On the Use of XML in Medical Imaging Web-Based Applications

The rapid growth of digital technology in medical fields over recent years has increased the need for applications able to manage patient medical records, imaging data, and chart information. Web-based applications are implemented with the purpose to link digital databases, storage and transmission protocols, management of large volumes of data and security concepts, allowing the possibility to read, analyze, and even diagnose remotely from the medical center where the information was acquired. The objective of this paper is to analyze the use of the Extensible Markup Language (XML) language in web-based applications that aid in diagnosis or treatment of patients, considering how this protocol allows indexing and exchanging the huge amount of information associated with each medical case. The purpose of this paper is to point out the main advantages and drawbacks of the XML technology in order to provide key ideas for future web-based applicationsPeer ReviewedPostprint (author's final draft

Distributed Object Medical Imaging Model

Abstract- Digital medical informatics and images are commonly used in hospitals today,. Because of the interrelatedness of the radiology department and other departments, especially the intensive care unit and emergency department, the transmission and sharing of medical images has become a critical issue. Our research group has developed a Java-based Distributed Object Medical Imaging Model(DOMIM) to facilitate the rapid development and deployment of medical imaging applications in a distributed environment that can be shared and used by related departments and mobile physiciansDOMIM is a unique suite of multimedia telemedicine applications developed for the use by medical related organizations. The applications support realtime patients’ data, image files, audio and video diagnosis annotation exchanges. The DOMIM enables joint collaboration between radiologists and physicians while they are at distant geographical locations. The DOMIM environment consists of heterogeneous, autonomous, and legacy resources. The Common Object Request Broker Architecture (CORBA), Java Database Connectivity (JDBC), and Java language provide the capability to combine the DOMIM resources into an integrated, interoperable, and scalable system. The underneath technology, including IDL ORB, Event Service, IIOP JDBC/ODBC, legacy system wrapping and Java implementation are explored. This paper explores a distributed collaborative CORBA/JDBC based framework that will enhance medical information management requirements and development. It encompasses a new paradigm for the delivery of health services that requires process reengineering, cultural changes, as well as organizational changes

Recuperação de informação multimodal em repositórios de imagem médica

The proliferation of digital medical imaging modalities in hospitals and other diagnostic facilities has created huge repositories of valuable data, often not fully explored. Moreover, the past few years show a growing trend of data production. As such, studying new ways to index, process and retrieve medical images becomes an important subject to be addressed by the wider community of radiologists, scientists and engineers. Content-based image retrieval, which encompasses various methods, can exploit the visual information of a medical imaging archive, and is known to be beneficial to practitioners and researchers. However, the integration of the latest systems for medical image retrieval into clinical workflows is still rare, and their effectiveness still show room for improvement. This thesis proposes solutions and methods for multimodal information retrieval, in the context of medical imaging repositories. The major contributions are a search engine for medical imaging studies supporting multimodal queries in an extensible archive; a framework for automated labeling of medical images for content discovery; and an assessment and proposal of feature learning techniques for concept detection from medical images, exhibiting greater potential than feature extraction algorithms that were pertinently used in similar tasks. These contributions, each in their own dimension, seek to narrow the scientific and technical gap towards the development and adoption of novel multimodal medical image retrieval systems, to ultimately become part of the workflows of medical practitioners, teachers, and researchers in healthcare.A proliferação de modalidades de imagem médica digital, em hospitais, clínicas e outros centros de diagnóstico, levou à criação de enormes repositórios de dados, frequentemente não explorados na sua totalidade. Além disso, os últimos anos revelam, claramente, uma tendência para o crescimento da produção de dados. Portanto, torna-se importante estudar novas maneiras de indexar, processar e recuperar imagens médicas, por parte da comunidade alargada de radiologistas, cientistas e engenheiros. A recuperação de imagens baseada em conteúdo, que envolve uma grande variedade de métodos, permite a exploração da informação visual num arquivo de imagem médica, o que traz benefícios para os médicos e investigadores. Contudo, a integração destas soluções nos fluxos de trabalho é ainda rara e a eficácia dos mais recentes sistemas de recuperação de imagem médica pode ser melhorada. A presente tese propõe soluções e métodos para recuperação de informação multimodal, no contexto de repositórios de imagem médica. As contribuições principais são as seguintes: um motor de pesquisa para estudos de imagem médica com suporte a pesquisas multimodais num arquivo extensível; uma estrutura para a anotação automática de imagens; e uma avaliação e proposta de técnicas de representation learning para deteção automática de conceitos em imagens médicas, exibindo maior potencial do que as técnicas de extração de features visuais outrora pertinentes em tarefas semelhantes. Estas contribuições procuram reduzir as dificuldades técnicas e científicas para o desenvolvimento e adoção de sistemas modernos de recuperação de imagem médica multimodal, de modo a que estes façam finalmente parte das ferramentas típicas dos profissionais, professores e investigadores da área da saúde.Programa Doutoral em Informátic

Towards case-based medical learning in radiological decision making using content-based image retrieval

<p>Abstract</p> <p>Background</p> <p>Radiologists' training is based on intensive practice and can be improved with the use of diagnostic training systems. However, existing systems typically require laboriously prepared training cases and lack integration into the clinical environment with a proper learning scenario. Consequently, diagnostic training systems advancing decision-making skills are not well established in radiological education.</p> <p>Methods</p> <p>We investigated didactic concepts and appraised methods appropriate to the radiology domain, as follows: (i) Adult learning theories stress the importance of work-related practice gained in a team of problem-solvers; (ii) Case-based reasoning (CBR) parallels the human problem-solving process; (iii) Content-based image retrieval (CBIR) can be useful for computer-aided diagnosis (CAD). To overcome the known drawbacks of existing learning systems, we developed the concept of image-based case retrieval for radiological education (IBCR-RE). The IBCR-RE diagnostic training is embedded into a didactic framework based on the Seven Jump approach, which is well established in problem-based learning (PBL). In order to provide a learning environment that is as similar as possible to radiological practice, we have analysed the radiological workflow and environment.</p> <p>Results</p> <p>We mapped the IBCR-RE diagnostic training approach into the Image Retrieval in Medical Applications (IRMA) framework, resulting in the proposed concept of the IRMAdiag training application. IRMAdiag makes use of the modular structure of IRMA and comprises (i) the IRMA core, i.e., the IRMA CBIR engine; and (ii) the IRMAcon viewer. We propose embedding IRMAdiag into hospital information technology (IT) infrastructure using the standard protocols Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7). Furthermore, we present a case description and a scheme of planned evaluations to comprehensively assess the system.</p> <p>Conclusions</p> <p>The IBCR-RE paradigm incorporates a novel combination of essential aspects of diagnostic learning in radiology: (i) Provision of work-relevant experiences in a training environment integrated into the radiologist's working context; (ii) Up-to-date training cases that do not require cumbersome preparation because they are provided by routinely generated electronic medical records; (iii) Support of the way adults learn while remaining suitable for the patient- and problem-oriented nature of medicine. Future work will address unanswered questions to complete the implementation of the IRMAdiag trainer.</p

Content Based Image Retrieval (CBIR) in Remote Clinical Diagnosis and Healthcare

Content-Based Image Retrieval (CBIR) locates, retrieves and displays images alike to one given as a query, using a set of features. It demands accessible data in medical archives and from medical equipment, to infer meaning after some processing. A problem similar in some sense to the target image can aid clinicians. CBIR complements text-based retrieval and improves evidence-based diagnosis, administration, teaching, and research in healthcare. It facilitates visual/automatic diagnosis and decision-making in real-time remote consultation/screening, store-and-forward tests, home care assistance and overall patient surveillance. Metrics help comparing visual data and improve diagnostic. Specially designed architectures can benefit from the application scenario. CBIR use calls for file storage standardization, querying procedures, efficient image transmission, realistic databases, global availability, access simplicity, and Internet-based structures. This chapter recommends important and complex aspects required to handle visual content in healthcare.Comment: 28 pages, 6 figures, Book Chapter from "Encyclopedia of E-Health and Telemedicine

Towards structured sharing of raw and derived neuroimaging data across existing resources

Data sharing efforts increasingly contribute to the acceleration of scientific discovery. Neuroimaging data is accumulating in distributed domain-specific databases and there is currently no integrated access mechanism nor an accepted format for the critically important meta-data that is necessary for making use of the combined, available neuroimaging data. In this manuscript, we present work from the Derived Data Working Group, an open-access group sponsored by the Biomedical Informatics Research Network (BIRN) and the International Neuroimaging Coordinating Facility (INCF) focused on practical tools for distributed access to neuroimaging data. The working group develops models and tools facilitating the structured interchange of neuroimaging meta-data and is making progress towards a unified set of tools for such data and meta-data exchange. We report on the key components required for integrated access to raw and derived neuroimaging data as well as associated meta-data and provenance across neuroimaging resources. The components include (1) a structured terminology that provides semantic context to data, (2) a formal data model for neuroimaging with robust tracking of data provenance, (3) a web service-based application programming interface (API) that provides a consistent mechanism to access and query the data model, and (4) a provenance library that can be used for the extraction of provenance data by image analysts and imaging software developers. We believe that the framework and set of tools outlined in this manuscript have great potential for solving many of the issues the neuroimaging community faces when sharing raw and derived neuroimaging data across the various existing database systems for the purpose of accelerating scientific discovery

PACS de patologia: uma plataforma centralizada para a gestão de imagem médica de patologia

The clinical area of digital Pathology is still giving its first steps in the development of interoperable solutions that enable the distributed acquisition, storage, and visualization of medical images, including diagnostic support tools. Nowadays, digital management solutions use proprietary image formats and communication protocols that are not compatible with the DICOM standard. Moreover, the available technologies are not mature enough to support the practice of medicine in an area where scanned images can reach several gigapixels, requiring new engineering approaches to support huge volumes of data, in the order of gigabytes per study, that need to be consumed in real time. This dissertation aims to research and develop new technologies and associated information systems, capable of supporting the digital acquisition of pathology images, their centralized archive, sharing, and collaborative review with decision support tools. The result is an innovative web solution, focused on increasing productivity, with safe diagnostics and based on normalized protocols. A common web browser was transformed into a professional workstation that is able to access the image repository at any place and time, regardless of the operating system and without any prior installation.A área de Patologia clínica digital ainda se encontra a dar os primeiros passos no desenvolvimento de soluções interoperáveis que permitam a aquisição, arquivo e visualização distribuída da imagem, incluindo ferramentas de suporte ao diagnóstico. Os atuais cenários de revisão à distância usam aplicações proprietárias que não são interoperáveis com a norma DICOM. Isto deve-se ao facto de a tecnologia não estar suficientemente madura para apoiar a prática clínica numa área em que uma imagem digitalizada pode atingir vários giga-pixels, requerendo novas soluções de engenharia para suportar grandes volumes de dados, da ordem de gigabyte por estudo, que necessitam de ser consumidos remotamente em tempo real. Esta dissertação teve como objetivo estudar e desenvolver tecnologias e sistemas de informação que permitam a aquisição digital da imagem de patologia, o seu arquivo centralizado, a partilha e revisão colaborativa com ferramentas de suporte à decisão. O resultado é uma solução Web inovadora, de elevada produtividade, diagnóstico seguro e baseada em processos e protocolos normalizados. Um Web-browser comum foi transformado numa estação de trabalho capaz de aceder ao arquivo em qualquer altura e qualquer lugar, independentemente do sistema operativo, computador ou dispositivo móvel.Mestrado em Engenharia Informátic

Gabor Barcodes for Medical Image Retrieval

In recent years, advances in medical imaging have led to the emergence of massive databases, containing images from a diverse range of modalities. This has significantly heightened the need for automated annotation of the images on one side, and fast and memory-efficient content-based image retrieval systems on the other side. Binary descriptors have recently gained more attention as a potential vehicle to achieve these goals. One of the recently introduced binary descriptors for tagging of medical images are Radon barcodes (RBCs) that are driven from Radon transform via local thresholding. Gabor transform is also a powerful transform to extract texture-based information. Gabor features have exhibited robustness against rotation, scale, and also photometric disturbances, such as illumination changes and image noise in many applications. This paper introduces Gabor Barcodes (GBCs), as a novel framework for the image annotation. To find the most discriminative GBC for a given query image, the effects of employing Gabor filters with different parameters, i.e., different sets of scales and orientations, are investigated, resulting in different barcode lengths and retrieval performances. The proposed method has been evaluated on the IRMA dataset with 193 classes comprising of 12,677 x-ray images for indexing, and 1,733 x-rays images for testing. A total error score as low as $351$ ($\approx 80\%$ accuracy for the first hit) was achieved.Comment: To appear in proceedings of The 2016 IEEE International Conference on Image Processing (ICIP 2016), Sep 25-28, 2016, Phoenix, Arizona, US

IT Infrastructure to Support the Secondary Use of Routinely Acquired Clinical Imaging Data for Research

We propose an infrastructure for the automated anonymization, extraction and processing of image data stored in clinical data repositories to make routinely acquired imaging data available for research purposes. The automated system, which was tested in the context of analyzing routinely acquired MR brain imaging data, consists of four modules: subject selection using PACS query, anonymization of privacy sensitive information and removal of facial features, quality assurance on DICOM header and image information, and quantitative imaging biomarker extraction. In total, 1,616 examinations were selected based on the following MRI scanning protocols: dementia protocol (246), multiple sclerosis protocol (446) and open question protocol (924). We evaluated the effectiveness of the infrastructure in accessing and successfully extracting biomarkers from routinely acquired clinical imaging data. To examine the validity, we compared brain volumes between patient groups with positive and negative diagnosis, according to the patient reports. Overall, success rates of image data retrieval and automatic processing were 82.5 %, 82.3 % and 66.2 % for the three protocol groups respectively, indicating that a large percentage of routinely acquired clinical imaging data can be used for brain volumetry research, despite image heterogeneity. In line with the literature, brain volumes were found to be significantly smaller (p-value <0.001) in patients with a positive diagnosis of dementia (915 ml) compared to patients with a negative diagnosis (939 ml). This study demonstrates that quantitative image biomarkers such as intracranial and brain volume can be extracted from routinely acquired clinical imaging data. This enables secondary use of clinical images for research into quantitative biomarkers at a hitherto unprecedented scale