MITK-ModelFit: A generic open-source framework for model fits and their exploration in medical imaging -- design, implementation and application on the example of DCE-MRI

Many medical imaging techniques utilize fitting approaches for quantitative parameter estimation and analysis. Common examples are pharmacokinetic modeling in DCE MRI/CT, ADC calculations and IVIM modeling in diffusion-weighted MRI and Z-spectra analysis in chemical exchange saturation transfer MRI. Most available software tools are limited to a special purpose and do not allow for own developments and extensions. Furthermore, they are mostly designed as stand-alone solutions using external frameworks and thus cannot be easily incorporated natively in the analysis workflow. We present a framework for medical image fitting tasks that is included in MITK, following a rigorous open-source, well-integrated and operating system independent policy. Software engineering-wise, the local models, the fitting infrastructure and the results representation are abstracted and thus can be easily adapted to any model fitting task on image data, independent of image modality or model. Several ready-to-use libraries for model fitting and use-cases, including fit evaluation and visualization, were implemented. Their embedding into MITK allows for easy data loading, pre- and post-processing and thus a natural inclusion of model fitting into an overarching workflow. As an example, we present a comprehensive set of plug-ins for the analysis of DCE MRI data, which we validated on existing and novel digital phantoms, yielding competitive deviations between fit and ground truth. Providing a very flexible environment, our software mainly addresses developers of medical imaging software that includes model fitting algorithms and tools. Additionally, the framework is of high interest to users in the domain of perfusion MRI, as it offers feature-rich, freely available, validated tools to perform pharmacokinetic analysis on DCE MRI data, with both interactive and automatized batch processing workflows.Comment: 31 pages, 11 figures URL: http://mitk.org/wiki/MITK-ModelFi

Data preparation for artificial intelligence in medical imaging: A comprehensive guide to open-access platforms and tools

The vast amount of data produced by today's medical imaging systems has led medical professionals to turn to novel technologies in order to efficiently handle their data and exploit the rich information present in them. In this context, artificial intelligence (AI) is emerging as one of the most prominent solutions, promising to revolutionise every day clinical practice and medical research. The pillar supporting the development of reliable and robust AI algorithms is the appropriate preparation of the medical images to be used by the AI-driven solutions. Here, we provide a comprehensive guide for the necessary steps to prepare medical images prior to developing or applying AI algorithms. The main steps involved in a typical medical image preparation pipeline include: (i) image acquisition at clinical sites, (ii) image de-identification to remove personal information and protect patient privacy, (iii) data curation to control for image and associated information quality, (iv) image storage, and (v) image annotation. There exists a plethora of open access tools to perform each of the aforementioned tasks and are hereby reviewed. Furthermore, we detail medical image repositories covering different organs and diseases. Such repositories are constantly increasing and enriched with the advent of big data. Lastly, we offer directions for future work in this rapidly evolving field

Conversion of JPG Image into DICOM Image Format with One Click Tagging

DICOM images are the centerpiece of radiological imaging. They contain a lot of metadata information about the patient, procedure, sequence of images, device and location. To modify, annotate or simply anonymize images for distribution, we often need to convert DICOM images to another format like jpeg since there are a number of image manipulation tools available for jpeg images compared to DICOM. As part of a research at our institution to customize radiology images to assess cognitive ability of multiple user groups, we created an open-source tool called Jpg2DicomTags, which is able to extract DICOM metadata tags, convert images to lossless jpg that can be manipulated and subsequently reconvert jpg images to DICOM by adding back the metadata tags. This tool provides a simple, easy to use user-interface for a tedious manual task that providers, researchers and patients might often need to do

The Open-Source Neuroimaging Research Enterprise

While brain imaging in the clinical setting is largely a practice of looking at images, research neuroimaging is a quantitative and integrative enterprise. Images are run through complex batteries of processing and analysis routines to generate numeric measures of brain characteristics. Other measures potentially related to brain function – demographics, genetics, behavioral tests, neuropsychological tests – are key components of most research studies. The canonical scanner – PACS – viewing station axis used in clinical practice is therefore inadequate for supporting neuroimaging research. Here, we model the neuroimaging research enterprise as a workflow. The principal components of the workflow include data acquisition, data archiving, data processing and analysis, and data utilization. We also describe a set of open-source applications to support each step of the workflow and the transitions between these steps. These applications include DIGITAL IMAGING AND COMMUNICATIONS IN MEDICINE viewing and storage tools, the EXTENSIBLE NEUROIMAGING ARCHIVE TOOLKIT data archiving and exploration platform, and an engine for running processing/analysis pipelines. The overall picture presented is aimed to motivate open-source developers to identify key integration and communication points for interoperating with complimentary applications

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

Information Technologies for the Healthcare Delivery System

That modern healthcare requires information technology to be efficient and fully effective is evident if one spends any time observing the delivery of institutional health care. Consider the observation of a practitioner of the discipline, David M. Eddy, MD, PhD, voiced in Clinical Decision Making, JAMA 263:1265-75, 1990, . . .All confirm what would be expected from common sense: The complexity of modern medicine exceeds the inherent limitations of the unaided human mind. The goal of this thesis is to identify the technological factors that are required to enable a fully sufficient application of information technology (IT) to the modern institutional practice of medicine. Perhaps the epitome of healthcare IT is the fully integrated, fully electronic patient medical record. Although, in 1991 the Institute of Medicine called for such a record to be standard technology by 2001, it has still not materialized. The author will argue that some of the technology and standards that are pre-requisite for this achievement have now arrived, while others are still evolving to fully sufficient levels. The paper will concentrate primarily on the health care system in the United States, although much of what is contained is applicable to a large degree, around the world. The paper will illustrate certain of these pre-requisite IT factors by discussing the actual installation of a major health care computer system at the University of Rochester Medical Center (URMC) in Rochester, New York. This system is a Picture Archiving and Communications System (PACS). As the name implies, PACS is a system of capturing health care images in digital format, storing them and communicating them to users throughout the enterprise

Grid technology for biomedical applications

International audienceThe deployment of biomedical applications in a grid environment has started about three years ago in several European projects and national ini-tiatives. These applications have demonstrated that the grid paradigm was rele-vant to the needs of the biomedical community. They have also highlighted that this community had very specific requirements on middleware and needed fur-ther structuring in large collaborations in order to participate to the deployment of grid infrastructures in the coming years. In this paper, we propose several ar-eas where grid technology can today improve research and healthcare. A cru-cial issue is to maximize the cross fertilization among projects in the perspec-tive of an environment where data of medical interest can be stored and made easily available to the different actors of healthcare, the physicians, the health-care centres and administrations, and of course the citizens