22 research outputs found

    Unterstützung von Prozessen der intersektoralen Vernetzung mit medizinischen Bildern unter Berücksichtigung der Qualitätssicherung

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    Im Gesundheitswesen wird der elektronische Austausch von Daten zwischen professionellen Anwendern wie Ärzten, Pflegekräften oder Medizinisch-technischen Assistenten/innen sowie zwischen Ärzten und Patienten immer wichtiger. Aber dennoch ist Kollaborationssoftware in diesem Bereich nach wie vor noch nicht großflächig im Einsatz, so dass sich folgende Fragen ergeben: Welche technischen Voraussetzungen müssen geschaffen werden, um den medizinischen Workflow zu unterstützen beziehungsweise zu verbessern? Und wie können Vernetzung, Qualitätssicherung, Daten- und damit auch Patientensicherheit miteinander vereint werden, um eine bessere Behandlung zu gewährleisten? In dieser Arbeit wurden unterschiedliche Methoden zur Unterstützung von Prozessen der intersektoralen Vernetzung vor allem mit medizinischen Bildern entwickelt und implementiert. Die vorgenommenen Realisierungen fanden dabei insbesondere mit Blick auf die Qualitätssicherung statt. Durch Weiterentwicklungen im Bereich von DICOM E-Mail wurden Verfahren zur einfachen Administration von Netzwerken und automatisierten Konstanzprüfung dem @GIT-Whitepaper ‚Empfehlung für ein standardisiertes Teleradiologie Übertragungsformat‘ hinzugefügt. Die Implementierung einer Multiknotenstatistik erlaubt die zeitunabhängige Nachverfolgung eines Transfers von radiologischen Bilddaten in heterogenen Netzwerken, auch über mehrere Empfangsknoten hinweg. Neben DICOM E-Mail kommen hier verschiedene Übertragungsprotokolle zum Einsatz. Die entwickelten Verfahren zur Verwaltung von DICOM E-Mail Netzwerken wurden durch die @GIT in ein IHE-Profil überführt, von welchem schlussendlich ein Teil in einem Change Proposal als Erweiterung eines bestehenden Profils der Domäne Radiologie angenommen wurde. Im Rahmen des INFOPAT-Projekts des Universitätsklinikums Heidelberg und im Bereich der intersektoralen Vernetzung wurden zahlreiche Erweiterungen und Performanceoptimierungen bei der Entwicklung eines IHE-Adapters für Altsysteme in einem Netzwerk vorgenommen, welche es ermöglichen, auch nicht-IHE-fähige Aktoren an eine persönliche elektronische Patientenakte anzuschließen. Weiterhin wurde ein XDS-fähiger mobiler Bildbetrachter für Patienten entwickelt, der es durch ein standardisiertes Single-Sign-On erlaubt, zwischen Patientenakte, radiologischem Viewer und mobilem Bildbetrachter nahtlos zu wechseln. Um eine einfachere Kommunikation zwischen Ärzten, medizinischen Dienstleistern und Patienten zu realisieren, wurde eine bestehende Teleradiologieakte durch die Entwicklung eines konfigurierbaren Workflowmanagements sowie verschiedene Freigabe- und Exportmodule erweitert. Abschließend wurde das Monitoring-System für teleradiolgische Netzwerke weiterentwickelt, um Probleme und Engstellen bei der Kommunikation frühzeitig und proaktiv erkennen und beheben zu können. Die im Rahmen dieser Arbeit beschriebenen Weiterentwicklungen unterschiedlicher Standards im Bereich der Qualitätssicherung und Teleradiologie sowie die Softwareentwicklungen im Bereich der Telemedizin und schlussendlich der intersektoralen Vernetzung unterstützen den Arbeitsablauf der medizinischen als auch administrativen Anwender. Mit Hilfe der etablierten Lösungen kann ein reibungsloser Ablauf und das Zusammenspiel verschiedener Komponenten in heterogenen Netzwerken auch unter dem Gesichtspunkt der Qualitätssicherung gewährleistet werden. Patienten erhalten dadurch einen einfachen Zugang zu ihren Daten. Die Ergebnisse der Arbeit zeigen, dass auch heute schon ein qualitätsgesicherter und komfortabler Austausch von Bilddaten im medizinischen Umfeld ad hoc über die Grenzen von dezentralen Einrichtungen des Gesundheitswesens hinaus möglich ist. Dadurch kann die intersektorale Behandlung beschleunigt, die Behandlungsqualität verbessert und Doppeluntersuchungen vermieden werden

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

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    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

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    Recuperação de informação multimodal em repositórios de imagem médica

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    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

    The impact of arterial input function determination variations on prostate dynamic contrast-enhanced magnetic resonance imaging pharmacokinetic modeling: a multicenter data analysis challenge, part II

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    This multicenter study evaluated the effect of variations in arterial input function (AIF) determination on pharmacokinetic (PK) analysis of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) data using the shutter-speed model (SSM). Data acquired from eleven prostate cancer patients were shared among nine centers. Each center used a site-specific method to measure the individual AIF from each data set and submitted the results to the managing center. These AIFs, their reference tissue-adjusted variants, and a literature population-averaged AIF, were used by the managing center to perform SSM PK analysis to estimate Ktrans (volume transfer rate constant), ve (extravascular, extracellular volume fraction), kep (efflux rate constant), and τi (mean intracellular water lifetime). All other variables, including the definition of the tumor region of interest and precontrast T1 values, were kept the same to evaluate parameter variations caused by variations in only the AIF. Considerable PK parameter variations were observed with within-subject coefficient of variation (wCV) values of 0.58, 0.27, 0.42, and 0.24 for Ktrans, ve, kep, and τi, respectively, using the unadjusted AIFs. Use of the reference tissue-adjusted AIFs reduced variations in Ktrans and ve (wCV = 0.50 and 0.10, respectively), but had smaller effects on kep and τi (wCV = 0.39 and 0.22, respectively). kep is less sensitive to AIF variation than Ktrans, suggesting it may be a more robust imaging biomarker of prostate microvasculature. With low sensitivity to AIF uncertainty, the SSM-unique τi parameter may have advantages over the conventional PK parameters in a longitudinal study

    Métodos computacionais para otimização de desempenho em redes de imagem médica

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    Over the last few years, the medical imaging has consolidated its position as a major mean of clinical diagnosis. The amount of data generated by the medical imaging practice is increasing tremendously. As a result, repositories are turning into rich databanks of semi-structured data related to patients, ailments, equipment and other stakeholders involved in the medical imaging panorama. The exploration of these repositories for secondary uses of data promises to elevate the quality standards and efficiency of the medical practice. However, supporting these advanced usage scenarios in traditional institutional systems raises many technical challenges that are yet to be overcome. Moreover, the reported poor performance of standard protocols opened doors to the general usage of proprietary solutions, compromising the interoperability necessary for supporting these advanced scenarios. This thesis has researched, developed, and now proposes a series of computer methods and architectures intended to maximize the performance of multi-institutional medical imaging environments. The methods are intended to improve the performance of standard protocols for medical imaging content discovery and retrieval. The main goal is to use them to increase the acceptance of vendor-neutral solutions through the improvement of their performance. Moreover, it intends to promote the adoption of such standard technologies in advanced scenarios that are still a mirage nowadays, such as clinical research or data analytics directly on top of live institutional repositories. Finally, these achievements will facilitate the cooperation between healthcare institutions and researchers, resulting in an increment of healthcare quality and institutional efficiency.As diversas modalidades de imagem médica têm vindo a consolidar a sua posição dominante como meio complementar de diagnóstico. O número de procedimentos realizados e o volume de dados gerados aumentou significativamente nos últimos anos, colocando pressão nas redes e sistemas que permitem o arquivo e distribuição destes estudos. Os repositórios de estudos imagiológicos são fontes de dados ricas contendo dados semiestruturados relacionados com pacientes, patologias, procedimentos e equipamentos. A exploração destes repositórios para fins de investigação e inteligência empresarial, tem potencial para melhorar os padrões de qualidade e eficiência da prática clínica. No entanto, estes cenários avançados são difíceis de acomodar na realidade atual dos sistemas e redes institucionais. O pobre desempenho de alguns protocolos standard usados em ambiente de produção, conduziu ao uso de soluções proprietárias nestes nichos aplicacionais, limitando a interoperabilidade de sistemas e a integração de fontes de dados. Este doutoramento investigou, desenvolveu e propõe um conjunto de métodos computacionais cujo objetivo é maximizar o desempenho das atuais redes de imagem médica em serviços de pesquisa e recuperação de conteúdos, promovendo a sua utilização em ambientes de elevados requisitos aplicacionais. As propostas foram instanciadas sobre uma plataforma de código aberto e espera-se que ajudem a promover o seu uso generalizado como solução vendor-neutral. As metodologias foram ainda instanciadas e validadas em cenários de uso avançado. Finalmente, é expectável que o trabalho desenvolvido possa facilitar a investigação em ambiente hospitalar de produção, promovendo, desta forma, um aumento da qualidade e eficiência dos serviços.Programa Doutoral em Engenharia Informátic

    Front-Line Physicians' Satisfaction with Information Systems in Hospitals

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    Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe

    Vergleich der dorso-palmaren und palmaro-proximal –palmaro-distalen Schrägaufnahme des Strahlbeins mit und ohne Kontrastmittel in der Bursa podotrochlearis an der Vordergliedmaße des Pferdes

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    In der vorliegenden Arbeit wurden radiologische Befunde der Oxspring- und Skylineaufnahme mit und ohne Kontrastmittel in der Bursa podotrochlearis mit den makroskopischen Befunden am Strahlbein und der tiefen Beugesehne von 96, isolierten Vordergliedmaßen von Schlachtpferden verglichen. Es wurden von 96, im Karpalgelenk abgesetzten Vordergliedmaßen, die vier oben genannten Röntgenbilder angefertigt. Anschließend wurden das Paket aus tiefer Beugesehne und Strahlbein präpariert und makroskopisch auf pathologische Veränderungen untersucht. Die in der Präparation und in den Röntgenbildern erhobenen Befunde wurden in ein objektives Punktesystem eingeteilt und mit Faktoren angepasst. Aus diesen Punkten wurden die Präparate und Röntgenbilder in Klassen von eins (gesund) bis vier (hochgradig geschädigt) eingeordnet. Diese Klassen wurden miteinander verglichen. Es wurden noch einzelne Merkmale mit den für sie typischen Röntgenbefunden verglichen. Die Auswertung zeigte, dass sich Befunde an mittelgradig und teilweise auch hochgradig veränderten Hufrollenpräparaten nur bedingt in konventionellen Röntgenprojektionen darstellen lassen. Diese Veränderungen wurden mit einer Sensitivität von 51,7% bei einer Spezifität von 92,5% in der Oxspringaufnahme festgestellt. In der Skylineaufnahme betrug die Sensitivität 55,2% bei einer Spezifität von 91.0%. Das Bursogramm ist eine einfache Möglichkeit, die Sensitivität der Röntgendiagnostik für pathologische Veränderungen an der Hufrolle zu erhöhen. So wurden zusätzlich vier der 29 mittel- bzw. hochgradig erkrankten Beine mit der Oxspringaufnahme mit Kontrastmittel identifiziert, bei einer Spezifität von 89,6%. Mit der Skylineaufnahme mit Kontrastmittel wurden 7 erkrankte Beine mehr als mit den konventionellen Bildern ermittelt. Die Spezifität war dabei 80,3%. 4 der 29 veränderten Präparate wurden auf keiner Röntgenaufnahme als krank eingeteilt. Es wurden gewichtete Kapa für die Übereinstimmung der Gruppen von 0,349 für die Oxspringaufnahme, 0,280 für die Skylineaufnahme, 0,358 für die Oxspring-Kontrast-Aufnahme und 0,455 für die Skyline-Kontrast-Aufnahme berechnet. Die Erhöhung der Sensitivität ließ sich auf das Darstellen von Oberflächen von Weichteilgeweben zurückführen. 9 von 10 Rissen in der Dorsalfläche der TBS, 7 von 8 Verwachsungen bzw. alle drei Verklebungen der TBS mit dem OSN ließen sich in der Skylineaufnahme mit Kontrastmittel darstellen. 6 von 10 Rissen in der Dorsalfläche der TBS und 7 von 8 Verwachsungen der TBS mit dem OSN zeigten sich in der Oxspringaufnahme mit Kontrastmittel. Tiefe Knorpeldefekte auf der Facies flexoria des Strahlbeins sich ebenfalls auf beiden Aufnahmen identifizieren. Mittelgradige Knorpelveränderungen, wie generalisierte Knorpelverdünnung ließen sich nicht sicher nachweisen. Die einzelnen Linien, die laut Literatur die Dicke des Faserknorpels widerspiegeln, waren sehr schwer auszuwerten und waren in nur 51 von 96 Röntgenbildern vorhanden. Alle 10 Präparate, in denen diese Linien deutlich unterbrochen war, waren mittel bis hochgradig verändert. Bei 3 von 19 Präparaten mit verändertem Knorpel wiesen, die drei Linien keine Veränderung auf. 13 von 20 unveränderten Hufrollenpräparatne wiesen jedoch auch geringe Abweichungen bei der Beurteilung auf. Beine, die auf mehr als einer Aufnahme einen positiven Befund hatten, waren zu 93,9% makroskopisch verändert. Die Summe der Röntgenklassen korreliert am besten mit der makroskopischen Bewertung. Es ließ sich ein Korrelationskoeffizient von 0,554 errechnen. Daraus lässt sich schließen, dass die Anfertigung von allen vier Bildern sinnvoll ist. Bei einem klinischen Verdacht auf eine Hufrollenerkrankung ist die konventionelle Röntgenuntersuchung die Standarduntersuchung. Ergebnisse der konventionellen Röntgenaufnahmen sind nicht sehr sensitiv, aber sehr spezifisch. Bei eindeutig positivem Ausfall der konventionellen Bilder ist somit die Bursographie nicht notwendig. Bei fraglichen oder negativen Befunden, kann die Sensitivität durch die Bursographie gesteigert werden. Ein Befund, der auf mehr als einer Aufnahme bestätigt wird, ist sicher. Bei negativen Ergebnissen sollten andere Untersuchungen, wie eine MRT-Untersuchung, durchgeführt werden. So ist die Bursographie eine sinnvolle Ergänzung zur Diagnostik des Equine-palmar-foot-syndrome.Comparison of the dorsoproximal‐palmarodistal and palmaroproximal-palmarodistal oblique view of the navicular bone with and without contrast media in the navicular bursa in the front feet in the horse Radiographs from 96 isolatet horse feets were compared with the anatomic preparation. A dorsoproximal-palmarodistal oblique and a palmaroproximal-palmarodistal oblique view were made. Each view was made with and without contrast medium in the navicular bursa. The pictures with contrast medium in the navicualar bursa are called bursography. The actual literature about the anatomy and physiology of the equine distal limb was reviewed. It has been also reviewed new insights about the osteoarthritis in science and the link to the equine palmar foot syndrome. At least there is a conclusion about the direct radiography systems and about the techniques in equine radiology. There were taken four different radiographs of the distal front limb. After this step the feet were dissected to make a gross evaluation of the surface from the deep digital flexor tendon and the flexor surface of the os naviculare. For each view and the preparation there was made a objective scoring system for each mark. After this step, there was also a summarizing category made from one for healthy to four for severe damage. This grading was made independent for each view. At least these categories and some special characteristics were compared. The comparison showed, that some severe damaged navicular bones respectively deep digital flexor tendons do not show severe abnormalities in the classical x-ray picture. The x-ray picture with contrast medium in the navicular bursa improved the sensitivity for lesions in this area. The weighted kappa was determined: 0,349 for the dorsoproximal-palmarodistal oblique view, 0,358 dorsoproximal-palmarodistal oblique view with contrast medium, 0,280 for the palmaroproximal-palmarodistal oblique and 0,455 for the palmaroproximal-palmarodistal oblique with contrast medium. Dorsal splits in the deep digital flexor tendon surface and adhesions between the flexor tendon and the navicular bone could be seen in the contrast enhanced views. The evaluation of early lesions, like thinning of the cartilage of the flexor surface from the navicular bone was questionable. The addition from the objective scoring from all four views showed the best relation to the gross evaluation. There was a 0,554 spearman correlation coefficient between the summation of all x-ray categories and the gross evaluation. In addition to that, 93,9% who were graded in more than one view as 3 or 4, showed some severe pathology in the gross evaluation. The standard views of the equine palmar foot have a very high specify. but a lack in sensitivity for pathologic changes in the navicular apparatus. Bursography is producing further information. But there are also lesions, which can not be seen in any x-ray projection. In these cases a magnet resonace tomography is necessary. So the bursography is a easy way to evaluate the podotrochlear apparatus of the horse if there is no MRI available

    DICOOGLE: No-SQL para suporte de ambientes Big Data

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    Mestrado em Engenharia de Computadores e TelemáticaThe last few years have been characterized by a proliferation of different types of medical imaging modalities in healthcare institutions. As a result, the services are migrating to infrastructures in the Cloud. Thus, in addition to a scenario where tremendous amounts of data are produced, we walked to a reality where processes are increasingly distributed. Consequently, this reality has created new technological challenges regarding storage, management and handling of this data, in order to guarantee high availability and performance of the information systems, dealing with the images. An Open Source Picture Archive and Communication System (PACS) has been developed by the bioinformatics research group at the University of Aveiro labeled Dicoogle. This system replaced the traditional relational database engine for an agile mechanism, which indexes and retrieves data. Thus it is possible to extract, index and store all the image’s metadata, including any private information, without re-engineering or reconfiguration process. Among other use cases, this system has already indexed more than 22 million images in 3 hospitals from the region of Aveiro. Currently, Dicoogle provides a solution based on the Apache Lucene library. However, it has performance issues in environments where we need to handle and search over large amounts of data, more particularly in data analytics scenarios. In the context of this work, different technologies capable of supporting a database of an image repository were studied. In sequence, four solutions were fully implemented based on relational databases, NoSQL and two distinct text engines. A test platform was also developed to evaluate the performance and scalability of these solutions, which allowed a comparative analysis of them. In the end, it is proposed a hybrid architecture of medical image database, which was implemented and validated. This proposal has demonstrated significant gains in terms of query, index time and in scenarios where it is required a wide data analyze.Os últimos anos têm sido caracterizados por uma proliferação de diversos tipos de modalidades de imagem médica nas instituições de saúde. Por outro lado, assistimos a uma migração de serviços para infraestruturas na Cloud. Assim, para além de um cenário onde são produzidos tremendos volumes de dados, caminhamos para uma realidade em que os processos são cada vez mais distribuídos. Tal realidade tem colocado novos desafios tecnológicos ao nível do arquivo, transmissão e visualização, muito particularmente nos aspetos de desempenho e escalabilidade dos sistemas de informação que lidam com a imagem. O grupo de bioinformática da universidade de Aveiro tem vindo a desenvolver um inovador sistema distribuído de arquivo de imagem médica, o Dicoogle Open Source PACS. Este sistema substituiu o tradicional motor de base de dados relacional por um mecanismo ágil de indexação e recuperação de dados. Desta forma é possível extrair, indexar e armazenar todos os metadados das imagens, incluindo eventuais elementos privados, sem necessidade de processos de reengenharia ou reconfiguração. Entre outros casos de uso, este sistema já indexou mais de 22 milhões de imagens em 3 hospitais da região de Aveiro. Atualmente, o Dicoogle dispõe de uma solução baseada na biblioteca Apache Lucene. No entanto, esta tem demonstrado alguns problemas de desempenho em ambientes em que temos necessidade de manusear e pesquisar sobre uma grande quantidade de dados, muito particularmente em cenários de análise de dados. No âmbito desta dissertação foram estudadas diferentes tecnologias capazes de suportar uma base dados de um repositório de imagem. Em sequência, foram implementadas quatro soluções baseadas em bases de dados relacionais, NoSQL e motor de indexação. Foi também desenvolvida uma plataforma de testes de desempenho e escalabilidade que permitiu efetuar uma análise comparativa das soluções implementadas. No final, é proposta uma arquitetura híbrida de base de dados de imagem médica que foi implementada e validada. Tal proposta demonstrou ter ganhos significativos ao nível dos tempos de pesquisa de conteúdos e em cenários de análise alargada de dados
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