. A software architecture, referred to as Bio-Image Warehouse System (BIWS), which can be used alongside a radiology information system/picture archiving and communication system (RIS/PACS) system to store neuroimaging data for research purposes, is presented. The system architecture is conceived with the purpose of enabling to query by diagnosis according to a predefined two-layered classification taxonomy. The operational impact of the system and the time needed to get acquainted with the web-based interface and with the taxonomy are found to be limited. The development of modules enabling automated creation of statistical templates is proposed.

UNC-Utah NA-MIC framework for DTI fiber tract analysis

PubMed Central

Verde, Audrey R.; Budin, Francois; Berger, Jean-Baptiste; Gupta, Aditya; Farzinfar, Mahshid; Kaiser, Adrien; Ahn, Mihye; Johnson, Hans; Matsui, Joy; Hazlett, Heather C.; Sharma, Anuja; Goodlett, Casey; Shi, Yundi; Gouttard, Sylvain; Vachet, Clement; Piven, Joseph; Zhu, Hongtu; Gerig, Guido; Styner, Martin

2014-01-01

Diffusion tensor imaging has become an important modality in the field of neuroimaging to capture changes in micro-organization and to assess white matter integrity or development. While there exists a number of tractography toolsets, these usually lack tools for preprocessing or to analyze diffusion properties along the fiber tracts. Currently, the field is in critical need of a coherent end-to-end toolset for performing an along-fiber tract analysis, accessible to non-technical neuroimaging researchers. The UNC-Utah NA-MIC DTI framework represents a coherent, open source, end-to-end toolset for atlas fiber tract based DTI analysis encompassing DICOM data conversion, quality control, atlas building, fiber tractography, fiber parameterization, and statistical analysis of diffusion properties. Most steps utilize graphical user interfaces (GUI) to simplify interaction and provide an extensive DTI analysis framework for non-technical researchers/investigators. We illustrate the use of our framework on a small sample, cross sectional neuroimaging study of eight healthy 1-year-old children from the Infant Brain Imaging Study (IBIS) Network. In this limited test study, we illustrate the power of our method by quantifying the diffusion properties at 1 year of age on the genu and splenium fiber tracts. PMID:24409141

Application of Digital Diagnosis and Treatment Technique in Benign Mandibular Diseases.

PubMed

Ju, Rui; Zeng, Wei; Lian, Xiaotian; Chen, Gang; Yin, Huaqiang; Tang, Wei

2018-05-01

To explore the feasibility of preoperative planning for treatment of benign mandibular lesions (BML) using digital technologies such as three-dimensional (3D) reconstruction, measurement, visualization as well as image contrast and design of neural positioning protection template (NPPT) in combination with 3D printing technology in the BML diagnosis and treatment. The 3D models of BML and inferior alveolar nerves (IAN) of 10 BML patients were reconstructed based on their digital imaging and communications in medicine (DICOM) data using MIMICS16.0 software. The models were used to visualize lesions and nerve contrast measurement and guide design of personalized NPPT and osteotomy after operation modality was determined in order to achieve accurate, minimally invasive operation with shortened intraoperative time. Intraoperative NPPT application could accurately locate lesions and their scope and assist osteotomy. The measurement results were consistent with those of preoperative reconstruction and measurement. The BML were curetted completely without damage IAN. The 10 BML patients had no numbness and other discomforts in the lower lip and mandibular teeth after operation. The digital diagnosis and treatment technology is an effective method for functional treatment of BML patients and its application could achieve personalized, minimally invasive and precise treatment and save intraoperation time.

Laser biostimulation therapy planning supported by imaging

NASA Astrophysics Data System (ADS)

Mester, Adam R.

2018-04-01

Ultrasonography and MR imaging can help to identify the area and depth of different lesions, like injury, overuse, inflammation, degenerative diseases. The appropriate power density, sufficient dose and direction of the laser treatment can be optimally estimated. If required minimum 5 mW photon density and required optimal energy dose: 2-4 Joule/cm2 wouldn't arrive into the depth of the target volume - additional techniques can help: slight compression of soft tissues can decrease the tissue thickness or multiple laser diodes can be used. In case of multiple diode clusters light scattering results deeper penetration. Another method to increase the penetration depth is a second pulsation (in kHz range) of laser light. (So called continuous wave laser itself has inherent THz pulsation by temporal coherence). Third solution of higher light intensity in the target volume is the multi-gate technique: from different angles the same joint can be reached based on imaging findings. Recent developments is ultrasonography: elastosonography and tissue harmonic imaging with contrast material offer optimal therapy planning. While MRI is too expensive modality for laser planning images can be optimally used if a diagnostic MRI already was done. Usual DICOM images offer "postprocessing" measurements in mm range.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kimpe, T; Marchessoux, C; Rostang, J

Purpose: Use of color images in medical imaging has increased significantly the last few years. As of today there is no agreed standard on how color information needs to be visualized on medical color displays, resulting into large variability of color appearance and it making consistency and quality assurance a challenge. This paper presents a proposal for an extension of DICOM GSDF towards color. Methods: Visualization needs for several color modalities (multimodality imaging, nuclear medicine, digital pathology, quantitative imaging applications…) have been studied. On this basis a proposal was made for desired color behavior of color medical display systems andmore » its behavior and effect on color medical images was analyzed. Results: Several medical color modalities could benefit from perceptually linear color visualization for similar reasons as why GSDF was put in place for greyscale medical images. An extension of the GSDF (Greyscale Standard Display Function) to color is proposed: CSDF (color standard display function). CSDF is based on deltaE2000 and offers a perceptually linear color behavior. CSDF uses GSDF as its neutral grey behavior. A comparison between sRGB/GSDF and CSDF confirms that CSDF significantly improves perceptual color linearity. Furthermore, results also indicate that because of the improved perceptual linearity, CSDF has the potential to increase perceived contrast of clinically relevant color features. Conclusion: There is a need for an extension of GSDF towards color visualization in order to guarantee consistency and quality. A first proposal (CSDF) for such extension has been made. Behavior of a CSDF calibrated display has been characterized and compared with sRGB/GSDF behavior. First results indicate that CSDF could have a positive influence on perceived contrast of clinically relevant color features and could offer benefits for quantitative imaging applications. Authors are employees of Barco Healthcare.« less

TU-FG-201-03: Automatic Pre-Delivery Verification Using Statistical Analysis of Consistencies in Treatment Plan Parameters by the Treatment Site and Modality

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, S; Wu, Y; Chang, X

Purpose: A novel computer software system, namely APDV (Automatic Pre-Delivery Verification), has been developed for verifying patient treatment plan parameters right prior to treatment deliveries in order to automatically detect and prevent catastrophic errors. Methods: APDV is designed to continuously monitor new DICOM plan files on the TMS computer at the treatment console. When new plans to be delivered are detected, APDV checks the consistencies of plan parameters and high-level plan statistics using underlying rules and statistical properties based on given treatment site, technique and modality. These rules were quantitatively derived by retrospectively analyzing all the EBRT treatment plans ofmore » the past 8 years at authors’ institution. Therapists and physicists will be notified with a warning message displayed on the TMS computer if any critical errors are detected, and check results, confirmation, together with dismissal actions will be saved into database for further review. Results: APDV was implemented as a stand-alone program using C# to ensure required real time performance. Mean values and standard deviations were quantitatively derived for various plan parameters including MLC usage, MU/cGy radio, beam SSD, beam weighting, and the beam gantry angles (only for lateral targets) per treatment site, technique and modality. 2D-based rules of combined MU/cGy ratio and averaged SSD values were also derived using joint probabilities of confidence error ellipses. The statistics of these major treatment plan parameters quantitatively evaluate the consistency of any treatment plans which facilitates automatic APDV checking procedures. Conclusion: APDV could be useful in detecting and preventing catastrophic errors immediately before treatment deliveries. Future plan including automatic patient identify and patient setup checks after patient daily images are acquired by the machine and become available on the TMS computer. This project is supported by the Agency for Healthcare Research and Quality (AHRQ) under award 1R01HS0222888. The senior author received research grants from ViewRay Inc. and Varian Medical System.« less

Evaluation of security algorithms used for security processing on DICOM images

NASA Astrophysics Data System (ADS)

Chen, Xiaomeng; Shuai, Jie; Zhang, Jianguo; Huang, H. K.

2005-04-01

In this paper, we developed security approach to provide security measures and features in PACS image acquisition and Tele-radiology image transmission. The security processing on medical images was based on public key infrastructure (PKI) and including digital signature and data encryption to achieve the security features of confidentiality, privacy, authenticity, integrity, and non-repudiation. There are many algorithms which can be used in PKI for data encryption and digital signature. In this research, we select several algorithms to perform security processing on different DICOM images in PACS environment, evaluate the security processing performance of these algorithms, and find the relationship between performance with image types, sizes and the implementation methods.

Interoperative fundus image and report sharing in compliance with integrating the healthcare enterprise conformance and web access to digital imaging and communication in medicine persistent object protocol.

PubMed

Wu, Hui-Qun; Lv, Zheng-Min; Geng, Xing-Yun; Jiang, Kui; Tang, Le-Min; Zhou, Guo-Min; Dong, Jian-Cheng

2013-01-01

To address issues in interoperability between different fundus image systems, we proposed a web eye-picture archiving and communication system (PACS) framework in conformance with digital imaging and communication in medicine (DICOM) and health level 7 (HL7) protocol to realize fundus images and reports sharing and communication through internet. Firstly, a telemedicine-based eye care work flow was established based on integrating the healthcare enterprise (IHE) Eye Care technical framework. Then, a browser/server architecture eye-PACS system was established in conformance with the web access to DICOM persistent object (WADO) protocol, which contains three tiers. In any client system installed with web browser, clinicians could log in the eye-PACS to observe fundus images and reports. Multipurpose internet mail extensions (MIME) type of a structured report is saved as pdf/html with reference link to relevant fundus image using the WADO syntax could provide enough information for clinicians. Some functions provided by open-source Oviyam could be used to query, zoom, move, measure, view DICOM fundus images. Such web eye-PACS in compliance to WADO protocol could be used to store and communicate fundus images and reports, therefore is of great significance for teleophthalmology.

Integration of CBIR in radiological routine in accordance with IHE

NASA Astrophysics Data System (ADS)

Welter, Petra; Deserno, Thomas M.; Fischer, Benedikt; Wein, Berthold B.; Ott, Bastian; Günther, Rolf W.

2009-02-01

Increasing use of digital imaging processing leads to an enormous amount of imaging data. The access to picture archiving and communication systems (PACS), however, is solely textually, leading to sparse retrieval results because of ambiguous or missing image descriptions. Content-based image retrieval (CBIR) systems can improve the clinical diagnostic outcome significantly. However, current CBIR systems are not able to integrate their results with clinical workflow and PACS. Existing communication standards like DICOM and HL7 leave many options for implementation and do not ensure full interoperability. We present a concept of the standardized integration of a CBIR system for the radiology workflow in accordance with the Integrating the Healthcare Enterprise (IHE) framework. This is based on the IHE integration profile 'Post-Processing Workflow' (PPW) defining responsibilities as well as standardized communication and utilizing the DICOM Structured Report (DICOM SR). Because nowadays most of PACS and RIS systems are not yet fully IHE compliant to PPW, we also suggest an intermediate approach with the concepts of the CAD-PACS Toolkit. The integration is independent of the particular PACS and RIS system. Therefore, it supports the widespread application of CBIR in radiological routine. As a result, the approach is exemplarily applied to the Image Retrieval in Medical Applications (IRMA) framework.

Software tools for interactive instruction in radiologic anatomy.

PubMed

Alvarez, Antonio; Gold, Garry E; Tobin, Brian; Desser, Terry S

2006-04-01

To promote active learning in an introductory Radiologic Anatomy course through the use of computer-based exercises. DICOM datasets from our hospital PACS system were transferred to a networked cluster of desktop computers in a medical school classroom. Medical students in the Radiologic Anatomy course were divided into four small groups and assigned to work on a clinical case for 45 minutes. The groups used iPACS viewer software, a free DICOM viewer, to view images and annotate anatomic structures. The classroom instructor monitored and displayed each group's work sequentially on the master screen by running SynchronEyes, a software tool for controlling PC desktops remotely. Students were able to execute the assigned tasks using the iPACS software with minimal oversight or instruction. Course instructors displayed each group's work on the main display screen of the classroom as the students presented the rationale for their decisions. The interactive component of the course received high ratings from the students and overall course ratings were higher than in prior years when the course was given solely in lecture format. DICOM viewing software is an excellent tool for enabling students to learn radiologic anatomy from real-life clinical datasets. Interactive exercises performed in groups can be powerful tools for stimulating students to learn radiologic anatomy.

Implementation of an anonymisation tool for clinical trials using a clinical trial processor integrated with an existing trial patient data information system.

PubMed

Aryanto, Kadek Y E; Broekema, André; Oudkerk, Matthijs; van Ooijen, Peter M A

2012-01-01

To present an adapted Clinical Trial Processor (CTP) test set-up for receiving, anonymising and saving Digital Imaging and Communications in Medicine (DICOM) data using external input from the original database of an existing clinical study information system to guide the anonymisation process. Two methods are presented for an adapted CTP test set-up. In the first method, images are pushed from the Picture Archiving and Communication System (PACS) using the DICOM protocol through a local network. In the second method, images are transferred through the internet using the HTTPS protocol. In total 25,000 images from 50 patients were moved from the PACS, anonymised and stored within roughly 2 h using the first method. In the second method, an average of 10 images per minute were transferred and processed over a residential connection. In both methods, no duplicated images were stored when previous images were retransferred. The anonymised images are stored in appropriate directories. The CTP can transfer and process DICOM images correctly in a very easy set-up providing a fast, secure and stable environment. The adapted CTP allows easy integration into an environment in which patient data are already included in an existing information system.

Non-vascular interventional procedures: effective dose to patient and equivalent dose to abdominal organs by means of DICOM images and Monte Carlo simulation.

PubMed

Longo, Mariaconcetta; Marchioni, Chiara; Insero, Teresa; Donnarumma, Raffaella; D'Adamo, Alessandro; Lucatelli, Pierleone; Fanelli, Fabrizio; Salvatori, Filippo Maria; Cannavale, Alessandro; Di Castro, Elisabetta

2016-03-01

This study evaluates X-ray exposure in patient undergoing abdominal extra-vascular interventional procedures by means of Digital Imaging and COmmunications in Medicine (DICOM) image headers and Monte Carlo simulation. The main aim was to assess the effective and equivalent doses, under the hypothesis of their correlation with the dose area product (DAP) measured during each examination. This allows to collect dosimetric information about each patient and to evaluate associated risks without resorting to in vivo dosimetry. The dose calculation was performed in 79 procedures through the Monte Carlo simulator PCXMC (A PC-based Monte Carlo program for calculating patient doses in medical X-ray examinations), by using the real geometrical and dosimetric irradiation conditions, automatically extracted from DICOM headers. The DAP measurements were also validated by using thermoluminescent dosemeters on an anthropomorphic phantom. The expected linear correlation between effective doses and DAP was confirmed with an R(2) of 0.974. Moreover, in order to easily calculate patient doses, conversion coefficients that relate equivalent doses to measurable quantities, such as DAP, were obtained. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

SU-E-T-29: A Web Application for GPU-Based Monte Carlo IMRT/VMAT QA with Delivered Dose Verification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Folkerts, M; University of California, San Diego, La Jolla, CA; Graves, Y

Purpose: To enable an existing web application for GPU-based Monte Carlo (MC) 3D dosimetry quality assurance (QA) to compute “delivered dose” from linac logfile data. Methods: We added significant features to an IMRT/VMAT QA web application which is based on existing technologies (HTML5, Python, and Django). This tool interfaces with python, c-code libraries, and command line-based GPU applications to perform a MC-based IMRT/VMAT QA. The web app automates many complicated aspects of interfacing clinical DICOM and logfile data with cutting-edge GPU software to run a MC dose calculation. The resultant web app is powerful, easy to use, and is ablemore » to re-compute both plan dose (from DICOM data) and delivered dose (from logfile data). Both dynalog and trajectorylog file formats are supported. Users upload zipped DICOM RP, CT, and RD data and set the expected statistic uncertainty for the MC dose calculation. A 3D gamma index map, 3D dose distribution, gamma histogram, dosimetric statistics, and DVH curves are displayed to the user. Additional the user may upload the delivery logfile data from the linac to compute a 'delivered dose' calculation and corresponding gamma tests. A comprehensive PDF QA report summarizing the results can also be downloaded. Results: We successfully improved a web app for a GPU-based QA tool that consists of logfile parcing, fluence map generation, CT image processing, GPU based MC dose calculation, gamma index calculation, and DVH calculation. The result is an IMRT and VMAT QA tool that conducts an independent dose calculation for a given treatment plan and delivery log file. The system takes both DICOM data and logfile data to compute plan dose and delivered dose respectively. Conclusion: We sucessfully improved a GPU-based MC QA tool to allow for logfile dose calculation. The high efficiency and accessibility will greatly facilitate IMRT and VMAT QA.« less

SU-E-T-473: A Patient-Specific QC Paradigm Based On Trajectory Log Files and DICOM Plan Files

DOE Office of Scientific and Technical Information (OSTI.GOV)

DeMarco, J; McCloskey, S; Low, D

Purpose: To evaluate a remote QC tool for monitoring treatment machine parameters and treatment workflow. Methods: The Varian TrueBeamTM linear accelerator is a digital machine that records machine axis parameters and MLC leaf positions as a function of delivered monitor unit or control point. This information is saved to a binary trajectory log file for every treatment or imaging field in the patient treatment session. A MATLAB analysis routine was developed to parse the trajectory log files for a given patient, compare the expected versus actual machine and MLC positions as well as perform a cross-comparison with the DICOM-RT planmore » file exported from the treatment planning system. The parsing routine sorts the trajectory log files based on the time and date stamp and generates a sequential report file listing treatment parameters and provides a match relative to the DICOM-RT plan file. Results: The trajectory log parsing-routine was compared against a standard record and verify listing for patients undergoing initial IMRT dosimetry verification and weekly and final chart QC. The complete treatment course was independently verified for 10 patients of varying treatment site and a total of 1267 treatment fields were evaluated including pre-treatment imaging fields where applicable. In the context of IMRT plan verification, eight prostate SBRT plans with 4-arcs per plan were evaluated based on expected versus actual machine axis parameters. The average value for the maximum RMS MLC error was 0.067±0.001mm and 0.066±0.002mm for leaf bank A and B respectively. Conclusion: A real-time QC analysis program was tested using trajectory log files and DICOM-RT plan files. The parsing routine is efficient and able to evaluate all relevant machine axis parameters during a patient treatment course including MLC leaf positions and table positions at time of image acquisition and during treatment.« less

WE-AB-BRA-07: Quantitative Evaluation of 2D-2D and 2D-3D Image Guided Radiation Therapy for Clinical Trial Credentialing, NRG Oncology/RTOG

DOE Office of Scientific and Technical Information (OSTI.GOV)

Giaddui, T; Yu, J; Xiao, Y

Purpose: 2D-2D kV image guided radiation therapy (IGRT) credentialing evaluation for clinical trial qualification was historically qualitative through submitting screen captures of the fusion process. However, as quantitative DICOM 2D-2D and 2D-3D image registration tools are implemented in clinical practice for better precision, especially in centers that treat patients with protons, better IGRT credentialing techniques are needed. The aim of this work is to establish methodologies for quantitatively reviewing IGRT submissions based on DICOM 2D-2D and 2D-3D image registration and to test the methodologies in reviewing 2D-2D and 2D-3D IGRT submissions for RTOG/NRG Oncology clinical trials qualifications. Methods: DICOM 2D-2Dmore » and 2D-3D automated and manual image registration have been tested using the Harmony tool in MIM software. 2D kV orthogonal portal images are fused with the reference digital reconstructed radiographs (DRR) in the 2D-2D registration while the 2D portal images are fused with DICOM planning CT image in the 2D-3D registration. The Harmony tool allows alignment of the two images used in the registration process and also calculates the required shifts. Shifts calculated using MIM are compared with those submitted by institutions for IGRT credentialing. Reported shifts are considered to be acceptable if differences are less than 3mm. Results: Several tests have been performed on the 2D-2D and 2D-3D registration. The results indicated good agreement between submitted and calculated shifts. A workflow for reviewing these IGRT submissions has been developed and will eventually be used to review IGRT submissions. Conclusion: The IROC Philadelphia RTQA center has developed and tested a new workflow for reviewing DICOM 2D-2D and 2D-3D IGRT credentialing submissions made by different cancer clinical centers, especially proton centers. NRG Center for Innovation in Radiation Oncology (CIRO) and IROC RTQA center continue their collaborative efforts to enhance quality assurance services and to be consistently adaptive to the new advances in radiation therapy. This project was supported by NCI grants U10CA180868, U10CA180822, U24CA180803, U24CA12014 and PA CURE Grant.« less

Design and development of an ethnically-diverse imaging informatics-based eFolder system for multiple sclerosis patients.

PubMed

Ma, Kevin C; Fernandez, James R; Amezcua, Lilyana; Lerner, Alex; Shiroishi, Mark S; Liu, Brent J

2015-12-01

MRI has been used to identify multiple sclerosis (MS) lesions in brain and spinal cord visually. Integrating patient information into an electronic patient record system has become key for modern patient care in medicine in recent years. Clinically, it is also necessary to track patients' progress in longitudinal studies, in order to provide comprehensive understanding of disease progression and response to treatment. As the amount of required data increases, there exists a need for an efficient systematic solution to store and analyze MS patient data, disease profiles, and disease tracking for both clinical and research purposes. An imaging informatics based system, called MS eFolder, has been developed as an integrated patient record system for data storage and analysis of MS patients. The eFolder system, with a DICOM-based database, includes a module for lesion contouring by radiologists, a MS lesion quantification tool to quantify MS lesion volume in 3D, brain parenchyma fraction analysis, and provide quantitative analysis and tracking of volume changes in longitudinal studies. Patient data, including MR images, have been collected retrospectively at University of Southern California Medical Center (USC) and Los Angeles County Hospital (LAC). The MS eFolder utilizes web-based components, such as browser-based graphical user interface (GUI) and web-based database. The eFolder database stores patient clinical data (demographics, MS disease history, family history, etc.), MR imaging-related data found in DICOM headers, and lesion quantification results. Lesion quantification results are derived from radiologists' contours on brain MRI studies and quantified into 3-dimensional volumes and locations. Quantified results of white matter lesions are integrated into a structured report based on DICOM-SR protocol and templates. The user interface displays patient clinical information, original MR images, and viewing structured reports of quantified results. The GUI also includes a data mining tool to handle unique search queries for MS. System workflow and dataflow steps has been designed based on the IHE post-processing workflow profile, including workflow process tracking, MS lesion contouring and quantification of MR images at a post-processing workstation, and storage of quantitative results as DICOM-SR in DICOM-based storage system. The web-based GUI is designed to display zero-footprint DICOM web-accessible data objects (WADO) and the SR objects. The MS eFolder system has been designed and developed as an integrated data storage and mining solution in both clinical and research environments, while providing unique features, such as quantitative lesion analysis and disease tracking over a longitudinal study. A comprehensive image and clinical data integrated database provided by MS eFolder provides a platform for treatment assessment, outcomes analysis and decision-support. The proposed system serves as a platform for future quantitative analysis derived automatically from CAD algorithms that can also be integrated within the system for individual disease tracking and future MS-related research. Ultimately the eFolder provides a decision-support infrastructure that can eventually be used as add-on value to the overall electronic medical record. Copyright © 2015 Elsevier Ltd. All rights reserved.

Design and development of an ethnically-diverse imaging informatics-based eFolder system for multiple sclerosis patients

PubMed Central

Ma, Kevin C.; Fernandez, James R.; Amezcua, Lilyana; Lerner, Alex; Shiroishi, Mark S.; Liu, Brent J.

2016-01-01

Purpose MRI has been used to identify multiple sclerosis (MS) lesions in brain and spinal cord visually. Integrating patient information into an electronic patient record system has become key for modern patient care in medicine in recent years. Clinically, it is also necessary to track patients' progress in longitudinal studies, in order to provide comprehensive understanding of disease progression and response to treatment. As the amount of required data increases, there exists a need for an efficient systematic solution to store and analyze MS patient data, disease profiles, and disease tracking for both clinical and research purposes. Method An imaging informatics based system, called MS eFolder, has been developed as an integrated patient record system for data storage and analysis of MS patients. The eFolder system, with a DICOM-based database, includes a module for lesion contouring by radiologists, a MS lesion quantification tool to quantify MS lesion volume in 3D, brain parenchyma fraction analysis, and provide quantitative analysis and tracking of volume changes in longitudinal studies. Patient data, including MR images, have been collected retrospectively at University of Southern California Medical Center (USC) and Los Angeles County Hospital (LAC). The MS eFolder utilizes web-based components, such as browser-based graphical user interface (GUI) and web-based database. The eFolder database stores patient clinical data (demographics, MS disease history, family history, etc.), MR imaging-related data found in DICOM headers, and lesion quantification results. Lesion quantification results are derived from radiologists' contours on brain MRI studies and quantified into 3-dimensional volumes and locations. Quantified results of white matter lesions are integrated into a structured report based on DICOM-SR protocol and templates. The user interface displays patient clinical information, original MR images, and viewing structured reports of quantified results. The GUI also includes a data mining tool to handle unique search queries for MS. System workflow and dataflow steps has been designed based on the IHE post-processing workflow profile, including workflow process tracking, MS lesion contouring and quantification of MR images at a post-processing workstation, and storage of quantitative results as DICOM-SR in DICOM-based storage system. The web-based GUI is designed to display zero-footprint DICOM web-accessible data objects (WADO) and the SR objects. Summary The MS eFolder system has been designed and developed as an integrated data storage and mining solution in both clinical and research environments, while providing unique features, such as quantitative lesion analysis and disease tracking over a longitudinal study. A comprehensive image and clinical data integrated database provided by MS eFolder provides a platform for treatment assessment, outcomes analysis and decision-support. The proposed system serves as a platform for future quantitative analysis derived automatically from CAD algorithms that can also be integrated within the system for individual disease tracking and future MS-related research. Ultimately the eFolder provides a decision-support infrastructure that can eventually be used as add-on value to the overall electronic medical record. PMID:26564667

Thin client (web browser)-based collaboration for medical imaging and web-enabled data.

PubMed

Le, Tuong Huu; Malhi, Nadeem

2002-01-01

Utilizing thin client software and open source server technology, a collaborative architecture was implemented allowing for sharing of Digital Imaging and Communications in Medicine (DICOM) and non-DICOM images with real-time markup. Using the Web browser as a thin client integrated with standards-based components, such as DHTML (dynamic hypertext markup language), JavaScript, and Java, collaboration was achieved through a Web server/proxy server combination utilizing Java Servlets and Java Server Pages. A typical collaborative session involved the driver, who directed the navigation of the other collaborators, the passengers, and provided collaborative markups of medical and nonmedical images. The majority of processing was performed on the server side, allowing for the client to remain thin and more accessible.

Integrating radiology information systems with healthcare delivery environments using DICOM and HL7 standards.

PubMed

Blazona, Bojan; Koncar, Miroslav

2006-01-01

Integration based on open standards, in order to achieve communication and information interoperability, is one of the key aspects of modern health care information systems. Interoperability presents data and communication layer interchange. In this context we identified the HL7 standard as the world's leading medical Information and communication technology (ICT) standard for the business layer in healthcare information systems and we tried to explore the ability to exchange clinical documents with minimal integrated healthcare information systems (IHCIS) change. We explored HL7 Clinical Document Architecture (CDA) abilities to achieve radiology information system integration (DICOM) to IHCIS (HL7). We introduced the use of WADO service interconnection to IHCIS and finally CDA rendering in widely used Internet explorers.

Bridging the gap: linking a legacy hospital information system with a filmless radiology picture archiving and communications system within a nonhomogeneous environment.

PubMed

Rubin, R K; Henri, C J; Cox, R D

1999-05-01

A health level 7 (HL7)-conformant data link to exchange information between the mainframe hospital information system (HIS) of our hospital and our home-grown picture archiving and communications system (PACS) is a result of a collaborative effort between the HIS department and the PACS development team. Based of the ability to link examination requisitions and image studies, applications have been generated to optimise workflow and to improve the reliability and distribution of radiology information. Now, images can be routed to individual radiologists and clinicians; worklists facilitate radiology reporting; applications exist to create, edit, and view reports and images via the internet; and automated quality control now limits the incidence of "lost" cases and errors in image routing. By following the HL7 standard to develop the gateway to the legacy system, the development of a radiology information system for booking, reading, reporting, and billing remains universal and does not preclude the option to integrate off-the-shelf commercial products.

Management and presentation of grouped procedures: has the IHE integration profile cracked the toughest radiology workflow nut?

NASA Astrophysics Data System (ADS)

Parisot, Charles R.; Channin, David S.; Avrin, David E.; Lindop, Christopher

2001-08-01

In a simple, typical radiology workflow process, an order generates a single procedure, which in turn generates a single data set, from which, one radiology report is generated. There are, however, occasions when a single order consists of more than one procedure each with a separate report, yet the procedures are accomplished by one physical acquisition of data. The prototypical example of this is the request for computed tomographic evaluation of the chest, abdomen and pelvis. The study is accomplished, with modern day scanners, by a single helical acquisition, yet there are typically three codable and billable procedures involved, and these may be reported independently either for administrative or academic reasons. This grouping of procedures remained up to now a challenge to automate across integrated modalities, PACS and RIS. This paper discusses a number of other practical cases where this situation occurs and reviews the capabilities of the Presentation of Grouped Procedures IHE Integration Profile in solving this problem. The DICOM services used are evaluated as well as the strengths and weaknesses of this IHE Integration Profile. The implementation experience gained on both a CT and an MR for the IHE Demonstration at RSNA 2000 and HIMSS 2001 is also reviewed. In conclusion, the resulting clinical and operational benefits are discussed.

Photodynamic therapy in neurosurgery: a proof of concept of treatment planning system

NASA Astrophysics Data System (ADS)

Dupont, C.; Reyns, N.; Mordon, S.; Vermandel, M.

2017-02-01

Glioblastoma (GBM) is the most common primary brain tumor. PhotoDynamic Therapy (PDT) appears as an interesting research field to improve GBM treatment. Nevertheless, PDT cannot fit into the current therapeutic modalities according to several reasons: the lack of reliable and reproducible therapy schemes (devices, light delivery system), the lack of consensus on a photosensitizer and the absence of randomized and controlled multicenter clinical trial. The main objective of this study is to bring a common support for PDT planning. Here, we describe a proof of concept of Treatment Planning System (TPS) dedicated to interstitial PDT for GBM treatment. The TPS was developed with the integrated development environment C++ Builder XE8 and the environment ArtiMED, developed in our laboratory. This software enables stereotactic registration of DICOM images, light sources insertion and an accelerated CUDA GPU dosimetry modeling. Although, Monte-Carlo is more robust to describe light diffusion in biological tissue, analytical model accelerated by GPU remains relevant for dose preview or fast reverse planning processes. Finally, this preliminary work proposes a new tool to plan interstitial or intraoperative PDT treatment and might be included in the design of future clinical trials in order to deliver PDT straightforwardly and homogenously in investigator centers.

Content Preserving Watermarking for Medical Images Using Shearlet Transform and SVD

NASA Astrophysics Data System (ADS)

Favorskaya, M. N.; Savchina, E. I.

2017-05-01

Medical Image Watermarking (MIW) is a special field of a watermarking due to the requirements of the Digital Imaging and COmmunications in Medicine (DICOM) standard since 1993. All 20 parts of the DICOM standard are revised periodically. The main idea of the MIW is to embed various types of information including the doctor's digital signature, fragile watermark, electronic patient record, and main watermark in a view of region of interest for the doctor into the host medical image. These four types of information are represented in different forms; some of them are encrypted according to the DICOM requirements. However, all types of information ought to be resulted into the generalized binary stream for embedding. The generalized binary stream may have a huge volume. Therefore, not all watermarking methods can be applied successfully. Recently, the digital shearlet transform had been introduced as a rigorous mathematical framework for the geometric representation of multi-dimensional data. Some modifications of the shearlet transform, particularly the non-subsampled shearlet transform, can be associated to a multi-resolution analysis that provides a fully shift-invariant, multi-scale, and multi-directional expansion. During experiments, a quality of the extracted watermarks under the JPEG compression and typical internet attacks was estimated using several metrics, including the peak signal to noise ratio, structural similarity index measure, and bit error rate.

How Secure Is Your Radiology Department? Mapping Digital Radiology Adoption and Security Worldwide.

PubMed

Stites, Mark; Pianykh, Oleg S

2016-04-01

Despite the long history of digital radiology, one of its most critical aspects--information security--still remains extremely underdeveloped and poorly standardized. To study the current state of radiology security, we explored the worldwide security of medical image archives. Using the DICOM data-transmitting standard, we implemented a highly parallel application to scan the entire World Wide Web of networked computers and devices, locating open and unprotected radiology servers. We used only legal and radiology-compliant tools. Our security-probing application initiated a standard DICOM handshake to remote computer or device addresses, and then assessed their security posture on the basis of handshake replies. The scan discovered a total of 2774 unprotected radiology or DICOM servers worldwide. Of those, 719 were fully open to patient data communications. Geolocation was used to analyze and rank our findings according to country utilization. As a result, we built maps and world ranking of clinical security, suggesting that even the most radiology-advanced countries have hospitals with serious security gaps. Despite more than two decades of active development and implementation, our radiology data still remains insecure. The results provided should be applied to raise awareness and begin an earnest dialogue toward elimination of the problem. The application we designed and the novel scanning approach we developed can be used to identify security breaches and to eliminate them before they are compromised.

Anatomy of an Extensible Open Source PACS.

PubMed

Valente, Frederico; Silva, Luís A Bastião; Godinho, Tiago Marques; Costa, Carlos

2016-06-01

The conception and deployment of cost effective Picture Archiving and Communication Systems (PACS) is a concern for small to medium medical imaging facilities, research environments, and developing countries' healthcare institutions. Financial constraints and the specificity of these scenarios contribute to a low adoption rate of PACS in those environments. Furthermore, with the advent of ubiquitous computing and new initiatives to improve healthcare information technologies and data sharing, such as IHE and XDS-i, a PACS must adapt quickly to changes. This paper describes Dicoogle, a software framework that enables developers and researchers to quickly prototype and deploy new functionality taking advantage of the embedded Digital Imaging and Communications in Medicine (DICOM) services. This full-fledged implementation of a PACS archive is very amenable to extension due to its plugin-based architecture and out-of-the-box functionality, which enables the exploration of large DICOM datasets and associated metadata. These characteristics make the proposed solution very interesting for prototyping, experimentation, and bridging functionality with deployed applications. Besides being an advanced mechanism for data discovery and retrieval based on DICOM object indexing, it enables the detection of inconsistencies in an institution's data and processes. Several use cases have benefited from this approach such as radiation dosage monitoring, Content-Based Image Retrieval (CBIR), and the use of the framework as support for classes targeting software engineering for clinical contexts.

Network-based reading system for lung cancer screening CT

NASA Astrophysics Data System (ADS)

Fujino, Yuichi; Fujimura, Kaori; Nomura, Shin-ichiro; Kawashima, Harumi; Tsuchikawa, Megumu; Matsumoto, Toru; Nagao, Kei-ichi; Uruma, Takahiro; Yamamoto, Shinji; Takizawa, Hotaka; Kuroda, Chikazumi; Nakayama, Tomio

2006-03-01

This research aims to support chest computed tomography (CT) medical checkups to decrease the death rate by lung cancer. We have developed a remote cooperative reading system for lung cancer screening over the Internet, a secure transmission function, and a cooperative reading environment. It is called the Network-based Reading System. A telemedicine system involves many issues, such as network costs and data security if we use it over the Internet, which is an open network. In Japan, broadband access is widespread and its cost is the lowest in the world. We developed our system considering human machine interface and security. It consists of data entry terminals, a database server, a computer aided diagnosis (CAD) system, and some reading terminals. It uses a secure Digital Imaging and Communication in Medicine (DICOM) encrypting method and Public Key Infrastructure (PKI) based secure DICOM image data distribution. We carried out an experimental trial over the Japan Gigabit Network (JGN), which is the testbed for the Japanese next-generation network, and conducted verification experiments of secure screening image distribution, some kinds of data addition, and remote cooperative reading. We found that network bandwidth of about 1.5 Mbps enabled distribution of screening images and cooperative reading and that the encryption and image distribution methods we proposed were applicable to the encryption and distribution of general DICOM images via the Internet.

A De-Identification Pipeline for Ultrasound Medical Images in DICOM Format.

PubMed

Monteiro, Eriksson; Costa, Carlos; Oliveira, José Luís

2017-05-01

Clinical data sharing between healthcare institutions, and between practitioners is often hindered by privacy protection requirements. This problem is critical in collaborative scenarios where data sharing is fundamental for establishing a workflow among parties. The anonymization of patient information burned in DICOM images requires elaborate processes somewhat more complex than simple de-identification of textual information. Usually, before sharing, there is a need for manual removal of specific areas containing sensitive information in the images. In this paper, we present a pipeline for ultrasound medical image de-identification, provided as a free anonymization REST service for medical image applications, and a Software-as-a-Service to streamline automatic de-identification of medical images, which is freely available for end-users. The proposed approach applies image processing functions and machine-learning models to bring about an automatic system to anonymize medical images. To perform character recognition, we evaluated several machine-learning models, being Convolutional Neural Networks (CNN) selected as the best approach. For accessing the system quality, 500 processed images were manually inspected showing an anonymization rate of 89.2%. The tool can be accessed at https://bioinformatics.ua.pt/dicom/anonymizer and it is available with the most recent version of Google Chrome, Mozilla Firefox and Safari. A Docker image containing the proposed service is also publicly available for the community.

Comparative analysis of semantic localization accuracies between adult and pediatric DICOM CT images

NASA Astrophysics Data System (ADS)

Robertson, Duncan; Pathak, Sayan D.; Criminisi, Antonio; White, Steve; Haynor, David; Chen, Oliver; Siddiqui, Khan

2012-02-01

Existing literature describes a variety of techniques for semantic annotation of DICOM CT images, i.e. the automatic detection and localization of anatomical structures. Semantic annotation facilitates enhanced image navigation, linkage of DICOM image content and non-image clinical data, content-based image retrieval, and image registration. A key challenge for semantic annotation algorithms is inter-patient variability. However, while the algorithms described in published literature have been shown to cope adequately with the variability in test sets comprising adult CT scans, the problem presented by the even greater variability in pediatric anatomy has received very little attention. Most existing semantic annotation algorithms can only be extended to work on scans of both adult and pediatric patients by adapting parameters heuristically in light of patient size. In contrast, our approach, which uses random regression forests ('RRF'), learns an implicit model of scale variation automatically using training data. In consequence, anatomical structures can be localized accurately in both adult and pediatric CT studies without the need for parameter adaptation or additional information about patient scale. We show how the RRF algorithm is able to learn scale invariance from a combined training set containing a mixture of pediatric and adult scans. Resulting localization accuracy for both adult and pediatric data remains comparable with that obtained using RRFs trained and tested using only adult data.

Encryption and watermark-treated medical image against hacking disease-An immune convention in spatial and frequency domains.

PubMed

Lakshmi, C; Thenmozhi, K; Rayappan, John Bosco Balaguru; Amirtharajan, Rengarajan

2018-06-01

Digital Imaging and Communications in Medicine (DICOM) is one among the significant formats used worldwide for the representation of medical images. Undoubtedly, medical-image security plays a crucial role in telemedicine applications. Merging encryption and watermarking in medical-image protection paves the way for enhancing the authentication and safer transmission over open channels. In this context, the present work on DICOM image encryption has employed a fuzzy chaotic map for encryption and the Discrete Wavelet Transform (DWT) for watermarking. The proposed approach overcomes the limitation of the Arnold transform-one of the most utilised confusion mechanisms in image ciphering. Various metrics have substantiated the effectiveness of the proposed medical-image encryption algorithm. Copyright © 2018 Elsevier B.V. All rights reserved.

An Approach Using Parallel Architecture to Storage DICOM Images in Distributed File System

NASA Astrophysics Data System (ADS)

Soares, Tiago S.; Prado, Thiago C.; Dantas, M. A. R.; de Macedo, Douglas D. J.; Bauer, Michael A.

2012-02-01

Telemedicine is a very important area in medical field that is expanding daily motivated by many researchers interested in improving medical applications. In Brazil was started in 2005, in the State of Santa Catarina has a developed server called the CyclopsDCMServer, which the purpose to embrace the HDF for the manipulation of medical images (DICOM) using a distributed file system. Since then, many researches were initiated in order to seek better performance. Our approach for this server represents an additional parallel implementation in I/O operations since HDF version 5 has an essential feature for our work which supports parallel I/O, based upon the MPI paradigm. Early experiments using four parallel nodes, provide good performance when compare to the serial HDF implemented in the CyclopsDCMServer.

A DICOM-RT based ePR radiation therapy information system for managing brain tumor patients

NASA Astrophysics Data System (ADS)

Liu, Brent J.; Law, Maria; Huang, H. K.; Zee, C. S.; Chan, Lawrence

2005-04-01

The need for comprehensive clinical image data and relevant information in image-guided Radiation Therapy (RT) is becoming steadily apparent. Multiple standalone systems utilizing the most technological advancements in imaging, therapeutic radiation, and computerized treatment planning systems acquire key data during the RT treatment course of a patient. One example are patients treated for brain tumors of greater sizes and irregular shapes that utilize state-of-the-art RT technology to deliver pinpoint accurate radiation doses. One such system, the Cyberknife, is a radiation treatment system that utilizes image-guided information to control a multi-jointed, six degrees of freedom, robotic arm to deliver precise and required radiation dose to the tumor site of a cancer patient. The image-guided system is capable of tracking the lesion orientations with respect to the patient"s position throughout the treatment process. This is done by correlating live radiographic images with pre-operative, CT and MR imaging information to determine relative patient and tumor position repeatedly over the course of the treatment. The disparate and complex data generated by the Cyberknife system along with related data is scattered throughout the RT department compromising an efficient clinical workflow since the data crucial for a clinical decision may be time-consuming to retrieve, temporarily missing, or even lost. To address these shortcomings, the ACR-NEMA Standards Committee extended its DICOM (Digital Imaging & Communications in Medicine) Standard from Radiology to RT by ratifying seven DICOM RT objects starting in 1997. However, they are rarely used by the RT community in daily clinical operations. In the past, the research focus of an RT department has primarily been developing new protocols and devices to improve treatment process and outcomes of cancer patients with minimal effort dedicated to integration of imaging and information systems. Our research, tightly-coupling radiology and RT information systems, represents a new frontier for medical informatics research that has never been previously considered. By combining our past experience in medical imaging informatics, DICOM-RT expertise, and system integration, we propose to test our hypothesis using a brain tumor case model that a DICOM-RT electronic patient record (ePR) system can improve clinical workflow efficiency for treatment and management of patients. This RT ePR system integrated with clinical images and RT data can impact the RT department in a similar fashion as PACS has already successfully done for Radiology. As a first step, the specific treatment case of patients with brain tumors specifically patients treated with the Cyberknife system will be the initial proof of concept for the research design, implementation, evaluation, and clinical relevance.

Experience with a proposed teleradiology system for digital mammography

NASA Astrophysics Data System (ADS)

Saulnier, Emilie T.; Mitchell, Robert J.; Abdel-Malek, Aiman A.; Dudding, Kathryn E.

1995-05-01

Teleradiology offers significant improvement in efficiency and effectiveness over current practices in traditional film/screen-based diagnosis. In the context of digital mammography, the increasing number of women who need to be screened for breast cancer, including those in remote rural regions, make the advantages of teleradiology especially attractive for digital mammography. At the same time, the size and resolution of digital mammograms are among the most challenging to support in a cost effective teleradiology system. This paper describes a teleradiology architecture developed for use with digital mammography by GE Corporate Research and Development in collaboration with Massachusetts General Hospital under National Cancer Institute (NCI/NIH) grant number R01 CA60246-01. Experience with a testbed prototype is described. The telemammography architecture is intended to consist of a main mammography diagnostic site serving several remote screening sites. As patient exams become available, they are forwarded by an image server to the diagnostic site over a WAN communications link. A radiologist at the diagnostic site views a patient exam as it arrives, interprets it, and then relays a report back to the technician at the remote site. A secondary future scenario consists of mobile units which forward images to a remote site, which then forwards them to the main diagnostic site. The testbed architecture is based on the Digital Imaging and Communications in Medicine (DICOM) standard, created by the American College of Radiology (ACR) and National Electrical Manufacturers Association (NEMA). A specification of vendor-independent data formats and data transfer services for digital medical images, DICOM specifies a protocol suite starting at the application layer downward, including the TCP/IP layers. The current DICOM definition does not provide an information element that is specifically tailored to mammography, so we have used the DICOM secondary capture data format for the mammography images. In conclusion, experience with the testbed is described, as is performance analysis related to selection of network components needed to extend this architecture to clinical evaluation. Recommendations are made as to the critical areas for future work.

Teleradiology mobile internet system with a new information security solution

NASA Astrophysics Data System (ADS)

Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kusumoto, Masahiko; Kaneko, Masahiro; Moriyama, Noriyuki

2014-03-01

We have developed an external storage system by using secret sharing scheme and tokenization for regional medical cooperation, PHR service and information preservation. The use of mobile devices such as smart phones and tablets will be accelerated for a PHR service, and the confidential medical information is exposed to the risk of damage and intercept. We verified the transfer rate of the sending and receiving of data to and from the external storage system that connected it with PACS by the Internet this time. External storage systems are the data centers that exist in Okinawa, in Osaka, in Sapporo and in Tokyo by using secret sharing scheme. PACS continuously transmitted 382 CT images to the external data centers. Total capacity of the CT images is about 200MB. The total time that had been required to transmit was about 250 seconds. Because the preservation method to use secret sharing scheme is applied, security is strong. But, it also takes the information transfer time of this system too much. Therefore, DICOM data is masked to the header information part because it is made to anonymity in our method. The DICOM data made anonymous is preserved in the data base in the hospital. Header information including individual information is divided into two or more tallies by secret sharing scheme, and preserved at two or more external data centers. The token to relate the DICOM data anonymity made to header information preserved outside is strictly preserved in the token server. The capacity of header information that contains patient's individual information is only about 2% of the entire DICOM data. This total time that had been required to transmit was about 5 seconds. Other, common solutions that can protect computer communication networks from attacks are classified as cryptographic techniques or authentication techniques. Individual number IC card is connected with electronic certification authority of web medical image conference system. Individual number IC card is given only to the person to whom the authority to operate web medical image conference system was given.

DICOM-compliant PACS with CD-based image archival

NASA Astrophysics Data System (ADS)

Cox, Robert D.; Henri, Christopher J.; Rubin, Richard K.; Bret, Patrice M.

1998-07-01

This paper describes the design and implementation of a low- cost PACS conforming to the DICOM 3.0 standard. The goal was to provide an efficient image archival and management solution on a heterogeneous hospital network as a basis for filmless radiology. The system follows a distributed, client/server model and was implemented at a fraction of the cost of a commercial PACS. It provides reliable archiving on recordable CD and allows access to digital images throughout the hospital and on the Internet. Dedicated servers have been designed for short-term storage, CD-based archival, data retrieval and remote data access or teleradiology. The short-term storage devices provide DICOM storage and query/retrieve services to scanners and workstations and approximately twelve weeks of 'on-line' image data. The CD-based archival and data retrieval processes are fully automated with the exception of CD loading and unloading. The system employs lossless compression on both short- and long-term storage devices. All servers communicate via the DICOM protocol in conjunction with both local and 'master' SQL-patient databases. Records are transferred from the local to the master database independently, ensuring that storage devices will still function if the master database server cannot be reached. The system features rules-based work-flow management and WWW servers to provide multi-platform remote data access. The WWW server system is distributed on the storage, retrieval and teleradiology servers allowing viewing of locally stored image data directly in a WWW browser without the need for data transfer to a central WWW server. An independent system monitors disk usage, processes, network and CPU load on each server and reports errors to the image management team via email. The PACS was implemented using a combination of off-the-shelf hardware, freely available software and applications developed in-house. The system has enabled filmless operation in CT, MR and ultrasound within the radiology department and throughout the hospital. The use of WWW technology has enabled the development of an intuitive we- based teleradiology and image management solution that provides complete access to image data.

42 CFR 37.42 - Approval of roentgenographic facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... signal-to-noise and detective quantum efficiency must be evaluated and judged acceptable by a qualified...): (A) DICOM Standard PS 3.3-2011, Annex A—Composite Information Object Definitions, sections: Computed...

42 CFR 37.42 - Chest radiograph specifications-digital radiography systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

... signal-to-noise and detective quantum efficiency must be evaluated and judged acceptable by a qualified...): (A) DICOM Standard PS 3.3-2011, Annex A—Composite Information Object Definitions, sections: Computed...

Security protection of DICOM medical images using dual-layer reversible watermarking with tamper detection capability.

PubMed

Tan, Chun Kiat; Ng, Jason Changwei; Xu, Xiaotian; Poh, Chueh Loo; Guan, Yong Liang; Sheah, Kenneth

2011-06-01

Teleradiology applications and universal availability of patient records using web-based technology are rapidly gaining importance. Consequently, digital medical image security has become an important issue when images and their pertinent patient information are transmitted across public networks, such as the Internet. Health mandates such as the Health Insurance Portability and Accountability Act require healthcare providers to adhere to security measures in order to protect sensitive patient information. This paper presents a fully reversible, dual-layer watermarking scheme with tamper detection capability for medical images. The scheme utilizes concepts of public-key cryptography and reversible data-hiding technique. The scheme was tested using medical images in DICOM format. The results show that the scheme is able to ensure image authenticity and integrity, and to locate tampered regions in the images.

Big data in multiple sclerosis: development of a web-based longitudinal study viewer in an imaging informatics-based eFolder system for complex data analysis and management

NASA Astrophysics Data System (ADS)

Ma, Kevin; Wang, Ximing; Lerner, Alex; Shiroishi, Mark; Amezcua, Lilyana; Liu, Brent

2015-03-01

In the past, we have developed and displayed a multiple sclerosis eFolder system for patient data storage, image viewing, and automatic lesion quantification results stored in DICOM-SR format. The web-based system aims to be integrated in DICOM-compliant clinical and research environments to aid clinicians in patient treatments and disease tracking. This year, we have further developed the eFolder system to handle big data analysis and data mining in today's medical imaging field. The database has been updated to allow data mining and data look-up from DICOM-SR lesion analysis contents. Longitudinal studies are tracked, and any changes in lesion volumes and brain parenchyma volumes are calculated and shown on the webbased user interface as graphical representations. Longitudinal lesion characteristic changes are compared with patients' disease history, including treatments, symptom progressions, and any other changes in the disease profile. The image viewer is updated such that imaging studies can be viewed side-by-side to allow visual comparisons. We aim to use the web-based medical imaging informatics eFolder system to demonstrate big data analysis in medical imaging, and use the analysis results to predict MS disease trends and patterns in Hispanic and Caucasian populations in our pilot study. The discovery of disease patterns among the two ethnicities is a big data analysis result that will help lead to personalized patient care and treatment planning.

DICOM: a standard for medical imaging

NASA Astrophysics Data System (ADS)

Horii, Steven C.; Bidgood, W. Dean

1993-01-01

Since 1983, the American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA) have been engaged in developing standards related to medical imaging. This alliance of users and manufacturers was formed to meet the needs of the medical imaging community as its use of digital imaging technology increased. The development of electronic picture archiving and communications systems (PACS), which could connect a number of medical imaging devices together in a network, led to the need for a standard interface and data structure for use on imaging equipment. Since medical image files tend to be very large and include much text information along with the image, the need for a fast, flexible, and extensible standard was quickly established. The ACR-NEMA Digital Imaging and Communications Standards Committee developed a standard which met these needs. The standard (ACR-NEMA 300-1988) was first published in 1985 and revised in 1988. It is increasingly available from equipment manufacturers. The current work of the ACR- NEMA Committee has been to extend the standard to incorporate direct network connection features, and build on standards work done by the International Standards Organization in its Open Systems Interconnection series. This new standard, called Digital Imaging and Communication in Medicine (DICOM), follows an object-oriented design methodology and makes use of as many existing internationally accepted standards as possible. This paper gives a brief overview of the requirements for communications standards in medical imaging, a history of the ACR-NEMA effort and what it has produced, and a description of the DICOM standard.

Validating automatic semantic annotation of anatomy in DICOM CT images

NASA Astrophysics Data System (ADS)

Pathak, Sayan D.; Criminisi, Antonio; Shotton, Jamie; White, Steve; Robertson, Duncan; Sparks, Bobbi; Munasinghe, Indeera; Siddiqui, Khan

2011-03-01

In the current health-care environment, the time available for physicians to browse patients' scans is shrinking due to the rapid increase in the sheer number of images. This is further aggravated by mounting pressure to become more productive in the face of decreasing reimbursement. Hence, there is an urgent need to deliver technology which enables faster and effortless navigation through sub-volume image visualizations. Annotating image regions with semantic labels such as those derived from the RADLEX ontology can vastly enhance image navigation and sub-volume visualization. This paper uses random regression forests for efficient, automatic detection and localization of anatomical structures within DICOM 3D CT scans. A regression forest is a collection of decision trees which are trained to achieve direct mapping from voxels to organ location and size in a single pass. This paper focuses on comparing automated labeling with expert-annotated ground-truth results on a database of 50 highly variable CT scans. Initial investigations show that regression forest derived localization errors are smaller and more robust than those achieved by state-of-the-art global registration approaches. The simplicity of the algorithm's context-rich visual features yield typical runtimes of less than 10 seconds for a 5123 voxel DICOM CT series on a single-threaded, single-core machine running multiple trees; each tree taking less than a second. Furthermore, qualitative evaluation demonstrates that using the detected organs' locations as index into the image volume improves the efficiency of the navigational workflow in all the CT studies.

Monte Carlo treatment planning with modulated electron radiotherapy: framework development and application

NASA Astrophysics Data System (ADS)

Alexander, Andrew William

Within the field of medical physics, Monte Carlo radiation transport simulations are considered to be the most accurate method for the determination of dose distributions in patients. The McGill Monte Carlo treatment planning system (MMCTP), provides a flexible software environment to integrate Monte Carlo simulations with current and new treatment modalities. A developing treatment modality called energy and intensity modulated electron radiotherapy (MERT) is a promising modality, which has the fundamental capabilities to enhance the dosimetry of superficial targets. An objective of this work is to advance the research and development of MERT with the end goal of clinical use. To this end, we present the MMCTP system with an integrated toolkit for MERT planning and delivery of MERT fields. Delivery is achieved using an automated "few leaf electron collimator" (FLEC) and a controller. Aside from the MERT planning toolkit, the MMCTP system required numerous add-ons to perform the complex task of large-scale autonomous Monte Carlo simulations. The first was a DICOM import filter, followed by the implementation of DOSXYZnrc as a dose calculation engine and by logic methods for submitting and updating the status of Monte Carlo simulations. Within this work we validated the MMCTP system with a head and neck Monte Carlo recalculation study performed by a medical dosimetrist. The impact of MMCTP lies in the fact that it allows for systematic and platform independent large-scale Monte Carlo dose calculations for different treatment sites and treatment modalities. In addition to the MERT planning tools, various optimization algorithms were created external to MMCTP. The algorithms produced MERT treatment plans based on dose volume constraints that employ Monte Carlo pre-generated patient-specific kernels. The Monte Carlo kernels are generated from patient-specific Monte Carlo dose distributions within MMCTP. The structure of the MERT planning toolkit software and optimization algorithms are demonstrated. We investigated the clinical significance of MERT on spinal irradiation, breast boost irradiation, and a head and neck sarcoma cancer site using several parameters to analyze the treatment plans. Finally, we investigated the idea of mixed beam photon and electron treatment planning. Photon optimization treatment planning tools were included within the MERT planning toolkit for the purpose of mixed beam optimization. In conclusion, this thesis work has resulted in the development of an advanced framework for photon and electron Monte Carlo treatment planning studies and the development of an inverse planning system for photon, electron or mixed beam radiotherapy (MBRT). The justification and validation of this work is found within the results of the planning studies, which have demonstrated dosimetric advantages to using MERT or MBRT in comparison to clinical treatment alternatives.

Web based tools for visualizing imaging data and development of XNATView, a zero footprint image viewer

PubMed Central

Gutman, David A.; Dunn, William D.; Cobb, Jake; Stoner, Richard M.; Kalpathy-Cramer, Jayashree; Erickson, Bradley

2014-01-01

Advances in web technologies now allow direct visualization of imaging data sets without necessitating the download of large file sets or the installation of software. This allows centralization of file storage and facilitates image review and analysis. XNATView is a light framework recently developed in our lab to visualize DICOM images stored in The Extensible Neuroimaging Archive Toolkit (XNAT). It consists of a PyXNAT-based framework to wrap around the REST application programming interface (API) and query the data in XNAT. XNATView was developed to simplify quality assurance, help organize imaging data, and facilitate data sharing for intra- and inter-laboratory collaborations. Its zero-footprint design allows the user to connect to XNAT from a web browser, navigate through projects, experiments, and subjects, and view DICOM images with accompanying metadata all within a single viewing instance. PMID:24904399

Bridging the integration gap between imaging and information systems: a uniform data concept for content-based image retrieval in computer-aided diagnosis.

PubMed

Welter, Petra; Riesmeier, Jörg; Fischer, Benedikt; Grouls, Christoph; Kuhl, Christiane; Deserno, Thomas M

2011-01-01

It is widely accepted that content-based image retrieval (CBIR) can be extremely useful for computer-aided diagnosis (CAD). However, CBIR has not been established in clinical practice yet. As a widely unattended gap of integration, a unified data concept for CBIR-based CAD results and reporting is lacking. Picture archiving and communication systems and the workflow of radiologists must be considered for successful data integration to be achieved. We suggest that CBIR systems applied to CAD should integrate their results in a picture archiving and communication systems environment such as Digital Imaging and Communications in Medicine (DICOM) structured reporting documents. A sample DICOM structured reporting template adaptable to CBIR and an appropriate integration scheme is presented. The proposed CBIR data concept may foster the promulgation of CBIR systems in clinical environments and, thereby, improve the diagnostic process.

Bridging the integration gap between imaging and information systems: a uniform data concept for content-based image retrieval in computer-aided diagnosis

PubMed Central

Riesmeier, Jörg; Fischer, Benedikt; Grouls, Christoph; Kuhl, Christiane; Deserno (né Lehmann), Thomas M

2011-01-01

It is widely accepted that content-based image retrieval (CBIR) can be extremely useful for computer-aided diagnosis (CAD). However, CBIR has not been established in clinical practice yet. As a widely unattended gap of integration, a unified data concept for CBIR-based CAD results and reporting is lacking. Picture archiving and communication systems and the workflow of radiologists must be considered for successful data integration to be achieved. We suggest that CBIR systems applied to CAD should integrate their results in a picture archiving and communication systems environment such as Digital Imaging and Communications in Medicine (DICOM) structured reporting documents. A sample DICOM structured reporting template adaptable to CBIR and an appropriate integration scheme is presented. The proposed CBIR data concept may foster the promulgation of CBIR systems in clinical environments and, thereby, improve the diagnostic process. PMID:21672913

Integration of healthcare information: from enterprise PACS to patient centered multimedia health record.

PubMed

Soriano, Enrique; Plazzotta, Fernando; Campos, Fernando; Kaminker, Diego; Cancio, Alfredo; Aguilera Díaz, Jerónimo; Luna, Daniel; Seehaus, Alberto; Carcía Mónaco, Ricardo; de Quirós, Fernán González Bernaldo

2010-01-01

Every single piece of healthcare information should be fully integrated and transparent within the electronic health record. The Italian Hospital of Buenos Aires initiated the project Multimedia Health Record with the goal to achieve this integration while maintaining a holistic view of current structure of the systems of the Hospital, where the axis remains are the patient and longitudinal history, commencing with section Computed Tomography. Was implemented DICOM standard for communication and image storage and bought a PACS. It was necessary adapt our generic reporting system for live up to the commercial RIS. The Computerized Tomography (CT) Scanners of our hospital were easily integrated into the DICOM network and all the CT Scans generated by our radiology service were stored in the PACS, reported using the Structured Reporting System (we installed diagnostic terminals equipped with 3 monitors) and displayed in the EHR at any point of HIBA's healthcare network.

A Study of NetCDF as an Approach for High Performance Medical Image Storage

NASA Astrophysics Data System (ADS)

Magnus, Marcone; Coelho Prado, Thiago; von Wangenhein, Aldo; de Macedo, Douglas D. J.; Dantas, M. A. R.

2012-02-01

The spread of telemedicine systems increases every day. The systems and PACS based on DICOM images has become common. This rise reflects the need to develop new storage systems, more efficient and with lower computational costs. With this in mind, this article discusses a study for application in NetCDF data format as the basic platform for storage of DICOM images. The study case comparison adopts an ordinary database, the HDF5 and the NetCDF to storage the medical images. Empirical results, using a real set of images, indicate that the time to retrieve images from the NetCDF for large scale images has a higher latency compared to the other two methods. In addition, the latency is proportional to the file size, which represents a drawback to a telemedicine system that is characterized by a large amount of large image files.

DEWEY: the DICOM-enabled workflow engine system.

PubMed

Erickson, Bradley J; Langer, Steve G; Blezek, Daniel J; Ryan, William J; French, Todd L

2014-06-01

Workflow is a widely used term to describe the sequence of steps to accomplish a task. The use of workflow technology in medicine and medical imaging in particular is limited. In this article, we describe the application of a workflow engine to improve workflow in a radiology department. We implemented a DICOM-enabled workflow engine system in our department. We designed it in a way to allow for scalability, reliability, and flexibility. We implemented several workflows, including one that replaced an existing manual workflow and measured the number of examinations prepared in time without and with the workflow system. The system significantly increased the number of examinations prepared in time for clinical review compared to human effort. It also met the design goals defined at its outset. Workflow engines appear to have value as ways to efficiently assure that complex workflows are completed in a timely fashion.

Schedule-Aware Workflow Management Systems

NASA Astrophysics Data System (ADS)

Mans, Ronny S.; Russell, Nick C.; van der Aalst, Wil M. P.; Moleman, Arnold J.; Bakker, Piet J. M.

Contemporary workflow management systems offer work-items to users through specific work-lists. Users select the work-items they will perform without having a specific schedule in mind. However, in many environments work needs to be scheduled and performed at particular times. For example, in hospitals many work-items are linked to appointments, e.g., a doctor cannot perform surgery without reserving an operating theater and making sure that the patient is present. One of the problems when applying workflow technology in such domains is the lack of calendar-based scheduling support. In this paper, we present an approach that supports the seamless integration of unscheduled (flow) and scheduled (schedule) tasks. Using CPN Tools we have developed a specification and simulation model for schedule-aware workflow management systems. Based on this a system has been realized that uses YAWL, Microsoft Exchange Server 2007, Outlook, and a dedicated scheduling service. The approach is illustrated using a real-life case study at the AMC hospital in the Netherlands. In addition, we elaborate on the experiences obtained when developing and implementing a system of this scale using formal techniques.

A novel method for efficient archiving and retrieval of biomedical images using MPEG-7

NASA Astrophysics Data System (ADS)

Meyer, Joerg; Pahwa, Ash

2004-10-01

Digital archiving and efficient retrieval of radiological scans have become critical steps in contemporary medical diagnostics. Since more and more images and image sequences (single scans or video) from various modalities (CT/MRI/PET/digital X-ray) are now available in digital formats (e.g., DICOM-3), hospitals and radiology clinics need to implement efficient protocols capable of managing the enormous amounts of data generated daily in a typical clinical routine. We present a method that appears to be a viable way to eliminate the tedious step of manually annotating image and video material for database indexing. MPEG-7 is a new framework that standardizes the way images are characterized in terms of color, shape, and other abstract, content-related criteria. A set of standardized descriptors that are automatically generated from an image is used to compare an image to other images in a database, and to compute the distance between two images for a given application domain. Text-based database queries can be replaced with image-based queries using MPEG-7. Consequently, image queries can be conducted without any prior knowledge of the keys that were used as indices in the database. Since the decoding and matching steps are not part of the MPEG-7 standard, this method also enables searches that were not planned by the time the keys were generated.

Applicability of three-dimensional imaging techniques in fetal medicine*

PubMed Central

Werner Júnior, Heron; dos Santos, Jorge Lopes; Belmonte, Simone; Ribeiro, Gerson; Daltro, Pedro; Gasparetto, Emerson Leandro; Marchiori, Edson

2016-01-01

Objective To generate physical models of fetuses from images obtained with three-dimensional ultrasound (3D-US), magnetic resonance imaging (MRI), and, occasionally, computed tomography (CT), in order to guide additive manufacturing technology. Materials and Methods We used 3D-US images of 31 pregnant women, including 5 who were carrying twins. If abnormalities were detected by 3D-US, both MRI and in some cases CT scans were then immediately performed. The images were then exported to a workstation in DICOM format. A single observer performed slice-by-slice manual segmentation using a digital high resolution screen. Virtual 3D models were obtained from software that converts medical images into numerical models. Those models were then generated in physical form through the use of additive manufacturing techniques. Results Physical models based upon 3D-US, MRI, and CT images were successfully generated. The postnatal appearance of either the aborted fetus or the neonate closely resembled the physical models, particularly in cases of malformations. Conclusion The combined use of 3D-US, MRI, and CT could help improve our understanding of fetal anatomy. These three screening modalities can be used for educational purposes and as tools to enable parents to visualize their unborn baby. The images can be segmented and then applied, separately or jointly, in order to construct virtual and physical 3D models. PMID:27818540

Impact of digital radiography on clinical workflow.

PubMed

May, G A; Deer, D D; Dackiewicz, D

2000-05-01

It is commonly accepted that digital radiography (DR) improves workflow and patient throughput compared with traditional film radiography or computed radiography (CR). DR eliminates the film development step and the time to acquire the image from a CR reader. In addition, the wide dynamic range of DR is such that the technologist can perform the quality-control (QC) step directly at the modality in a few seconds, rather than having to transport the newly acquired image to a centralized QC station for review. Furthermore, additional workflow efficiencies can be achieved with DR by employing tight radiology information system (RIS) integration. In the DR imaging environment, this provides for patient demographic information to be automatically downloaded from the RIS to populate the DR Digital Imaging and Communications in Medicine (DICOM) image header. To learn more about this workflow efficiency improvement, we performed a comparative study of workflow steps under three different conditions: traditional film/screen x-ray, DR without RIS integration (ie, manual entry of patient demographics), and DR with RIS integration. This study was performed at the Cleveland Clinic Foundation (Cleveland, OH) using a newly acquired amorphous silicon flat-panel DR system from Canon Medical Systems (Irvine, CA). Our data show that DR without RIS results in substantial workflow savings over traditional film/screen practice. There is an additional 30% reduction in total examination time using DR with RIS integration.

MR efficiency using automated MRI-desktop eProtocol

NASA Astrophysics Data System (ADS)

Gao, Fei; Xu, Yanzhe; Panda, Anshuman; Zhang, Min; Hanson, James; Su, Congzhe; Wu, Teresa; Pavlicek, William; James, Judy R.

2017-03-01

MRI protocols are instruction sheets that radiology technologists use in routine clinical practice for guidance (e.g., slice position, acquisition parameters etc.). In Mayo Clinic Arizona (MCA), there are over 900 MR protocols (ranging across neuro, body, cardiac, breast etc.) which makes maintaining and updating the protocol instructions a labor intensive effort. The task is even more challenging given different vendors (Siemens, GE etc.). This is a universal problem faced by all the hospitals and/or medical research institutions. To increase the efficiency of the MR practice, we designed and implemented a web-based platform (eProtocol) to automate the management of MRI protocols. It is built upon a database that automatically extracts protocol information from DICOM compliant images and provides a user-friendly interface to the technologists to create, edit and update the protocols. Advanced operations such as protocol migrations from scanner to scanner and capability to upload Multimedia content were also implemented. To the best of our knowledge, eProtocol is the first MR protocol automated management tool used clinically. It is expected that this platform will significantly improve the radiology operations efficiency including better image quality and exam consistency, fewer repeat examinations and less acquisition errors. These protocols instructions will be readily available to the technologists during scans. In addition, this web-based platform can be extended to other imaging modalities such as CT, Mammography, and Interventional Radiology and different vendors for imaging protocol management.

Small PACS implementation using publicly available software

NASA Astrophysics Data System (ADS)

Passadore, Diego J.; Isoardi, Roberto A.; Gonzalez Nicolini, Federico J.; Ariza, P. P.; Novas, C. V.; Omati, S. A.

1998-07-01

Building cost effective PACS solutions is a main concern in developing countries. Hardware and software components are generally much more expensive than in developed countries and also more tightened financial constraints are the main reasons contributing to a slow rate of implementation of PACS. The extensive use of Internet for sharing resources and information has brought a broad number of freely available software packages to an ever-increasing number of users. In the field of medical imaging is possible to find image format conversion packages, DICOM compliant servers for all kinds of service classes, databases, web servers, image visualization, manipulation and analysis tools, etc. This paper describes a PACS implementation for review and storage built on freely available software. It currently integrates four diagnostic modalities (PET, CT, MR and NM), a Radiotherapy Treatment Planning workstation and several computers in a local area network, for image storage, database management and image review, processing and analysis. It also includes a web-based application that allows remote users to query the archive for studies from any workstation and to view the corresponding images and reports. We conclude that the advantage of using this approach is twofold. It allows a full understanding of all the issues involved in the implementation of a PACS and also contributes to keep costs down while enabling the development of a functional system for storage, distribution and review that can prove to be helpful for radiologists and referring physicians.

Advanced Concepts and Methods of Approximate Reasoning

DTIC Science & Technology

1989-12-01

immeasurably by numerous conversations and discussions with Nadal Bat- tle, Hamid Berenji , Piero Bonissone, Bernadette Bouchon-Meunier, Miguel Delgado, Di...comments of Claudi Alsina, Hamid Berenji , Piero Bonissone, Didier Dubois, Francesc Esteva, Oscar Firschein, Marty Fischler, Pascal Fua, Maria Angeles

Competency-Based Teaching in Radiology - Implementation and Evaluation of Interactive Workstation-Based Learning to Apply NKLM-Based Content.

PubMed

Koestner, Wolfgang; Otten, Wiebke; Kaireit, Till; Wacker, Frank K; Dettmer, Sabine

2017-11-01

Purpose  New teaching formats are required to implement competency-based teaching in radiology teaching. Therefore, we have established and evaluated two practical competency-based radiological courses. Materials and Methods  The courses were held in a multimedia room with 25 computers and a professional DICOM viewer. Students were taught basic image analysis and presented clinical cases with a DICOM viewer under supervision of an instructor using desktop monitoring software. Two courses (elective course and obligatory course) were evaluated by the students (n = 160 and n = 100) and instructors (n = 9) using an anonymized online survey. Results  Courses were evaluated positively by the students and instructors. From the perspective of the students, the courses increased understanding of cross-sectional anatomy (elective/obligatory course: 97 %/95 %) and radiologic findings (97 %/99 %). Furthermore, the course increased the students' interest in radiology (61 %/65 %). The students considered this way of teaching to be relevant to their future occupation (92 % of students in the obligatory course). The higher incidence of teacher-student interaction and the possibility of independent image analysis were rated positively. The majority of instructors did not observe increased distractibility due to the computers (67 %) or notice worse preparation for MC tests (56 %). However, 56 % of instructors reported greater preparation effort. Conclusion  Practical competency-based radiological teaching using a DICOM viewer is a feasible innovative approach with high acceptance among students and instructors. It fosters competency-based learning as proposed by the model curriculum of the German Radiological Society (DRG) and the National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM). Key Points   · Practical competency-based radiological teaching is highly accepted by students and instructors.. · Students report improved understanding of imaging anatomy and radiological findings.. · Interactive case presentation with a DICOM viewer fosters competency-based learning.. Citation Format · Koestner W, Otten W, Kaireit T et al. Competency-Based Teaching in Radiology - Implementation and Evaluation of Interactive Workstation-Based Learning to Apply NKLM-Based Content. Fortschr Röntgenstr 2017; 189: 1076 - 1085. © Georg Thieme Verlag KG Stuttgart · New York.

HL7 and DICOM based integration of radiology departments with healthcare enterprise information systems.

PubMed

Blazona, Bojan; Koncar, Miroslav

2007-12-01

Integration based on open standards, in order to achieve communication and information interoperability, is one of the key aspects of modern health care information systems. However, this requirement represents one of the major challenges for the Information and Communication Technology (ICT) solutions, as systems today use diverse technologies, proprietary protocols and communication standards which are often not interoperable. One of the main producers of clinical information in healthcare settings represent Radiology Information Systems (RIS) that communicate using widely adopted DICOM (Digital Imaging and COmmunications in Medicine) standard, but in very few cases can efficiently integrate information of interest with other systems. In this context we identified HL7 standard as the world's leading medical ICT standard that is envisioned to provide the umbrella for medical data semantic interoperability, which amongst other things represents the cornerstone for the Croatia's National Integrated Healthcare Information System (IHCIS). The aim was to explore the ability to integrate and exchange RIS originated data with Hospital Information Systems based on HL7's CDA (Clinical Document Architecture) standard. We explored the ability of HL7 CDA specifications and methodology to address the need of RIS integration HL7 based healthcare information systems. We introduced the use of WADO service interconnection to IHCIS and finally CDA rendering in widely used Internet explorers. The outcome of our pilot work proves our original assumption of HL7 standard being able to adopt radiology data into the integrated healthcare systems. Uniform DICOM to CDA translation scripts and business processes within IHCIS is desired and cost effective regarding to use of supporting IHCIS services aligned to SOA.

Medical image security in a HIPAA mandated PACS environment.

PubMed

Cao, F; Huang, H K; Zhou, X Q

2003-01-01

Medical image security is an important issue when digital images and their pertinent patient information are transmitted across public networks. Mandates for ensuring health data security have been issued by the federal government such as Health Insurance Portability and Accountability Act (HIPAA), where healthcare institutions are obliged to take appropriate measures to ensure that patient information is only provided to people who have a professional need. Guidelines, such as digital imaging and communication in medicine (DICOM) standards that deal with security issues, continue to be published by organizing bodies in healthcare. However, there are many differences in implementation especially for an integrated system like picture archiving and communication system (PACS), and the infrastructure to deploy these security standards is often lacking. Over the past 6 years, members in the Image Processing and Informatics Laboratory, Childrens Hospital, Los Angeles/University of Southern California, have actively researched image security issues related to PACS and teleradiology. The paper summarizes our previous work and presents an approach to further research on the digital envelope (DE) concept that provides image integrity and security assurance in addition to conventional network security protection. The DE, including the digital signature (DS) of the image as well as encrypted patient information from the DICOM image header, can be embedded in the background area of the image as an invisible permanent watermark. The paper outlines the systematic development, evaluation and deployment of the DE method in a PACS environment. We have also proposed a dedicated PACS security server that will act as an image authority to check and certify the image origin and integrity upon request by a user, and meanwhile act also as a secure DICOM gateway to the outside connections and a PACS operation monitor for HIPAA supporting information. Copyright 2002 Elsevier Science Ltd.

A framework for organ dose estimation in x-ray angiography and interventional radiology based on dose-related data in DICOM structured reports

NASA Astrophysics Data System (ADS)

Omar, Artur; Bujila, Robert; Fransson, Annette; Andreo, Pedro; Poludniowski, Gavin

2016-04-01

Although interventional x-ray angiography (XA) procedures involve relatively high radiation doses that can lead to deterministic tissue reactions in addition to stochastic effects, convenient and accurate estimation of absorbed organ doses has traditionally been out of reach. This has mainly been due to the absence of practical means to access dose-related data that describe the physical context of the numerous exposures during an XA procedure. The present work provides a comprehensive and general framework for the determination of absorbed organ dose, based on non-proprietary access to dose-related data by utilizing widely available DICOM radiation dose structured reports. The framework comprises a straightforward calculation workflow to determine the incident kerma and reconstruction of the geometrical relation between the projected x-ray beam and the patient’s anatomy. The latter is difficult in practice, as the position of the patient on the table top is unknown. A novel patient-specific approach for reconstruction of the patient position on the table is presented. The proposed approach was evaluated for 150 patients by comparing the estimated position of the primary irradiated organs (the target organs) with their position in clinical DICOM images. The approach is shown to locate the target organ position with a mean (max) deviation of 1.3 (4.3), 1.8 (3.6) and 1.4 (2.9) cm for neurovascular, adult and paediatric cardiovascular procedures, respectively. To illustrate the utility of the framework for systematic and automated organ dose estimation in routine clinical practice, a prototype implementation of the framework with Monte Carlo simulations is included.

Enterprise-wide PACS: beyond radiology, an architecture to manage all medical images.

PubMed

Bandon, David; Lovis, Christian; Geissbühler, Antoine; Vallée, Jean-Paul

2005-08-01

Picture archiving and communication systems (PACS) have the vocation to manage all medical images acquired within the hospital. To address the various situations encountered in the imaging specialties, the traditional architecture used for the radiology department has to evolve. We present our preliminarily results toward an enterprise-wide PACS intended to support all kind of image production in medicine, from biomolecular images to whole-body pictures. Our solution is based on an existing radiologic PACS system from which images are distributed through an electronic patient record to all care facilities. This platform is enriched with a flexible integration framework supporting digital image communication in medicine (DICOM) and DICOM-XML formats. In addition, a generic workflow engine highly customizable is used to drive work processes. Echocardiology; hematology; ear, nose, and throat; and dermatology, including wounds, follow-up is the first implemented extensions outside of radiology. We also propose a global strategy for further developments based on three possible architectures for an enterprise-wide PACS.

[Study of sharing platform of web-based enhanced extracorporeal counterpulsation hemodynamic waveform data].

PubMed

Huang, Mingbo; Hu, Ding; Yu, Donglan; Zheng, Zhensheng; Wang, Kuijian

2011-12-01

Enhanced extracorporeal counterpulsation (EECP) information consists of both text and hemodynamic waveform data. At present EECP text information has been successfully managed through Web browser, while the management and sharing of hemodynamic waveform data through Internet has not been solved yet. In order to manage EECP information completely, based on the in-depth analysis of EECP hemodynamic waveform file of digital imaging and communications in medicine (DICOM) format and its disadvantages in Internet sharing, we proposed the use of the extensible markup language (XML), which is currently the Internet popular data exchange standard, as the storage specification for the sharing of EECP waveform data. Then we designed a web-based sharing system of EECP hemodynamic waveform data via ASP. NET 2.0 platform. Meanwhile, we specifically introduced the four main system function modules and their implement methods, including DICOM to XML conversion module, EECP waveform data management module, retrieval and display of EECP waveform module and the security mechanism of the system.

DICOM to print, 35-mm slides, web, and video projector: tutorial using Adobe Photoshop.

PubMed

Gurney, Jud W

2002-10-01

Preparing images for publication has dealt with film and the photographic process. With picture archiving and communications systems, many departments will no longer produce film. This will change how images are produced for publication. DICOM, the file format for radiographic images, has to be converted and then prepared for traditional publication, 35-mm slides, the newest techniques of video projection, and the World Wide Web. Tagged image file format is the common format for traditional print publication, whereas joint photographic expert group is the current file format for the World Wide Web. Each medium has specific requirements that can be met with a common image-editing program such as Adobe Photoshop (Adobe Systems, San Jose, CA). High-resolution images are required for print, a process that requires interpolation. However, the Internet requires images with a small file size for rapid transmission. The resolution of each output differs and the image resolution must be optimized to match the output of the publishing medium.

Security middleware infrastructure for DICOM images in health information systems.

PubMed

Kallepalli, Vijay N V; Ehikioya, Sylvanus A; Camorlinga, Sergio; Rueda, Jose A

2003-12-01

In health care, it is mandatory to maintain the privacy and confidentiality of medical data. To achieve this, a fine-grained access control and an access log for accessing medical images are two important aspects that need to be considered in health care systems. Fine-grained access control provides access to medical data only to authorized persons based on priority, location, and content. A log captures each attempt to access medical data. This article describes an overall middleware infrastructure required for secure access to Digital Imaging and Communication in Medicine (DICOM) images, with an emphasis on access control and log maintenance. We introduce a hybrid access control model that combines the properties of two existing models. A trust relationship between hospitals is used to make the hybrid access control model scalable across hospitals. We also discuss events that have to be logged and where the log has to be maintained. A prototype of security middleware infrastructure is implemented.

Qualitative Evaluation of Fiducial Markers for Radiotherapy Imaging

PubMed Central

Chan, Maria F.; Cohen, Gil’ad N.; Deasy, Joseph O.

2016-01-01

Purpose To evaluate visibility, artifacts, and distortions of various commercial markers in magnetic resonance imaging (MRI), computer tomography (CT), and ultrasound imaging used for radiotherapy planning and treatment guidance. Methods We compare 2 solid gold markers, 4 gold coils, and 1 polymer marker from 3 vendors. Imaging modalities used were 3-T and 1.5-T GE MRIs, Siemens Sequoia 512 Ultrasound, Phillips Big Bore CT, Varian Trilogy linear accelerator (cone-beam CT [CBCT], on-board imager kilovoltage [OBI-kV], electronic portal imaging device megavoltage [EPID-MV]), and Medtronic O-ARM CBCT. Markers were imaged in a 30 × 30 × 10 cm3 custom bolus phantom. In one experiment, Surgilube was used around the markers to reduce air gaps. Images were saved in Digital Imaging and Communications in Medicine (DICOM) format and analyzed using an in-house software. Profiles across the markers were used for objective comparison of the markers’ signals. The visibility and artifacts/distortions produced by each marker were assessed qualitatively and quantitatively. Results All markers are visible in CT, CBCT, OBI-kV, and ultrasound. Gold markers below 0.75 mm in diameter are not visible in EPID-MV images. The larger the markers, the more CT and CBCT image artifacts there are, yet the degree of the artifact depends on scan parameters and the scanner itself. Visibility of gold coils of 0.75 mm diameter or larger is comparable across all imaging modalities studied. The polymer marker causes minimal artifacts in CT and CBCT but has poor visibility in EPID-MV. Gold coils of 0.5 mm exhibit poor visibility in MRI and EPID-MV due to their small size. Gold markers are more visible in 3-T T1 gradient-recalled echo than in 1.5-T T1 fast spin-echo, depending on the scan sequence. In this study, all markers are clearly visible on ultrasound. Conclusion All gold markers are visible in CT, CBCT, kV, and ultrasound; however, only the large diameter markers are visible in MV. When MR and EPID-MV imagers are used, the selection of fiducial markers is not straightforward. For hybrid kV/MV image-guided radiotherapy imaging, larger diameter markers are suggested. If using kV imaging alone, smaller sized markers may be used in smaller sized patients in order to reduce artifacts. Only larger diameter gold markers are visible across all imaging modalities. PMID:25230715

MO-E-17A-01: BEST IN PHYSICS (IMAGING) - Calculating SSDE From CT Exams Using Size Data Available in the DICOM Header of CT Localizer Radiographs

DOE Office of Scientific and Technical Information (OSTI.GOV)

McMillan, K; Bostani, M; McNitt-Gray, M

2014-06-15

Purpose: To demonstrate the feasibility of using existing data stored within the DICOM header of certain CT localizer radiographs as a patient size metric for calculating CT size-specific dose estimates (SSDE). Methods: For most Siemens CT scanners, the CT localizer radiograph (topogram) contains a private DICOM field that stores an array of numbers describing AP and LAT attenuation-based measures of patient dimension. The square root of the product of the AP and LAT size data, which provides an estimate of water-equivalent-diameter (WED), was calculated retrospectively from topogram data of 20 patients who received clinically-indicated abdomen/pelvis (n=10) and chest (n=10) scansmore » (WED-topo). In addition, slice-by-slice water-equivalent-diameter (WED-image) and effective diameter (ED-image) values were calculated from the respective image data. Using TG-204 lookup tables, size-dependent conversion factors were determined based upon WED-topo, WED-image and ED-image values. These conversion factors were used with the reported CTDIvol to calculate slice-by-slice SSDE for each method. Averaging over all slices, a single SSDE value was determined for each patient and size metric. Patientspecific SSDE and CTDIvol values were then compared with patientspecific organ doses derived from detailed Monte Carlo simulations of fixed tube current scans. Results: For abdomen/pelvis scans, the average difference between liver dose and CTDIvol, SSDE(WED-topo), SSDE(WED-image), and SSDE(ED-image) was 18.70%, 8.17%, 6.84%, and 7.58%, respectively. For chest scans, the average difference between lung dose and CTDIvol, SSDE(WED-topo), SSDE(WED-image), and SSDE(ED-image) was 25.80%, 3.33%, 4.11%, and 7.66%, respectively. Conclusion: SSDE calculated using WED derived from data in the DICOM header of the topogram was comparable to SSDE calculated using WED and ED derived from axial images; each of these estimated organ dose to within 10% for both abdomen/pelvis and chest CT examinations. The topogrambased method has the advantage that WED data are already provided and therefore available without additional post-processing of the image data. Funding Support: NIH Grant R01-EB017095; Disclosures - Michael McNitt-Gray: Institutional Research Agreement, Siemens AG; Research Support, Siemens AG; Consultant, Flaherty Sensabaugh Bonasso PLLC; Consultant, Fulbright and Jaworski; Disclosures - Cynthia McCollough: Research Grant, Siemens Healthcare.« less

Computer hardware for radiologists: Part I

PubMed Central

Indrajit, IK; Alam, A

2010-01-01

Computers are an integral part of modern radiology practice. They are used in different radiology modalities to acquire, process, and postprocess imaging data. They have had a dramatic influence on contemporary radiology practice. Their impact has extended further with the emergence of Digital Imaging and Communications in Medicine (DICOM), Picture Archiving and Communication System (PACS), Radiology information system (RIS) technology, and Teleradiology. A basic overview of computer hardware relevant to radiology practice is presented here. The key hardware components in a computer are the motherboard, central processor unit (CPU), the chipset, the random access memory (RAM), the memory modules, bus, storage drives, and ports. The personnel computer (PC) has a rectangular case that contains important components called hardware, many of which are integrated circuits (ICs). The fiberglass motherboard is the main printed circuit board and has a variety of important hardware mounted on it, which are connected by electrical pathways called “buses”. The CPU is the largest IC on the motherboard and contains millions of transistors. Its principal function is to execute “programs”. A Pentium® 4 CPU has transistors that execute a billion instructions per second. The chipset is completely different from the CPU in design and function; it controls data and interaction of buses between the motherboard and the CPU. Memory (RAM) is fundamentally semiconductor chips storing data and instructions for access by a CPU. RAM is classified by storage capacity, access speed, data rate, and configuration. PMID:21042437

Fully automatic three-dimensional visualization of intravascular optical coherence tomography images: methods and feasibility in vivo

PubMed Central

Ughi, Giovanni J; Adriaenssens, Tom; Desmet, Walter; D’hooge, Jan

2012-01-01

Intravascular optical coherence tomography (IV-OCT) is an imaging modality that can be used for the assessment of intracoronary stents. Recent publications pointed to the fact that 3D visualizations have potential advantages compared to conventional 2D representations. However, 3D imaging still requires a time consuming manual procedure not suitable for on-line application during coronary interventions. We propose an algorithm for a rapid and fully automatic 3D visualization of IV-OCT pullbacks. IV-OCT images are first processed for the segmentation of the different structures. This also allows for automatic pullback calibration. Then, according to the segmentation results, different structures are depicted with different colors to visualize the vessel wall, the stent and the guide-wire in details. Final 3D rendering results are obtained through the use of a commercial 3D DICOM viewer. Manual analysis was used as ground-truth for the validation of the segmentation algorithms. A correlation value of 0.99 and good limits of agreement (Bland Altman statistics) were found over 250 images randomly extracted from 25 in vivo pullbacks. Moreover, 3D rendering was compared to angiography, pictures of deployed stents made available by the manufacturers and to conventional 2D imaging corroborating visualization results. Computational time for the visualization of an entire data sets resulted to be ~74 sec. The proposed method allows for the on-line use of 3D IV-OCT during percutaneous coronary interventions, potentially allowing treatments optimization. PMID:23243578

Integrated software environment based on COMKAT for analyzing tracer pharmacokinetics with molecular imaging.

PubMed

Fang, Yu-Hua Dean; Asthana, Pravesh; Salinas, Cristian; Huang, Hsuan-Ming; Muzic, Raymond F

2010-01-01

An integrated software package, Compartment Model Kinetic Analysis Tool (COMKAT), is presented in this report. COMKAT is an open-source software package with many functions for incorporating pharmacokinetic analysis in molecular imaging research and has both command-line and graphical user interfaces. With COMKAT, users may load and display images, draw regions of interest, load input functions, select kinetic models from a predefined list, or create a novel model and perform parameter estimation, all without having to write any computer code. For image analysis, COMKAT image tool supports multiple image file formats, including the Digital Imaging and Communications in Medicine (DICOM) standard. Image contrast, zoom, reslicing, display color table, and frame summation can be adjusted in COMKAT image tool. It also displays and automatically registers images from 2 modalities. Parametric imaging capability is provided and can be combined with the distributed computing support to enhance computation speeds. For users without MATLAB licenses, a compiled, executable version of COMKAT is available, although it currently has only a subset of the full COMKAT capability. Both the compiled and the noncompiled versions of COMKAT are free for academic research use. Extensive documentation, examples, and COMKAT itself are available on its wiki-based Web site, http://comkat.case.edu. Users are encouraged to contribute, sharing their experience, examples, and extensions of COMKAT. With integrated functionality specifically designed for imaging and kinetic modeling analysis, COMKAT can be used as a software environment for molecular imaging and pharmacokinetic analysis.

[Radiological dose and metadata management].

PubMed

Walz, M; Kolodziej, M; Madsack, B

2016-12-01

This article describes the features of management systems currently available in Germany for extraction, registration and evaluation of metadata from radiological examinations, particularly in the digital imaging and communications in medicine (DICOM) environment. In addition, the probable relevant developments in this area concerning radiation protection legislation, terminology, standardization and information technology are presented.

21 CFR 892.2030 - Medical image digitizer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical image digitizer. 892.2030 Section 892.2030 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Communications in Medicine (DICOM) Std., Joint Photographic Experts Group (JPEG) Std.). [63 FR 23387, Apr. 29...

21 CFR 892.2040 - Medical image hardcopy device.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical image hardcopy device. 892.2040 Section 892.2040 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Communications in Medicine (DICOM) Std., Joint Photographic Experts Group (JPEG) Std., Society of Motion Picture...

PACS on mobile devices

NASA Astrophysics Data System (ADS)

Parikh, Ashesh; Mehta, Nihal

2015-03-01

Recent advances in internet browser technologies makes it possible to incorporate advanced functionality of a traditional PACS for viewing DICOM medical images on standard web browsers without the need to pre-install any plug-ins, apps or software. We demonstrate some of the capabilities of standard web browsers setting the stage for a cloud-based PACS.

Integration of a Zero-footprint Cloud-based Picture Archiving and Communication System with Customizable Forms for Radiology Research and Education.

PubMed

Hostetter, Jason; Khanna, Nishanth; Mandell, Jacob C

2018-06-01

The purpose of this study was to integrate web-based forms with a zero-footprint cloud-based Picture Archiving and Communication Systems (PACS) to create a tool of potential benefit to radiology research and education. Web-based forms were created with a front-end and back-end architecture utilizing common programming languages including Vue.js, Node.js and MongoDB, and integrated into an existing zero-footprint cloud-based PACS. The web-based forms application can be accessed in any modern internet browser on desktop or mobile devices and allows the creation of customizable forms consisting of a variety of questions types. Each form can be linked to an individual DICOM examination or a collection of DICOM examinations. Several uses are demonstrated through a series of case studies, including implementation of a research platform for multi-reader multi-case (MRMC) studies and other imaging research, and creation of an online Objective Structure Clinical Examination (OSCE) and an educational case file. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Relevance of eHealth standards for big data interoperability in radiology and beyond.

PubMed

Marcheschi, Paolo

2017-06-01

The aim of this paper is to report on the implementation of radiology and related information technology standards to feed big data repositories and so to be able to create a solid substrate on which to operate with analysis software. Digital Imaging and Communications in Medicine (DICOM) and Health Level 7 (HL7) are the major standards for radiology and medical information technology. They define formats and protocols to transmit medical images, signals, and patient data inside and outside hospital facilities. These standards can be implemented but big data expectations are stimulating a new approach, simplifying data collection and interoperability, seeking reduction of time to full implementation inside health organizations. Virtual Medical Record, DICOM Structured Reporting and HL7 Fast Healthcare Interoperability Resources (FHIR) are changing the way medical data are shared among organization and they will be the keys to big data interoperability. Until we do not find simple and comprehensive methods to store and disseminate detailed information on the patient's health we will not be able to get optimum results from the analysis of those data.

Clinical image processing engine

NASA Astrophysics Data System (ADS)

Han, Wei; Yao, Jianhua; Chen, Jeremy; Summers, Ronald

2009-02-01

Our group provides clinical image processing services to various institutes at NIH. We develop or adapt image processing programs for a variety of applications. However, each program requires a human operator to select a specific set of images and execute the program, as well as store the results appropriately for later use. To improve efficiency, we design a parallelized clinical image processing engine (CIPE) to streamline and parallelize our service. The engine takes DICOM images from a PACS server, sorts and distributes the images to different applications, multithreads the execution of applications, and collects results from the applications. The engine consists of four modules: a listener, a router, a job manager and a data manager. A template filter in XML format is defined to specify the image specification for each application. A MySQL database is created to store and manage the incoming DICOM images and application results. The engine achieves two important goals: reduce the amount of time and manpower required to process medical images, and reduce the turnaround time for responding. We tested our engine on three different applications with 12 datasets and demonstrated that the engine improved the efficiency dramatically.

PACS in Töölö hospital.

PubMed

Kinnunen, J; Pohjonen, H

2001-07-01

A 3-year PACS project was started in 1997 and completed in 1999 with filmless radiology and surgery. An efficient network for transferring images provides the infrastructure for integration of different distributed imaging systems and enables efficient handling of all patient-related information on one display station. Because of the need for high-speed communications and the massive amount of image data transferred in radiology, ATM (25, 155 Mbit/s) was chosen to be the main technology used. Both hardware and software redundancy of the system have been carefully planned. The size of the Dicom image library utilizing MO discs is currently 1.2 TB with 300 GB RAID capacity. For the increasing amount of teleradiologic consultations, a special Dicom gateway is planned. It allows a centralized and resilient handling and routing of received images around the hospital. Hospital-wide PACS has already improved the speed and quality of patient care by providing instant access to diagnostic information at multiple locations simultaneously. The benefits of PACS are considered from the viewpoint of the entire hospital: PACS offers a method for efficiently transporting patient-related images and reports to the referring physicians.

SU-E-J-129: A Strategy to Consolidate the Image Database of a VERO Unit Into a Radiotherapy Management System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yan, Y; Medin, P; Yordy, J

2014-06-01

Purpose: To present a strategy to integrate the imaging database of a VERO unit with a treatment management system (TMS) to improve clinical workflow and consolidate image data to facilitate clinical quality control and documentation. Methods: A VERO unit is equipped with both kV and MV imaging capabilities for IGRT treatments. It has its own imaging database behind a firewall. It has been a challenge to transfer images on this unit to a TMS in a radiation therapy clinic so that registered images can be reviewed remotely with an approval or rejection record. In this study, a software system, iPump-VERO,more » was developed to connect VERO and a TMS in our clinic. The patient database folder on the VERO unit was mapped to a read-only folder on a file server outside VERO firewall. The application runs on a regular computer with the read access to the patient database folder. It finds the latest registered images and fuses them in one of six predefined patterns before sends them via DICOM connection to the TMS. The residual image registration errors will be overlaid on the fused image to facilitate image review. Results: The fused images of either registered kV planar images or CBCT images are fully DICOM compatible. A sentinel module is built to sense new registered images with negligible computing resources from the VERO ExacTrac imaging computer. It takes a few seconds to fuse registered images and send them to the TMS. The whole process is automated without any human intervention. Conclusion: Transferring images in DICOM connection is the easiest way to consolidate images of various sources in your TMS. Technically the attending does not have to go to the VERO treatment console to review image registration prior delivery. It is a useful tool for a busy clinic with a VERO unit.« less

SU-E-T-220: A Web-Based Research System for Outcome Analysis of NSCLC Treated with SABR.

PubMed

Le, A; Yang, Y; Michalski, D; Heron, D; Huq, M

2012-06-01

To establish a web-based software system, an electronic patient record (ePR), to consolidate and evaluate clinical data, dose delivery and treatment outcomes for non small cell lung cancer (NSCLC) patients treated with hypofractionated stereotactic ablative radiation therapy (SABR) across institutions. The new trend of information technology in medical imaging and informatics is towards the development of an electronic patient record (ePR), in which all health and medical information of each patient are organized under the patient's name and identification number. The system has been developed using the Wamp Server, a package of Apache web server, PHP and MySQL database to facilitate patient data input and management, and evaluation of patient clinical data and dose delivery across institution using web technology. The data of each patient to be recorded in the database include pre-treatment clinical data, treatment plan in DICOM-RT format and follow-up data. The pre-treatment data include demographics data, pathology condition, cancer staging. The follow-up data include the survival status, local tumor control condition and toxicity. The clinical data are entered to the system through the web page while the treatment plan data will be imported from the treatment planning system (TPS) using DICOM communication. The collection of data of NSCLC patients treated with SABR stored in the ePR is always accessible and can be retrieved and processed in the future. The core of the ePR is the database which integrates all patient data in one location. The web-based DICOM RT ePR system utilizes the current state-of-the-art medical informatics approach to investigate the combination and consolidation of patient data and outcome results. This will allow clinically-driven data mining for dose distributions and resulting treatment outcome in connection with biological modeling of the treatment parameters to quantify the efficacy of SABR in treating NSCLC patients. © 2012 American Association of Physicists in Medicine.

Prior Image Constrained Compressed Sensing Metal Artifact Reduction (PICCS-MAR): 2D and 3D Image Quality Improvement with Hip Prostheses at CT Colonography.

PubMed

Bannas, Peter; Li, Yinsheng; Motosugi, Utaroh; Li, Ke; Lubner, Meghan; Chen, Guang-Hong; Pickhardt, Perry J

2016-07-01

To assess the effect of the prior-image-constrained-compressed-sensing-based metal-artefact-reduction (PICCS-MAR) algorithm on streak artefact reduction and 2D and 3D-image quality improvement in patients with total hip arthroplasty (THA) undergoing CT colonography (CTC). PICCS-MAR was applied to filtered-back-projection (FBP)-reconstructed DICOM CTC-images in 52 patients with THA (unilateral, n = 30; bilateral, n = 22). For FBP and PICCS-MAR series, ROI-measurements of CT-numbers were obtained at predefined levels for fat, muscle, air, and the most severe artefact. Two radiologists independently reviewed 2D and 3D CTC-images and graded artefacts and image quality using a five-point-scale (1 = severe streak/no-diagnostic confidence, 5 = no streak/excellent image-quality, high-confidence). Results were compared using paired and unpaired t-tests and Wilcoxon signed-rank and Mann-Whitney-tests. Streak artefacts and image quality scores for FBP versus PICCS-MAR 2D-images (median: 1 vs. 3 and 2 vs. 3, respectively) and 3D images (median: 2 vs. 4 and 3 vs. 4, respectively) showed significant improvement after PICCS-MAR (all P < 0.001). PICCS-MAR significantly improved the accuracy of mean CT numbers for fat, muscle and the area with the most severe artefact (all P < 0.001). PICCS-MAR substantially reduces streak artefacts related to THA on DICOM images, thereby enhancing visualization of anatomy on 2D and 3D CTC images and increasing diagnostic confidence. • PICCS-MAR significantly reduces streak artefacts associated with total hip arthroplasty on 2D and 3D CTC. • PICCS-MAR significantly improves 2D and 3D CTC image quality and diagnostic confidence. • PICCS-MAR can be applied retrospectively to DICOM images from single-kVp CT.

PACS for surgery and interventional radiology: features of a Therapy Imaging and Model Management System (TIMMS).

PubMed

Lemke, Heinz U; Berliner, Leonard

2011-05-01

Appropriate use of information and communication technology (ICT) and mechatronic (MT) systems is viewed by many experts as a means to improve workflow and quality of care in the operating room (OR). This will require a suitable information technology (IT) infrastructure, as well as communication and interface standards, such as specialized extensions of DICOM, to allow data interchange between surgical system components in the OR. A design of such an infrastructure, sometimes referred to as surgical PACS, but better defined as a Therapy Imaging and Model Management System (TIMMS), will be introduced in this article. A TIMMS should support the essential functions that enable and advance image guided therapy, and in the future, a more comprehensive form of patient-model guided therapy. Within this concept, the "image-centric world view" of the classical PACS technology is complemented by an IT "model-centric world view". Such a view is founded in the special patient modelling needs of an increasing number of modern surgical interventions as compared to the imaging intensive working mode of diagnostic radiology, for which PACS was originally conceptualised and developed. The modelling aspects refer to both patient information and workflow modelling. Standards for creating and integrating information about patients, equipment, and procedures are vitally needed when planning for an efficient OR. The DICOM Working Group 24 (WG-24) has been established to develop DICOM objects and services related to image and model guided surgery. To determine these standards, it is important to define step-by-step surgical workflow practices and create interventional workflow models per procedures or per variable cases. As the boundaries between radiation therapy, surgery and interventional radiology are becoming less well-defined, precise patient models will become the greatest common denominator for all therapeutic disciplines. In addition to imaging, the focus of WG-24 is to serve the therapeutic disciplines by enabling modelling technology to be based on standards. Copyright © 2011. Published by Elsevier Ireland Ltd.

SU-E-T-205: Improving Quality Assurance of HDR Brachytherapy: Verifying Agreement Between Planned and Delivered Dose Distributions Using DICOM RTDose and Advanced Film Dosimetry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palmer, A L; University of Surrey, Guildford, Surrey; Bradley, D A

Purpose: HDR brachytherapy is undergoing significant development, and quality assurance (QA) checks must keep pace. Current recommendations do not adequately verify delivered against planned dose distributions: This is particularly relevant for new treatment planning system (TPS) calculation algorithms (non TG-43 based), and an era of significant patient-specific plan optimisation. Full system checks are desirable in modern QA recommendations, complementary to device-centric individual tests. We present a QA system incorporating TPS calculation, dose distribution export, HDR unit performance, and dose distribution measurement. Such an approach, more common in external beam radiotherapy, has not previously been reported in the literature for brachytherapy.more » Methods: Our QA method was tested at 24 UK brachytherapy centres. As a novel approach, we used the TPS DICOM RTDose file export to compare planned dose distribution with that measured using Gafchromic EBT3 films placed around clinical brachytherapy treatment applicators. Gamma analysis was used to compare the dose distributions. Dose difference and distance to agreement were determined at prescription Point A. Accurate film dosimetry was achieved using a glass compression plate at scanning to ensure physically-flat films, simultaneous scanning of known dose films with measurement films, and triple-channel dosimetric analysis. Results: The mean gamma pass rate of RTDose compared to film-measured dose distributions was 98.1% at 3%(local), 2 mm criteria. The mean dose difference, measured to planned, at Point A was -0.5% for plastic treatment applicators and -2.4% for metal applicators, due to shielding not accounted for in TPS. The mean distance to agreement was 0.6 mm. Conclusion: It is recommended to develop brachytherapy QA to include full-system verification of agreement between planned and delivered dose distributions. This is a novel approach for HDR brachytherapy QA. A methodology using advanced film dosimetry and gamma comparison to DICOM RTDose files has been demonstrated as suitable to fulfil this need.« less

TU-CD-304-11: Veritas 2.0: A Cloud-Based Tool to Facilitate Research and Innovation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mishra, P; Patankar, A; Etmektzoglou, A

Purpose: We introduce Veritas 2.0, a cloud-based, non-clinical research portal, to facilitate translation of radiotherapy research ideas to new delivery techniques. The ecosystem of research tools includes web apps for a research beam builder for TrueBeam Developer Mode, an image reader for compressed and uncompressed XIM files, and a trajectory log file based QA/beam delivery analyzer. Methods: The research beam builder can generate TrueBeam readable XML file either from scratch or from pre-existing DICOM-RT plans. DICOM-RT plan is first converted to XML format and then researcher can interactively modify or add control points to them. Delivered beam can be verifiedmore » via reading generated images and analyzing trajectory log files. Image reader can read both uncompressed and HND-compressed XIM images. The trajectory log analyzer lets researchers plot expected vs. actual values and deviations among 30 mechanical axes. The analyzer gives an animated view of MLC patterns for the beam delivery. Veritas 2.0 is freely available and its advantages versus standalone software are i) No software installation or maintenance needed, ii) easy accessibility across all devices iii) seamless upgrades and iv) OS independence. Veritas is written using open-source tools like twitter bootstrap, jQuery, flask, and Python-based modules. Results: In the first experiment, an anonymized 7-beam DICOM-RT IMRT plan was converted to XML beam containing 1400 control points. kV and MV imaging points were inserted into this XML beam. In another experiment, a binary log file was analyzed to compare actual vs expected values and deviations among axes. Conclusions: Veritas 2.0 is a public cloud-based web app that hosts a pool of research tools for facilitating research from conceptualization to verification. It is aimed at providing a platform for facilitating research and collaboration. I am full time employee at Varian Medical systems, Palo Alto.« less

Three-dimensional Cross-Platform Planning for Complex Spinal Procedures: A New Method Adaptive to Different Navigation Systems.

PubMed

Kosterhon, Michael; Gutenberg, Angelika; Kantelhardt, Sven R; Conrad, Jens; Nimer Amr, Amr; Gawehn, Joachim; Giese, Alf

2017-08-01

A feasibility study. To develop a method based on the DICOM standard which transfers complex 3-dimensional (3D) trajectories and objects from external planning software to any navigation system for planning and intraoperative guidance of complex spinal procedures. There have been many reports about navigation systems with embedded planning solutions but only few on how to transfer planning data generated in external software. Patients computerized tomography and/or magnetic resonance volume data sets of the affected spinal segments were imported to Amira software, reconstructed to 3D images and fused with magnetic resonance data for soft-tissue visualization, resulting in a virtual patient model. Objects needed for surgical plans or surgical procedures such as trajectories, implants or surgical instruments were either digitally constructed or computerized tomography scanned and virtually positioned within the 3D model as required. As crucial step of this method these objects were fused with the patient's original diagnostic image data, resulting in a single DICOM sequence, containing all preplanned information necessary for the operation. By this step it was possible to import complex surgical plans into any navigation system. We applied this method not only to intraoperatively adjustable implants and objects under experimental settings, but also planned and successfully performed surgical procedures, such as the percutaneous lateral approach to the lumbar spine following preplanned trajectories and a thoracic tumor resection including intervertebral body replacement using an optical navigation system. To demonstrate the versatility and compatibility of the method with an entirely different navigation system, virtually preplanned lumbar transpedicular screw placement was performed with a robotic guidance system. The presented method not only allows virtual planning of complex surgical procedures, but to export objects and surgical plans to any navigation or guidance system able to read DICOM data sets, expanding the possibilities of embedded planning software.

WE-D-204-03: A Six-Year Longitudinal Evaluation of the DICOM GSDF Conformance Stability of LCD Monitors

DOE Office of Scientific and Technical Information (OSTI.GOV)

McKenney, S; Bevins, N; Flynn, M

2015-06-15

Purpose: The calibration of monitors in radiology is critical to ensure a standardized reading environment. If left unchecked, monitors initially calibrated to follow the DICOM Grayscale Standard Display Function (GSDF) can fall out of calibration. This work presents a quantitative evaluation of the stability of a cohort of monitors with similar deployment times and clinical utilization. Methods: Fifty-four liquid crystal display (LCD) monitors (NEC L200ME) were deployed for clinical use in 2009. At that time, a subset of eight of these monitors were used to generate a look-up table (LUT) using the open-source software pacsDisplay. The software was used tomore » load the LUT to the graphics card of the computer in order to make the monitors compliant with the GSDF. The luminance response of the monitors was evaluated twice over six years, once in 2011 and again in 2015. Results: As expected, the maximum luminance of the monitors decreased over time, with an average reduction from 2009 of 35% in 2011, and 53% in 2015. The luminance ratio (maximum luminance divided by the minimum) also decreased, with the all of the decrease occurring in the first two years (average 20%). There was an overall increase in relative error compared with the DICOM GSDF from measurement to measurement, indicating that deviation from the GSDF increases with monitor luminance reduction. Along with changes in luminance, several other issues were identified during the testing, including non-uniformities, bad pixels, and missing calibration software. Conclusion: From the initial installation of these monitors, most of the degradation occurred during the first two years, highlighting the importance of routine clinical testing of displays. Following such quality assurance, displays could be either re-calibrated or replaced depending on different thresholds. In addition, other issues not related to luminance could be identified and corrected.« less

[Postmortem CT examination in a case of alleged drowning--a case report].

PubMed

Woźniak, Krzysztof; Urbanik, Andrzej; Rzepecka-Woźniak, Ewa; Moskała, Artur; Kłys, Małgorzata

2009-01-01

The authors present an analysis of postmortem CT examination in a case of drowning in fresh water of a young male. Both the results of conventional forensic autopsy and radiologic examination have been compared. The analysis is illustrated by two-dimensional and three-dimensional reconstructions based on the DICOM files obtained during postmortem CT examination.

PACS development in Asia.

PubMed

Inamura, Kiyonari; Kousaka, Susumu; Yamamoto, Yuichiro; Sukenobu, Yoshiharu; Okura, Yasuhiko; Matsumura, Yasushi; Takeda, Hiroshi

2003-01-01

First, history of PACS in Japan from 1982 to 2002 has been investigated. By 2002 total of 1468 PACS units have been installed. Of these, 1174 are small-size PACS with less than four image display terminals, 203 are medium-size with 5-14 terminals, and 91 are large-size with 15 up to 1300 terminals. The main nine large-size PACS of 91 have been retrospectively investigated from 1984 for PACS experiments and from 1989 for PACS operation. Most of these nine hospitals have increased the number of PACS terminals by installing additional PACS units, instead of reinforcing the existing single PACS. The use of DICOM interfaces has increased the number of modalities connected to PACS and influenced the spreading of PACS installations in Japan. The status of HIS and RIS coupling to PACS, and the use of PACS in primary diagnosis or in image referral are discussed. Assessment of PACS is now in an early stage. Baseline studies of HIS/RIS/PACS effectiveness have been carried out to assess quantitatively the PACS merit. Second, history of PACS development in Korea is described. Very acute climbing up of filmless PACS diffusion was observed from 2000 to 2002. The reasons seem to be lack of domestic X-ray film industry, economic crisis in 1997 and PACS Reimbursement Act in health insurance in Korea. Third, the Hong Kong Wide Area Image Distribution/PACS Project is reported. It is now under phase 1 of design and partial implementation employing the latest and the highest ends of advanced technology such as failure resilience. Copyright 2002 Elsevier Science Ltd.

Perfusion quantification in contrast-enhanced ultrasound (CEUS)--ready for research projects and routine clinical use.

PubMed

Tranquart, F; Mercier, L; Frinking, P; Gaud, E; Arditi, M

2012-07-01

With contrast-enhanced ultrasound (CEUS) now established as a valuable imaging modality for many applications, a more specific demand has recently emerged for quantifying perfusion and using measured parameters as objective indicators for various disease states. However, CEUS perfusion quantification remains challenging and is not well integrated in daily clinical practice. The development of VueBox™ alleviates existing limitations and enables quantification in a standardized way. VueBox™ operates as an off-line software application, after dynamic contrast-enhanced ultrasound (DCE-US) is performed. It enables linearization of DICOM clips, assessment of perfusion using patented curve-fitting models, and generation of parametric images by synthesizing perfusion information at the pixel level using color coding. VueBox™ is compatible with most of the available ultrasound platforms (nonlinear contrast-enabled), has the ability to process both bolus and disruption-replenishment kinetics loops, allows analysis results and their context to be saved, and generates analysis reports automatically. Specific features have been added to VueBox™, such as fully automatic in-plane motion compensation and an easy-to-use clip editor. Processing time has been reduced as a result of parallel programming optimized for multi-core processors. A long list of perfusion parameters is available for each of the two administration modes to address all possible demands currently reported in the literature for diagnosis or treatment monitoring. In conclusion, VueBox™ is a valid and robust quantification tool to be used for standardizing perfusion quantification and to improve the reproducibility of results across centers. © Georg Thieme Verlag KG Stuttgart · New York.

Is the Training of Imaging Informatics Personnel in New Zealand Adequate?

PubMed

Hughes, Kevin; Poletti, John L

2016-12-01

The purpose of this study of Imaging Informatics Professionals (IIPs) in New Zealand was to assess their experience, background, educational qualifications and needs for support and continuing education. The IIP role includes administration of DICOM modalities, picture archiving and communication systems (PACS), radiology information systems (RIS) and many additional software and hardware systems, including the interface to New Zealand's nationwide individual electronic medical records (EMR) system. Despite the complexity of current systems, training programmes for IIPs are almost non-existent in Australasia. This cross-sectional qualitative case study used triangulated data sources, via online questionnaire, interview and critical incident analysis. Demographic data was also obtained from the questionnaire. Participants included about one third of the IIPs in New Zealand. Quantitative results were summarised with descriptive statistics or frequency data. Qualitative data was assessed by iterative multi-staged thematic analysis. This study found that the IIP role is undertaken by personnel from diverse backgrounds. Most of the IIPs learned what they know from vendors and on the job. Many feel that their biggest issue is in not knowing what they do not know and therefore not having sufficient understanding of the imaging informatics field. Only one IIP had any formal certification in PACS administration. Most respondents indicated their desire for some form of additional training. The number of IIPs in New Zealand healthcare is very small, so neither a formal training programme nor regulatory body is viable or justified. However, IIPs believe there is a need for education, regulation and recognition that their role is a critical component in healthcare.

Introducing keytagging, a novel technique for the protection of medical image-based tests.

PubMed

Rubio, Óscar J; Alesanco, Álvaro; García, José

2015-08-01

This paper introduces keytagging, a novel technique to protect medical image-based tests by implementing image authentication, integrity control and location of tampered areas, private captioning with role-based access control, traceability and copyright protection. It relies on the association of tags (binary data strings) to stable, semistable or volatile features of the image, whose access keys (called keytags) depend on both the image and the tag content. Unlike watermarking, this technique can associate information to the most stable features of the image without distortion. Thus, this method preserves the clinical content of the image without the need for assessment, prevents eavesdropping and collusion attacks, and obtains a substantial capacity-robustness tradeoff with simple operations. The evaluation of this technique, involving images of different sizes from various acquisition modalities and image modifications that are typical in the medical context, demonstrates that all the aforementioned security measures can be implemented simultaneously and that the algorithm presents good scalability. In addition to this, keytags can be protected with standard Cryptographic Message Syntax and the keytagging process can be easily combined with JPEG2000 compression since both share the same wavelet transform. This reduces the delays for associating keytags and retrieving the corresponding tags to implement the aforementioned measures to only ≃30 and ≃90ms respectively. As a result, keytags can be seamlessly integrated within DICOM, reducing delays and bandwidth when the image test is updated and shared in secure architectures where different users cooperate, e.g. physicians who interpret the test, clinicians caring for the patient and researchers. Copyright © 2015 Elsevier Inc. All rights reserved.

Extracting numeric measurements and temporal coordinates from Japanese radiological reports

NASA Astrophysics Data System (ADS)

Imai, Takeshi; Onogi, Yuzo

2004-04-01

Medical records are written mainly, in natural language. The focus of this study is narrative radiological reports written in natural Japanese. These reports cannot be used for advanced retrieval, data mining, and so on, unless they are stored, using a structured format such as DICOM-SR. The goal is to structure narrative reports progressively, using natural language processing (NLP). Structure has many different levels, for example, DICOM-SR has three established levels -- basic text, enhanced and comprehensive. At the enhanced level, it is necessary to use numerical measurements and spatial & temporal coordinates. In this study, the wording used in the reports was first standardized, dictionaries were organized, and morphological analysis performed. Next, numerical measurements and temporal coordinates were extracted, and the objects to which they referred, analyzed. 10,000 CT and MR reports were separated into 82,122 sentences, and 34,269 of the 36,444 numerical descriptions were tagged. Periods, slashes, hyphens, and parentheses are ambiguously used in the description of enumerated lists, dates, image numbers, and anatomical names, as well as at the end of sentences; to resolve this ambiguity, descriptions were processed, according to the order -- date, size, unit, enumerated list, and abbreviation -- then, the tagged reports were separated into sentences.

Medical 3D Printing for the Radiologist

PubMed Central

Mitsouras, Dimitris; Liacouras, Peter; Imanzadeh, Amir; Giannopoulos, Andreas A.; Cai, Tianrun; Kumamaru, Kanako K.; George, Elizabeth; Wake, Nicole; Caterson, Edward J.; Pomahac, Bohdan; Ho, Vincent B.; Grant, Gerald T.

2015-01-01

While use of advanced visualization in radiology is instrumental in diagnosis and communication with referring clinicians, there is an unmet need to render Digital Imaging and Communications in Medicine (DICOM) images as three-dimensional (3D) printed models capable of providing both tactile feedback and tangible depth information about anatomic and pathologic states. Three-dimensional printed models, already entrenched in the nonmedical sciences, are rapidly being embraced in medicine as well as in the lay community. Incorporating 3D printing from images generated and interpreted by radiologists presents particular challenges, including training, materials and equipment, and guidelines. The overall costs of a 3D printing laboratory must be balanced by the clinical benefits. It is expected that the number of 3D-printed models generated from DICOM images for planning interventions and fabricating implants will grow exponentially. Radiologists should at a minimum be familiar with 3D printing as it relates to their field, including types of 3D printing technologies and materials used to create 3D-printed anatomic models, published applications of models to date, and clinical benefits in radiology. Online supplemental material is available for this article. ©RSNA, 2015 PMID:26562233

The peer review system (PRS) for quality assurance and treatment improvement in radiation therapy

NASA Astrophysics Data System (ADS)

Le, Anh H. T.; Kapoor, Rishabh; Palta, Jatinder R.

2012-02-01

Peer reviews are needed across all disciplines of medicine to address complex medical challenges in disease care, medical safety, insurance coverage handling, and public safety. Radiation therapy utilizes technologically advanced imaging for treatment planning, often with excellent efficacy. Since planning data requirements are substantial, patients are at risk for repeat diagnostic procedures or suboptimal therapeutic intervention due to a lack of knowledge regarding previous treatments. The Peer Review System (PRS) will make this critical radiation therapy information readily available on demand via Web technology. The PRS system has been developed with current Web technology, .NET framework, and in-house DICOM library. With the advantages of Web server-client architecture, including IIS web server, SOAP Web Services and Silverlight for the client side, the patient data can be visualized through web browser and distributed across multiple locations by the local area network and Internet. This PRS will significantly improve the quality, safety, and accessibility, of treatment plans in cancer therapy. Furthermore, the secure Web-based PRS with DICOM-RT compliance will provide flexible utilities for organization, sorting, and retrieval of imaging studies and treatment plans to optimize the patient treatment and ultimately improve patient safety and treatment quality.

[Investigation of the accurate measurement of the basic imaging properties for the digital radiographic system based on flat panel detector].

PubMed

Katayama, R; Sakai, S; Sakaguchi, T; Maeda, T; Takada, K; Hayabuchi, N; Morishita, J

2008-07-20

PURPOSE/AIM OF THE EXHIBIT: The purpose of this exhibit is: 1. To explain "resampling", an image data processing, performed by the digital radiographic system based on flat panel detector (FPD). 2. To show the influence of "resampling" on the basic imaging properties. 3. To present accurate measurement methods of the basic imaging properties of the FPD system. 1. The relationship between the matrix sizes of the output image and the image data acquired on FPD that automatically changes depending on a selected image size (FOV). 2. The explanation of the image data processing of "resampling". 3. The evaluation results of the basic imaging properties of the FPD system using two types of DICOM image to which "resampling" was performed: characteristic curves, presampled MTFs, noise power spectra, detective quantum efficiencies. CONCLUSION/SUMMARY: The major points of the exhibit are as follows: 1. The influence of "resampling" should not be disregarded in the evaluation of the basic imaging properties of the flat panel detector system. 2. It is necessary for the basic imaging properties to be measured by using DICOM image to which no "resampling" is performed.

DICOMGrid: a middleware to integrate PACS and EELA-2 grid infrastructure

NASA Astrophysics Data System (ADS)

Moreno, Ramon A.; de Sá Rebelo, Marina; Gutierrez, Marco A.

2010-03-01

Medical images provide lots of information for physicians, but the huge amount of data produced by medical image equipments in a modern Health Institution is not completely explored in its full potential yet. Nowadays medical images are used in hospitals mostly as part of routine activities while its intrinsic value for research is underestimated. Medical images can be used for the development of new visualization techniques, new algorithms for patient care and new image processing techniques. These research areas usually require the use of huge volumes of data to obtain significant results, along with enormous computing capabilities. Such qualities are characteristics of grid computing systems such as EELA-2 infrastructure. The grid technologies allow the sharing of data in large scale in a safe and integrated environment and offer high computing capabilities. In this paper we describe the DicomGrid to store and retrieve medical images, properly anonymized, that can be used by researchers to test new processing techniques, using the computational power offered by grid technology. A prototype of the DicomGrid is under evaluation and permits the submission of jobs into the EELA-2 grid infrastructure while offering a simple interface that requires minimal understanding of the grid operation.

Marker-free registration for the accurate integration of CT images and the subject's anatomy during navigation surgery of the maxillary sinus

PubMed Central

Kang, S-H; Kim, M-K; Kim, J-H; Park, H-K; Park, W

2012-01-01

Objective This study compared three marker-free registration methods that are applicable to a navigation system that can be used for maxillary sinus surgery, and evaluated the associated errors, with the aim of determining which registration method is the most applicable for operations that require accurate navigation. Methods The CT digital imaging and communications in medicine (DICOM) data of ten maxillary models in DICOM files were converted into stereolithography file format. All of the ten maxillofacial models were scanned three dimensionally using a light-based three-dimensional scanner. The methods applied for registration of the maxillofacial models utilized the tooth cusp, bony landmarks and maxillary sinus anterior wall area. The errors during registration were compared between the groups. Results There were differences between the three registration methods in the zygoma, sinus posterior wall, molar alveolar, premolar alveolar, lateral nasal aperture and the infraorbital areas. The error was smallest using the overlay method for the anterior wall of the maxillary sinus, and the difference was statistically significant. Conclusion The navigation error can be minimized by conducting registration using the anterior wall of the maxillary sinus during image-guided surgery of the maxillary sinus. PMID:22499127

White matter fiber tracking computation based on diffusion tensor imaging for clinical applications.

PubMed

Dellani, Paulo R; Glaser, Martin; Wille, Paulo R; Vucurevic, Goran; Stadie, Axel; Bauermann, Thomas; Tropine, Andrei; Perneczky, Axel; von Wangenheim, Aldo; Stoeter, Peter

2007-03-01

Fiber tracking allows the in vivo reconstruction of human brain white matter fiber trajectories based on magnetic resonance diffusion tensor imaging (MR-DTI), but its application in the clinical routine is still in its infancy. In this study, we present a new software for fiber tracking, developed on top of a general-purpose DICOM (digital imaging and communications in medicine) framework, which can be easily integrated into existing picture archiving and communication system (PACS) of radiological institutions. Images combining anatomical information and the localization of different fiber tract trajectories can be encoded and exported in DICOM and Analyze formats, which are valuable resources in the clinical applications of this method. Fiber tracking was implemented based on existing line propagation algorithms, but it includes a heuristic for fiber crossings in the case of disk-shaped diffusion tensors. We successfully performed fiber tracking on MR-DTI data sets from 26 patients with different types of brain lesions affecting the corticospinal tracts. In all cases, the trajectories of the central spinal tract (pyramidal tract) were reconstructed and could be applied at the planning phase of the surgery as well as in intraoperative neuronavigation.

Medical 3D Printing for the Radiologist.

PubMed

Mitsouras, Dimitris; Liacouras, Peter; Imanzadeh, Amir; Giannopoulos, Andreas A; Cai, Tianrun; Kumamaru, Kanako K; George, Elizabeth; Wake, Nicole; Caterson, Edward J; Pomahac, Bohdan; Ho, Vincent B; Grant, Gerald T; Rybicki, Frank J

2015-01-01

While use of advanced visualization in radiology is instrumental in diagnosis and communication with referring clinicians, there is an unmet need to render Digital Imaging and Communications in Medicine (DICOM) images as three-dimensional (3D) printed models capable of providing both tactile feedback and tangible depth information about anatomic and pathologic states. Three-dimensional printed models, already entrenched in the nonmedical sciences, are rapidly being embraced in medicine as well as in the lay community. Incorporating 3D printing from images generated and interpreted by radiologists presents particular challenges, including training, materials and equipment, and guidelines. The overall costs of a 3D printing laboratory must be balanced by the clinical benefits. It is expected that the number of 3D-printed models generated from DICOM images for planning interventions and fabricating implants will grow exponentially. Radiologists should at a minimum be familiar with 3D printing as it relates to their field, including types of 3D printing technologies and materials used to create 3D-printed anatomic models, published applications of models to date, and clinical benefits in radiology. Online supplemental material is available for this article. (©)RSNA, 2015.

Fault tolerant high-performance PACS network design and implementation

NASA Astrophysics Data System (ADS)

Chimiak, William J.; Boehme, Johannes M.

1998-07-01

The Wake Forest University School of Medicine and the Wake Forest University/Baptist Medical Center (WFUBMC) are implementing a second generation PACS. The first generation PACS provided helpful information about the functional and temporal requirements of the system. It highlighted the importance of image retrieval speed, system availability, RIS/HIS integration, the ability to rapidly view images on any PACS workstation, network bandwidth, equipment redundancy, and the ability for the system to evolve using standards-based components. This paper deals with the network design and implementation of the PACS. The physical layout of the hospital areas served by the PACS, the choice of network equipment and installation issues encountered are addressed. Efforts to optimize fault tolerance are discussed. The PACS network is a gigabit, mixed-media network based on LAN emulation over ATM (LANE) with a rapid migration from LANE to Multiple Protocols Over ATM (MPOA) planned. Two fault-tolerant backbone ATM switches serve to distribute network accesses with two load-balancing 622 megabit per second (Mbps) OC-12 interconnections. The switch was sized to be upgradable to provide a 2.54 Gbps OC-48 interconnection with an OC-12 interconnection as a load-balancing backup. Modalities connect with legacy network interface cards to a switched-ethernet device. This device has two 155 Mbps OC-3 load-balancing uplinks to each of the backbone ATM switches of the PACS. This provides a fault-tolerant logical connection to the modality servers which pass verified DICOM images to the PACS servers and proper PACS diagnostic workstations. Where fiber pulls were prohibitively expensive, edge ATM switches were installed with an OC-12 uplink to a backbone ATM switches. The PACS and data base servers are fault-tolerant, hot-swappable Sun Enterprise Servers with an OC-12 connection to a backbone ATM switch and a fast-ethernet connection to a back-up network. The workstations come with 10/100 BASET autosense cards. A redundant switched-ethernet network will be installed to provide yet another degree of network fault-tolerance. The switched-ethernet devices are connected to each of the backbone ATM switches with two-load-balancing OC-3 connections to provide fault-tolerant connectivity in the event of a primary network failure.

Digital image archiving: challenges and choices.

PubMed

Dumery, Barbara

2002-01-01

In the last five years, imaging exam volume has grown rapidly. In addition to increased image acquisition, there is more patient information per study. RIS-PACS integration and information-rich DICOM headers now provide us with more patient information relative to each study. The volume of archived digital images is increasing and will continue to rise at a steeper incline than film-based storage of the past. Many filmless facilities have been caught off guard by this increase, which has been stimulated by many factors. The most significant factor is investment in new digital and DICOM-compliant modalities. A huge volume driver is the increase in images per study from multi-slice technology. Storage requirements also are affected by disaster recovery initiatives and state retention mandates. This burgeoning rate of imaging data volume presents many challenges: cost of ownership, data accessibility, storage media obsolescence, database considerations, physical limitations, reliability and redundancy. There are two basic approaches to archiving--single tier and multi-tier. Each has benefits. With a single-tier approach, all the data is stored on a single media that can be accessed very quickly. A redundant copy of the data is then stored onto another less expensive media. This is usually a removable media. In this approach, the on-line storage is increased incrementally as volume grows. In a multi-tier approach, storage levels are set up based on access speed and cost. In other words, all images are stored at the deepest archiving level, which is also the least expensive. Images are stored on or moved back to the intermediate and on-line levels if they will need to be accessed more quickly. It can be difficult to decide what the best approach is for your organization. The options include RAIDs (redundant array of independent disks), direct attached RAID storage (DAS), network storage using RAIDs (NAS and SAN), removable media such as different types of tape, compact disks (CDs and DVDs) and magneto-optical disks (MODs). As you evaluate the various options for storage, it is important to consider both performance and cost. For most imaging enterprises, a single-tier archiving approach is the best solution. With the cost of hard drives declining, NAS is a very feasible solution today. It is highly reliable, offers immediate access to all exams, and easily scales as imaging volume grows. Best of all, media obsolescence challenges need not be of concern. For back-up storage, removable media can be implemented, with a smaller investment needed as it will only be used for a redundant copy of the data. There is no need to keep it online and available. If further system redundancy is desired, multiple servers should be considered. The multi-tier approach still has its merits for smaller enterprises, but with a detailed long-term cost of ownership analysis, NAS will probably still come out on top as the solution of choice for many imaging facilities.

The Visible Heart® project and free-access website 'Atlas of Human Cardiac Anatomy'.

PubMed

Iaizzo, Paul A

2016-12-01

Pre- and post-evaluations of implantable cardiac devices require innovative and critical testing in all phases of the design process. The Visible Heart ® Project was successfully launched in 1997 and 3 years later the Atlas of Human Cardiac Anatomy website was online. The Visible Heart ® methodologies and Atlas website can be used to better understand human cardiac anatomy, disease states and/or to improve cardiac device design throughout the development process. To date, Visible ® Heart methodologies have been used to reanimate 75 human hearts, all considered non-viable for transplantation. The Atlas is a unique free-access website featuring novel images of functional and fixed human cardiac anatomies from >400 human heart specimens. Furthermore, this website includes education tutorials on anatomy, physiology, congenital heart disease and various imaging modalities. For instance, the Device Tutorial provides examples of commonly deployed devices that were present at the time of in vitro reanimation or were subsequently delivered, including: leads, catheters, valves, annuloplasty rings, leadless pacemakers and stents. Another section of the website displays 3D models of vasculature, blood volumes, and/or tissue volumes reconstructed from computed tomography (CT) and magnetic resonance images (MRI) of various heart specimens. A new section allows the user to interact with various heart models. Visible Heart ® methodologies have enabled our laboratory to reanimate 75 human hearts and visualize functional cardiac anatomies and device/tissue interfaces. The website freely shares all images, video clips and CT/MRI DICOM files in honour of the generous gifts received from donors and their families. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For Permissions, please email: journals.permissions@oup.com.

The MCIC collection: a shared repository of multi-modal, multi-site brain image data from a clinical investigation of schizophrenia

PubMed Central

Gollub, Randy L.; Shoemaker, Jody M.; King, Margaret D.; White, Tonya; Ehrlich, Stefan; Sponheim, Scott R.; Clark, Vincent P.; Turner, Jessica A.; Mueller, Bryon A.; Magnotta, Vince; O’Leary, Daniel; Ho, Beng C.; Brauns, Stefan; Manoach, Dara S.; Seidman, Larry; Bustillo, Juan R.; Lauriello, John; Bockholt, Jeremy; Lim, Kelvin O.; Rosen, Bruce R.; Schulz, S. Charles; Calhoun, Vince D.; Andreasen, Nancy C.

2013-01-01

Expertly collected, well-curated data sets consisting of comprehensive clinical characterization and raw structural, functional and diffusion-weighted DICOM images in schizophrenia patients and sex and age-matched controls are now accessible to the scientific community through an on-line data repository (coins.mrn.org). The Mental Illness and Neuroscience Discovery Institute, now the Mind Research Network (MRN, www.mrn.org), comprised of investigators at the University of New Mexico, the University of Minnesota, Massachusetts General Hospital, and the University of Iowa, conducted a cross-sectional study to identify quantitative neuroimaging biomarkers of schizophrenia. Data acquisition across multiple sites permitted the integration and cross-validation of clinical, cognitive, morphometric, and functional neuroimaging results gathered from unique samples of schizophrenia patients and controls using a common protocol across sites. Particular effort was made to recruit patients early in the course of their illness, at the onset of their symptoms. There is a relatively even sampling of illness duration in chronic patients. This data repository will be useful to 1) scientists who can study schizophrenia by further analysis of this cohort and/or by pooling with other data; 2) computer scientists and software algorithm developers for testing and validating novel registration, segmentation, and other analysis software; and 3) educators in the fields of neuroimaging, medical image analysis and medical imaging informatics who need exemplar data sets for courses and workshops. Sharing provides the opportunity for independent replication of already published results from this data set and novel exploration. This manuscript describes the inclusion/exclusion criteria, imaging parameters and other information that will assist those wishing to use this data repository. PMID:23760817

WE-D-9A-06: Open Source Monitor Calibration and Quality Control Software for Enterprise Display Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bevins, N; Vanderhoek, M; Lang, S

2014-06-15

Purpose: Medical display monitor calibration and quality control present challenges to medical physicists. The purpose of this work is to demonstrate and share experiences with an open source package that allows for both initial monitor setup and routine performance evaluation. Methods: A software package, pacsDisplay, has been developed over the last decade to aid in the calibration of all monitors within the radiology group in our health system. The software is used to calibrate monitors to follow the DICOM Grayscale Standard Display Function (GSDF) via lookup tables installed on the workstation. Additional functionality facilitates periodic evaluations of both primary andmore » secondary medical monitors to ensure satisfactory performance. This software is installed on all radiology workstations, and can also be run as a stand-alone tool from a USB disk. Recently, a database has been developed to store and centralize the monitor performance data and to provide long-term trends for compliance with internal standards and various accrediting organizations. Results: Implementation and utilization of pacsDisplay has resulted in improved monitor performance across the health system. Monitor testing is now performed at regular intervals and the software is being used across multiple imaging modalities. Monitor performance characteristics such as maximum and minimum luminance, ambient luminance and illuminance, color tracking, and GSDF conformity are loaded into a centralized database for system performance comparisons. Compliance reports for organizations such as MQSA, ACR, and TJC are generated automatically and stored in the same database. Conclusion: An open source software solution has simplified and improved the standardization of displays within our health system. This work serves as an example method for calibrating and testing monitors within an enterprise health system.« less

A case for automated tape in clinical imaging.

PubMed

Bookman, G; Baune, D

1998-08-01

Electronic archiving of radiology images over many years will require many terabytes of storage with a need for rapid retrieval of these images. As more large PACS installations are installed and implemented, a data crisis occurs. The ability to store this large amount of data using the traditional method of optical jukeboxes or online disk alone becomes an unworkable solution. The amount of floor space number of optical jukeboxes, and off-line shelf storage required to store the images becomes unmanageable. With the recent advances in tape and tape drives, the use of tape for long term storage of PACS data has become the preferred alternative. A PACS system consisting of a centrally managed system of RAID disk, software and at the heart of the system, tape, presents a solution that for the first time solves the problems of multi-modality high end PACS, non-DICOM image, electronic medical record and ADT data storage. This paper will examine the installation of the University of Utah, Department of Radiology PACS system and the integration of automated tape archive. The tape archive is also capable of storing data other than traditional PACS data. The implementation of an automated data archive to serve the many other needs of a large hospital will also be discussed. This will include the integration of a filmless cardiology department and the backup/archival needs of a traditional MIS department. The need for high bandwidth to tape with a large RAID cache will be examined and how with an interface to a RIS pre-fetch engine, tape can be a superior solution to optical platters or other archival solutions. The data management software will be discussed in detail. The performance and cost of RAID disk cache and automated tape compared to a solution that includes optical will be examined.

The MCIC collection: a shared repository of multi-modal, multi-site brain image data from a clinical investigation of schizophrenia.

PubMed

Gollub, Randy L; Shoemaker, Jody M; King, Margaret D; White, Tonya; Ehrlich, Stefan; Sponheim, Scott R; Clark, Vincent P; Turner, Jessica A; Mueller, Bryon A; Magnotta, Vince; O'Leary, Daniel; Ho, Beng C; Brauns, Stefan; Manoach, Dara S; Seidman, Larry; Bustillo, Juan R; Lauriello, John; Bockholt, Jeremy; Lim, Kelvin O; Rosen, Bruce R; Schulz, S Charles; Calhoun, Vince D; Andreasen, Nancy C

2013-07-01

Expertly collected, well-curated data sets consisting of comprehensive clinical characterization and raw structural, functional and diffusion-weighted DICOM images in schizophrenia patients and sex and age-matched controls are now accessible to the scientific community through an on-line data repository (coins.mrn.org). The Mental Illness and Neuroscience Discovery Institute, now the Mind Research Network (MRN, http://www.mrn.org/ ), comprised of investigators at the University of New Mexico, the University of Minnesota, Massachusetts General Hospital, and the University of Iowa, conducted a cross-sectional study to identify quantitative neuroimaging biomarkers of schizophrenia. Data acquisition across multiple sites permitted the integration and cross-validation of clinical, cognitive, morphometric, and functional neuroimaging results gathered from unique samples of schizophrenia patients and controls using a common protocol across sites. Particular effort was made to recruit patients early in the course of their illness, at the onset of their symptoms. There is a relatively even sampling of illness duration in chronic patients. This data repository will be useful to 1) scientists who can study schizophrenia by further analysis of this cohort and/or by pooling with other data; 2) computer scientists and software algorithm developers for testing and validating novel registration, segmentation, and other analysis software; and 3) educators in the fields of neuroimaging, medical image analysis and medical imaging informatics who need exemplar data sets for courses and workshops. Sharing provides the opportunity for independent replication of already published results from this data set and novel exploration. This manuscript describes the inclusion/exclusion criteria, imaging parameters and other information that will assist those wishing to use this data repository.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Apte, A; Veeraraghavan, H; Oh, J

Purpose: To present an open source and free platform to facilitate radiomics research — The “Radiomics toolbox” in CERR. Method: There is scarcity of open source tools that support end-to-end modeling of image features to predict patient outcomes. The “Radiomics toolbox” strives to fill the need for such a software platform. The platform supports (1) import of various kinds of image modalities like CT, PET, MR, SPECT, US. (2) Contouring tools to delineate structures of interest. (3) Extraction and storage of image based features like 1st order statistics, gray-scale co-occurrence and zonesize matrix based texture features and shape features andmore » (4) Statistical Analysis. Statistical analysis of the extracted features is supported with basic functionality that includes univariate correlations, Kaplan-Meir curves and advanced functionality that includes feature reduction and multivariate modeling. The graphical user interface and the data management are performed with Matlab for the ease of development and readability of code and features for wide audience. Open-source software developed with other programming languages is integrated to enhance various components of this toolbox. For example: Java-based DCM4CHE for import of DICOM, R for statistical analysis. Results: The Radiomics toolbox will be distributed as an open source, GNU copyrighted software. The toolbox was prototyped for modeling Oropharyngeal PET dataset at MSKCC. The analysis will be presented in a separate paper. Conclusion: The Radiomics Toolbox provides an extensible platform for extracting and modeling image features. To emphasize new uses of CERR for radiomics and image-based research, we have changed the name from the “Computational Environment for Radiotherapy Research” to the “Computational Environment for Radiological Research”.« less

TRENCADIS - secure architecture to share and manage DICOM objects in a ontological framework based on OGSA.

PubMed

Blanquer, Ignacio; Hernandez, Vicente; Segrelles, Damià; Torres, Erik

2007-01-01

Today most European healthcare centers use the digital format for their databases of images. TRENCADIS is a software architecture comprising a set of services as a solution for interconnecting, managing and sharing selected parts of medical DICOM data for the development of training and decision support tools. The organization of the distributed information in virtual repositories is based on semantic criteria. Different groups of researchers could organize themselves to propose a Virtual Organization (VO). These VOs will be interested in specific target areas, and will share information concerning each area. Although the private part of the information to be shared will be removed, special considerations will be taken into account to avoid the access by non-authorized users. This paper describes the security model implemented as part of TRENCADIS. The paper is organized as follows. First introduces the problem and presents our motivations. Section 1 defines the objectives. Section 2 presents an overview of the existing proposals per objective. Section 3 outlines the overall architecture. Section 4 describes how TRENCADIS is architected to realize the security goals discussed in the previous sections. The different security services and components of the infrastructure are briefly explained, as well as the exposed interfaces. Finally, Section 5 concludes and gives some remarks on our future work.

[Automatic Extraction and Analysis of Dosimetry Data in Radiotherapy Plans].

PubMed

Song, Wei; Zhao, Di; Lu, Hong; Zhang, Biyun; Ma, Jun; Yu, Dahai

To improve the efficiency and accuracy of extraction and analysis of dosimetry data in radiotherapy plans for a batch of patients. With the interface function provided in Matlab platform, a program was written to extract the dosimetry data exported from treatment planning system in DICOM RT format and exported the dose-volume data to an Excel file with the SPSS compatible format. This method was compared with manual operation for 14 gastric carcinoma patients to validate the efficiency and accuracy. The output Excel data were compatible with SPSS in format, the dosimetry data error for PTV dose interval of 90%-98%, PTV dose interval of 99%-106% and all OARs were -3.48E-5 ± 3.01E-5, -1.11E-3 ± 7.68E-4, -7.85E-5 ± 9.91E-5 respectively. Compared with manual operation, the time required was reduced from 5.3 h to 0.19 h and input error was reduced from 0.002 to 0. The automatic extraction of dosimetry data in DICOM RT format for batch patients, the SPSS compatible data exportation, quick analysis were achieved in this paper. The efficiency of clinical researches based on dosimetry data analysis of large number of patients will be improved with this methods.

Brain early infarct detection using gamma correction extreme-level eliminating with weighting distribution.

PubMed

Teh, V; Sim, K S; Wong, E K

2016-11-01

According to the statistic from World Health Organization (WHO), stroke is one of the major causes of death globally. Computed tomography (CT) scan is one of the main medical diagnosis system used for diagnosis of ischemic stroke. CT scan provides brain images in Digital Imaging and Communication in Medicine (DICOM) format. The presentation of CT brain images is mainly relied on the window setting (window center and window width), which converts an image from DICOM format into normal grayscale format. Nevertheless, the ordinary window parameter could not deliver a proper contrast on CT brain images for ischemic stroke detection. In this paper, a new proposed method namely gamma correction extreme-level eliminating with weighting distribution (GCELEWD) is implemented to improve the contrast on CT brain images. GCELEWD is capable of highlighting the hypodense region for diagnosis of ischemic stroke. The performance of this new proposed technique, GCELEWD, is compared with four of the existing contrast enhancement technique such as brightness preserving bi-histogram equalization (BBHE), dualistic sub-image histogram equalization (DSIHE), extreme-level eliminating histogram equalization (ELEHE), and adaptive gamma correction with weighting distribution (AGCWD). GCELEWD shows better visualization for ischemic stroke detection and higher values with image quality assessment (IQA) module. SCANNING 38:842-856, 2016. © 2016 Wiley Periodicals, Inc. © Wiley Periodicals, Inc.

A web-based institutional DICOM distribution system with the integration of the Clinical Trial Processor (CTP).

PubMed

Aryanto, K Y E; Broekema, A; Langenhuysen, R G A; Oudkerk, M; van Ooijen, P M A

2015-05-01

To develop and test a fast and easy rule-based web-environment with optional de-identification of imaging data to facilitate data distribution within a hospital environment. A web interface was built using Hypertext Preprocessor (PHP), an open source scripting language for web development, and Java with SQL Server to handle the database. The system allows for the selection of patient data and for de-identifying these when necessary. Using the services provided by the RSNA Clinical Trial Processor (CTP), the selected images were pushed to the appropriate services using a protocol based on the module created for the associated task. Five pipelines, each performing a different task, were set up in the server. In a 75 month period, more than 2,000,000 images are transferred and de-identified in a proper manner while 20,000,000 images are moved from one node to another without de-identification. While maintaining a high level of security and stability, the proposed system is easy to setup, it integrate well with our clinical and research practice and it provides a fast and accurate vendor-neutral process of transferring, de-identifying, and storing DICOM images. Its ability to run different de-identification processes in parallel pipelines is a major advantage in both clinical and research setting.

Informatics in radiology: Efficiency metrics for imaging device productivity.

PubMed

Hu, Mengqi; Pavlicek, William; Liu, Patrick T; Zhang, Muhong; Langer, Steve G; Wang, Shanshan; Place, Vicki; Miranda, Rafael; Wu, Teresa Tong

2011-01-01

Acute awareness of the costs associated with medical imaging equipment is an ever-present aspect of the current healthcare debate. However, the monitoring of productivity associated with expensive imaging devices is likely to be labor intensive, relies on summary statistics, and lacks accepted and standardized benchmarks of efficiency. In the context of the general Six Sigma DMAIC (design, measure, analyze, improve, and control) process, a World Wide Web-based productivity tool called the Imaging Exam Time Monitor was developed to accurately and remotely monitor imaging efficiency with use of Digital Imaging and Communications in Medicine (DICOM) combined with a picture archiving and communication system. Five device efficiency metrics-examination duration, table utilization, interpatient time, appointment interval time, and interseries time-were derived from DICOM values. These metrics allow the standardized measurement of productivity, to facilitate the comparative evaluation of imaging equipment use and ongoing efforts to improve efficiency. A relational database was constructed to store patient imaging data, along with device- and examination-related data. The database provides full access to ad hoc queries and can automatically generate detailed reports for administrative and business use, thereby allowing staff to monitor data for trends and to better identify possible changes that could lead to improved productivity and reduced costs in association with imaging services. © RSNA, 2011.

On-demand server-side image processing for web-based DICOM image display

NASA Astrophysics Data System (ADS)

Sakusabe, Takaya; Kimura, Michio; Onogi, Yuzo

2000-04-01

Low cost image delivery is needed in modern networked hospitals. If a hospital has hundreds of clients, cost of client systems is a big problem. Naturally, a Web-based system is the most effective solution. But a Web browser could not display medical images with certain image processing such as a lookup table transformation. We developed a Web-based medical image display system using Web browser and on-demand server-side image processing. All images displayed on a Web page are generated from DICOM files on a server, delivered on-demand. User interaction on the Web page is handled by a client-side scripting technology such as JavaScript. This combination makes a look-and-feel of an imaging workstation not only for its functionality but also for its speed. Real time update of images with tracing mouse motion is achieved on Web browser without any client-side image processing which may be done by client-side plug-in technology such as Java Applets or ActiveX. We tested performance of the system in three cases. Single client, small number of clients in a fast speed network, and large number of clients in a normal speed network. The result shows that there are very slight overhead for communication and very scalable in number of clients.

Evaluation of aortic contractility based on analysis of CT images of the heart

NASA Astrophysics Data System (ADS)

DzierŻak, RóŻa; Maciejewski, Ryszard; Uhlig, Sebastian

2017-08-01

The paper presents a method to assess the aortic contractility based on the analysis of CT images of the heart. This is an alternative method that can be used for patients who cannot be examined by using echocardiography. Usage of medical imaging application for DICOM file processing allows to evaluate the aortic cross section during systole and diastole. It makes possible to assess the level of aortic contractility.

Approach to implementing a DICOM network: incorporate both economics and workflow adaptation

NASA Astrophysics Data System (ADS)

Beaver, S. Merritt; Sippel-Schmidt, Teresa M.

1995-05-01

This paper describes an approach to aide in the decision-making process for the justification and design of a digital image and information management system. It identifies key technical and clinical issues that need to be addressed by a healthcare institution during this process. Some issues identified here are very controversial and may take months or years for a department to determine solutions which meet their specific staffing, financial, and technical needs.

[Reconstruction of an air-gun injury track in the neck region--a case report].

PubMed

Woźniak, Krzysztof; Nowaczek-Dziocha, Elzbieta; Moskała, Artur; Urbanik, Andrzej; Pohl, Jerzy

2009-01-01

The authors present a case of an air-gun injury of the neck region with a foreign body left in situ. The DICOM files obtained during clinical CT examination (including computed tomography angiography) gave the opportunity for three-dimensional reconstructions of the location of the pellet, neighboring blood vessels and the bullet track--essential for a successful analysis of a possible version according to the testimonies related to the critical event.

Clinical Applications of a CT Window Blending Algorithm: RADIO (Relative Attenuation-Dependent Image Overlay).

PubMed

Mandell, Jacob C; Khurana, Bharti; Folio, Les R; Hyun, Hyewon; Smith, Stacy E; Dunne, Ruth M; Andriole, Katherine P

2017-06-01

A methodology is described using Adobe Photoshop and Adobe Extendscript to process DICOM images with a Relative Attenuation-Dependent Image Overlay (RADIO) algorithm to visualize the full dynamic range of CT in one view, without requiring a change in window and level settings. The potential clinical uses for such an algorithm are described in a pictorial overview, including applications in emergency radiology, oncologic imaging, and nuclear medicine and molecular imaging.

ImageJ: Image processing and analysis in Java

NASA Astrophysics Data System (ADS)

Rasband, W. S.

2012-06-01

ImageJ is a public domain Java image processing program inspired by NIH Image. It can display, edit, analyze, process, save and print 8-bit, 16-bit and 32-bit images. It can read many image formats including TIFF, GIF, JPEG, BMP, DICOM, FITS and "raw". It supports "stacks", a series of images that share a single window. It is multithreaded, so time-consuming operations such as image file reading can be performed in parallel with other operations.

Advanced Mail Systems Scanner Technology. Executive Summary and Appendixes A-E.

DTIC Science & Technology

1980-10-01

data base. 6. Perform color acquisition studies. 7. Investigate address and bar code reading. MASS MEMORY TECHNOLOGY 1. Collect performance data on...area of the 1728-by-2200 ICAS image memory and to transmit the data to any of the three color memories of the Comtal. Function table information can...for printing color images. The software allows the transmission of data from the ICAS frame-store memory via the MCU to the Dicomed. Software test

Feasibility study of proton-based quality assurance of proton range compensator

NASA Astrophysics Data System (ADS)

Park, S.; Jeong, C.; Min, B. J.; Kwak, J.; Lee, J.; Cho, S.; Shin, D.; Lim, Y. K.; Park, S. Y.; Lee, S. B.

2013-06-01

All patient specific range compensators (RCs) are customized for achieving distal dose conformity of target volume in passively scattered proton therapy. Compensators are milled precisely using a computerized machine. In proton therapy, precision of the compensator is critical and quality assurance (QA) is required to protect normal tissues and organs from radiation damage. This study aims to evaluate the precision of proton-based quality assurance of range compensator. First, the geometry information of two compensators was extracted from the DICOM Radiotherapy (RT) plan. Next, RCs were irradiated on the EBT film individually by proton beam which is modulated to have a photon-like percent depth dose (PDD). Step phantoms were also irradiated on the EBT film to generate calibration curve which indicates relationship between optical density of irradiated film and perpendicular depth of compensator. Comparisons were made using the mean absolute difference (MAD) between coordinate information from DICOM RT and converted depth information from the EBT film. MAD over the whole region was 1.7, and 2.0 mm. However, MAD over the relatively flat regions on each compensator selected for comparison was within 1 mm. These results shows that proton-based quality assurance of range compensator is feasible and it is expected to achieve MAD over the whole region less than 1 mm with further correction about scattering effect of proton imaging.

Free and open-source software application for the evaluation of coronary computed tomography angiography images.

PubMed

Hadlich, Marcelo Souza; Oliveira, Gláucia Maria Moraes; Feijóo, Raúl A; Azevedo, Clerio F; Tura, Bernardo Rangel; Ziemer, Paulo Gustavo Portela; Blanco, Pablo Javier; Pina, Gustavo; Meira, Márcio; Souza e Silva, Nelson Albuquerque de

2012-10-01

The standardization of images used in Medicine in 1993 was performed using the DICOM (Digital Imaging and Communications in Medicine) standard. Several tests use this standard and it is increasingly necessary to design software applications capable of handling this type of image; however, these software applications are not usually free and open-source, and this fact hinders their adjustment to most diverse interests. To develop and validate a free and open-source software application capable of handling DICOM coronary computed tomography angiography images. We developed and tested the ImageLab software in the evaluation of 100 tests randomly selected from a database. We carried out 600 tests divided between two observers using ImageLab and another software sold with Philips Brilliance computed tomography appliances in the evaluation of coronary lesions and plaques around the left main coronary artery (LMCA) and the anterior descending artery (ADA). To evaluate intraobserver, interobserver and intersoftware agreements, we used simple and kappa statistics agreements. The agreements observed between software applications were generally classified as substantial or almost perfect in most comparisons. The ImageLab software agreed with the Philips software in the evaluation of coronary computed tomography angiography tests, especially in patients without lesions, with lesions < 50% in the LMCA and < 70% in the ADA. The agreement for lesions > 70% in the ADA was lower, but this is also observed when the anatomical reference standard is used.

Development of a data mining and imaging informatics display tool for a multiple sclerosis e-folder system

NASA Astrophysics Data System (ADS)

Liu, Margaret; Loo, Jerry; Ma, Kevin; Liu, Brent

2011-03-01

Multiple sclerosis (MS) is a debilitating autoimmune disease of the central nervous system that damages axonal pathways through inflammation and demyelination. In order to address the need for a centralized application to manage and study MS patients, the MS e-Folder - a web-based, disease-specific electronic medical record system - was developed. The e-Folder has a PHP and MySQL based graphical user interface (GUI) that can serve as both a tool for clinician decision support and a data mining tool for researchers. This web-based GUI gives the e-Folder a user friendly interface that can be securely accessed through the internet and requires minimal software installation on the client side. The e-Folder GUI displays and queries patient medical records--including demographic data, social history, past medical history, and past MS history. In addition, DICOM format imaging data, and computer aided detection (CAD) results from a lesion load algorithm are also displayed. The GUI interface is dynamic and allows manipulation of the DICOM images, such as zoom, pan, and scrolling, and the ability to rotate 3D images. Given the complexity of clinical management and the need to bolster research in MS, the MS e-Folder system will improve patient care and provide MS researchers with a function-rich patient data hub.

RADIANCE: An automated, enterprise-wide solution for archiving and reporting CT radiation dose estimates.

PubMed

Cook, Tessa S; Zimmerman, Stefan L; Steingall, Scott R; Maidment, Andrew D A; Kim, Woojin; Boonn, William W

2011-01-01

There is growing interest in the ability to monitor, track, and report exposure to radiation from medical imaging. Historically, however, dose information has been stored on an image-based dose sheet, an arrangement that precludes widespread indexing. Although scanner manufacturers are beginning to include dose-related parameters in the Digital Imaging and Communications in Medicine (DICOM) headers of imaging studies, there remains a vast repository of retrospective computed tomographic (CT) data with image-based dose sheets. Consequently, it is difficult for imaging centers to monitor their dose estimates or participate in the American College of Radiology (ACR) Dose Index Registry. An automated extraction software pipeline known as Radiation Dose Intelligent Analytics for CT Examinations (RADIANCE) has been designed that quickly and accurately parses CT dose sheets to extract and archive dose-related parameters. Optical character recognition of information in the dose sheet leads to creation of a text file, which along with the DICOM study header is parsed to extract dose-related data. The data are then stored in a relational database that can be queried for dose monitoring and report creation. RADIANCE allows efficient dose analysis of CT examinations and more effective education of technologists, radiologists, and referring physicians regarding patient exposure to radiation at CT. RADIANCE also allows compliance with the ACR's dose reporting guidelines and greater awareness of patient radiation dose, ultimately resulting in improved patient care and treatment.

Lesion registration for longitudinal disease tracking in an imaging informatics-based multiple sclerosis eFolder

NASA Astrophysics Data System (ADS)

Ma, Kevin; Liu, Joseph; Zhang, Xuejun; Lerner, Alex; Shiroishi, Mark; Amezcua, Lilyana; Liu, Brent

2016-03-01

We have designed and developed a multiple sclerosis eFolder system for patient data storage, image viewing, and automatic lesion quantification results stored in DICOM-SR format. The web-based system aims to be integrated in DICOM-compliant clinical and research environments to aid clinicians in patient treatments and data analysis. The system needs to quantify lesion volumes, identify and register lesion locations to track shifts in volume and quantity of lesions in a longitudinal study. In order to perform lesion registration, we have developed a brain warping and normalizing methodology using Statistical Parametric Mapping (SPM) MATLAB toolkit for brain MRI. Patients' brain MR images are processed via SPM's normalization processes, and the brain images are analyzed and warped according to the tissue probability map. Lesion identification and contouring are completed by neuroradiologists, and lesion volume quantification is completed by the eFolder's CAD program. Lesion comparison results in longitudinal studies show key growth and active regions. The results display successful lesion registration and tracking over a longitudinal study. Lesion change results are graphically represented in the web-based user interface, and users are able to correlate patient progress and changes in the MRI images. The completed lesion and disease tracking tool would enable the eFolder to provide complete patient profiles, improve the efficiency of patient care, and perform comprehensive data analysis through an integrated imaging informatics system.

Impact of Three-Dimensional Printed Pelvicaliceal System Models on Residents' Understanding of Pelvicaliceal System Anatomy Before Percutaneous Nephrolithotripsy Surgery: A Pilot Study.

PubMed

Atalay, Hasan Anıl; Ülker, Volkan; Alkan, İlter; Canat, Halil Lütfi; Özkuvancı, Ünsal; Altunrende, Fatih

2016-10-01

To investigate the impact of three-dimensional (3D) printed pelvicaliceal system models on residents' understanding of pelvicaliceal system anatomy before percutaneous nephrolithotripsy (PCNL). Patients with unilateral complex renal stones indicating PCNL were selected. Usable data of patients were obtained from CT-scans in Digital Imaging and Communications in Medicine (DICOM) format. Mimics software version 16.0 (Materialise, Belgium) was used for segmentation and extraction of pelvicaliceal systems (PCSs). All DICOM-formatted files were converted to the stereolithography file format. Finally, fused deposition modeling was used to create plasticine 3D models of PCSs. A questionnaire was designed so that residents could assess the 3D models' effects on their understanding of the anatomy of the pelvicaliceal system before PCNL (Fig. 3). Five patients' anatomically accurate models of the human renal collecting system were effectively generated (Figs. 1 and 2). After presentation of the 3D models, residents were 86% and 88% better at determining the number of anterior and posterior calices, respectively, 60% better at understanding stone location, and 64% better at determining optimal entry calix into the collecting system (Fig. 5). Generating kidney models of PCSs using 3D printing technology is feasible, and the models were accepted by residents as aids in surgical planning and understanding of pelvicaliceal system anatomy before PCNL.

Research of processes of reception and analysis of dynamic digital medical images in hardware/software complexes used for diagnostics and treatment of cardiovascular diseases

NASA Astrophysics Data System (ADS)

Karmazikov, Y. V.; Fainberg, E. M.

2005-06-01

Work with DICOM compatible equipment integrated into hardware and software systems for medical purposes has been considered. Structures of process of reception and translormation of the data are resulted by the example of digital rentgenography and angiography systems, included in hardware-software complex DIMOL-IK. Algorithms of reception and the analysis of the data are offered. Questions of the further processing and storage of the received data are considered.

Three-dimensional reconstructions from computed tomographic scans on smartphones and tablets: a simple tutorial for the ward and operating room using public domain software.

PubMed

Ketoff, Serge; Khonsari, Roman Hossein; Schouman, Thomas; Bertolus, Chloé

2014-11-01

Handling 3-dimensional reconstructions of computed tomographic scans on portable devices is problematic because of the size of the Digital Imaging and Communications in Medicine (DICOM) stacks. The authors provide a user-friendly method allowing the production, transfer, and sharing of good-quality 3-dimensional reconstructions on smartphones and tablets. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Spending an Evening in the Dark: The Radiology Medical Student Call Experience.

PubMed

Monks, Dennis; Pagano, Brian; Hartman, Matthew

The level of independent decision-making required of a radiology resident, as well as the acuity of studies populating the worklist, differ between the normal workday and a call shift. However, unlike clerkships where call is standard, medical students in radiology typically only have half of the true resident experience. To expose our rotating medical students to what a future career in radiology might actually look like, we implemented a required call shift as part of our medical student curriculum. All rotating third- and fourth-year medical students were assigned a single 3-hour short call shift alongside a radiology resident during the final week of their rotation. Following this shift, students answered questions via anonymous online survey regarding their perceptions of radiology (primary end point) as well as workload and role of radiology in the clinical care of patients (secondary end points). Following medical student call, 63% of students reported a more positive view of radiology as a career. Additionally, 57% felt that radiology residents work as much or more than other specialties while one call, and several students identified communication issues regarding indications or appropriateness of studies. While we hope that this overwhelmingly positive experience will draw more students into radiology as a career, we also believe that many participating medical students will benefit from a greater understanding of what a radiologist׳s job entails, as well as how this may be affected by communication issues or increased utilization of imaging. Copyright © 2017 Elsevier Inc. All rights reserved.

Software solutions alone cannot guarantee useful radiology requests.

PubMed

Van Borsel, Mathias D; Devolder, Pieter Jd; Bosmans, Jan Ml

2016-11-01

Background The availability of clinical information and a pertinent clinical question can improve the diagnostic accuracy of the imaging process. Purpose To examine if an electronic request form forcing referring clinicians to provide separate input of both clinical information and a clinical question can improve the quality of the request. Material and Methods A total of 607 request forms in the clinical worklists for a computed tomography (CT) scan of the thorax, the abdomen or their combination, were examined. Using software of our own making, we examined the presence of clinical information and a clinical question before and after the introduction of a new, more compelling order method. We scored and compared the quality of the clinical information and the clinical question between the two systems and we examined the effect on productivity. Results Both clinical information and a clinical question were present in 76.7% of cases under the old system and in 95.3% under the new system ( P < 0.001). Individual characteristics of the clinical information and the clinical question however, with the exception of incompleteness, showed little improvement under the new system. There was also no significant difference between the two systems in the number of requests requiring further search. Conclusion The introduction of electronic radiology request forms compelling referring clinicians to provide separate input of clinical information and a clinical question provides only limited benefit to the quality of the request. Raising awareness among clinicians of the importance of a well-written request remains essential.

Radiology metrics for safe use and regulatory compliance with CT imaging

NASA Astrophysics Data System (ADS)

Paden, Robert; Pavlicek, William

2018-03-01

The MACRA Act creates a Merit-Based Payment System, with monitoring patient exposure from CT providing one possible quality metric for meeting merit requirements. Quality metrics are also required by The Joint Commission, ACR, and CMS as facilities are tasked to perform reviews of CT irradiation events outside of expected ranges, review protocols for appropriateness, and validate parameters for low dose lung cancer screening. In order to efficiently collect and analyze irradiation events and associated DICOM tags, all clinical CT devices were DICOM connected to a parser which extracted dose related information for storage into a database. Dose data from every exam is compared to the appropriate external standard exam type. AAPM recommended CTDIvol values for head and torso, adult and pediatrics, coronary and perfusion exams are used for this study. CT doses outside the expected range were automatically formatted into a report for analysis and review documentation. CT Technologist textual content, the reason for proceeding with an irradiation above the recommended threshold, is captured for inclusion in the follow up reviews by physics staff. The use of a knowledge based approach in labeling individual protocol and device settings is a practical solution resulting in efficiency of analysis and review. Manual methods would require approximately 150 person-hours for our facility, exclusive of travel time and independent of device availability. An efficiency of 89% time savings occurs through use of this informatics tool including a low dose CT comparison review and low dose lung cancer screening requirements set forth by CMS.

Internationalization of healthcare applications: a generic approach for PACS workstations.

PubMed

Hussein, R; Engelmann, U; Schroeter, A; Meinzer, H P

2004-01-01

Along with the revolution of information technology and the increasing use of computers world-wide, software providers recognize the emerging need for internationalized, or global, software applications. The importance of internationalization comes from its benefits such as addressing a broader audience, making the software applications more accessible, easier to use, more flexible to support and providing users with more consistent information. In addition, some governmental agencies, e.g., in Spain, accept only fully localized software. Although the healthcare communication standards, namely, Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7) support wide areas of internationalization, most of the implementers are still protective about supporting the complex languages. This paper describes a generic internationalization approach for Picture Archiving and Communication System (PACS) workstations. The Unicode standard is used to internationalize the application user interface. An encoding converter was developed to encode and decode the data between the rendering module (in Unicode encoding) and the DICOM data (in ISO 8859 encoding). An integration gateway was required to integrate the internationalized PACS components with the different PACS installations. To introduce a pragmatic example, the described approach was applied to the CHILI PACS workstation. The approach has enabled the application to handle the different internationalization aspects transparently, such as supporting complex languages, switching between different languages at runtime, and supporting multilingual clinical reports. In the healthcare enterprises, internationalized applications play an essential role in supporting a seamless flow of information between the heterogeneous multivendor information systems.

Medical data sheet in safe havens - A tri-layer cryptic solution.

PubMed

Praveenkumar, Padmapriya; Amirtharajan, Rengarajan; Thenmozhi, K; Balaguru Rayappan, John Bosco

2015-07-01

Secured sharing of the diagnostic reports and scan images of patients among doctors with complementary expertise for collaborative treatment will help to provide maximum care through faster and decisive decisions. In this context, a tri-layer cryptic solution has been proposed and implemented on Digital Imaging and Communications in Medicine (DICOM) images to establish a secured communication for effective referrals among peers without compromising the privacy of patients. In this approach, a blend of three cryptic schemes, namely Latin square image cipher (LSIC), discrete Gould transform (DGT) and Rubik׳s encryption, has been adopted. Among them, LSIC provides better substitution, confusion and shuffling of the image blocks; DGT incorporates tamper proofing with authentication; and Rubik renders a permutation of DICOM image pixels. The developed algorithm has been successfully implemented and tested in both the software (MATLAB 7) and hardware Universal Software Radio Peripheral (USRP) environments. Specifically, the encrypted data were tested by transmitting them through an additive white Gaussian noise (AWGN) channel model. Furthermore, the sternness of the implemented algorithm was validated by employing standard metrics such as the unified average changing intensity (UACI), number of pixels change rate (NPCR), correlation values and histograms. The estimated metrics have also been compared with the existing methods and dominate in terms of large key space to defy brute force attack, cropping attack, strong key sensitivity and uniform pixel value distribution on encryption. Copyright © 2015 Elsevier Ltd. All rights reserved.

DICOM organ dose does not accurately represent calculated dose in mammography

NASA Astrophysics Data System (ADS)

Suleiman, Moayyad E.; Brennan, Patrick C.; McEntee, Mark F.

2016-03-01

This study aims to analyze the agreement between the mean glandular dose estimated by the mammography unit (organ dose) and mean glandular dose calculated using Dance et al published method (calculated dose). Anonymised digital mammograms from 50 BreastScreen NSW centers were downloaded and exposure information required for the calculation of dose was extracted from the DICOM header along with the organ dose estimated by the system. Data from quality assurance annual tests for the included centers were collected and used to calculate the mean glandular dose for each mammogram. Bland-Altman analysis and a two-tailed paired t-test were used to study the agreement between calculated and organ dose and the significance of any differences. A total of 27,869 dose points from 40 centers were included in the study, mean calculated dose and mean organ dose (+/- standard deviation) were 1.47 (+/-0.66) and 1.38 (+/-0.56) mGy respectively. A statistically significant 0.09 mGy bias (t = 69.25; p<0.0001) with 95% limits of agreement between calculated and organ doses ranging from -0.34 and 0.52 were shown by Bland-Altman analysis, which indicates a small yet highly significant difference between the two means. The use of organ dose for dose audits is done at the risk of over or underestimating the calculated dose, hence, further work is needed to identify the causal agents for differences between organ and calculated doses and to generate a correction factor for organ dose.

Cardio-PACs: a new opportunity

NASA Astrophysics Data System (ADS)

Heupler, Frederick A., Jr.; Thomas, James D.; Blume, Hartwig R.; Cecil, Robert A.; Heisler, Mary

2000-05-01

It is now possible to replace film-based image management in the cardiac catheterization laboratory with a Cardiology Picture Archiving and Communication System (Cardio-PACS) based on digital imaging technology. The first step in the conversion process is installation of a digital image acquisition system that is capable of generating high-quality DICOM-compatible images. The next three steps, which are the subject of this presentation, involve image display, distribution, and storage. Clinical requirements and associated cost considerations for these three steps are listed below: Image display: (1) Image quality equal to film, with DICOM format, lossless compression, image processing, desktop PC-based with color monitor, and physician-friendly imaging software; (2) Performance specifications include: acquire 30 frames/sec; replay 15 frames/sec; access to file server 5 seconds, and to archive 5 minutes; (3) Compatibility of image file, transmission, and processing formats; (4) Image manipulation: brightness, contrast, gray scale, zoom, biplane display, and quantification; (5) User-friendly control of image review. Image distribution: (1) Standard IP-based network between cardiac catheterization laboratories, file server, long-term archive, review stations, and remote sites; (2) Non-proprietary formats; (3) Bidirectional distribution. Image storage: (1) CD-ROM vs disk vs tape; (2) Verification of data integrity; (3) User-designated storage capacity for catheterization laboratory, file server, long-term archive. Costs: (1) Image acquisition equipment, file server, long-term archive; (2) Network infrastructure; (3) Review stations and software; (4) Maintenance and administration; (5) Future upgrades and expansion; (6) Personnel.

Does the choice of display system influence perception and visibility of clinically relevant features in digital pathology images?

NASA Astrophysics Data System (ADS)

Kimpe, Tom; Rostang, Johan; Avanaki, Ali; Espig, Kathryn; Xthona, Albert; Cocuranu, Ioan; Parwani, Anil V.; Pantanowitz, Liron

2014-03-01

Digital pathology systems typically consist of a slide scanner, processing software, visualization software, and finally a workstation with display for visualization of the digital slide images. This paper studies whether digital pathology images can look different when presenting them on different display systems, and whether these visual differences can result in different perceived contrast of clinically relevant features. By analyzing a set of four digital pathology images of different subspecialties on three different display systems, it was concluded that pathology images look different when visualized on different display systems. The importance of these visual differences is elucidated when they are located in areas of the digital slide that contain clinically relevant features. Based on a calculation of dE2000 differences between background and clinically relevant features, it was clear that perceived contrast of clinically relevant features is influenced by the choice of display system. Furthermore, it seems that the specific calibration target chosen for the display system has an important effect on the perceived contrast of clinically relevant features. Preliminary results suggest that calibrating to DICOM GSDF calibration performed slightly worse than sRGB, while a new experimental calibration target CSDF performed better than both DICOM GSDF and sRGB. This result is promising as it suggests that further research work could lead to better definition of an optimized calibration target for digital pathology images resulting in a positive effect on clinical performance.

Calibration of medium-resolution monochrome cathode ray tube displays for the purpose of board examinations.

PubMed

Evanoff, M G; Roehrig, H; Giffords, R S; Capp, M P; Rovinelli, R J; Hartmann, W H; Merritt, C

2001-06-01

This report discusses calibration and set-up procedures for medium-resolution monochrome cathode ray tubes (CRTs) taken in preparation of the oral portion of the board examination of the American Board of Radiology (ABR). The board examinations took place in more than 100 rooms of a hotel. There was one display-station (a computer and the associated CRT display) in each of the hotel rooms used for the examinations. The examinations covered the radiologic specialties cardiopulmonary, musculoskeletal, gastrointestinal, vascular, pediatric, and genitourinary. The software used for set-up and calibration was the VeriLUM 4.0 package from Image Smiths in Germantown, MD. The set-up included setting minimum luminance and maximum luminance, as well as positioning of the CRT in each examination room with respect to reflections of roomlights. The calibration for the grey scale rendition was done meeting the Digital Imaging and communication in Medicine (DICOM) 14 Standard Display Function. We describe these procedures, and present the calibration data in. tables and graphs, listing initial values of minimum luminance, maximum luminance, and grey scale rendition (DICOM 14 standard display function). Changes of these parameters over the duration of the examination were observed and recorded on 11 monitors in a particular room. These changes strongly suggest that all calibrated CRTs be monitored over the duration of the examination. In addition, other CRT performance data affecting image quality such as spatial resolution should be included in set-up and image quality-control procedures.

Using a high-speed movie camera to evaluate slice dropping in clinical image interpretation with stack mode viewers.

PubMed

Yakami, Masahiro; Yamamoto, Akira; Yanagisawa, Morio; Sekiguchi, Hiroyuki; Kubo, Takeshi; Togashi, Kaori

2013-06-01

The purpose of this study is to verify objectively the rate of slice omission during paging on picture archiving and communication system (PACS) viewers by recording the images shown on the computer displays of these viewers with a high-speed movie camera. This study was approved by the institutional review board. A sequential number from 1 to 250 was superimposed on each slice of a series of clinical Digital Imaging and Communication in Medicine (DICOM) data. The slices were displayed using several DICOM viewers, including in-house developed freeware and clinical PACS viewers. The freeware viewer and one of the clinical PACS viewers included functions to prevent slice dropping. The series was displayed in stack mode and paged in both automatic and manual paging modes. The display was recorded with a high-speed movie camera and played back at a slow speed to check whether slices were dropped. The paging speeds were also measured. With a paging speed faster than half the refresh rate of the display, some viewers dropped up to 52.4 % of the slices, while other well-designed viewers did not, if used with the correct settings. Slice dropping during paging was objectively confirmed using a high-speed movie camera. To prevent slice dropping, the viewer must be specially designed for the purpose and must be used with the correct settings, or the paging speed must be slower than half of the display refresh rate.

Distributed PACS using distributed file system with hierarchical meta data servers.

PubMed

Hiroyasu, Tomoyuki; Minamitani, Yoshiyuki; Miki, Mitsunori; Yokouchi, Hisatake; Yoshimi, Masato

2012-01-01

In this research, we propose a new distributed PACS (Picture Archiving and Communication Systems) which is available to integrate several PACSs that exist in each medical institution. The conventional PACS controls DICOM file into one data-base. On the other hand, in the proposed system, DICOM file is separated into meta data and image data and those are stored individually. Using this mechanism, since file is not always accessed the entire data, some operations such as finding files, changing titles, and so on can be performed in high-speed. At the same time, as distributed file system is utilized, accessing image files can also achieve high-speed access and high fault tolerant. The introduced system has a more significant point. That is the simplicity to integrate several PACSs. In the proposed system, only the meta data servers are integrated and integrated system can be constructed. This system also has the scalability of file access with along to the number of file numbers and file sizes. On the other hand, because meta-data server is integrated, the meta data server is the weakness of this system. To solve this defect, hieratical meta data servers are introduced. Because of this mechanism, not only fault--tolerant ability is increased but scalability of file access is also increased. To discuss the proposed system, the prototype system using Gfarm was implemented. For evaluating the implemented system, file search operating time of Gfarm and NFS were compared.

Vertical bone measurements from cone beam computed tomography images using different software packages.

PubMed

Vasconcelos, Taruska Ventorini; Neves, Frederico Sampaio; Moraes, Lívia Almeida Bueno; Freitas, Deborah Queiroz

2015-01-01

This article aimed at comparing the accuracy of linear measurement tools of different commercial software packages. Eight fully edentulous dry mandibles were selected for this study. Incisor, canine, premolar, first molar and second molar regions were selected. Cone beam computed tomography (CBCT) images were obtained with i-CAT Next Generation. Linear bone measurements were performed by one observer on the cross-sectional images using three different software packages: XoranCat®, OnDemand3D® and KDIS3D®, all able to assess DICOM images. In addition, 25% of the sample was reevaluated for the purpose of reproducibility. The mandibles were sectioned to obtain the gold standard for each region. Intraclass coefficients (ICC) were calculated to examine the agreement between the two periods of evaluation; the one-way analysis of variance performed with the post-hoc Dunnett test was used to compare each of the software-derived measurements with the gold standard. The ICC values were excellent for all software packages. The least difference between the software-derived measurements and the gold standard was obtained with the OnDemand3D and KDIS3D (-0.11 and -0.14 mm, respectively), and the greatest, with the XoranCAT (+0.25 mm). However, there was no statistical significant difference between the measurements obtained with the different software packages and the gold standard (p> 0.05). In conclusion, linear bone measurements were not influenced by the software package used to reconstruct the image from CBCT DICOM data.

Using experience with bidirectional HL7-ACR-NEMA interfaces between the federal government HIS/RIS and commercial PACS to plan for DICOM

NASA Astrophysics Data System (ADS)

Kuzmak, Peter M.; Norton, Gary S.; Dayhoff, Ruth E.

1995-05-01

The Department of Veterans Affairs has developed a bidirectional HL7 - ACR-NEMA V 2.0 interface for connecting existing federal government hospital/radiology information systems (HIS/RIS) to commercial picture archive and communication systems (PACS). The interface has been in use since October 1993 at the Baltimore VAMC between the VA's HIS/RIS (DHCP) and a commercial PACS, and handles both text and image transfer. The text-only portion of the interface has been ported to work with a second vendor's PACS, and to work with the Department of Defense HIS/RIS (CHCS). Currently the interface is in production at two VA and three DoD sites. The common benefit experienced at all these sites is that passing patient, order, and report information directly from the HIS/RIS to the PACS greatly improves the flow of work in the Radiology Department. Image transfer to the DHCP Imaging System at the Baltimore VAMC demonstrated the advantage of providing `reference quality' (1K X 1K X 8-bit) radiology images to treating clinicians throughout the hospital. Experience has shown that the gateway must handle transactions between the HIS/RIS and the PACS quickly in order to keep up with the volume, and must provide an audit trail for system diagnostic purposes. Work is underway to construct a HL7 - DICOM gateway built upon the operational experience gathered from the existing interface.

TU-AB-BRC-12: Optimized Parallel MonteCarlo Dose Calculations for Secondary MU Checks

DOE Office of Scientific and Technical Information (OSTI.GOV)

French, S; Nazareth, D; Bellor, M

Purpose: Secondary MU checks are an important tool used during a physics review of a treatment plan. Commercial software packages offer varying degrees of theoretical dose calculation accuracy, depending on the modality involved. Dose calculations of VMAT plans are especially prone to error due to the large approximations involved. Monte Carlo (MC) methods are not commonly used due to their long run times. We investigated two methods to increase the computational efficiency of MC dose simulations with the BEAMnrc code. Distributed computing resources, along with optimized code compilation, will allow for accurate and efficient VMAT dose calculations. Methods: The BEAMnrcmore » package was installed on a high performance computing cluster accessible to our clinic. MATLAB and PYTHON scripts were developed to convert a clinical VMAT DICOM plan into BEAMnrc input files. The BEAMnrc installation was optimized by running the VMAT simulations through profiling tools which indicated the behavior of the constituent routines in the code, e.g. the bremsstrahlung splitting routine, and the specified random number generator. This information aided in determining the most efficient compiling parallel configuration for the specific CPU’s available on our cluster, resulting in the fastest VMAT simulation times. Our method was evaluated with calculations involving 10{sup 8} – 10{sup 9} particle histories which are sufficient to verify patient dose using VMAT. Results: Parallelization allowed the calculation of patient dose on the order of 10 – 15 hours with 100 parallel jobs. Due to the compiler optimization process, further speed increases of 23% were achieved when compared with the open-source compiler BEAMnrc packages. Conclusion: Analysis of the BEAMnrc code allowed us to optimize the compiler configuration for VMAT dose calculations. In future work, the optimized MC code, in conjunction with the parallel processing capabilities of BEAMnrc, will be applied to provide accurate and efficient secondary MU checks.« less

3D ultrasonography is as accurate as low-dose CT in thyroid volumetry.

PubMed

Licht, K; Darr, A; Opfermann, T; Winkens, T; Freesmeyer, M

2014-01-01

The purpose of this study was to compare thyroid volumetry by three-dimensional mechanically swept ultrasonography (3DmsUS) and low-dose computed tomography (ldCT). 30 subjects referred for radioiodine therapy of benign thyroid diseases were subjected to 3DmsUS and ldCT. A prerequisite of 3DmsUS analyses was that the scans had to capture the entire thyroid, excluding therefore cases with a very large volume or retrosternal portions. The 3DmsUS data were transformed into a DICOM format, and volumetry calculations were performed via a multimodal workstation equipped with standard software for cross-sectional imaging. Volume was calculated applying both the ellipsoid model and a manually tracing method. Statistical analyses included 95% confidence intervals (CI) of the means and limits of agreement according to Bland and Altman, the latter including 95% of all expected values. Volumetric measurements by 3DmsUS and ldCT resulted in very high, significant correlation coefficients, r = 0.997 using the ellipsoid model and r = 0.993 with the manually tracing method. The mean relative differences of the two imaging modalities proved very small (-1.2±4.0% [95% CI -2.62; 0.28] using the ellipsoid model; -1.1±5.2% [95% CI -2.93; 0.80] using the manually tracing method) and the limits of agreement sufficiently narrow (-9.1% to 6.8%; -11.3% to 9.2%, respectively). For moderately enlarged thyroids, volumetry with 3DmsUS proved comparable to that of ldCT, irrespective of whether the ellipsoid model or the manually tracing method was applied. Thus, 3DmsUS qualifies as a potential alternative to ldCT, provided that the organ is completely accessible. The use of a standard workstation for cross-sectional imaging with routine software did not prove problematic.

Using applet-servlet communication for optimizing window, level and crop for DICOM to JPEG conversion.

PubMed

Kamauu, Aaron W C; DuVall, Scott L; Wiggins, Richard H; Avrin, David E

2008-09-01

In the creation of interesting radiological cases in a digital teaching file, it is necessary to adjust the window and level settings of an image to effectively display the educational focus. The web-based applet described in this paper presents an effective solution for real-time window and level adjustments without leaving the picture archiving and communications system workstation. Optimized images are created, as user-defined parameters are passed between the applet and a servlet on the Health Insurance Portability and Accountability Act-compliant teaching file server.

Automatic Atlas Based Electron Density and Structure Contouring for MRI-based Prostate Radiation Therapy on the Cloud

NASA Astrophysics Data System (ADS)

Dowling, J. A.; Burdett, N.; Greer, P. B.; Sun, J.; Parker, J.; Pichler, P.; Stanwell, P.; Chandra, S.; Rivest-Hénault, D.; Ghose, S.; Salvado, O.; Fripp, J.

2014-03-01

Our group have been developing methods for MRI-alone prostate cancer radiation therapy treatment planning. To assist with clinical validation of the workflow we are investigating a cloud platform solution for research purposes. Benefits of cloud computing can include increased scalability, performance and extensibility while reducing total cost of ownership. In this paper we demonstrate the generation of DICOM-RT directories containing an automatic average atlas based electron density image and fast pelvic organ contouring from whole pelvis MR scans.

On the mechanics of cerebral aneurysms: experimental research and numerical simulation

NASA Astrophysics Data System (ADS)

Parshin, D. V.; Kuianova, I. O.; Yunoshev, A. S.; Ovsyannikov, K. S.; Dubovoy, A. V.

2017-10-01

This research extends existing experimental data for CA tissues [1, 2] and presents the preliminary results of numerical calculations. Experiments were performed to measure aneurysm wall stiffness and the data obtained was analyzed. To reconstruct the geometry of the CAs, DICOM images of real patients with aneurysms and ITK Snap [3] were used. In addition, numerical calculations were performed in ANSYS (commercial software, License of Lavrentyev Institute of Hydrodynamics). The results of these numerical calculations show a high level of agreement with experimental data from previous literature.

DICOM version 3.0 demonstration at InfoRAD 1992

NASA Astrophysics Data System (ADS)

Jost, R. Gilbert

1993-09-01

Over the past 10 years, a large number of devoted individuals have worked on a project to develop a standard for the storage and exchange of medical images. Known as the ACR/NEMA standardization effort, this project is jointly sponsored by the American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA). Over the years, radiologists and industry representatives alike have supported the standardization effort, but there has been little evidence of actual exchanges of medical images among medical equipment vendors who use the ACR/NEMA standard.

Design challenges and gaps in standards in developing an interoperable zero footprint DI thin client for use in image-enabled electronic health record solutions

NASA Astrophysics Data System (ADS)

Agrawal, Arun; Koff, David; Bak, Peter; Bender, Duane; Castelli, Jane

2015-03-01

The deployment of regional and national Electronic Health Record solutions has been a focus of many countries throughout the past decade. A major challenge for these deployments has been support for ubiquitous image viewing. More specifically, these deployments require an imaging solution that can work over the Internet, leverage any point of service device: desktop, tablet, phone; and access imaging data from any source seamlessly. Whereas standards exist to enable ubiquitous image viewing, few if any solutions exist that leverage these standards and meet the challenge. Rather, most of the currently available web based DI viewing solutions are either proprietary solutions or require special plugins. We developed a true zero foot print browser based DI viewing solution based on the Web Access DICOM Objects (WADO) and Cross-enterprise Document Sharing for Imaging (XDS-I.b) standards to a) demonstrate that a truly ubiquitous image viewer can be deployed; b) identify the gaps in the current standards and the design challenges for developing such a solution. The objective was to develop a viewer, which works on all modern browsers on both desktop and mobile devices. The implementation allows basic viewing functionalities of scroll, zoom, pan and window leveling (limited). The major gaps identified in the current DICOM WADO standards are a lack of ability to allow any kind of 3D reconstruction or MPR views. Other design challenges explored include considerations related to optimization of the solution for response time and low memory foot print.

A simple tool for neuroimaging data sharing

PubMed Central

Haselgrove, Christian; Poline, Jean-Baptiste; Kennedy, David N.

2014-01-01

Data sharing is becoming increasingly common, but despite encouragement and facilitation by funding agencies, journals, and some research efforts, most neuroimaging data acquired today is still not shared due to political, financial, social, and technical barriers to sharing data that remain. In particular, technical solutions are few for researchers that are not a part of larger efforts with dedicated sharing infrastructures, and social barriers such as the time commitment required to share can keep data from becoming publicly available. We present a system for sharing neuroimaging data, designed to be simple to use and to provide benefit to the data provider. The system consists of a server at the International Neuroinformatics Coordinating Facility (INCF) and user tools for uploading data to the server. The primary design principle for the user tools is ease of use: the user identifies a directory containing Digital Imaging and Communications in Medicine (DICOM) data, provides their INCF Portal authentication, and provides identifiers for the subject and imaging session. The user tool anonymizes the data and sends it to the server. The server then runs quality control routines on the data, and the data and the quality control reports are made public. The user retains control of the data and may change the sharing policy as they need. The result is that in a few minutes of the user’s time, DICOM data can be anonymized and made publicly available, and an initial quality control assessment can be performed on the data. The system is currently functional, and user tools and access to the public image database are available at http://xnat.incf.org/. PMID:24904398

CytometryML binary data standards

NASA Astrophysics Data System (ADS)

Leif, Robert C.

2005-03-01

CytometryML is a proposed new Analytical Cytology (Cytomics) data standard, which is based on a common set of XML schemas for encoding flow cytometry and digital microscopy text based data types (metadata). CytometryML schemas reference both DICOM (Digital Imaging and Communications in Medicine) codes and FCS keywords. Flow Cytometry Standard (FCS) list-mode has been mapped to the DICOM Waveform Information Object. The separation of the large binary data objects (list mode and image data) from the XML description of the metadata permits the metadata to be directly displayed, analyzed, and reported with standard commercial software packages; the direct use of XML languages; and direct interfacing with clinical information systems. The separation of the binary data into its own files simplifies parsing because all extraneous header data has been eliminated. The storage of images as two-dimensional arrays without any extraneous data, such as in the Adobe Photoshop RAW format, facilitates the development by scientists of their own analysis and visualization software. Adobe Photoshop provided the display infrastructure and the translation facility to interconvert between the image data from commercial formats and RAW format. Similarly, the storage and parsing of list mode binary data type with a group of parameters that are specified at compilation time is straight forward. However when the user is permitted at run-time to select a subset of the parameters and/or specify results of mathematical manipulations, the development of special software was required. The use of CytometryML will permit investigators to be able to create their own interoperable data analysis software and to employ commercially available software to disseminate their data.

Quantitative assessment of multiple sclerosis lesion load using CAD and expert input

NASA Astrophysics Data System (ADS)

Gertych, Arkadiusz; Wong, Alexis; Sangnil, Alan; Liu, Brent J.

2008-03-01

Multiple sclerosis (MS) is a frequently encountered neurological disease with a progressive but variable course affecting the central nervous system. Outline-based lesion quantification in the assessment of lesion load (LL) performed on magnetic resonance (MR) images is clinically useful and provides information about the development and change reflecting overall disease burden. Methods of LL assessment that rely on human input are tedious, have higher intra- and inter-observer variability and are more time-consuming than computerized automatic (CAD) techniques. At present it seems that methods based on human lesion identification preceded by non-interactive outlining by CAD are the best LL quantification strategies. We have developed a CAD that automatically quantifies MS lesions, displays 3-D lesion map and appends radiological findings to original images according to current DICOM standard. CAD is also capable to display and track changes and make comparison between patient's separate MRI studies to determine disease progression. The findings are exported to a separate imaging tool for review and final approval by expert. Capturing and standardized archiving of manual contours is also implemented. Similarity coefficients calculated from quantities of LL in collected exams show a good correlation of CAD-derived results vs. those incorporated as expert's reading. Combining the CAD approach with an expert interaction may impact to the diagnostic work-up of MS patients because of improved reproducibility in LL assessment and reduced time for single MR or comparative exams reading. Inclusion of CAD-generated outlines as DICOM-compliant overlays into the image data can serve as a better reference in MS progression tracking.

Wireless remote control of clinical image workflow: using a PDA for off-site distribution and disaster recovery.

PubMed

Documet, Jorge; Liu, Brent J; Documet, Luis; Huang, H K

2006-07-01

This paper describes a picture archiving and communication system (PACS) tool based on Web technology that remotely manages medical images between a PACS archive and remote destinations. Successfully implemented in a clinical environment and also demonstrated for the past 3 years at the conferences of various organizations, including the Radiological Society of North America, this tool provides a very practical and simple way to manage a PACS, including off-site image distribution and disaster recovery. The application is robust and flexible and can be used on a standard PC workstation or a Tablet PC, but more important, it can be used with a personal digital assistant (PDA). With a PDA, the Web application becomes a powerful wireless and mobile image management tool. The application's quick and easy-to-use features allow users to perform Digital Imaging and Communications in Medicine (DICOM) queries and retrievals with a single interface, without having to worry about the underlying configuration of DICOM nodes. In addition, this frees up dedicated PACS workstations to perform their specialized roles within the PACS workflow. This tool has been used at Saint John's Health Center in Santa Monica, California, for 2 years. The average number of queries per month is 2,021, with 816 C-MOVE retrieve requests. Clinical staff members can use PDAs to manage image workflow and PACS examination distribution conveniently for off-site consultations by referring physicians and radiologists and for disaster recovery. This solution also improves radiologists' effectiveness and efficiency in health care delivery both within radiology departments and for off-site clinical coverage.

Radiation dose and image quality for paediatric interventional cardiology

NASA Astrophysics Data System (ADS)

Vano, E.; Ubeda, C.; Leyton, F.; Miranda, P.

2008-08-01

Radiation dose and image quality for paediatric protocols in a biplane x-ray system used for interventional cardiology have been evaluated. Entrance surface air kerma (ESAK) and image quality using a test object and polymethyl methacrylate (PMMA) phantoms have been measured for the typical paediatric patient thicknesses (4-20 cm of PMMA). Images from fluoroscopy (low, medium and high) and cine modes have been archived in digital imaging and communications in medicine (DICOM) format. Signal-to-noise ratio (SNR), figure of merit (FOM), contrast (CO), contrast-to-noise ratio (CNR) and high contrast spatial resolution (HCSR) have been computed from the images. Data on dose transferred to the DICOM header have been used to test the values of the dosimetric display at the interventional reference point. ESAK for fluoroscopy modes ranges from 0.15 to 36.60 µGy/frame when moving from 4 to 20 cm PMMA. For cine, these values range from 2.80 to 161.10 µGy/frame. SNR, FOM, CO, CNR and HCSR are improved for high fluoroscopy and cine modes and maintained roughly constant for the different thicknesses. Cumulative dose at the interventional reference point resulted 25-45% higher than the skin dose for the vertical C-arm (depending of the phantom thickness). ESAK and numerical image quality parameters allow the verification of the proper setting of the x-ray system. Knowing the increases in dose per frame when increasing phantom thicknesses together with the image quality parameters will help cardiologists in the good management of patient dose and allow them to select the best imaging acquisition mode during clinical procedures.

A brain imaging repository of normal structural MRI across the life course: Brain Images of Normal Subjects (BRAINS).

PubMed

Job, Dominic E; Dickie, David Alexander; Rodriguez, David; Robson, Andrew; Danso, Sammy; Pernet, Cyril; Bastin, Mark E; Boardman, James P; Murray, Alison D; Ahearn, Trevor; Waiter, Gordon D; Staff, Roger T; Deary, Ian J; Shenkin, Susan D; Wardlaw, Joanna M

2017-01-01

The Brain Images of Normal Subjects (BRAINS) Imagebank (http://www.brainsimagebank.ac.uk) is an integrated repository project hosted by the University of Edinburgh and sponsored by the Scottish Imaging Network: A Platform for Scientific Excellence (SINAPSE) collaborators. BRAINS provide sharing and archiving of detailed normal human brain imaging and relevant phenotypic data already collected in studies of healthy volunteers across the life-course. It particularly focusses on the extremes of age (currently older age, and in future perinatal) where variability is largest, and which are under-represented in existing databanks. BRAINS is a living imagebank where new data will be added when available. Currently BRAINS contains data from 808 healthy volunteers, from 15 to 81years of age, from 7 projects in 3 centres. Additional completed and ongoing studies of normal individuals from 1st to 10th decades are in preparation and will be included as they become available. BRAINS holds several MRI structural sequences, including T1, T2, T2* and fluid attenuated inversion recovery (FLAIR), available in DICOM (http://dicom.nema.org/); in future Diffusion Tensor Imaging (DTI) will be added where available. Images are linked to a wide range of 'textual data', such as age, medical history, physiological measures (e.g. blood pressure), medication use, cognitive ability, and perinatal information for pre/post-natal subjects. The imagebank can be searched to include or exclude ranges of these variables to create better estimates of 'what is normal' at different ages. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Rapid 3D bioprinting from medical images: an application to bone scaffolding

NASA Astrophysics Data System (ADS)

Lee, Daniel Z.; Peng, Matthew W.; Shinde, Rohit; Khalid, Arbab; Hong, Abigail; Pennacchi, Sara; Dawit, Abel; Sipzner, Daniel; Udupa, Jayaram K.; Rajapakse, Chamith S.

2018-03-01

Bioprinting of tissue has its applications throughout medicine. Recent advances in medical imaging allows the generation of 3-dimensional models that can then be 3D printed. However, the conventional method of converting medical images to 3D printable G-Code instructions has several limitations, namely significant processing time for large, high resolution images, and the loss of microstructural surface information from surface resolution and subsequent reslicing. We have overcome these issues by creating a JAVA program that skips the intermediate triangularization and reslicing steps and directly converts binary dicom images into G-Code. In this study, we tested the two methods of G-Code generation on the application of synthetic bone graft scaffold generation. We imaged human cadaveric proximal femurs at an isotropic resolution of 0.03mm using a high resolution peripheral quantitative computed tomography (HR-pQCT) scanner. These images, of the Digital Imaging and Communications in Medicine (DICOM) format, were then processed through two methods. In each method, slices and regions of print were selected, filtered to generate a smoothed image, and thresholded. In the conventional method, these processed images are converted to the STereoLithography (STL) format and then resliced to generate G-Code. In the new, direct method, these processed images are run through our JAVA program and directly converted to G-Code. File size, processing time, and print time were measured for each. We found that this new method produced a significant reduction in G-Code file size as well as processing time (92.23% reduction). This allows for more rapid 3D printing from medical images.

SU-F-T-156: Monte Carlo Simulation Using TOPAS for Synchrotron Based Proton Discrete Spot Scanning System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moskvin, V; Pirlepesov, F; Tsiamas, P

Purpose: This study provides an overview of the design and commissioning of the Monte Carlo (MC) model of the spot-scanning proton therapy nozzle and its implementation for the patient plan simulation. Methods: The Hitachi PROBEAT V scanning nozzle was simulated based on vendor specifications using the TOPAS extension of Geant4 code. FLUKA MC simulation was also utilized to provide supporting data for the main simulation. Validation of the MC model was performed using vendor provided data and measurements collected during acceptance/commissioning of the proton therapy machine. Actual patient plans using CT based treatment geometry were simulated and compared to themore » dose distributions produced by the treatment planning system (Varian Eclipse 13.6), and patient quality assurance measurements. In-house MATLAB scripts are used for converting DICOM data into TOPAS input files. Results: Comparison analysis of integrated depth doses (IDDs), therapeutic ranges (R90), and spot shape/sizes at different distances from the isocenter, indicate good agreement between MC and measurements. R90 agreement is within 0.15 mm across all energy tunes. IDDs and spot shapes/sizes differences are within statistical error of simulation (less than 1.5%). The MC simulated data, validated with physical measurements, were used for the commissioning of the treatment planning system. Patient geometry simulations were conducted based on the Eclipse produced DICOM plans. Conclusion: The treatment nozzle and standard option beam model were implemented in the TOPAS framework to simulate a highly conformal discrete spot-scanning proton beam system.« less

A comprehensive operating room information system using the Kinect sensors and RFID.

PubMed

Nouei, Mahyar Taghizadeh; Kamyad, Ali Vahidian; Soroush, Ahmad Reza; Ghazalbash, Somayeh

2015-04-01

Occasionally, surgeons do need various types of information to be available rapidly, efficiently and safely during surgical procedures. Meanwhile, they need to free up hands throughout the surgery to necessarily access the mouse to control any application in the sterility mode. In addition, they are required to record audio as well as video files, and enter and save some data. This is an attempt to develop a comprehensive operating room information system called "Medinav" to tackle all mentioned issues. An integrated and comprehensive operating room information system is introduced to be compatible with Health Level 7 (HL7) and digital imaging and communications in medicine (DICOM). DICOM is a standard for handling, storing, printing, and transmitting information in medical imaging. Besides, a natural user interface (NUI) is designed specifically for operating rooms where touch-less interactions with finger and hand tracking are in use. Further, the system could both record procedural data automatically, and view acquired information from multiple perspectives graphically. A prototype system is tested in a live operating room environment at an Iranian teaching hospital. There are also contextual interviews and usability satisfaction questionnaires conducted with the "MediNav" system to investigate how useful the proposed system could be. The results reveal that integration of these systems into a complete solution is the key to not only stream up data and workflow but maximize surgical team usefulness as well. It is now possible to comprehensively collect and visualize medical information, and access a management tool with a touch-less NUI in a rather quick, practical, and harmless manner.

A reliable, low-cost picture archiving and communications system for small and medium veterinary practices built using open-source technology.

PubMed

Iotti, Bryan; Valazza, Alberto

2014-10-01

Picture Archiving and Communications Systems (PACS) are the most needed system in a modern hospital. As an integral part of the Digital Imaging and Communications in Medicine (DICOM) standard, they are charged with the responsibility for secure storage and accessibility of the diagnostic imaging data. These machines need to offer high performance, stability, and security while proving reliable and ergonomic in the day-to-day and long-term storage and retrieval of the data they safeguard. This paper reports the experience of the authors in developing and installing a compact and low-cost solution based on open-source technologies in the Veterinary Teaching Hospital for the University of Torino, Italy, during the course of the summer of 2012. The PACS server was built on low-cost x86-based hardware and uses an open source operating system derived from Oracle OpenSolaris (Oracle Corporation, Redwood City, CA, USA) to host the DCM4CHEE PACS DICOM server (DCM4CHEE, http://www.dcm4che.org ). This solution features very high data security and an ergonomic interface to provide easy access to a large amount of imaging data. The system has been in active use for almost 2 years now and has proven to be a scalable, cost-effective solution for practices ranging from small to very large, where the use of different hardware combinations allows scaling to the different deployments, while the use of paravirtualization allows increased security and easy migrations and upgrades.

High-performance web viewer for cardiac images

NASA Astrophysics Data System (ADS)

dos Santos, Marcelo; Furuie, Sergio S.

2004-04-01

With the advent of the digital devices for medical diagnosis the use of the regular films in radiology has decreased. Thus, the management and handling of medical images in digital format has become an important and critical task. In Cardiology, for example, the main difficulty is to display dynamic images with the appropriated color palette and frame rate used on acquisition process by Cath, Angio and Echo systems. In addition, other difficulty is handling large images in memory by any existing personal computer, including thin clients. In this work we present a web-based application that carries out these tasks with robustness and excellent performance, without burdening the server and network. This application provides near-diagnostic quality display of cardiac images stored as DICOM 3.0 files via a web browser and provides a set of resources that allows the viewing of still and dynamic images. It can access image files from the local disks, or network connection. Its features include: allows real-time playback, dynamic thumbnails image viewing during loading, access to patient database information, image processing tools, linear and angular measurements, on-screen annotations, image printing and exporting DICOM images to other image formats, and many others, all characterized by a pleasant user-friendly interface, inside a Web browser by means of a Java application. This approach offers some advantages over the most of medical images viewers, such as: facility of installation, integration with other systems by means of public and standardized interfaces, platform independence, efficient manipulation and display of medical images, all with high performance.

[Central online quality assurance in radiology: an IT solution exemplified by the German Breast Cancer Screening Program].

PubMed

Czwoydzinski, J; Girnus, R; Sommer, A; Heindel, W; Lenzen, H

2011-09-01

Physical-technical quality assurance is one of the essential tasks of the National Reference Centers in the German Breast Cancer Screening Program. For this purpose the mammography units are required to transfer the measured values of the constancy tests on a daily basis and all phantom images created for this purpose on a weekly basis to the reference centers. This is a serious logistical challenge. To meet these requirements, we developed an innovative software tool. By the end of 2005, we had already developed web-based software (MammoControl) allowing the transmission of constancy test results via entry forms. For automatic analysis and transmission of the phantom images, we then introduced an extension (MammoControl DIANA). This was based on Java, Java Web Start, the NetBeans Rich Client Platform, the Pixelmed Java DICOM Toolkit and the ImageJ library. MammoControl DIANA was designed to run locally in the mammography units. This allows automated on-site image analysis. Both results and compressed images can then be transmitted to the reference center. We developed analysis modules for the daily and monthly consistency tests and additionally for a homogeneity test. The software we developed facilitates the immediate availability of measurement results, phantom images, and DICOM header data in all reference centers. This allows both targeted guidance and short response time in the case of errors. We achieved a consistent IT-based evaluation with standardized tools for the entire screening program in Germany. © Georg Thieme Verlag KG Stuttgart · New York.

Increasing the Efficiency on Producing Radiology Reports for Breast Cancer Diagnosis by Means of Structured Reports. A Comparative Study.

PubMed

Segrelles, J Damian; Medina, Rosana; Blanquer, Ignacio; Martí-Bonmatí, Luis

2017-05-18

Radiology reports are commonly written on free-text using voice recognition devices. Structured reports (SR) have a high potential but they are usually considered more difficult to fill-in so their adoption in clinical practice leads to a lower efficiency. However, some studies have demonstrated that in some cases, producing SRs may require shorter time than plain-text ones. This work focuses on the definition and demonstration of a methodology to evaluate the productivity of software tools for producing radiology reports. A set of SRs for breast cancer diagnosis based on BI-RADS have been developed using this method. An analysis of their efficiency with respect to free-text reports has been performed. The methodology proposed compares the Elapsed Time (ET) on a set of radiological reports. Free-text reports are produced with the speech recognition devices used in the clinical practice. Structured reports are generated using a web application generated with TRENCADIS framework. A team of six radiologists with three different levels of experience in the breast cancer diagnosis was recruited. These radiologists performed the evaluation, each one introducing 50 reports for mammography, 50 for ultrasound scan and 50 for MRI using both approaches. Also, the Relative Efficiency (REF) was computed for each report, dividing the ET of both methods. We applied the T-Student (T-S) test to compare the ETs and the ANOVA test to compare the REFs. Both tests were computed using the SPSS software. The study produced three DICOM-SR templates for Breast Cancer Diagnosis on mammography, ultrasound and MRI, using RADLEX terms based on BIRADs 5th edition. The T-S test on radiologists with high or intermediate profile, showed that the difference between the ET was only statistically significant for mammography and ultrasound. The ANOVA test performed grouping the REF by modalities, indicated that there were no significant differences between mammograms and ultrasound scans, but both have significant statistical differences with MRI. The ANOVA test of the REF for each modality, indicated that there were only significant differences in Mammography (ANOVA p = 0.024) and Ultrasound (ANOVA p = 0.008). The ANOVA test for each radiologist profile, indicated that there were significant differences on the high profile (ANOVA p = 0.028) and medium (ANOVA p = 0.045). In this work, we have defined and demonstrated a methodology to evaluate the productivity of software tools for producing radiology reports in Breast Cancer. We have evaluated that adopting Structured Reporting in mammography and ultrasound studies in breast cancer diagnosis improves the performance in producing reports.

Mobile healthcare information management utilizing Cloud Computing and Android OS.

PubMed

Doukas, Charalampos; Pliakas, Thomas; Maglogiannis, Ilias

2010-01-01

Cloud Computing provides functionality for managing information data in a distributed, ubiquitous and pervasive manner supporting several platforms, systems and applications. This work presents the implementation of a mobile system that enables electronic healthcare data storage, update and retrieval using Cloud Computing. The mobile application is developed using Google's Android operating system and provides management of patient health records and medical images (supporting DICOM format and JPEG2000 coding). The developed system has been evaluated using the Amazon's S3 cloud service. This article summarizes the implementation details and presents initial results of the system in practice.

Measuring watershed runoff capability with ERTS data. [Washita River Basin, Oklahoma

NASA Technical Reports Server (NTRS)

Blanchard, B. J.

1974-01-01

Parameters of most equations used to predict runoff from an ungaged area are based on characteristics of the watershed and subject to the biases of a hydrologist. Digital multispectral scanner, MSS, data from ERTS was reduced with the aid of computer programs and a Dicomed display. Multivariate analyses of the MSS data indicate that discrimination between watersheds with different runoff capabilities is possible using ERTS data. Differences between two visible bands of MSS data can be used to more accurately evaluate the parameters than present subjective methods, thus reducing construction cost due to overdesign of flood detention structures.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Myronakis, M; Cai, W; Dhou, S

Purpose: To design a comprehensive open-source, publicly available, graphical user interface (GUI) to facilitate the configuration, generation, processing and use of the 4D Extended Cardiac-Torso (XCAT) phantom. Methods: The XCAT phantom includes over 9000 anatomical objects as well as respiratory, cardiac and tumor motion. It is widely used for research studies in medical imaging and radiotherapy. The phantom generation process involves the configuration of a text script to parameterize the geometry, motion, and composition of the whole body and objects within it, and to generate simulated PET or CT images. To avoid the need for manual editing or script writing,more » our MATLAB-based GUI uses slider controls, drop-down lists, buttons and graphical text input to parameterize and process the phantom. Results: Our GUI can be used to: a) generate parameter files; b) generate the voxelized phantom; c) combine the phantom with a lesion; d) display the phantom; e) produce average and maximum intensity images from the phantom output files; f) incorporate irregular patient breathing patterns; and f) generate DICOM files containing phantom images. The GUI provides local help information using tool-tip strings on the currently selected phantom, minimizing the need for external documentation. The DICOM generation feature is intended to simplify the process of importing the phantom images into radiotherapy treatment planning systems or other clinical software. Conclusion: The GUI simplifies and automates the use of the XCAT phantom for imaging-based research projects in medical imaging or radiotherapy. This has the potential to accelerate research conducted with the XCAT phantom, or to ease the learning curve for new users. This tool does not include the XCAT phantom software itself. We would like to acknowledge funding from MRA, Varian Medical Systems Inc.« less

Diagnostic accuracy of an iPhone DICOM viewer for the interpretation of magnetic resonance imaging of the knee.

PubMed

De Maio, Peter; White, Lawrence M; Bleakney, Robert; Menezes, Ravi J; Theodoropoulos, John

2014-07-01

To evaluate the diagnostic performance of viewing magnetic resonance (MR) images on a handheld mobile device compared with a conventional radiology workstation for the diagnosis of intra-articular knee pathology. Prospective comparison study. Tertiary care center. Fifty consecutive subjects who had MR imaging of the knee followed by knee arthroscopy were prospectively evaluated. Two musculoskeletal radiologists independently reviewed each MR study using 2 different viewers: the OsiriX DICOM viewer software on an Apple iPhone 3GS device and eFilm Workstation software on a conventional picture archiving and communications system workstation. Sensitivity and specificity of the iPhone and workstation interpretations was performed using knee arthroscopy as the reference standard. Intraobserver concordance and agreement between the iPhone and workstation interpretations were determined. There was no statistically significant difference between the 2 devices for each paired comparison of diagnostic performance. For the iPhone interpretations, sensitivity ranged from 77% (13 of 17) for the lateral meniscus to 100% (17 of 17) for the anterior cruciate ligament. Specificity ranged from 74% (14 of 19) for cartilage to 100% (50 of 50) for the posterior cruciate ligament. There was a very high level of interobserver and intraobserver agreement between devices and readers. The iPhone reads took longer than the corresponding workstation reads, with a significant mean difference between the iPhone and workstation reads of 3.98 minutes (P < 0.001). The diagnostic performance of interpreting MR images on a handheld mobile device for the assessment of intra-articular knee pathology is similar to that of a conventional radiology workstation, however, requires a longer viewing time. Timely and accurate interpretation of complex medical images using mobile device solutions could result in new workflow efficiencies and ultimately improve patient care.

PANDA: a pipeline toolbox for analyzing brain diffusion images.

PubMed

Cui, Zaixu; Zhong, Suyu; Xu, Pengfei; He, Yong; Gong, Gaolang

2013-01-01

Diffusion magnetic resonance imaging (dMRI) is widely used in both scientific research and clinical practice in in-vivo studies of the human brain. While a number of post-processing packages have been developed, fully automated processing of dMRI datasets remains challenging. Here, we developed a MATLAB toolbox named "Pipeline for Analyzing braiN Diffusion imAges" (PANDA) for fully automated processing of brain diffusion images. The processing modules of a few established packages, including FMRIB Software Library (FSL), Pipeline System for Octave and Matlab (PSOM), Diffusion Toolkit and MRIcron, were employed in PANDA. Using any number of raw dMRI datasets from different subjects, in either DICOM or NIfTI format, PANDA can automatically perform a series of steps to process DICOM/NIfTI to diffusion metrics [e.g., fractional anisotropy (FA) and mean diffusivity (MD)] that are ready for statistical analysis at the voxel-level, the atlas-level and the Tract-Based Spatial Statistics (TBSS)-level and can finish the construction of anatomical brain networks for all subjects. In particular, PANDA can process different subjects in parallel, using multiple cores either in a single computer or in a distributed computing environment, thus greatly reducing the time cost when dealing with a large number of datasets. In addition, PANDA has a friendly graphical user interface (GUI), allowing the user to be interactive and to adjust the input/output settings, as well as the processing parameters. As an open-source package, PANDA is freely available at http://www.nitrc.org/projects/panda/. This novel toolbox is expected to substantially simplify the image processing of dMRI datasets and facilitate human structural connectome studies.

Automated replication of cone beam CT-guided treatments in the Pinnacle(3) treatment planning system for adaptive radiotherapy.

PubMed

Hargrave, Catriona; Mason, Nicole; Guidi, Robyn; Miller, Julie-Anne; Becker, Jillian; Moores, Matthew; Mengersen, Kerrie; Poulsen, Michael; Harden, Fiona

2016-03-01

Time-consuming manual methods have been required to register cone-beam computed tomography (CBCT) images with plans in the Pinnacle(3) treatment planning system in order to replicate delivered treatments for adaptive radiotherapy. These methods rely on fiducial marker (FM) placement during CBCT acquisition or the image mid-point to localise the image isocentre. A quality assurance study was conducted to validate an automated CBCT-plan registration method utilising the Digital Imaging and Communications in Medicine (DICOM) Structure Set (RS) and Spatial Registration (RE) files created during online image-guided radiotherapy (IGRT). CBCTs of a phantom were acquired with FMs and predetermined setup errors using various online IGRT workflows. The CBCTs, DICOM RS and RE files were imported into Pinnacle(3) plans of the phantom and the resulting automated CBCT-plan registrations were compared to existing manual methods. A clinical protocol for the automated method was subsequently developed and tested retrospectively using CBCTs and plans for six bladder patients. The automated CBCT-plan registration method was successfully applied to thirty-four phantom CBCT images acquired with an online 0 mm action level workflow. Ten CBCTs acquired with other IGRT workflows required manual workarounds. This was addressed during the development and testing of the clinical protocol using twenty-eight patient CBCTs. The automated CBCT-plan registrations were instantaneous, replicating delivered treatments in Pinnacle(3) with errors of ±0.5 mm. These errors were comparable to mid-point-dependant manual registrations but superior to FM-dependant manual registrations. The automated CBCT-plan registration method quickly and reliably replicates delivered treatments in Pinnacle(3) for adaptive radiotherapy.

An open source software for analysis of dynamic contrast enhanced magnetic resonance images: UMMPerfusion revisited.

PubMed

Zöllner, Frank G; Daab, Markus; Sourbron, Steven P; Schad, Lothar R; Schoenberg, Stefan O; Weisser, Gerald

2016-01-14

Perfusion imaging has become an important image based tool to derive the physiological information in various applications, like tumor diagnostics and therapy, stroke, (cardio-) vascular diseases, or functional assessment of organs. However, even after 20 years of intense research in this field, perfusion imaging still remains a research tool without a broad clinical usage. One problem is the lack of standardization in technical aspects which have to be considered for successful quantitative evaluation; the second problem is a lack of tools that allow a direct integration into the diagnostic workflow in radiology. Five compartment models, namely, a one compartment model (1CP), a two compartment exchange (2CXM), a two compartment uptake model (2CUM), a two compartment filtration model (2FM) and eventually the extended Toft's model (ETM) were implemented as plugin for the DICOM workstation OsiriX. Moreover, the plugin has a clean graphical user interface and provides means for quality management during the perfusion data analysis. Based on reference test data, the implementation was validated against a reference implementation. No differences were found in the calculated parameters. We developed open source software to analyse DCE-MRI perfusion data. The software is designed as plugin for the DICOM Workstation OsiriX. It features a clean GUI and provides a simple workflow for data analysis while it could also be seen as a toolbox providing an implementation of several recent compartment models to be applied in research tasks. Integration into the infrastructure of a radiology department is given via OsiriX. Results can be saved automatically and reports generated automatically during data analysis ensure certain quality control.

Improved planning of endoscopic sinonasal surgery from 3-dimensional images with Osirix® and stereolithography.

PubMed

Sánchez-Gómez, Serafín; Herrero-Salado, Tomás F; Maza-Solano, Juan M; Ropero-Romero, Francisco; González-García, Jaime; Ambrosiani-Fernández, Jesús

2015-01-01

The high variability of sinonasal anatomy requires the best knowledge of its three-dimensional (3D) conformation to perform surgery more safely and efficiently. The aim of the study was to validate the utility of Osirix® and stereolithography in improving endoscopic sinonasal surgery planning. Osirix® was used as a viewer and Digital Imaging and Communications in Medicine (DICOM) 3D imaging manager to improve planning for 114 sinonasal endoscopic operations with polyposis (86) and chronic rhinosinusitis (CRS) (28). Stereolithography rapid prototyping was used for 7 frontoethmoidal mucoceles. Using Osirix® and stereolithography, a greater number of anatomical structures were identified and this was done faster, with a statistically-significant clinical-radiological correlation (P<.01) compared with 2D CT plates. With a share of more than 75% of surgery performed by residents, surgical time was reduced by 38±12.3min in CRS and 42±27.9 in sinonasal polyposis. The fourth-year residents reached 100% surgical competence in critical surgical milestones with 16 surgeries (CI 12-19). The systematic use of Osirix® for visualisation and treatment of 3D sinonasal images from DICOM data files, along with the surgical team's ability to manipulate them as virtual reality, allows surgeons to perform endoscopic sinonasal surgery with greater confidence and in less time than using 2D images. Residents also achieve surgical competence faster, more safely and with fewer complications. This beneficial impact is increased when the surgical team has stereolithography rapid prototyping in more complex cases. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ruuge, A; Erdi, Y; Mahmood, U

Purpose: The conformance of Primary Diagnostic Monitors (PDMs) to the DICOM GSDF is increasingly required by several state and city regulators. Our purpose was to quantitatively characterize the luminance performance of the internal, built in photometer of BARCO monitors against an externally calibrated luminance meter. Methods: Thirty one PDMs (BARCO) were included in our analysis. An externally calibrated photometer (RaySafe Solo Light) was used to measure the luminance and illuminance values. Measured monitors were located at various hospital sites, radiology physicians’ offices and radiology reading rooms. All measured PDMs were equipped with the manufacturer’s built-in photometers and connected to Barcomore » MediCal QA web service for manual and automatic quality control measurements. PDM combinations included 1, 2 and 4 monitors depending on the location. TG-18 and SMPTE test patterns were used to evaluate monitor performance. Results: All the PDMs exceeded the luminance ratio of 250:1, as required by NYC PDM guidelines. One PDM failed the NYC requirement for the minimal luminance level of 350 cd/m2. As compared to the external photometer, the difference in measurement of the maximum luminance with the built-in photometer was found to exceed 5% on 6 of the PDM measured, with a maximum deviation of 10%. The age of the monitors that failed was on average 5 years. All monitors passed the luminance uniformity test, which was 30% from the center of the monitor to the 4 corner locations. Four PDMs failed the Gray Scale Display Function (GSDF) calibration. Conclusion: For the consistent display of medical images and continued conformance with the DICOM GSDF standard, it is essential to compare the performance of the built-in photometer with an externally calibrated photometer for monitors that are older than 5 years.« less

Wireless remote control clinical image workflow: utilizing a PDA for offsite distribution

NASA Astrophysics Data System (ADS)

Liu, Brent J.; Documet, Luis; Documet, Jorge; Huang, H. K.; Muldoon, Jean

2004-04-01

Last year we presented in RSNA an application to perform wireless remote control of PACS image distribution utilizing a handheld device such as a Personal Digital Assistant (PDA). This paper describes the clinical experiences including workflow scenarios of implementing the PDA application to route exams from the clinical PACS archive server to various locations for offsite distribution of clinical PACS exams. By utilizing this remote control application, radiologists can manage image workflow distribution with a single wireless handheld device without impacting their clinical workflow on diagnostic PACS workstations. A PDA application was designed and developed to perform DICOM Query and C-Move requests by a physician from a clinical PACS Archive to a CD-burning device for automatic burning of PACS data for the distribution to offsite. In addition, it was also used for convenient routing of historical PACS exams to the local web server, local workstations, and teleradiology systems. The application was evaluated by radiologists as well as other clinical staff who need to distribute PACS exams to offsite referring physician"s offices and offsite radiologists. An application for image workflow management utilizing wireless technology was implemented in a clinical environment and evaluated. A PDA application was successfully utilized to perform DICOM Query and C-Move requests from the clinical PACS archive to various offsite exam distribution devices. Clinical staff can utilize the PDA to manage image workflow and PACS exam distribution conveniently for offsite consultations by referring physicians and radiologists. This solution allows the radiologist to expand their effectiveness in health care delivery both within the radiology department as well as offisite by improving their clinical workflow.

PANDA: a pipeline toolbox for analyzing brain diffusion images

PubMed Central

Cui, Zaixu; Zhong, Suyu; Xu, Pengfei; He, Yong; Gong, Gaolang

2013-01-01

Diffusion magnetic resonance imaging (dMRI) is widely used in both scientific research and clinical practice in in-vivo studies of the human brain. While a number of post-processing packages have been developed, fully automated processing of dMRI datasets remains challenging. Here, we developed a MATLAB toolbox named “Pipeline for Analyzing braiN Diffusion imAges” (PANDA) for fully automated processing of brain diffusion images. The processing modules of a few established packages, including FMRIB Software Library (FSL), Pipeline System for Octave and Matlab (PSOM), Diffusion Toolkit and MRIcron, were employed in PANDA. Using any number of raw dMRI datasets from different subjects, in either DICOM or NIfTI format, PANDA can automatically perform a series of steps to process DICOM/NIfTI to diffusion metrics [e.g., fractional anisotropy (FA) and mean diffusivity (MD)] that are ready for statistical analysis at the voxel-level, the atlas-level and the Tract-Based Spatial Statistics (TBSS)-level and can finish the construction of anatomical brain networks for all subjects. In particular, PANDA can process different subjects in parallel, using multiple cores either in a single computer or in a distributed computing environment, thus greatly reducing the time cost when dealing with a large number of datasets. In addition, PANDA has a friendly graphical user interface (GUI), allowing the user to be interactive and to adjust the input/output settings, as well as the processing parameters. As an open-source package, PANDA is freely available at http://www.nitrc.org/projects/panda/. This novel toolbox is expected to substantially simplify the image processing of dMRI datasets and facilitate human structural connectome studies. PMID:23439846

Business Model for the Security of a Large-Scale PACS, Compliance with ISO/27002:2013 Standard.

PubMed

Gutiérrez-Martínez, Josefina; Núñez-Gaona, Marco Antonio; Aguirre-Meneses, Heriberto

2015-08-01

Data security is a critical issue in an organization; a proper information security management (ISM) is an ongoing process that seeks to build and maintain programs, policies, and controls for protecting information. A hospital is one of the most complex organizations, where patient information has not only legal and economic implications but, more importantly, an impact on the patient's health. Imaging studies include medical images, patient identification data, and proprietary information of the study; these data are contained in the storage device of a PACS. This system must preserve the confidentiality, integrity, and availability of patient information. There are techniques such as firewalls, encryption, and data encapsulation that contribute to the protection of information. In addition, the Digital Imaging and Communications in Medicine (DICOM) standard and the requirements of the Health Insurance Portability and Accountability Act (HIPAA) regulations are also used to protect the patient clinical data. However, these techniques are not systematically applied to the picture and archiving and communication system (PACS) in most cases and are not sufficient to ensure the integrity of the images and associated data during transmission. The ISO/IEC 27001:2013 standard has been developed to improve the ISM. Currently, health institutions lack effective ISM processes that enable reliable interorganizational activities. In this paper, we present a business model that accomplishes the controls of ISO/IEC 27002:2013 standard and criteria of security and privacy from DICOM and HIPAA to improve the ISM of a large-scale PACS. The methodology associated with the model can monitor the flow of data in a PACS, facilitating the detection of unauthorized access to images and other abnormal activities.

A 3-dimensional mathematic cylinder phantom for the evaluation of the fundamental performance of SPECT.

PubMed

Onishi, Hideo; Motomura, Nobutoku; Takahashi, Masaaki; Yanagisawa, Masamichi; Ogawa, Koichi

2010-03-01

Degradation of SPECT images results from various physical factors. The primary aim of this study was the development of a digital phantom for use in the characterization of factors that contribute to image degradation in clinical SPECT studies. A 3-dimensional mathematic cylinder (3D-MAC) phantom was devised and developed. The phantom (200 mm in diameter and 200 mm long) comprised 3 imbedded stacks of five 30-mm-long cylinders (diameters, 4, 10, 20, 40, and 60 mm). In simulations, the 3 stacks and the background were assigned radioisotope concentrations and attenuation coefficients. SPECT projection datasets that included Compton scattering effects, photoelectric effects, and gamma-camera models were generated using the electron gamma-shower Monte Carlo simulation program. Collimator parameters, detector resolution, total photons acquired, number of projections acquired, and radius of rotation were varied in simulations. The projection data were formatted in Digital Imaging and Communications in Medicine (DICOM) and imported to and reconstructed using commercial reconstruction software on clinical SPECT workstations. Using the 3D-MAC phantom, we validated that contrast depended on size of region of interest (ROI) and was overestimated when the ROI was small. The low-energy general-purpose collimator caused a greater partial-volume effect than did the low-energy high-resolution collimator, and contrast in the cold region was higher using the filtered backprojection algorithm than using the ordered-subset expectation maximization algorithm in the SPECT images. We used imported DICOM projection data and reconstructed these data using vendor software; in addition, we validated reconstructed images. The devised and developed 3D-MAC SPECT phantom is useful for the characterization of various physical factors, contrasts, partial-volume effects, reconstruction algorithms, and such, that contribute to image degradation in clinical SPECT studies.

Automated Reporting of DXA Studies Using a Custom-Built Computer Program.

PubMed

England, Joseph R; Colletti, Patrick M

2018-06-01

Dual-energy x-ray absorptiometry (DXA) scans are a critical population health tool and relatively simple to interpret but can be time consuming to report, often requiring manual transfer of bone mineral density and associated statistics into commercially available dictation systems. We describe here a custom-built computer program for automated reporting of DXA scans using Pydicom, an open-source package built in the Python computer language, and regular expressions to mine DICOM tags for patient information and bone mineral density statistics. This program, easy to emulate by any novice computer programmer, has doubled our efficiency at reporting DXA scans and has eliminated dictation errors.

Fully automated processing of fMRI data in SPM: from MRI scanner to PACS.

PubMed

Maldjian, Joseph A; Baer, Aaron H; Kraft, Robert A; Laurienti, Paul J; Burdette, Jonathan H

2009-01-01

Here we describe the Wake Forest University Pipeline, a fully automated method for the processing of fMRI data using SPM. The method includes fully automated data transfer and archiving from the point of acquisition, real-time batch script generation, distributed grid processing, interface to SPM in MATLAB, error recovery and data provenance, DICOM conversion and PACS insertion. It has been used for automated processing of fMRI experiments, as well as for the clinical implementation of fMRI and spin-tag perfusion imaging. The pipeline requires no manual intervention, and can be extended to any studies requiring offline processing.

QUIJOTE Experiment: status of telescopes and instrumentation

NASA Astrophysics Data System (ADS)

Pérez-de-Taoro, M. R.; Aguiar-González, M.; Cózar-Castellano, J.; Génova-Santos, R.; Gómez-Reñasco, F.; Hoyland, R.; Peláez-Santos, A.; Poidevin, F.; Tramonte, D.; Rebolo-López, R.; Rubiño-Martín, J. A.; Sánchez-de-la-Rosa, V.; Vega-Moreno, A.; Viera-Curbelo, T.; Vignaga, R.; Casas, F. J.; Martinez-Gonzalez, E.; Ortiz, D.; Aja, B.; Artal, E.; Cano-de-Diego, J. L.; de-la-Fuente, L.; Mediavilla, A.; Terán, J. V.; Villa, E.; Harper, S.; McCulloch, M.; Melhuish, S.; Piccirillo, L.; Lasenby, A.

2016-07-01

The QUIJOTE Experiment (Q-U-I JOint TEnerife) is a combined operation of two telescopes and three instruments working in the microwave band to measure the polarization of the Cosmic Microwave Background (CMB) from the northern hemisphere, at medium and large angular scales. The experiment is located at the Teide Observatory in Tenerife, one of the seven Canary Islands (Spain). The project is a consortium maintained by several institutions: the Instituto de Astrofísica de Canarias (IAC), the Instituto de Física de Cantabria (IFCA), the Communications Engineering Department (DICOM) at Universidad de Cantabria, and the Universities of Manchester and Cambridge. The consortium is led by the IAC.

Useful diagnostic biometabolic data obtained by PET/CT and MR fusion imaging using open source software.

PubMed

Antonica, Filippo; Asabella, Artor Niccoli; Ferrari, Cristina; Rubini, Domenico; Notaristefano, Antonio; Nicoletti, Adriano; Altini, Corinna; Merenda, Nunzio; Mossa, Emilio; Guarini, Attilio; Rubini, Giuseppe

2014-01-01

In the last decade numerous attempts were considered to co-register and integrate different imaging data. Like PET/CT the integration of PET to MR showed great interest. PET/MR scanners are recently tested on different distrectual or systemic pathologies. Unfortunately PET/MR scanners are expensive and diagnostic protocols are still under studies and investigations. Nuclear Medicine imaging highlights functional and biometabolic information but has poor anatomic details. The aim of this study is to integrate MR and PET data to produce distrectual or whole body fused images acquired from different scanners even in different days. We propose an offline method to fuse PET with MR data using an open-source software that has to be inexpensive, reproducible and capable to exchange data over the network. We also evaluate global quality, alignment quality, and diagnostic confidence of fused PET-MR images. We selected PET/CT studies performed in our Nuclear Medicine unit, MR studies provided by patients on DICOM CD media or network received. We used Osirix 5.7 open source version. We aligned CT slices with the first MR slice, pointed and marked for co-registration using MR-T1 sequence and CT as reference and fused with PET to produce a PET-MR image. A total of 100 PET/CT studies were fused with the following MR studies: 20 head, 15 thorax, 24 abdomen, 31 pelvis, 10 whole body. An interval of no more than 15 days between PET and MR was the inclusion criteria. PET/CT, MR and fused studies were evaluated by two experienced radiologist and two experienced nuclear medicine physicians. Each one filled a five point based evaluation scoring scheme based on image quality, image artifacts, segmentation errors, fusion misalignment and diagnostic confidence. Our fusion method showed best results for head, thorax and pelvic districts in terms of global quality, alignment quality and diagnostic confidence,while for the abdomen and pelvis alignement quality and global quality resulted poor due to internal organs filling variation and time shifting beetwen examinations. PET/CT images with time of flight reconstruction and real attenuation correction were combined with anatomical detailed MRI images. We used Osirix, an image processing Open Source Software dedicated to DICOM images. No additional costs, to buy and upgrade proprietary software are required for combining data. No high technology or very expensive PET/MR scanner, that requires dedicated shielded room spaces and personnel to be employed or to be trained, are needed. Our method allows to share patient PET/MR fused data with different medical staff using dedicated networks. The proposed method may be applied to every MR sequence (MR-DWI and MR-STIR, magnet enhanced sequences) to characterize soft tissue alterations and improve discrimination diseases. It can be applied not only to PET with MR but virtually to every DICOM study.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clemente, F; Perez, C

Purpose: Redundant treatment verifications in conformal and intensity-modulated radiation therapy techniques are traditionally performed with single point calculations. New solutions can replace these checks with 3D treatment plan verifications. This work describes a software tool (Mobius3D, Mobius Medical Systems) that uses a GPU-accelerated collapsed cone algorithm to perform 3D independent verifications of TPS calculations. Methods: Mobius3D comes with reference beam models for common linear accelerators. The system uses an independently developed collapsed cone algorithm updated with recent enhancements. 144 isotropically-spaced cones are used for each voxel for calculations. These complex calculations can be sped up by using GPUs. Mobius3D calculatemore » dose using DICOM information coming from TPS (CT, RT Struct, RT Plan RT Dose). DVH-metrics and 3D gamma tests can be used to compare both TPS and secondary calculations. 170 patients treated with all common techniques as 3DCFRT (including wedged), static and dynamic IMRT and VMAT have been successfully verified with this solution. Results: Calculation times are between 3–5 minutes for 3DCFRT treatments and 15–20 for most complex dMLC and VMAT plans. For all PTVs mean dose and 90% coverage differences are (1.12±0.97)% and (0.68±1.19)%, respectively. Mean dose discrepancies for all OARs is (0.64±1.00)%. 3D gamma (global, 3%/3 mm) analysis shows a mean passing rate of (97.8 ± 3.0)% for PTVs and (99.0±3.0)% for OARs. 3D gamma pasing rate for all voxels in CT has a mean value of (98.5±1.6)%. Conclusion: Mobius3D is a powerful tool to verify all modalities of radiation therapy treatments. Dose discrepancies calculated by this system are in good agreement with TPS. The use of reference beam data results in time savings and can be used to avoid the propagation of errors in original beam data into our QA system. GPU calculations permit enhanced collapsed cone calculations with reasonable calculation times.« less

Interpreting three-dimensional structures from two-dimensional images: a web-based interactive 3D teaching model of surgical liver anatomy

PubMed Central

Crossingham, Jodi L; Jenkinson, Jodie; Woolridge, Nick; Gallinger, Steven; Tait, Gordon A; Moulton, Carol-Anne E

2009-01-01

Background: Given the increasing number of indications for liver surgery and the growing complexity of operations, many trainees in surgical, imaging and related subspecialties require a good working knowledge of the complex intrahepatic anatomy. Computed tomography (CT), the most commonly used liver imaging modality, enhances our understanding of liver anatomy, but comprises a two-dimensional (2D) representation of a complex 3D organ. It is challenging for trainees to acquire the necessary skills for converting these 2D images into 3D mental reconstructions because learning opportunities are limited and internal hepatic anatomy is complicated, asymmetrical and variable. We have created a website that uses interactive 3D models of the liver to assist trainees in understanding the complex spatial anatomy of the liver and to help them create a 3D mental interpretation of this anatomy when viewing CT scans. Methods: Computed tomography scans were imported into DICOM imaging software (OsiriX™) to obtain 3D surface renderings of the liver and its internal structures. Using these 3D renderings as a reference, 3D models of the liver surface and the intrahepatic structures, portal veins, hepatic veins, hepatic arteries and the biliary system were created using 3D modelling software (Cinema 4D™). Results: Using current best practices for creating multimedia tools, a unique, freely available, online learning resource has been developed, entitled Visual Interactive Resource for Teaching, Understanding And Learning Liver Anatomy (VIRTUAL Liver) (http://pie.med.utoronto.ca/VLiver). This website uses interactive 3D models to provide trainees with a constructive resource for learning common liver anatomy and liver segmentation, and facilitates the development of the skills required to mentally reconstruct a 3D version of this anatomy from 2D CT scans. Discussion: Although the intended audience for VIRTUAL Liver consists of residents in various medical and surgical specialties, the website will also be useful for other health care professionals (i.e. radiologists, nurses, hepatologists, radiation oncologists, family doctors) and educators because it provides a comprehensive resource for teaching liver anatomy. PMID:19816618

Can the risk of secondary cancer induction after breast conserving therapy be reduced using intraoperative radiotherapy (IORT) with low-energy x-rays?

PubMed

Aziz, Muhammad Hammad; Schneider, Frank; Clausen, Sven; Blank, Elena; Herskind, Carsten; Afzal, Muhammad; Wenz, Frederik

2011-12-16

Radiation induced secondary cancers are a rare but severe late effect after breast conserving therapy. Intraoperative radiotherapy (IORT) is increasingly used during breast conserving surgery. The purpose of this analysis was to estimate secondary cancer risks after IORT compared to other modalities of breast radiotherapy (APBI - accelerated partial breast irradiation, EBRT - external beam radiotherapy). Computer-tomography scans of an anthropomorphic phantom were acquired with an INTRABEAM IORT applicator (diameter 4 cm) in the outer quadrant of the breast and transferred via DICOM to the treatment planning system. Ipsilateral breast, contralateral breast, ipsilateral lung, contralateral lung, spine and heart were contoured. An INTRABEAM source (50 kV) was defined with the tip of the drift tube at the center of the spherical applicator. A dose of 20 Gy at 0 mm depth from the applicator surface was prescribed for IORT and 34 Gy (5 days × 2 × 3.4 Gy) at 10 mm depth for APBI. For EBRT a total dose of 50 Gy in 2 Gy fractions was planned using two tangential fields with wedges. The mean and maximal doses, DVHs and volumes receiving more than 0.1 Gy and 4 Gy of organs at risk (OAR) were calculated and compared. The life time risk for secondary cancers was estimated according to NCRP report 116. IORT delivered the lowest maximal doses to contralateral breast (< 0.3 Gy), ipsilateral (1.8 Gy) and contralateral lung (< 0.3 Gy), heart (1 Gy) and spine (< 0.3 Gy). In comparison, maximal doses for APBI were 2-5 times higher. EBRT delivered a maximal dose of 10.4 Gy to the contralateral breast and 53 Gy to the ipsilateral lung. OAR volumes receiving more than 4 Gy were 0% for IORT, < 2% for APBI and up to 10% for EBRT (ipsilateral lung). The estimated risk for secondary cancer in the respective OAR is considerably lower after IORT and/or APBI as compared to EBRT. The calculations for maximal doses and volumes of OAR suggest that the risk of secondary cancer induction after IORT is lower than compared to APBI and EBRT.

SU-E-J-192: Verification of 4D-MRI Internal Target Volume Using Cine MRI

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lafata, K; Czito, B; Palta, M

Purpose: To investigate the accuracy of 4D-MRI in determining the Internal Target Volume (ITV) used in radiation oncology treatment planning of liver cancers. Cine MRI is used as the standard baseline in establishing the feasibility and accuracy of 4D-MRI tumor motion within the liver. Methods: IRB approval was obtained for this retrospective study. Analysis was performed on MR images from four patients receiving external beam radiation therapy for liver cancer at our institution. Eligible patients received both Cine and 4D-MRI scans before treatment. Cine images were acquired sagittally in real time at a slice bisecting the tumor, while 4D imagesmore » were acquired volumetrically. Cine MR DICOM headers were manipulated such that each respiratory frame was assigned a unique slice location. This approach permitted the treatment planning system (Eclipse, Varian Medical Systems) to recognize a complete respiratory cycle as a “volume”, where the gross tumor was contoured temporally. Software was developed to calculate the union of all frame contours in the structure set, resulting in the corresponding plane of the ITV projecting through the middle of the tumor, defined as the Internal Target Area (ITA). This was repeated for 4D-MRI, at the corresponding slice location, allowing a direct comparison of ITAs obtained from each modality. Results: Four patients have been analyzed. ITAs contoured from 4D-MRI correlate with contours from Cine MRI. The mean error of 4D values relative to Cine values is 7.67 +/− 2.55 %. No single ITA contoured from 4D-MRI demonstrated more than 10.5 % error compared to its Cine MRI counterpart. Conclusion: Motion management is a significant aspect of treatment planning within dynamic environments such as the liver, where diaphragmatic and cardiac activity influence plan accuracy. This small pilot study suggests that 4D-MRI based ITA measurements agree with Cine MRI based measurements, an important step towards clinical implementation. NIH 1R21CA165384-01A1.« less

Proximal humeral fracture classification systems revisited.

PubMed

Majed, Addie; Macleod, Iain; Bull, Anthony M J; Zyto, Karol; Resch, Herbert; Hertel, Ralph; Reilly, Peter; Emery, Roger J H

2011-10-01

This study evaluated several classification systems and expert surgeons' anatomic understanding of these complex injuries based on a consecutive series of patients. We hypothesized that current proximal humeral fracture classification systems, regardless of imaging methods, are not sufficiently reliable to aid clinical management of these injuries. Complex fractures in 96 consecutive patients were investigated by generation of rapid sequence prototyping models from computed tomography Digital Imaging and Communications in Medicine (DICOM) imaging data. Four independent senior observers were asked to classify each model using 4 classification systems: Neer, AO, Codman-Hertel, and a prototype classification system by Resch. Interobserver and intraobserver κ coefficient values were calculated for the overall classification system and for selected classification items. The κ coefficient values for the interobserver reliability were 0.33 for Neer, 0.11 for AO, 0.44 for Codman-Hertel, and 0.15 for Resch. Interobserver reliability κ coefficient values were 0.32 for the number of fragments and 0.30 for the anatomic segment involved using the Neer system, 0.30 for the AO type (A, B, C), and 0.53, 0.48, and 0.08 for the Resch impaction/distraction, varus/valgus and flexion/extension subgroups, respectively. Three-part fractures showed low reliability for the Neer and AO systems. Currently available evidence suggests fracture classifications in use have poor intra- and inter-observer reliability despite the modality of imaging used thus making treating these injuries difficult as weak as affecting scientific research as well. This study was undertaken to evaluate the reliability of several systems using rapid sequence prototype models. Overall interobserver κ values represented slight to moderate agreement. The most reliable interobserver scores were found with the Codman-Hertel classification, followed by elements of Resch's trial system. The AO system had the lowest values. The higher interobserver reliability values for the Codman-Hertel system showed that is the only comprehensive fracture description studied, whereas the novel classification by Resch showed clear definition in respect to varus/valgus and impaction/distraction angulation. Copyright © 2011 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

A DICOM Based Collaborative Platform for Real-Time Medical Teleconsultation on Medical Images.

PubMed

Maglogiannis, Ilias; Andrikos, Christos; Rassias, Georgios; Tsanakas, Panayiotis

2017-01-01

The paper deals with the design of a Web-based platform for real-time medical teleconsultation on medical images. The proposed platform combines the principles of heterogeneous Workflow Management Systems (WfMSs), the peer-to-peer networking architecture and the SPA (Single-Page Application) concept, to facilitate medical collaboration among healthcare professionals geographically distributed. The presented work leverages state-of-the-art features of the web to support peer-to-peer communication using the WebRTC (Web Real Time Communication) protocol and client-side data processing for creating an integrated collaboration environment. The paper discusses the technical details of implementation and presents the operation of the platform in practice along with some initial results.

[Development of a software for 3D virtual phantom design].

PubMed

Zou, Lian; Xie, Zhao; Wu, Qi

2014-02-01

In this paper, we present a 3D virtual phantom design software, which was developed based on object-oriented programming methodology and dedicated to medical physics research. This software was named Magical Phan tom (MPhantom), which is composed of 3D visual builder module and virtual CT scanner. The users can conveniently construct any complex 3D phantom, and then export the phantom as DICOM 3.0 CT images. MPhantom is a user-friendly and powerful software for 3D phantom configuration, and has passed the real scene's application test. MPhantom will accelerate the Monte Carlo simulation for dose calculation in radiation therapy and X ray imaging reconstruction algorithm research.

Treating voxel geometries in radiation protection dosimetry with a patched version of the Monte Carlo codes MCNP and MCNPX.

PubMed

Burn, K W; Daffara, C; Gualdrini, G; Pierantoni, M; Ferrari, P

2007-01-01

The question of Monte Carlo simulation of radiation transport in voxel geometries is addressed. Patched versions of the MCNP and MCNPX codes are developed aimed at transporting radiation both in the standard geometry mode and in the voxel geometry treatment. The patched code reads an unformatted FORTRAN file derived from DICOM format data and uses special subroutines to handle voxel-to-voxel radiation transport. The various phases of the development of the methodology are discussed together with the new input options. Examples are given of employment of the code in internal and external dosimetry and comparisons with results from other groups are reported.

Technical Challenges of Enterprise Imaging: HIMSS-SIIM Collaborative White Paper.

PubMed

Clunie, David A; Dennison, Don K; Cram, Dawn; Persons, Kenneth R; Bronkalla, Mark D; Primo, Henri Rik

2016-10-01

This white paper explores the technical challenges and solutions for acquiring (capturing) and managing enterprise images, particularly those involving visible light applications. The types of acquisition devices used for various general-purpose photography and specialized applications including dermatology, endoscopy, and anatomic pathology are reviewed. The formats and standards used, and the associated metadata requirements and communication protocols for transfer and workflow are considered. Particular emphasis is placed on the importance of metadata capture in both order- and encounter-based workflow. The benefits of using DICOM to provide a standard means of recording and accessing both metadata and image and video data are considered, as is the role of IHE and FHIR.

Novel Software for Performing Leksell Stereotactic Surgery without the Use of Printing Films: Technical Note.

PubMed

Hashizume, Akira; Akimitsu, Tomohide; Iida, Koji; Kagawa, Kota; Katagiri, Masaya; Hanaya, Ryosuke; Arita, Kazunori; Kurisu, Kaoru

2016-01-01

Hospitals in Japan have recently begun to employ the DICOM viewer system on desktop or laptop monitors. However, conventional embedding surgery for deep-brain stimulation with the Leksell stereotactic system (LSS) requires printed X-ray films for defining the coordination, coregistration of actual surgical films with the reference coordinates, and validation of the needle trajectories. While just performing these procedures on desktop or laptop monitors, the authors were able to develop novel software to facilitate complete digital manipulation with the Leksell frame without printing films. In this study, we validated the practical use of LSS, and benefit of this software in the Takanobashi Central Hospital and Kagoshima University Hospital.

Modal sound transmission loss of a single leaf panel: Effects of inter-modal coupling.

PubMed

Wang, Chong

2015-06-01

Sound transmission through a single leaf panel has mostly been discussed and explained by using the approaching wave concept, from which the well-known mass law can be derived. In this paper, the modal behavior in sound transmission coefficients is explored, and it is shown that the mutual modal radiation impedances in modal sound transmission coefficients may not be ignored even for a panel immersed in a light fluid. By introducing the equivalent modal impedance which incorporates the inter-modal coupling effect, an analytical expression for the modal sound transmission coefficient is derived, and the overall sound transmission coefficient is simply a modal superposition of modal sound transmission coefficients. A good correlation is obtained between analytical calculation and boundary element method. In addition, it is found that inter-modal coupling has noticeable effects in modal sound transmission coefficients in the subsonic region but may be ignored as modes become supersonic. It is also shown that the well-known mass law performance is attributed to all the supersonic modes.

Auditory, visual and auditory-visual memory and sequencing performance in typically developing children.

PubMed

Pillai, Roshni; Yathiraj, Asha

2017-09-01

The study evaluated whether there exists a difference/relation in the way four different memory skills (memory score, sequencing score, memory span, & sequencing span) are processed through the auditory modality, visual modality and combined modalities. Four memory skills were evaluated on 30 typically developing children aged 7 years and 8 years across three modality conditions (auditory, visual, & auditory-visual). Analogous auditory and visual stimuli were presented to evaluate the three modality conditions across the two age groups. The children obtained significantly higher memory scores through the auditory modality compared to the visual modality. Likewise, their memory scores were significantly higher through the auditory-visual modality condition than through the visual modality. However, no effect of modality was observed on the sequencing scores as well as for the memory and the sequencing span. A good agreement was seen between the different modality conditions that were studied (auditory, visual, & auditory-visual) for the different memory skills measures (memory scores, sequencing scores, memory span, & sequencing span). A relatively lower agreement was noted only between the auditory and visual modalities as well as between the visual and auditory-visual modality conditions for the memory scores, measured using Bland-Altman plots. The study highlights the efficacy of using analogous stimuli to assess the auditory, visual as well as combined modalities. The study supports the view that the performance of children on different memory skills was better through the auditory modality compared to the visual modality. Copyright © 2017 Elsevier B.V. All rights reserved.

Modality-specific spectral dynamics in response to visual and tactile sequential shape information processing tasks: An MEG study using multivariate pattern classification analysis.

PubMed

Gohel, Bakul; Lee, Peter; Jeong, Yong

2016-08-01

Brain regions that respond to more than one sensory modality are characterized as multisensory regions. Studies on the processing of shape or object information have revealed recruitment of the lateral occipital cortex, posterior parietal cortex, and other regions regardless of input sensory modalities. However, it remains unknown whether such regions show similar (modality-invariant) or different (modality-specific) neural oscillatory dynamics, as recorded using magnetoencephalography (MEG), in response to identical shape information processing tasks delivered to different sensory modalities. Modality-invariant or modality-specific neural oscillatory dynamics indirectly suggest modality-independent or modality-dependent participation of particular brain regions, respectively. Therefore, this study investigated the modality-specificity of neural oscillatory dynamics in the form of spectral power modulation patterns in response to visual and tactile sequential shape-processing tasks that are well-matched in terms of speed and content between the sensory modalities. Task-related changes in spectral power modulation and differences in spectral power modulation between sensory modalities were investigated at source-space (voxel) level, using a multivariate pattern classification (MVPC) approach. Additionally, whole analyses were extended from the voxel level to the independent-component level to take account of signal leakage effects caused by inverse solution. The modality-specific spectral dynamics in multisensory and higher-order brain regions, such as the lateral occipital cortex, posterior parietal cortex, inferior temporal cortex, and other brain regions, showed task-related modulation in response to both sensory modalities. This suggests modality-dependency of such brain regions on the input sensory modality for sequential shape-information processing. Copyright © 2016 Elsevier B.V. All rights reserved.

Dissociable identity- and modality-specific neural representations as revealed by cross-modal nonspatial inhibition of return.

PubMed

Chi, Yukai; Yue, Zhenzhu; Liu, Yupin; Mo, Lei; Chen, Qi

2014-08-01

There are ongoing debates on whether object concepts are coded as supramodal identity-based or modality-specific representations in the human brain. In this fMRI study, we adopted a cross-modal "prime-neutral cue-target" semantic priming paradigm, in which the prime-target relationship was manipulated along both the identity and the modality dimensions. The prime and the target could refer to either the same or different semantic identities, and could be delivered via either the same or different sensory modalities. By calculating the main effects and interactions of this 2 (identity cue validity: "Identity_Cued" vs. "Identity_Uncued") × 2 (modality cue validity: "Modality_Cued" vs. "Modality_Uncued") factorial design, we aimed at dissociating three neural networks involved in creating novel identity-specific representations independent of sensory modality, in creating modality-specific representations independent of semantic identity, and in evaluating changes of an object along both the identity and the modality dimensions, respectively. Our results suggested that bilateral lateral occipital cortex was involved in creating a new supramodal semantic representation irrespective of the input modality, left dorsal premotor cortex, and left intraparietal sulcus were involved in creating a new modality-specific representation irrespective of its semantic identity, and bilateral superior temporal sulcus was involved in creating a representation when the identity and modality properties were both cued or both uncued. In addition, right inferior frontal gyrus showed enhanced neural activity only when both the identity and the modality of the target were new, indicating its functional role in novelty detection. Copyright © 2014 Wiley Periodicals, Inc.

Preparing a business justification for going electronic.

PubMed

Ortiz, A Orlando; Luyckx, Michael P

2002-01-01

Exponential advances in the technology sector and computer industry have benefited the science and practice of radiology. Modalities such as digital radiography, computed radiography, computed tomography, magnetic resonance imaging, ultrasound, digital angiography, and gamma cameras are all capable of producing DICOM compliant images. Text can likewise be acquired using voice recognition technology (VRT) and efficiently rendered into a digital format. All of these digital data sets can subsequently be transferred over a network between machines for display and further manipulation on workstations. Large capacity archiving units are required to store these voluminous data sets. The enterprise components of radiology departments and imaging centers--radiology information systems (RIS) and picture archiving and communications systems (PACS)--have thus undergone a transition from hardcopy to softcopy. When preparing to make transition to a digital environment, the first step is introspective. A detailed SWOT (strengths, weaknesses, opportunities and threats) analysis, with a focus on the status of "electronic preparedness," ensues. The next step in the strategic planning process is to formulate responses to the following questions: Will this technology acquisition provide sufficient value to my organization to justify the expense? Is there a true need for the new technology? What issues or problems does this technology address? What customer needs will this technology satisfy today and tomorrow? How will the organization's shareholders benefit from this technology? The answers to these questions and the questions that they in turn generate will stimulate the strategic planning process to define demands, investigate technology and investment options, identify resources and set goals. The mission of your radiology center will determine what you will demand from the electronic environment. All radiology practices must address the demand of clinical service. Additional demands based on your mission may include education and research. The investigation of options is probably the most time consuming portion of the analysis. It is in this stage where the system architecture is drafted. Important contributions must be solicited from your information technology division, radiologists and other physicians, hospital administration and any other service where the use of imaging technology information is required and beneficial. Vendors and consultants can be extremely valuable in generating workflow diagrams, which include imaging acquisition components and imaging display components. A request for proposal (RFP) may facilitate this step. A detailed inventory of imaging equipment, imaging equipment locations and use, imaging equipment DICOM compatibility, imaging equipment upgrade requirements, reading locations and user locations must be obtained and confirmed. It is a good idea to take a careful inventory of your resources during the process of investigating system architecture and financial options. An often-ignored issue is the human resource allocation that is required to implement, maintain and upgrade the system. These costs must be estimated and included in the financial analysis. Further, to predict the finances of your operation in the future, a solid understanding of your center's historical financial data is required. This will enable you to make legitimate and reasonable financial calculations using incremental volumes. The radiology center must formulate and articulate discrete clinical and business goals for the transition to a digital environment that are consistent with the institutional or enterprise mission. Once goals are set, it is possible to generate a strategic plan. It is necessary to establish individual accountability for all aspects of the planning and implementation process. A realistic timetable should be implemented. Keep in mind that this is a dynamic process; technology is rapidly changing, as are clinical service demands and regulatory initiatives. It is therefore prudent to monitor the process, make appropriate revisions when necessary and address contingencies as they arise.

Interoperability in healthcare: major challenges in the creation of the enterprise environment

NASA Astrophysics Data System (ADS)

Lindsköld, L.; Wintell, M.; Lundberg, N.

2009-02-01

There is today a lack of interoperability in healthcare although the need for it is obvious. A new healthcare enterprise environment has been deployed for secure healthcare interoperability in the Western Region in Sweden (WRS). This paper is an empirical overview of the new enterprise environment supporting regional shared and transparent radiology domain information in the WRS. The enterprise environment compromises 17 radiology departments, 1,5 million inhabitants, using different RIS and PACS in a joint work-oriented network and additional cardiology, dentistry and clinical physiology departments. More than 160 terabytes of information are stored in the enterprise repository. Interoperability is developed according to the IHE mission, i.e. applying standards such as Digital Imaging and Communication in Medicine (DICOM) and Health Level 7 (HL7) to address specific clinical communication needs and support optimal patient care. The entire enterprise environment is implemented and used daily in WRS. The central prerequisites in the development of the enterprise environment in western region of Sweden were: 1) information harmonization, 2) reuse of standardized messages e.g. HL7 v2.x and v3.x, 3) development of a holistic information domain including both text and images, and 4) to create a continuous and dynamic update functionality. The central challenges in this project were: 1) the many different vendors acting in the region and the negotiations with them to apply communication roles/profiles such as HL7 (CDA, CCR), DICOM, and XML, 2) the question of whom owns the data, and 3) incomplete technical standards. This study concludes that to create a workflow that runs within an enterprise environment there are a number of central prerequisites and challenges that needs to be in place. This calls for negotiations on an international, national and regional level with standardization organizations, vendors, health management and health personnel.

Technology and Technique Standards for Camera-Acquired Digital Dermatologic Images: A Systematic Review.

PubMed

Quigley, Elizabeth A; Tokay, Barbara A; Jewell, Sarah T; Marchetti, Michael A; Halpern, Allan C

2015-08-01

Photographs are invaluable dermatologic diagnostic, management, research, teaching, and documentation tools. Digital Imaging and Communications in Medicine (DICOM) standards exist for many types of digital medical images, but there are no DICOM standards for camera-acquired dermatologic images to date. To identify and describe existing or proposed technology and technique standards for camera-acquired dermatologic images in the scientific literature. Systematic searches of the PubMed, EMBASE, and Cochrane databases were performed in January 2013 using photography and digital imaging, standardization, and medical specialty and medical illustration search terms and augmented by a gray literature search of 14 websites using Google. Two reviewers independently screened titles of 7371 unique publications, followed by 3 sequential full-text reviews, leading to the selection of 49 publications with the most recent (1985-2013) or detailed description of technology or technique standards related to the acquisition or use of images of skin disease (or related conditions). No universally accepted existing technology or technique standards for camera-based digital images in dermatology were identified. Recommendations are summarized for technology imaging standards, including spatial resolution, color resolution, reproduction (magnification) ratios, postacquisition image processing, color calibration, compression, output, archiving and storage, and security during storage and transmission. Recommendations are also summarized for technique imaging standards, including environmental conditions (lighting, background, and camera position), patient pose and standard view sets, and patient consent, privacy, and confidentiality. Proposed standards for specific-use cases in total body photography, teledermatology, and dermoscopy are described. The literature is replete with descriptions of obtaining photographs of skin disease, but universal imaging standards have not been developed, validated, and adopted to date. Dermatologic imaging is evolving without defined standards for camera-acquired images, leading to variable image quality and limited exchangeability. The development and adoption of universal technology and technique standards may first emerge in scenarios when image use is most associated with a defined clinical benefit.

A virtual image chain for perceived image quality of medical display

NASA Astrophysics Data System (ADS)

Marchessoux, Cédric; Jung, Jürgen

2006-03-01

This paper describes a virtual image chain for medical display (project VICTOR: granted in the 5th framework program by European commission). The chain starts from raw data of an image digitizer (CR, DR) or synthetic patterns and covers image enhancement (MUSICA by Agfa) and both display possibilities, hardcopy (film on viewing box) and softcopy (monitor). Key feature of the chain is a complete image wise approach. A first prototype is implemented in an object-oriented software platform. The display chain consists of several modules. Raw images are either taken from scanners (CR-DR) or from a pattern generator, in which characteristics of DR- CR systems are introduced by their MTF and their dose-dependent Poisson noise. The image undergoes image enhancement and comes to display. For soft display, color and monochrome monitors are used in the simulation. The image is down-sampled. The non-linear response of a color monitor is taken into account by the GOG or S-curve model, whereas the Standard Gray-Scale-Display-Function (DICOM) is used for monochrome display. The MTF of the monitor is applied on the image in intensity levels. For hardcopy display, the combination of film, printer, lightbox and viewing condition is modeled. The image is up-sampled and the DICOM-GSDF or a Kanamori Look-Up-Table is applied. An anisotropic model for the MTF of the printer is applied on the image in intensity levels. The density-dependent color (XYZ) of the hardcopy film is introduced by Look-Up-tables. Finally a Human Visual System Model is applied to the intensity images (XYZ in terms of cd/m2) in order to eliminate nonvisible differences. Comparison leads to visible differences, which are quantified by higher order image quality metrics. A specific image viewer is used for the visualization of the intensity image and the visual difference maps.

Meeting the challenges of the digital medical enterprise of the future by reusing enterprise software components

NASA Astrophysics Data System (ADS)

Shani, Uri; Kol, Tomer; Shachor, Gal

2004-04-01

Managing medical digital information objects, and in particular medical images is an enterprise-grade problem. Firstly, there is the sheer amount of digital data that is generated in the proliferation of digital (and film-free) medical imaging. Secondly, the managing software ought to enjoy high availability, recoverability and manageability that are found only in the most business-critical systems. Indeed, such requirements are borrowed from the business enterprise world. Moreover, the solution for the medical information management problem should too employ the same software tools, middlewares and architectures. It is safe to say that all first-line medical PACS products strive to provide a solution for all these challenging requirements. The DICOM standard has been a prime enabler of such solutions. DICOM created the interconnectivity, which made it possible for a PACS service to manage millions of exams consisting of trillions of images. With the more comprehensive IHE architecture, the enterprise is expanded into a multi-facility regional conglomerate, which presents extreme demands from the data management system. HIPPA legislations add considerable challenges per security, privacy and other legal issues, which aggravate the situation. In this paper, we firstly present what in our view should be the general requirements for a first-line medical PACS, taken from an enterprise medical imaging storage and management solution perspective. While these requirements can be met by homegrown implementations, we suggest looking at the existing technologies, which have emerged in the recent years to meet exactly these challenges in the business world. We present an evolutionary process, which led to the design and implementation of a medical object management subsystem. This is indeed an enterprise medical imaging solution that is built upon respective technological components. The system answers all these challenges simply by not reinventing wheels, but rather reusing the best "wheels" for the job. Relying on such middleware components allowed us to concentrate on added value for this specific problem domain.

An automatic dose verification system for adaptive radiotherapy for helical tomotherapy

NASA Astrophysics Data System (ADS)

Mo, Xiaohu; Chen, Mingli; Parnell, Donald; Olivera, Gustavo; Galmarini, Daniel; Lu, Weiguo

2014-03-01

Purpose: During a typical 5-7 week treatment of external beam radiotherapy, there are potential differences between planned patient's anatomy and positioning, such as patient weight loss, or treatment setup. The discrepancies between planned and delivered doses resulting from these differences could be significant, especially in IMRT where dose distributions tightly conforms to target volumes while avoiding organs-at-risk. We developed an automatic system to monitor delivered dose using daily imaging. Methods: For each treatment, a merged image is generated by registering the daily pre-treatment setup image and planning CT using treatment position information extracted from the Tomotherapy archive. The treatment dose is then computed on this merged image using our in-house convolution-superposition based dose calculator implemented on GPU. The deformation field between merged and planning CT is computed using the Morphon algorithm. The planning structures and treatment doses are subsequently warped for analysis and dose accumulation. All results are saved in DICOM format with private tags and organized in a database. Due to the overwhelming amount of information generated, a customizable tolerance system is used to flag potential treatment errors or significant anatomical changes. A web-based system and a DICOM-RT viewer were developed for reporting and reviewing the results. Results: More than 30 patients were analysed retrospectively. Our in-house dose calculator passed 97% gamma test evaluated with 2% dose difference and 2mm distance-to-agreement compared with Tomotherapy calculated dose, which is considered sufficient for adaptive radiotherapy purposes. Evaluation of the deformable registration through visual inspection showed acceptable and consistent results, except for cases with large or unrealistic deformation. Our automatic flagging system was able to catch significant patient setup errors or anatomical changes. Conclusions: We developed an automatic dose verification system that quantifies treatment doses, and provides necessary information for adaptive planning without impeding clinical workflows.

MO-F-16A-01: Implementation of MPPG TPS Verification Tests On Various Accelerators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smilowitz, J; Bredfeldt, J; Geurts, M

2014-06-15

Purpose: To demonstrate the implementation of the Medical Physics Practice Guideline (MPPG) for dose calculation and beam parameters verification of treatment planning systems (TPS). Methods: We implemented the draft TPS MPPG for three linacs: Varian Trilogy, TomoHDA and Elekta Infinity. Static and modulated test plans were created. The static fields are different than used in commissioning. Data was collected using ion chambers and diodes in a scanning water tank, Delta4 phantom and a custom phantom. MatLab and Microsoft Excel were used to create analysis tools to compare reference DICOM dose with scan data. This custom code allowed for the interpolation,more » registration and gamma analysis of arbitrary dose profiles. It will be provided as open source code. IMRT fields were validated with Delta4 registration and comparison tools. The time for each task was recorded. Results: The tests confirmed the strengths, and revealed some limitations, of our TPS. The agreement between calculated and measured dose was reported for all beams. For static fields, percent depth dose and profiles were analyzed with criteria in the draft MPPG. The results reveal areas of slight mismatch with the model (MLC leaf penumbra, buildup region.) For TomoTherapy, the IMRT plan 2%/2 mm gamma analysis revealed poorest agreement in the low dose regions. For one static test plan for all 10MV Trilogy photon beams, the plan generation, scan queue creation, data collection, data analysis and report took 2 hours, excluding tank setup. Conclusions: We have demonstrated the implementation feasibility of the TPS MPPG. This exercise generated an open source tool for dose comparisons between scan data and DICOM dose data. An easily reproducible and efficient infrastructure with streamlined data collection was created for repeatable robust testing of the TPS. The tests revealed minor discrepancies in our models and areas for improvement that are being investigated.« less

SU-E-T-50: Automatic Validation of Megavoltage Beams Modeled for Clinical Use in Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Melchior, M; Salinas Aranda, F; 21st Century Oncology, Ft. Myers, FL

2014-06-01

Purpose: To automatically validate megavoltage beams modeled in XiO™ 4.50 (Elekta, Stockholm, Sweden) and Varian Eclipse™ Treatment Planning Systems (TPS) (Varian Associates, Palo Alto, CA, USA), reducing validation time before beam-on for clinical use. Methods: A software application that can automatically read and analyze DICOM RT Dose and W2CAD files was developed using MatLab integrated development environment.TPS calculated dose distributions, in DICOM RT Dose format, and dose values measured in different Varian Clinac beams, in W2CAD format, were compared. Experimental beam data used were those acquired for beam commissioning, collected on a water phantom with a 2D automatic beam scanningmore » system.Two methods were chosen to evaluate dose distributions fitting: gamma analysis and point tests described in Appendix E of IAEA TECDOC-1583. Depth dose curves and beam profiles were evaluated for both open and wedged beams. Tolerance parameters chosen for gamma analysis are 3% and 3 mm dose and distance, respectively.Absolute dose was measured independently at points proposed in Appendix E of TECDOC-1583 to validate software results. Results: TPS calculated depth dose distributions agree with measured beam data under fixed precision values at all depths analyzed. Measured beam dose profiles match TPS calculated doses with high accuracy in both open and wedged beams. Depth and profile dose distributions fitting analysis show gamma values < 1. Relative errors at points proposed in Appendix E of TECDOC-1583 meet therein recommended tolerances.Independent absolute dose measurements at points proposed in Appendix E of TECDOC-1583 confirm software results. Conclusion: Automatic validation of megavoltage beams modeled for their use in the clinic was accomplished. The software tool developed proved efficient, giving users a convenient and reliable environment to decide whether to accept or not a beam model for clinical use. Validation time before beam-on for clinical use was reduced to a few hours.« less

WE-E-BRB-11: Riview a Web-Based Viewer for Radiotherapy.

PubMed

Apte, A; Wang, Y; Deasy, J

2012-06-01

Collaborations involving radiotherapy data collection, such as the recently proposed international radiogenomics consortium, require robust, web-based tools to facilitate reviewing treatment planning information. We present the architecture and prototype characteristics for a web-based radiotherapy viewer. The web-based environment developed in this work consists of the following components: 1) Import of DICOM/RTOG data: CERR was leveraged to import DICOM/RTOG data and to convert to database friendly RT objects. 2) Extraction and Storage of RT objects: The scan and dose distributions were stored as .png files per slice and view plane. The file locations were written to the MySQL database. Structure contours and DVH curves were written to the database as numeric data. 3) Web interfaces to query, retrieve and visualize the RT objects: The Web application was developed using HTML 5 and Ruby on Rails (RoR) technology following the MVC philosophy. The open source ImageMagick library was utilized to overlay scan, dose and structures. The application allows users to (i) QA the treatment plans associated with a study, (ii) Query and Retrieve patients matching anonymized ID and study, (iii) Review up to 4 plans simultaneously in 4 window panes (iv) Plot DVH curves for the selected structures and dose distributions. A subset of data for lung cancer patients was used to prototype the system. Five user accounts were created to have access to this study. The scans, doses, structures and DVHs for 10 patients were made available via the web application. A web-based system to facilitate QA, and support Query, Retrieve and the Visualization of RT data was prototyped. The RIVIEW system was developed using open source and free technology like MySQL and RoR. We plan to extend the RIVIEW system further to be useful in clinical trial data collection, outcomes research, cohort plan review and evaluation. © 2012 American Association of Physicists in Medicine.

SU-G-TeP2-12: IROCHouston and MDAPL SRS Anthropomorphic Phantom Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Molineu, A; Kry, S; Alvarez, P

Purpose: To report the results of SRS phantom irradiations Methods: Anthropomorphic SRS head phantoms were sent to institutions participating in NCI sponsored SRS clinical trials and institutions interested in verifying SRS treatment delivery. The phantom shell was purchased from Phantom Laboratory and altered to house dosimetry and imaging inserts. The imaging insert has 1.9 cm diameter spherical target. The dosimetry insert holds two TLD capsules and radiochromic film in the coronal and sagittal planes through the center of the target. Institutions were asked to image, plan and treat the phantom as they would an SRS patient. GammaKnife, CyberKnife and c-armmore » accelerator institutions were asked to cover the target with 15 Gy, 20 Gy and 25 Gy, respectively. Following these guidelines and typical planning protocols for these three types of machines gives roughly 30 Gy to the center of the target for all units. Submission of the DICOM digital data set was required for analysis. Criteria of 5% for TLD results and 85% of pixels passing 5%/3mm gamma analysis were applied beginning in 2013. Results: The phantom was analyzed 269 times between the beginning of 2013 to present. The pass rate is 81%. Nineteen of the irradiation results failed only the TLD criteria, 19 failed only the film criteria and 12 failed both. Irradiations included 32 CyberKnife 23 GammaKnife, 3 TomoTherapy and 211 c-arm units. Planning systems included Eclipse, Ergo, GammaPlan, Hi-Art, iPlan, Monaco, MultiPlan, Pinnacle, RayStation, XiO and XKnife. Irradiations that were not accompanied with DICOM data were not included in this analysis. Conclusion: The phantom is a valuable end-to-end test used to independently verify the accuracy of SRS treatment delivery. This investigation was supported by IROC grant CA180803 awarded by the NCI.« less

SU-E-T-595: Design of a Graphical User Interface for An In-House Monte Carlo Based Treatment Planning System: Planning and Contouring Tools

DOE Office of Scientific and Technical Information (OSTI.GOV)

EMAM, M; Eldib, A; Lin, M

2014-06-01

Purpose: An in-house Monte Carlo based treatment planning system (MC TPS) has been developed for modulated electron radiation therapy (MERT). Our preliminary MERT planning experience called for a more user friendly graphical user interface. The current work aimed to design graphical windows and tools to facilitate the contouring and planning process. Methods: Our In-house GUI MC TPS is built on a set of EGS4 user codes namely MCPLAN and MCBEAM in addition to an in-house optimization code, which was named as MCOPTIM. Patient virtual phantom is constructed using the tomographic images in DICOM format exported from clinical treatment planning systemsmore » (TPS). Treatment target volumes and critical structures were usually contoured on clinical TPS and then sent as a structure set file. In our GUI program we developed a visualization tool to allow the planner to visualize the DICOM images and delineate the various structures. We implemented an option in our code for automatic contouring of the patient body and lungs. We also created an interface window displaying a three dimensional representation of the target and also showing a graphical representation of the treatment beams. Results: The new GUI features helped streamline the planning process. The implemented contouring option eliminated the need for performing this step on clinical TPS. The auto detection option for contouring the outer patient body and lungs was tested on patient CTs and it was shown to be accurate as compared to that of clinical TPS. The three dimensional representation of the target and the beams allows better selection of the gantry, collimator and couch angles. Conclusion: An in-house GUI program has been developed for more efficient MERT planning. The application of aiding tools implemented in the program is time saving and gives better control of the planning process.« less

CytometryML and other data formats

NASA Astrophysics Data System (ADS)

Leif, Robert C.

2006-02-01

Cytology automation and research will be enhanced by the creation of a common data format. This data format would provide the pathology and research communities with a uniform way for annotating and exchanging images, flow cytometry, and associated data. This specification and/or standard will include descriptions of the acquisition device, staining, the binary representations of the image and list-mode data, the measurements derived from the image and/or the list-mode data, and descriptors for clinical/pathology and research. An international, vendor-supported, non-proprietary specification will allow pathologists, researchers, and companies to develop and use image capture/analysis software, as well as list-mode analysis software, without worrying about incompatibilities between proprietary vendor formats. Presently, efforts to create specifications and/or descriptions of these formats include the Laboratory Digital Imaging Project (LDIP) Data Exchange Specification; extensions to the Digital Imaging and Communications in Medicine (DICOM); Open Microscopy Environment (OME); Flowcyt, an extension to the present Flow Cytometry Standard (FCS); and CytometryML. The feasibility of creating a common data specification for digital microscopy and flow cytometry in a manner consistent with its use for medical devices and interoperability with both hospital information and picture archiving systems has been demonstrated by the creation of the CytometryML schemas. The feasibility of creating a software system for digital microscopy has been demonstrated by the OME. CytometryML consists of schemas that describe instruments and their measurements. These instruments include digital microscopes and flow cytometers. Optical components including the instruments' excitation and emission parts are described. The description of the measurements made by these instruments includes the tagged molecule, data acquisition subsystem, and the format of the list-mode and/or image data. Many of the CytometryML data-types are based on the Digital Imaging and Communications in Medicine (DICOM). Binary files for images and list-mode data have been created and read.

TH-C-12A-04: Dosimetric Evaluation of a Modulated Arc Technique for Total Body Irradiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tsiamas, P; Czerminska, M; Makrigiorgos, G

2014-06-15

Purpose: A simplified Total Body Irradiation (TBI) was developed to work with minimal requirements in a compact linac room without custom motorized TBI couch. Results were compared to our existing fixed-gantry double 4 MV linac TBI system with prone patient and simultaneous AP/PA irradiation. Methods: Modulated arc irradiates patient positioned in prone/supine positions along the craniocaudal axis. A simplified inverse planning method developed to optimize dose rate as a function of gantry angle for various patient sizes without the need of graphical 3D treatment planning system. This method can be easily adapted and used with minimal resources. Fixed maximum fieldmore » size (40×40 cm2) is used to decrease radiation delivery time. Dose rate as a function of gantry angle is optimized to result in uniform dose inside rectangular phantoms of various sizes and a custom VMAT DICOM plans were generated using a DICOM editor tool. Monte Carlo simulations, film and ionization chamber dosimetry for various setups were used to derive and test an extended SSD beam model based on PDD/OAR profiles for Varian 6EX/ TX. Measurements were obtained using solid water phantoms. Dose rate modulation function was determined for various size patients (100cm − 200cm). Depending on the size of the patient arc range varied from 100° to 120°. Results: A PDD/OAR based beam model for modulated arc TBI therapy was developed. Lateral dose profiles produced were similar to profiles of our existing TBI facility. Calculated delivery time and full arc depended on the size of the patient (∼8min/ 100° − 10min/ 120°, 100 cGy). Dose heterogeneity varied by about ±5% − ±10% depending on the patient size and distance to the surface (buildup region). Conclusion: TBI using simplified modulated arc along craniocaudal axis of different size patients positioned on the floor can be achieved without graphical / inverse 3D planning.« less

Phased development of a web-based PACS viewer

NASA Astrophysics Data System (ADS)

Gidron, Yoad; Shani, Uri; Shifrin, Mark

2000-05-01

The Web browser is an excellent environment for the rapid development of an effective and inexpensive PACS viewer. In this paper we will share our experience in developing a browser-based viewer, from the inception and prototype stages to its current state of maturity. There are many operational advantages to a browser-based viewer, even when native viewers already exist in the system (with multiple and/or high resolution screens): (1) It can be used on existing personal workstations throughout the hospital. (2) It is easy to make the service available from physician's homes. (3) The viewer is extremely portable and platform independent. There is a wide variety of means available for implementing the browser- based viewer. Each file sent to the client by the server can perform some end-user or client/server interaction. These means range from HTML (for HyperText Markup Language) files, through Java Script, to Java applets. Some data types may also invoke plug-in code in the client, although this would reduce the portability of the viewer, it would provide the needed efficiency in critical places. On the server side the range of means is also very rich: (1) A set of files: html, Java Script, Java applets, etc. (2) Extensions of the server via cgi-bin programs, (3) Extensions of the server via servlets, (4) Any other helper application residing and working with the server to access the DICOM archive. The viewer architecture consists of two basic parts: The first part performs query and navigation through the DICOM archive image folders. The second part does the image access and display. While the first part deals with low data traffic, it involves many database transactions. The second part is simple as far as access transactions are concerned, but requires much more data traffic and display functions. Our web-based viewer has gone through three development stages characterized by the complexity of the means and tools employed on both client and server sides.

Cloud based emergency health care information service in India.

PubMed

Karthikeyan, N; Sukanesh, R

2012-12-01

A hospital is a health care organization providing patient treatment by expert physicians, surgeons and equipments. A report from a health care accreditation group says that miscommunication between patients and health care providers is the reason for the gap in providing emergency medical care to people in need. In developing countries, illiteracy is the major key root for deaths resulting from uncertain diseases constituting a serious public health problem. Mentally affected, differently abled and unconscious patients can't communicate about their medical history to the medical practitioners. Also, Medical practitioners can't edit or view DICOM images instantly. Our aim is to provide palm vein pattern recognition based medical record retrieval system, using cloud computing for the above mentioned people. Distributed computing technology is coming in the new forms as Grid computing and Cloud computing. These new forms are assured to bring Information Technology (IT) as a service. In this paper, we have described how these new forms of distributed computing will be helpful for modern health care industries. Cloud Computing is germinating its benefit to industrial sectors especially in medical scenarios. In Cloud Computing, IT-related capabilities and resources are provided as services, via the distributed computing on-demand. This paper is concerned with sprouting software as a service (SaaS) by means of Cloud computing with an aim to bring emergency health care sector in an umbrella with physical secured patient records. In framing the emergency healthcare treatment, the crucial thing considered necessary to decide about patients is their previous health conduct records. Thus a ubiquitous access to appropriate records is essential. Palm vein pattern recognition promises a secured patient record access. Likewise our paper reveals an efficient means to view, edit or transfer the DICOM images instantly which was a challenging task for medical practitioners in the past years. We have developed two services for health care. 1. Cloud based Palm vein recognition system 2. Distributed Medical image processing tools for medical practitioners.

SU-E-T-184: Clinical VMAT QA Practice Using LINAC Delivery Log Files

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnston, H; Jacobson, T; Gu, X

2015-06-15

Purpose: To evaluate the accuracy of volumetric modulated arc therapy (VMAT) treatment delivery dose clouds by comparing linac log data to doses measured using an ionization chamber and film. Methods: A commercial IMRT quality assurance (QA) process utilizing a DICOM-RT framework was tested for clinical practice using 30 prostate and 30 head and neck VMAT plans. Delivered 3D VMAT dose distributions were independently checked using a PinPoint ionization chamber and radiographic film in a solid water phantom. DICOM RT coordinates were used to extract the corresponding point and planar doses from 3D log file dose distributions. Point doses were evaluatedmore » by computing the percent error between log file and chamber measured values. A planar dose evaluation was performed for each plan using a 2D gamma analysis with 3% global dose difference and 3 mm isodose point distance criteria. The same analysis was performed to compare treatment planning system (TPS) doses to measured values to establish a baseline assessment of agreement. Results: The mean percent error between log file and ionization chamber dose was 1.0%±2.1% for prostate VMAT plans and −0.2%±1.4% for head and neck plans. The corresponding TPS calculated and measured ionization chamber values agree within 1.7%±1.6%. The average 2D gamma passing rates for the log file comparison to film are 98.8%±1.0% and 96.2%±4.2% for the prostate and head and neck plans, respectively. The corresponding passing rates for the TPS comparison to film are 99.4%±0.5% and 93.9%±5.1%. Overall, the point dose and film data indicate that log file determined doses are in excellent agreement with measured values. Conclusion: Clinical VMAT QA practice using LINAC treatment log files is a fast and reliable method for patient-specific plan evaluation.« less

SU-E-I-10: Automatic Monitoring of Accumulated Dose Indices From DICOM RDSR to Improve Radiation Safety in X-Ray Angiography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Omar, A; Bujila, R; Nowik, P

2014-06-01

Purpose: To investigate the potential benefits of automatic monitoring of accumulated patient and staff dose indicators, i.e., CAK and KAP, from DICOM Radiation Dose Structured Reports (RDSR) in x-ray angiography (XA). Methods: Recently RDSR has enabled the convenient aggregation of dose indices and technique parameters for XA procedures. The information contained in RDSR objects for three XA systems, dedicated to different types of clinical procedures, has been collected and aggregated in a database for over one year using a system developed with open-source software at the Karolinska University Hospital. Patient weight was complemented to the RDSR data via an interfacemore » with the Hospital Information System (HIS). Results: The linearly approximated trend in KAP over a time period of a year for cerebrovascular, pelvic/peripheral vascular, and cardiovascular procedures showed a decrease of 12%, 20%, and 14%, respectively. The decrease was mainly due to hardware/software upgrades and new low-dose imaging protocols, and partially due to ongoing systematic radiation safety education of the clinical staff. The CAK was in excess of 3 Gy for 15 procedures, and exceeded 5 Gy for 3 procedures. The dose indices have also shown a significant dependence on patient weight for cardiovascular and pelvic/peripheral vascular procedures; a 10 kg shift in mean patient weight can result in a dose index increase of 25%. Conclusion: Automatic monitoring of accumulated dose indices can be utilized to notify the clinical staff and medical physicists when the dose index has exceeded a predetermined action level. This allows for convenient and systematic follow-up of patients in risk of developing deterministic skin injuries. Furthermore, trend analyses of dose indices over time is a valuable resource for the identification of potential positive or negative effects (dose increase/decrease) from changes in hardware, software, and clinical work habits.« less

Modality and Task Switching Interactions using Bi-Modal and Bivalent Stimuli

ERIC Educational Resources Information Center

Sandhu, Rajwant; Dyson, Benjamin J.

2013-01-01

Investigations of concurrent task and modality switching effects have to date been studied under conditions of uni-modal stimulus presentation. As such, it is difficult to directly compare resultant task and modality switching effects, as the stimuli afford both tasks on each trial, but only one modality. The current study investigated task and…

Computing the modal mass from the state space model in combined experimental-operational modal analysis

NASA Astrophysics Data System (ADS)

Cara, Javier

2016-05-01

Modal parameters comprise natural frequencies, damping ratios, modal vectors and modal masses. In a theoretic framework, these parameters are the basis for the solution of vibration problems using the theory of modal superposition. In practice, they can be computed from input-output vibration data: the usual procedure is to estimate a mathematical model from the data and then to compute the modal parameters from the estimated model. The most popular models for input-output data are based on the frequency response function, but in recent years the state space model in the time domain has become popular among researchers and practitioners of modal analysis with experimental data. In this work, the equations to compute the modal parameters from the state space model when input and output data are available (like in combined experimental-operational modal analysis) are derived in detail using invariants of the state space model: the equations needed to compute natural frequencies, damping ratios and modal vectors are well known in the operational modal analysis framework, but the equation needed to compute the modal masses has not generated much interest in technical literature. These equations are applied to both a numerical simulation and an experimental study in the last part of the work.

Analysis of structural response data using discrete modal filters. M.S. Thesis

NASA Technical Reports Server (NTRS)

Freudinger, Lawrence C.

1991-01-01

The application of reciprocal modal vectors to the analysis of structural response data is described. Reciprocal modal vectors are constructed using an existing experimental modal model and an existing frequency response matrix of a structure, and can be assembled into a matrix that effectively transforms the data from the physical space to a modal space within a particular frequency range. In other words, the weighting matrix necessary for modal vector orthogonality (typically the mass matrix) is contained within the reciprocal model matrix. The underlying goal of this work is mostly directed toward observing the modal state responses in the presence of unknown, possibly closed loop forcing functions, thus having an impact on both operating data analysis techniques and independent modal space control techniques. This study investigates the behavior of reciprocol modal vectors as modal filters with respect to certain calculation parameters and their performance with perturbed system frequency response data.

Exploring Modality Switching Effects in Negated Sentences: Further Evidence for Grounded Representations

PubMed Central

Hald, Lea A.; Hocking, Ian; Vernon, David; Marshall, Julie-Ann; Garnham, Alan

2013-01-01

Theories of embodied cognition (e.g., Perceptual Symbol Systems Theory; Barsalou, 1999, 2009) suggest that modality specific simulations underlie the representation of concepts. Supporting evidence comes from modality switch costs: participants are slower to verify a property in one modality (e.g., auditory, BLENDER-loud) after verifying a property in a different modality (e.g., gustatory, CRANBERRIES-tart) compared to the same modality (e.g., LEAVES-rustling, Pecher et al., 2003). Similarly, modality switching costs lead to a modulation of the N400 effect in event-related potentials (ERPs; Collins et al., 2011; Hald et al., 2011). This effect of modality switching has also been shown to interact with the veracity of the sentence (Hald et al., 2011). The current ERP study further explores the role of modality match/mismatch on the processing of veracity as well as negation (sentences containing “not”). Our results indicate a modulation in the ERP based on modality and veracity, plus an interaction. The evidence supports the idea that modality specific simulations occur during language processing, and furthermore suggest that these simulations alter the processing of negation. PMID:23450002

An adaptive learning control system for large flexible structures

NASA Technical Reports Server (NTRS)

Thau, F. E.

1985-01-01

The objective of the research has been to study the design of adaptive/learning control systems for the control of large flexible structures. In the first activity an adaptive/learning control methodology for flexible space structures was investigated. The approach was based on using a modal model of the flexible structure dynamics and an output-error identification scheme to identify modal parameters. In the second activity, a least-squares identification scheme was proposed for estimating both modal parameters and modal-to-actuator and modal-to-sensor shape functions. The technique was applied to experimental data obtained from the NASA Langley beam experiment. In the third activity, a separable nonlinear least-squares approach was developed for estimating the number of excited modes, shape functions, modal parameters, and modal amplitude and velocity time functions for a flexible structure. In the final research activity, a dual-adaptive control strategy was developed for regulating the modal dynamics and identifying modal parameters of a flexible structure. A min-max approach was used for finding an input to provide modal parameter identification while not exceeding reasonable bounds on modal displacement.

Missing Modality Transfer Learning via Latent Low-Rank Constraint.

PubMed

Ding, Zhengming; Shao, Ming; Fu, Yun

2015-11-01

Transfer learning is usually exploited to leverage previously well-learned source domain for evaluating the unknown target domain; however, it may fail if no target data are available in the training stage. This problem arises when the data are multi-modal. For example, the target domain is in one modality, while the source domain is in another. To overcome this, we first borrow an auxiliary database with complete modalities, then consider knowledge transfer across databases and across modalities within databases simultaneously in a unified framework. The contributions are threefold: 1) a latent factor is introduced to uncover the underlying structure of the missing modality from the known data; 2) transfer learning in two directions allows the data alignment between both modalities and databases, giving rise to a very promising recovery; and 3) an efficient solution with theoretical guarantees to the proposed latent low-rank transfer learning algorithm. Comprehensive experiments on multi-modal knowledge transfer with missing target modality verify that our method can successfully inherit knowledge from both auxiliary database and source modality, and therefore significantly improve the recognition performance even when test modality is inaccessible in the training stage.

Physical modalities in chronic pain management.

PubMed

Rakel, Barbara; Barr, John O

2003-09-01

The following conclusions can be made based on review of the evidence: There is limited but positive evidence that select physical modalities are effective in managing chronic pain associated with specific conditions experienced by adults and older individuals. Overall, studies have provided the most support for the modality of therapeutic exercise. Different physical modalities have similar magnitudes of effects on chronic pain. Therefore, selection of the most appropriate physical modality may depend on the desired functional outcome for the patient, the underlying impairment, and the patient's preference or prior experience with the modality. Certain patient characteristics may decrease the effectiveness of physical modalities, as has been seen with TENS. These characteristics include depression, high trait anxiety, a powerful others locus of control, obesity, narcotic use, and neuroticism. The effect on pain by various modalities is generally strongest in the short-term period immediately after the intervention series, but effects can last as long as 1 year after treatment (e.g., with massage). Most research has tested the effect of physical modalities on chronic low back pain and knee OA. The effectiveness of physical modalities for other chronic pain conditions needs to be evaluated more completely. Older and younger adults often experience similar effects on their perception of pain from treatment with physical modalities. Therefore, use of these modalities for chronic pain in older adults is appropriate, but special precautions need to be taken. Practitioners applying physical modalities need formal training that includes the risks and precautions for these modalities. If practitioners lack formal training in the use of physical modalities, or if modality use is not within their scope of practice, it is important to consult with and refer patients to members of the team who have this specialized training. Use of a multidisciplinary approach to chronic pain management is of value for all adults and older individuals in particular [79-81]. Historically, physical therapists have been trained to evaluate and treat patients with the range of physical modalities discussed in this article. Although members of the nursing staff traditionally have used some of these modalities (e.g. some forms of heat or cold and massage), increasing numbers of nurses now are being trained to apply more specialized procedures (e.g., TENS). Healthcare professionals must be knowledgeable about the strength of evidence underlying the use of physical modalities for the management of chronic pain. Based on the limited research evidence available (especially related to assistive devices, orthotics, and thermal modalities), it often is difficult to accept or exclude select modalities as having a potential role in chronic pain management for adults and older individuals. Improved research methodologies are needed to address physical modality effectiveness better.

Cross-modal versus within-modal recall: differences in behavioral and brain responses.

PubMed

Butler, Andrew J; James, Karin H

2011-10-31

Although human experience is multisensory in nature, previous research has focused predominantly on memory for unisensory as opposed to multisensory information. In this work, we sought to investigate behavioral and neural differences between the cued recall of cross-modal audiovisual associations versus within-modal visual or auditory associations. Participants were presented with cue-target associations comprised of pairs of nonsense objects, pairs of nonsense sounds, objects paired with sounds, and sounds paired with objects. Subsequently, they were required to recall the modality of the target given the cue while behavioral accuracy, reaction time, and blood oxygenation level dependent (BOLD) activation were measured. Successful within-modal recall was associated with modality-specific reactivation in primary perceptual regions, and was more accurate than cross-modal retrieval. When auditory targets were correctly or incorrectly recalled using a cross-modal visual cue, there was re-activation in auditory association cortex, and recall of information from cross-modal associations activated the hippocampus to a greater degree than within-modal associations. Findings support theories that propose an overlap between regions active during perception and memory, and show that behavioral and neural differences exist between within- and cross-modal associations. Overall the current study highlights the importance of the role of multisensory information in memory. Copyright © 2011 Elsevier B.V. All rights reserved.

On modal cross-coupling in the asymptotic modal limit

NASA Astrophysics Data System (ADS)

Culver, Dean; Dowell, Earl

2018-03-01

The conditions under which significant modal cross-coupling occurs in dynamical systems responding to high-frequency, broadband forcing that excites many modes is studied. The modal overlap factor plays a key role in the analysis of these systems as the modal density (the ratio of number of modes to the frequency bandwidth) becomes large. The modal overlap factor is effectively the ratio of the width of a resonant peak (the damping ratio times the resonant frequency) to the average frequency interval between resonant peaks (or rather, the inverse of the modal density). It is shown that this parameter largely determines whether substantial modal cross-coupling occurs in a given system's response. Here, two prototypical systems are considered. The first is a simple rectangular plate whose significant modal cross-coupling is the exception rather than the norm. The second is a pair of rectangular plates attached at a point where significant modal cross-coupling is more likely to occur. We show that, for certain cases of modal density and damping, non-negligible cross coupling occurs in both systems. Under similar circumstances, the constraint force between the two plates in the latter system becomes broadband. The implications of this for using Asymptotic Modal Analysis (AMA) in multi-component systems are discussed.

A Medical Image Backup Architecture Based on a NoSQL Database and Cloud Computing Services.

PubMed

Santos Simões de Almeida, Luan Henrique; Costa Oliveira, Marcelo

2015-01-01

The use of digital systems for storing medical images generates a huge volume of data. Digital images are commonly stored and managed on a Picture Archiving and Communication System (PACS), under the DICOM standard. However, PACS is limited because it is strongly dependent on the server's physical space. Alternatively, Cloud Computing arises as an extensive, low cost, and reconfigurable resource. However, medical images contain patient information that can not be made available in a public cloud. Therefore, a mechanism to anonymize these images is needed. This poster presents a solution for this issue by taking digital images from PACS, converting the information contained in each image file to a NoSQL database, and using cloud computing to store digital images.

A joint watermarking/encryption algorithm for verifying medical image integrity and authenticity in both encrypted and spatial domains.

PubMed

Bouslimi, D; Coatrieux, G; Roux, Ch

2011-01-01

In this paper, we propose a new joint watermarking/encryption algorithm for the purpose of verifying the reliability of medical images in both encrypted and spatial domains. It combines a substitutive watermarking algorithm, the quantization index modulation (QIM), with a block cipher algorithm, the Advanced Encryption Standard (AES), in CBC mode of operation. The proposed solution gives access to the outcomes of the image integrity and of its origins even though the image is stored encrypted. Experimental results achieved on 8 bits encoded Ultrasound images illustrate the overall performances of the proposed scheme. By making use of the AES block cipher in CBC mode, the proposed solution is compliant with or transparent to the DICOM standard.

SemVisM: semantic visualizer for medical image

NASA Astrophysics Data System (ADS)

Landaeta, Luis; La Cruz, Alexandra; Baranya, Alexander; Vidal, María.-Esther

2015-01-01

SemVisM is a toolbox that combines medical informatics and computer graphics tools for reducing the semantic gap between low-level features and high-level semantic concepts/terms in the images. This paper presents a novel strategy for visualizing medical data annotated semantically, combining rendering techniques, and segmentation algorithms. SemVisM comprises two main components: i) AMORE (A Modest vOlume REgister) to handle input data (RAW, DAT or DICOM) and to initially annotate the images using terms defined on medical ontologies (e.g., MesH, FMA or RadLex), and ii) VOLPROB (VOlume PRObability Builder) for generating the annotated volumetric data containing the classified voxels that belong to a particular tissue. SemVisM is built on top of the semantic visualizer ANISE.1

A Dependable Massive Storage Service for Medical Imaging.

PubMed

Núñez-Gaona, Marco Antonio; Marcelín-Jiménez, Ricardo; Gutiérrez-Martínez, Josefina; Aguirre-Meneses, Heriberto; Gonzalez-Compean, José Luis

2018-05-18

We present the construction of Babel, a distributed storage system that meets stringent requirements on dependability, availability, and scalability. Together with Babel, we developed an application that uses our system to store medical images. Accordingly, we show the feasibility of our proposal to provide an alternative solution for massive scientific storage and describe the software architecture style that manages the DICOM images life cycle, utilizing Babel like a virtual local storage component for a picture archiving and communication system (PACS-Babel Interface). Furthermore, we describe the communication interface in the Unified Modeling Language (UML) and show how it can be extended to manage the hard work associated with data migration processes on PACS in case of updates or disaster recovery.

Dynamic code block size for JPEG 2000

NASA Astrophysics Data System (ADS)

Tsai, Ping-Sing; LeCornec, Yann

2008-02-01

Since the standardization of the JPEG 2000, it has found its way into many different applications such as DICOM (digital imaging and communication in medicine), satellite photography, military surveillance, digital cinema initiative, professional video cameras, and so on. The unified framework of the JPEG 2000 architecture makes practical high quality real-time compression possible even in video mode, i.e. motion JPEG 2000. In this paper, we present a study of the compression impact using dynamic code block size instead of fixed code block size as specified in the JPEG 2000 standard. The simulation results show that there is no significant impact on compression if dynamic code block sizes are used. In this study, we also unveil the advantages of using dynamic code block sizes.

[The use of open source software in graphic anatomic reconstructions and in biomechanic simulations].

PubMed

Ciobanu, O

2009-01-01

The objective of this study was to obtain three-dimensional (3D) images and to perform biomechanical simulations starting from DICOM images obtained by computed tomography (CT). Open source software were used to prepare digitized 2D images of tissue sections and to create 3D reconstruction from the segmented structures. Finally, 3D images were used in open source software in order to perform biomechanic simulations. This study demonstrates the applicability and feasibility of open source software developed in our days for the 3D reconstruction and biomechanic simulation. The use of open source software may improve the efficiency of investments in imaging technologies and in CAD/CAM technologies for implants and prosthesis fabrication which need expensive specialized software.

MyFreePACS: a free web-based radiology image storage and viewing tool.

PubMed

de Regt, David; Weinberger, Ed

2004-08-01

We developed an easy-to-use method for central storage and subsequent viewing of radiology images for use on any PC equipped with Internet Explorer. We developed MyFreePACS, a program that uses a DICOM server to receive and store images and transmit them over the Web to the MyFreePACS Web client. The MyFreePACS Web client is a Web page that uses an ActiveX control for viewing and manipulating images. The client contains many of the tools found in modern image viewing stations including 3D localization and multiplanar reformation. The system is built entirely with free components and is freely available for download and installation from the Web at www.myfreepacs.com.

Short-Term Memory in Mathematics-Proficient and Mathematics-Disabled Students as a Function of Input-Modality/Output-Modality Pairings.

ERIC Educational Resources Information Center

Webster, Raymond E.

1980-01-01

A significant two-way input modality by output modality interaction suggested that short term memory capacity among the groups differed as a function of the modality used to present the items in combination with the output response required. (Author/CL)

Response Modality Variations Affect Determinations of Children's Learning Styles.

ERIC Educational Resources Information Center

Janowitz, Jeffrey M.

The Swassing-Barbe Modality Index (SBMI) uses visual, auditory, and tactile inputs, but only reconstructed output, to measure children's modality strengths. In this experiment, the SBMI's three input modalities were crossed with two output modalities (spoken and drawn) in addition to the reconstructed standard to result in nine treatment…

Modal analysis using a Fourier analyzer, curve-fitting, and modal tuning

NASA Technical Reports Server (NTRS)

Craig, R. R., Jr.; Chung, Y. T.

1981-01-01

The proposed modal test program differs from single-input methods in that preliminary data may be acquired using multiple inputs, and modal tuning procedures may be employed to define closely spaced frquency modes more accurately or to make use of frequency response functions (FRF's) which are based on several input locations. In some respects the proposed modal test proram resembles earlier sine-sweep and sine-dwell testing in that broadband FRF's are acquired using several input locations, and tuning is employed to refine the modal parameter estimates. The major tasks performed in the proposed modal test program are outlined. Data acquisition and FFT processing, curve fitting, and modal tuning phases are described and examples are given to illustrate and evaluate them.

How many training modalities are needed to obtain procedural confidence in intraosseous access? A questionnaire study.

PubMed

Hallas, Peter; Folkestad, Lars; Brabrand, Mikkel

2011-12-01

Participants in advanced resuscitation courses are often expected to learn to perform intraosseous access (IO). But how many learning modalities are needed to achieve procedural confidence in IO? We distributed an online questionnaire to members of emergency medicine, paediatric and anaesthesiology societies in Scandinavia. The responders without real-life experience with IO (n=322) were classified as 'not confident' or 'confident' in IO. Of total responders 22.8% without training felt confident. Confidence increased to 74.8% after one training modality, 87.9% after two modalities, 98.7% after three modalities and 100% after four modalities (P<0.0001). Of total responders 89.5% who had 'workshop or similar training with hands-on experience' as sole teaching method was confident. Confidence in IO increases with the number of learning modalities. 'Workshop or similar training with hands-on experience' as single training modality seemed as effective as the combination of two modalities.

Modal sound transmission loss of a single leaf panel: Asymptotic solutions.

PubMed

Wang, Chong

2015-12-01

In a previously published paper [C. Wang, J. Acoust. Soc. Am. 137(6), 3514-3522 (2015)], the modal sound transmission coefficients of a single leaf panel were discussed with regard to the inter-modal coupling effects. By incorporating such effect into the equivalent modal radiation impedance, which is directly related to the modal sound transmission coefficient of each mode, the overall sound transmission loss for both normal and randomized sound incidences was computed through a simple modal superposition. Benefiting from the analytical expressions of the equivalent modal impedance and modal transmission coefficients, in this paper, behaviors of modal sound transmission coefficients in several typical frequency ranges are discussed in detail. Asymptotic solutions are also given for the panels with relatively low bending stiffnesses, for which the sound transmission loss has been assumed to follow the mass law of a limp panel. Results are also compared to numerical analysis and the renowned mass law theories.

Learning Across Senses: Cross-Modal Effects in Multisensory Statistical Learning

PubMed Central

Mitchel, Aaron D.; Weiss, Daniel J.

2014-01-01

It is currently unknown whether statistical learning is supported by modality-general or modality-specific mechanisms. One issue within this debate concerns the independence of learning in one modality from learning in other modalities. In the present study, the authors examined the extent to which statistical learning across modalities is independent by simultaneously presenting learners with auditory and visual streams. After establishing baseline rates of learning for each stream independently, they systematically varied the amount of audiovisual correspondence across 3 experiments. They found that learners were able to segment both streams successfully only when the boundaries of the audio and visual triplets were in alignment. This pattern of results suggests that learners are able to extract multiple statistical regularities across modalities provided that there is some degree of cross-modal coherence. They discuss the implications of their results in light of recent claims that multisensory statistical learning is guided by modality-independent mechanisms. PMID:21574745

Structural system identification based on variational mode decomposition

NASA Astrophysics Data System (ADS)

Bagheri, Abdollah; Ozbulut, Osman E.; Harris, Devin K.

2018-03-01

In this paper, a new structural identification method is proposed to identify the modal properties of engineering structures based on dynamic response decomposition using the variational mode decomposition (VMD). The VMD approach is a decomposition algorithm that has been developed as a means to overcome some of the drawbacks and limitations of the empirical mode decomposition method. The VMD-based modal identification algorithm decomposes the acceleration signal into a series of distinct modal responses and their respective center frequencies, such that when combined their cumulative modal responses reproduce the original acceleration response. The decaying amplitude of the extracted modal responses is then used to identify the modal damping ratios using a linear fitting function on modal response data. Finally, after extracting modal responses from available sensors, the mode shape vector for each of the decomposed modes in the system is identified from all obtained modal response data. To demonstrate the efficiency of the algorithm, a series of numerical, laboratory, and field case studies were evaluated. The laboratory case study utilized the vibration response of a three-story shear frame, whereas the field study leveraged the ambient vibration response of a pedestrian bridge to characterize the modal properties of the structure. The modal properties of the shear frame were computed using analytical approach for a comparison with the experimental modal frequencies. Results from these case studies demonstrated that the proposed method is efficient and accurate in identifying modal data of the structures.

HEAVY-DUTY DIESEL VEHICLE MODAL EMISSION MODEL (HDDV-MEM): VOLUME I: MODAL EMISSION MODELING FRAMEWORK; VOLUME II: MODAL COMPONENTS AND OUTPUTS

EPA Science Inventory

This research outlines a proposed Heavy-Duty Diesel Vehicle Modal Emission Modeling Framework (HDDV-MEMF) for heavy-duty diesel-powered trucks and buses. The heavy-duty vehicle modal modules being developed under this research effort, although different, should be compatible wi...

Ares I-X In-Flight Modal Identification

NASA Technical Reports Server (NTRS)

Bartkowicz, Theodore J.; James, George H., III

2011-01-01

Operational modal analysis is a procedure that allows the extraction of modal parameters of a structure in its operating environment. It is based on the idealized premise that input to the structure is white noise. In some cases, when free decay responses are corrupted by unmeasured random disturbances, the response data can be processed into cross-correlation functions that approximate free decay responses. Modal parameters can be computed from these functions by time domain identification methods such as the Eigenvalue Realization Algorithm (ERA). The extracted modal parameters have the same characteristics as impulse response functions of the original system. Operational modal analysis is performed on Ares I-X in-flight data. Since the dynamic system is not stationary due to propellant mass loss, modal identification is only possible by analyzing the system as a series of linearized models over short periods of time via a sliding time-window of short time intervals. A time-domain zooming technique was also employed to enhance the modal parameter extraction. Results of this study demonstrate that free-decay time domain modal identification methods can be successfully employed for in-flight launch vehicle modal extraction.

Neural practice effect during cross-modal selective attention: Supra-modal and modality-specific effects.

PubMed

Xia, Jing; Zhang, Wei; Jiang, Yizhou; Li, You; Chen, Qi

2018-05-16

Practice and experiences gradually shape the central nervous system, from the synaptic level to large-scale neural networks. In natural multisensory environment, even when inundated by streams of information from multiple sensory modalities, our brain does not give equal weight to different modalities. Rather, visual information more frequently receives preferential processing and eventually dominates consciousness and behavior, i.e., visual dominance. It remains unknown, however, the supra-modal and modality-specific practice effect during cross-modal selective attention, and moreover whether the practice effect shows similar modality preferences as the visual dominance effect in the multisensory environment. To answer the above two questions, we adopted a cross-modal selective attention paradigm in conjunction with the hybrid fMRI design. Behaviorally, visual performance significantly improved while auditory performance remained constant with practice, indicating that visual attention more flexibly adapted behavior with practice than auditory attention. At the neural level, the practice effect was associated with decreasing neural activity in the frontoparietal executive network and increasing activity in the default mode network, which occurred independently of the modality attended, i.e., the supra-modal mechanisms. On the other hand, functional decoupling between the auditory and the visual system was observed with the progress of practice, which varied as a function of the modality attended. The auditory system was functionally decoupled with both the dorsal and ventral visual stream during auditory attention while was decoupled only with the ventral visual stream during visual attention. To efficiently suppress the irrelevant visual information with practice, auditory attention needs to additionally decouple the auditory system from the dorsal visual stream. The modality-specific mechanisms, together with the behavioral effect, thus support the visual dominance model in terms of the practice effect during cross-modal selective attention. Copyright © 2018 Elsevier Ltd. All rights reserved.

Method of fan sound mode structure determination computer program user's manual: Modal calculation program

NASA Technical Reports Server (NTRS)

Pickett, G. F.; Wells, R. A.; Love, R. A.

1977-01-01

A computer user's manual describing the operation and the essential features of the Modal Calculation Program is presented. The modal Calculation Program calculates the amplitude and phase of modal structures by means of acoustic pressure measurements obtained from microphones placed at selected locations within the fan inlet duct. In addition, the Modal Calculation Program also calculates the first-order errors in the modal coefficients that are due to tolerances in microphone location coordinates and inaccuracies in the acoustic pressure measurements.

Central Cross-Talk in Task Switching : Evidence from Manipulating Input-Output Modality Compatibility

ERIC Educational Resources Information Center

Stephan, Denise Nadine; Koch, Iring

2010-01-01

Two experiments examined the role of compatibility of input and output (I-O) modality mappings in task switching. We define I-O modality compatibility in terms of similarity of stimulus modality and modality of response-related sensory consequences. Experiment 1 included switching between 2 compatible tasks (auditory-vocal vs. visual-manual) and…

Integrating Conceptual Knowledge Within and Across Representational Modalities

PubMed Central

McNorgan, Chris; Reid, Jackie; McRae, Ken

2011-01-01

Research suggests that concepts are distributed across brain regions specialized for processing information from different sensorimotor modalities. Multimodal semantic models fall into one of two broad classes differentiated by the assumed hierarchy of convergence zones over which information is integrated. In shallow models, communication within- and between-modality is accomplished using either direct connectivity, or a central semantic hub. In deep models, modalities are connected via cascading integration sites with successively wider receptive fields. Four experiments provide the first direct behavioral tests of these models using speeded tasks involving feature inference and concept activation. Shallow models predict no within-modal versus cross-modal difference in either task, whereas deep models predict a within-modal advantage for feature inference, but a cross-modal advantage for concept activation. Experiments 1 and 2 used relatedness judgments to tap participants’ knowledge of relations for within- and cross-modal feature pairs. Experiments 3 and 4 used a dual feature verification task. The pattern of decision latencies across Experiments 1 to 4 is consistent with a deep integration hierarchy. PMID:21093853

Integration of Multi-Modal Biomedical Data to Predict Cancer Grade and Patient Survival.

PubMed

Phan, John H; Hoffman, Ryan; Kothari, Sonal; Wu, Po-Yen; Wang, May D

2016-02-01

The Big Data era in Biomedical research has resulted in large-cohort data repositories such as The Cancer Genome Atlas (TCGA). These repositories routinely contain hundreds of matched patient samples for genomic, proteomic, imaging, and clinical data modalities, enabling holistic and multi-modal integrative analysis of human disease. Using TCGA renal and ovarian cancer data, we conducted a novel investigation of multi-modal data integration by combining histopathological image and RNA-seq data. We compared the performances of two integrative prediction methods: majority vote and stacked generalization. Results indicate that integration of multiple data modalities improves prediction of cancer grade and outcome. Specifically, stacked generalization, a method that integrates multiple data modalities to produce a single prediction result, outperforms both single-data-modality prediction and majority vote. Moreover, stacked generalization reveals the contribution of each data modality (and specific features within each data modality) to the final prediction result and may provide biological insights to explain prediction performance.

Modal cost analysis for simple continua

NASA Technical Reports Server (NTRS)

Hu, A.; Skelton, R. E.; Yang, T. Y.

1988-01-01

The most popular finite element codes are based upon appealing theories of convergence of modal frequencies. For example, the popularity of cubic elements for beam-like structures is due to the rapid convergence of modal frequencies and stiffness properties. However, for those problems in which the primary consideration is the accuracy of response of the structure at specified locations, it is more important to obtain accuracy in the modal costs than in the modal frequencies. The modal cost represents the contribution of a mode in the norm of the response vector. This paper provides a complete modal cost analysis for simple continua such as beam-like structures. Upper bounds are developed for mode truncation errors in the model reduction process and modal cost analysis dictates which modes to retain in order to reduce the model for control design purposes.

To increase controllability of a large flexible antenna by modal optimization

NASA Astrophysics Data System (ADS)

Wang, Feng; Wang, Pengpeng; Jiang, Wenjian

2017-12-01

Large deployable antennas are widely used in aerospace engineering to meet the envelop limit of rocket fairing. The high flexibility and low damping of antenna has proposed critical requirement not only for stability control of the antenna itself, but also for attitude control of the satellite. This paper aims to increase controllability of a large flexible antenna by modal optimization. Firstly, Sensitivity analysis of antenna modal frequencies to stiffness of support structure and stiffness of scanning mechanism are conducted respectively. Secondly, Modal simulation results of antenna frequencies are given, influences of scanning angles on moment of inertia and modal frequencies are evaluated, and modal test is carried out to validate the simulation results. All the simulation and test results show that, after modal optimization the modal characteristic of the large deployable antenna meets the controllability requirement well.

Audition dominates vision in duration perception irrespective of salience, attention, and temporal discriminability

PubMed Central

Ortega, Laura; Guzman-Martinez, Emmanuel; Grabowecky, Marcia; Suzuki, Satoru

2014-01-01

Whereas the visual modality tends to dominate over the auditory modality in bimodal spatial perception, the auditory modality tends to dominate over the visual modality in bimodal temporal perception. Recent results suggest that the visual modality dominates bimodal spatial perception because spatial discriminability is typically greater for the visual than auditory modality; accordingly, visual dominance is eliminated or reversed when visual-spatial discriminability is reduced by degrading visual stimuli to be equivalent or inferior to auditory spatial discriminability. Thus, for spatial perception, the modality that provides greater discriminability dominates. Here we ask whether auditory dominance in duration perception is similarly explained by factors that influence the relative quality of auditory and visual signals. In contrast to the spatial results, the auditory modality dominated over the visual modality in bimodal duration perception even when the auditory signal was clearly weaker, when the auditory signal was ignored (i.e., the visual signal was selectively attended), and when the temporal discriminability was equivalent for the auditory and visual signals. Thus, unlike spatial perception where the modality carrying more discriminable signals dominates, duration perception seems to be mandatorily linked to auditory processing under most circumstances. PMID:24806403

The Inception of OMA in the Development of Modal Testing Technology for Wind Turbines

NASA Technical Reports Server (NTRS)

James, George H., III; Carne. Thomas G.

2008-01-01

Wind turbines are immense, flexible structures with aerodynamic forces acting on the rotating blades at harmonics of the turbine rotational frequency, which are comparable to the modal frequencies of the structure. Predicting and experimentally measuring the modal frequencies of wind turbines has been important to their successful design and operation. Performing modal tests on wind turbine structures over 100 meters tall is a substantial challenge, which has inspired innovative developments in modal test technology. For wind turbines, a further complication is that the modal frequencies are dependent on the turbine rotation speed. The history and development of a new technique for acquiring the modal parameters using output-only response data, called the Natural Excitation Technique (NExT), will be reviewed, showing historical tests and techniques. The initial attempts at output-only modal testing began in the late 1980's with the development of NExT in the 1990's. NExT was a predecessor to OMA, developed to overcome these challenges of testing immense structures excited with environmental inputs. We will trace the difficulties and successes of wind turbine modal testing from 1982 to the present. Keywords: OMA, Modal Analysis, NExT, Wind Turbines, Wind Excitation

Making electronic prescribing alerts more effective: scenario-based experimental study in junior doctors

PubMed Central

Shah, Priya; Wyatt, Jeremy C; Makubate, Boikanyo; Cross, Frank W

2011-01-01

Objective Expert authorities recommend clinical decision support systems to reduce prescribing error rates, yet large numbers of insignificant on-screen alerts presented in modal dialog boxes persistently interrupt clinicians, limiting the effectiveness of these systems. This study compared the impact of modal and non-modal electronic (e-) prescribing alerts on prescribing error rates, to help inform the design of clinical decision support systems. Design A randomized study of 24 junior doctors each performing 30 simulated prescribing tasks in random order with a prototype e-prescribing system. Using a within-participant design, doctors were randomized to be shown one of three types of e-prescribing alert (modal, non-modal, no alert) during each prescribing task. Measurements The main outcome measure was prescribing error rate. Structured interviews were performed to elicit participants' preferences for the prescribing alerts and their views on clinical decision support systems. Results Participants exposed to modal alerts were 11.6 times less likely to make a prescribing error than those not shown an alert (OR 11.56, 95% CI 6.00 to 22.26). Those shown a non-modal alert were 3.2 times less likely to make a prescribing error (OR 3.18, 95% CI 1.91 to 5.30) than those not shown an alert. The error rate with non-modal alerts was 3.6 times higher than with modal alerts (95% CI 1.88 to 7.04). Conclusions Both kinds of e-prescribing alerts significantly reduced prescribing error rates, but modal alerts were over three times more effective than non-modal alerts. This study provides new evidence about the relative effects of modal and non-modal alerts on prescribing outcomes. PMID:21836158

Modality-specific selective attention attenuates multisensory integration.

PubMed

Mozolic, Jennifer L; Hugenschmidt, Christina E; Peiffer, Ann M; Laurienti, Paul J

2008-01-01

Stimuli occurring in multiple sensory modalities that are temporally synchronous or spatially coincident can be integrated together to enhance perception. Additionally, the semantic content or meaning of a stimulus can influence cross-modal interactions, improving task performance when these stimuli convey semantically congruent or matching information, but impairing performance when they contain non-matching or distracting information. Attention is one mechanism that is known to alter processing of sensory stimuli by enhancing perception of task-relevant information and suppressing perception of task-irrelevant stimuli. It is not known, however, to what extent attention to a single sensory modality can minimize the impact of stimuli in the unattended sensory modality and reduce the integration of stimuli across multiple sensory modalities. Our hypothesis was that modality-specific selective attention would limit processing of stimuli in the unattended sensory modality, resulting in a reduction of performance enhancements produced by semantically matching multisensory stimuli, and a reduction in performance decrements produced by semantically non-matching multisensory stimuli. The results from two experiments utilizing a cued discrimination task demonstrate that selective attention to a single sensory modality prevents the integration of matching multisensory stimuli that is normally observed when attention is divided between sensory modalities. Attention did not reliably alter the amount of distraction caused by non-matching multisensory stimuli on this task; however, these findings highlight a critical role for modality-specific selective attention in modulating multisensory integration.