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

Medical Image Data and Datasets in the Era of Machine Learning-Whitepaper from the 2016 C-MIMI Meeting Dataset Session.

At the first annual Conference on Machine Intelligence in Medical Imaging (C-MIMI), held in September 2016, a conference session on medical image data and datasets for machine learning identified multiple issues. The common theme from attendees was that everyone participating in medical image evaluation with machine learning is data starved. There is an urgent need to find better ways to collect, annotate, and reuse medical imaging data. Unique domain issues with medical image datasets require further study, development, and dissemination of best practices and standards, and a coordinated effort among medical imaging domain experts, medical imaging informaticists, government and industry data scientists, and interested commercial, academic, and government entities. High-level attributes of reusable medical image datasets suitable to train, test, validate, verify, and regulate ML products should be better described. NIH and other government agencies should promote and, where applicable, enforce, access to medical image datasets. We should improve communication among medical imaging domain experts, medical imaging informaticists, academic clinical and basic science researchers, government and industry data scientists, and interested commercial entities

Improving knowledge management through the support of image examination and data annotation using DICOM structured reporting

[EN] An important effort has been invested on improving the image diagnosis process in different medical areas using information technologies. The field of medical imaging involves two main data types: medical imaging and reports. Developments based on the DICOM standard have demonstrated to be a convenient and widespread solution among the medical community. The main objective of this work is to design a Web application prototype that will be able to improve diagnosis and follow-on of breast cancer patients. It is based on TRENCADIS middleware, which provides a knowledge-oriented storage model composed by federated repositories of DICOM image studies and DICOM-SR medical reports. The full structure and contents of the diagnosis reports are used as metadata for indexing images. The TRENCADIS infrastructure takes full advantage of Grid technologies by deploying multi-resource grid services that enable multiple views (reports schemes) of the knowledge database. The paper presents a real deployment of such Web application prototype in the Dr. Peset Hospital providing radiologists with a tool to create, store and search diagnostic reports based on breast cancer explorations (mammography, magnetic resonance, ultrasound, pre-surgery biopsy and post-surgery biopsy), improving support for diagnostics decisions. A technical details for use cases (outlining enhanced multi-resource grid services communication and processing steps) and interactions between actors and the deployed prototype are described. As a result, information is more structured, the logic is clearer, network messages have been reduced and, in general, the system is more resistant to failures.The authors wish to thank the financial support received from The Spanish Ministry of Education and Science to develop the project "CodeCloud", with reference TIN2010-17804.Salavert Torres, J.; Segrelles Quilis, JD.; Blanquer Espert, I.; Hernández García, V. (2012). Improving knowledge management through the support of image examination and data annotation using DICOM structured reporting. Journal of Biomedical Informatics. 45(6):1066-1074. https://doi.org/10.1016/j.jbi.2012.07.004S1066107445

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

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

Shanoir: Software as a Service Environment to Manage Population Imaging Research Repositories

International audienceSome of the major concerns of researchers and clinicians involved in popu- lation imaging experiments are on one hand, to manage the huge quantity and diversi- ty of produced data and, on the other hand, to be able to confront their experiments and the programs they develop with peers. In this context, we introduce Shanoir, a “Software as a Service” (SaaS) environment that offers cloud services for managing the information related to population imaging data production in the context of clini- cal neurosciences. We show how the produced images are accessible through the Sha- noir Data Management System, and we describe some of the data repositories that are hosted and managed by the Shanoir environment in different contexts

Comparative study of healthcare messaging standards for interoperability in ehealth systems

Advances in the information and communication technology have created the field of "health informatics," which amalgamates healthcare, information technology and business. The use of information systems in healthcare organisations dates back to 1960s, however the use of technology for healthcare records, referred to as Electronic Medical Records (EMR), management has surged since 1990’s (Net-Health, 2017) due to advancements the internet and web technologies. Electronic Medical Records (EMR) and sometimes referred to as Personal Health Record (PHR) contains the patient’s medical history, allergy information, immunisation status, medication, radiology images and other medically related billing information that is relevant. There are a number of benefits for healthcare industry when sharing these data recorded in EMR and PHR systems between medical institutions (AbuKhousa et al., 2012). These benefits include convenience for patients and clinicians, cost-effective healthcare solutions, high quality of care, resolving the resource shortage and collecting a large volume of data for research and educational needs. My Health Record (MyHR) is a major project funded by the Australian government, which aims to have all data relating to health of the Australian population stored in digital format, allowing clinicians to have access to patient data at the point of care. Prior to 2015, MyHR was known as Personally Controlled Electronic Health Record (PCEHR). Though the Australian government took consistent initiatives there is a significant delay (Pearce and Haikerwal, 2010) in implementing eHealth projects and related services. While this delay is caused by many factors, interoperability is identified as the main problem (Benson and Grieve, 2016c) which is resisting this project delivery. To discover the current interoperability challenges in the Australian healthcare industry, this comparative study is conducted on Health Level 7 (HL7) messaging models such as HL7 V2, V3 and FHIR (Fast Healthcare Interoperability Resources). In this study, interoperability, security and privacy are main elements compared. In addition, a case study conducted in the NSW Hospitals to understand the popularity in usage of health messaging standards was utilised to understand the extent of use of messaging standards in healthcare sector. Predominantly, the project used the comparative study method on different HL7 (Health Level Seven) messages and derived the right messaging standard which is suitable to cover the interoperability, security and privacy requirements of electronic health record. The issues related to practical implementations, change over and training requirements for healthcare professionals are also discussed

NEArBy : pesquisa em imagens cerebrais suportada em Atlas

Mestrado em Engenharia de Computadores e Telemática,Brain atlases have been used as reference to classify and tag topological information either structural or functional from brain images. Using atlases, the resulting analysis allows the extraction of semantic information from the existing image data. However the process of classifying and tagging brain images using an atlas is often tedious and mostly dependent on human observation and validation. At the same time, even when available is often difficult to use, namely when using typical query retrieve services in modern imaging repositories (e.g. DICOM based PACS). In this work we propose NEArBy, a solution that provides query and retrieve services based on brain atlas semantics that can be easily integrated in existing DICOM based imaging repositories. Using a web interface, NEArBy supports not only typical DICOM query retrieve searches but also query tokens matching the brain atlas dictionary. To automate the semantic tagging of the brain images we rely on external methods to identify relevant spatial features that are later labelled using standard brain atlas. Being DICOM a tag based standard, atlases related tags are then privately embedded into DICOM files as NEArBy XML descriptors. These descriptors encode the mapping between feature type, spatial location in the atlas and the respective atlas tag. XML encoded tags are also suitable for indexation by a medical imaging Q/R tool such as Dicoogle allowing queries based both on standard DICOM tags and specifically on atlases related tokens included by NEArBy middleware. NEArBy provides a way to perform queries over a medical imaging repository using technical and atlas based topological information. We illustrate the NEArBy potential usage over a set of functional magnetic resonance imaging (fMRI) datasets using the web user interface to formulate the queries with atlas related criteria and access the retrieved results. Several experiments were successfully performed demonstrating the effectiveness in retrieving subjects with activations in similar areas and in specific locations.Os atlas cerebrais têm vindo a ser utilizados como referência na classificação e identificação de informação topológica, tanto estrutural como funcional, de imagens do cérebro. Com recurso ao atlas, a análise que daí surge permite a extração de informação semântica a partir dos dados existentes na imagem. Contudo, o processo de classificação e catalogação de imagens cerebrais com recurso ao atlas é frequentemente entediante e maioritariamente depende da observação e validação humana. Simultaneamente, mesmo quando disponível, é frequentemente de difícil utilização, nomeadamente quando se faz uso de serviços de consulta e recuperação de informação em repositórios de imagens médicas atuais. (e.g. PACS com base DICOM). Neste trabalho, propomos a NEArBy, a solução que disponibiliza serviços de consulta e recuperação de informação com base na semântica de atlas cerebrais, facilmente integrado em repositórios de imagens médicas DICOM existentes. Recorrendo a uma interface web, a NEArBy suporta, não apenas as típicas buscas de consulta e recuperação, mas também chaves de consulta correspondendo ao dicionário de atlas cerebral. Para automatizar a catalogação semântica das imagens cerebrais, recorremos a métodos externos na identificação de características espaciais relevantes que são posteriormente rotulados usando um atlas cerebral standard. Sendo o DICOM um standard baseado em tags, estas relacionadas com o atlas são, assim, discretamente embebidas em ficheiros DICOM como descritores XML NEArBy. Estes descritores codificam o mapeamento entre o tipo de característica, localização espacial no atlas e a respetiva tag do atlas. As tags codificadas do XLM são também adequadas para a indexação através de uma ferramenta de imagens médicas Q/R, como Dicoogle, permitindo consultas com base, ambos em tags standard de DICOM e em chaves relacionadas com o atlas incluídas no middleware NEArBy. NEArBy permite fazer consultas num repositório de imagens médicas, recorrendo a informação técnica e topológica com base em atlas. Ilustramos a potencial utilização da NEArBy num conjunto de imagens por ressonância magnética funcional (IRMf), utilizando a interface web do utilizador para formular as consultas em critérios relacionados com o atlas e aceder aos resultados daí recuperados. Foram levadas a cabo várias experiências com sucesso, demonstrando a eficácia na recuperação de sujeitos com ativações em áreas similares e em locais específicos