MammoApplet: an interactive Java applet tool for manual annotation in medical imaging

Web-based applications in computational medicine have become increasingly important during the last years. The rapid growth of the World Wide Web supposes a new paradigm in the telemedicine and eHealth areas in order to assist and enhance the prevention, diagnosis and treatment of patients. Furthermore, training of radiologists and management of medical databases are also becoming increasingly important issues in the field. In this paper, we present MammoApplet , an interactive Java applet interface designed as a web-based tool. It aims to facilitate the diagnosis of new mammographic cases by providing a set of image processing tools that allow a better visualization of the images, and a set of drawing tools, used to annotate the suspicious regions. Each annotation allows including the attributes considered by the experts when issuing the final diagnosis. The overall set of overlays is stored in a database as XML files associated with the original images. The final goal is to obtain a database of already diagnosed cases for training and enhancing the performance of novice radiologistsPeer ReviewedPostprint (author's final draft

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

Diagnóstico precoz de la osteoporosis transitoria de la cadera versus necrosis isquémica de la cabeza femoral: ¿existen realmente signos diferenciales?

—Se han estudiado de forma retrospectiva las posibles diferencias clínicas y en pruebas de imagen de 2 procesos patológicos: la osteoporosis transitoria de la cadera (OTC) y la necrosis isquémica de la cabeza femoral (NICF). El estudio se ha llevado a cabo sobre 7 pacientes diagnosticados de OTC y se han comparado los hallazgos obtenidos con 12 casos de NICF en fase inicial de evolución. Se debate si la OTC es un síndrome distinto a la NICF o si es la manifestación de un estadio precoz y reversible de la misma. Las pruebas de imagen en que se ha basado el estudio han sido: la radiografía simple, el rastreo óseo isotópico y, principalmente, la resonancia magnética (RM). Se han encontrado signos diferenciales entre ambos procesos, pero éstos no nos permiten concluir que se trata de 2 entidades patológicas totalmente diferentes. Se discute por último la actitud terapéutica a llevar a cabo ante un caso de OTC.We report a retrospective study about the differences in clinical signs and in imaging techniques between transient osteoporosis of the hip and avascular necrosis. The study was done on 7 patients of transient osteoporosis and the results obtained were compared with 12 cases of avascular necrosis. We discuss if transient osteoporosis is an individual syndrome or it is an early and reversible stage of avascular necrosis. The imaging techniques studies were: standard X-ray, radionuclide, bone-scanning and MRI. We found differential signs between there two process, but this don't allow us to conclude that the two illness are different. Finally, we discuss the treatment lo carry out in case of transient osteoporosis of the hi

Translating radiological research into practice — from discovery to clinical impact

At the European Society of Radiology (ESR), we strive to provide evidence for radiological practices that improve patient outcomes and have a societal impact. Successful translation of radiological research into clinical practice requires multiple factors including tailored methodology, a multidisciplinary approach aiming beyond technical validation, and a focus on unmet clinical needs. Low levels of evidence are a threat to radiology, resulting in low visibility and credibility. Here, we provide the background and rationale for the thematic series Translating radiological research into practice—from discovery to clinical impact, inviting authors to describe their processes of achieving clinically impactful radiological research. We describe the challenges unique to radiological research. Additionally, a survey was sent to non-radiological clinical societies. The majority of respondents (6/11) were in the field of gastrointestinal/abdominal medicine. The implementation of CT/MRI techniques for disease characterisation, detection and staging of cancer, and treatment planning and radiological interventions were mentioned as the most important radiological developments in the past years. The perception was that patients are substantially unaware of the impact of these developments. Unmet clinical needs were mostly early diagnosis and staging of cancer, microstructural/functional assessment of tissues and organs, and implant assessment. All but one respondent considered radiology important for research in their discipline, but five indicated that radiology is currently not involved in their research. Radiology research holds the potential for being transformative to medical practice. It is our responsibility to take the lead in studies including radiology and strive towards the highest levels of evidence. Critical relevance statement For radiological research to make a clinical and societal impact, radiologists should take the lead in radiological studies, go beyond the assessment of technical feasibility and diagnostic accuracy, and—in a multidisciplinary approach—address clinical unmet needs. Key points • Multiple factors are essential for radiological research to make a clinical and societal impact. • Radiological research needs to go beyond diagnostic accuracy and address unmet clinical needs. • Radiologists should take the lead in radiological studies with a multidisciplinary approach.</p

Translating radiological research into practice—from discovery to clinical impact

At the European Society of Radiology (ESR), we strive to provide evidence for radiological practices that improve patient outcomes and have a societal impact. Successful translation of radiological research into clinical practice requires multiple factors including tailored methodology, a multidisciplinary approach aiming beyond technical validation, and a focus on unmet clinical needs. Low levels of evidence are a threat to radiology, resulting in low visibility and credibility. Here, we provide the background and rationale for the thematic series Translating radiological research into practice—from discovery to clinical impact, inviting authors to describe their processes of achieving clinically impactful radiological research. We describe the challenges unique to radiological research. Additionally, a survey was sent to non-radiological clinical societies. The majority of respondents (6/11) were in the field of gastrointestinal/abdominal medicine. The implementation of CT/MRI techniques for disease characterisation, detection and staging of cancer, and treatment planning and radiological interventions were mentioned as the most important radiological developments in the past years. The perception was that patients are substantially unaware of the impact of these developments. Unmet clinical needs were mostly early diagnosis and staging of cancer, microstructural/functional assessment of tissues and organs, and implant assessment. All but one respondent considered radiology important for research in their discipline, but five indicated that radiology is currently not involved in their research. Radiology research holds the potential for being transformative to medical practice. It is our responsibility to take the lead in studies including radiology and strive towards the highest levels of evidence. Critical relevance statement For radiological research to make a clinical and societal impact, radiologists should take the lead in radiological studies, go beyond the assessment of technical feasibility and diagnostic accuracy, and—in a multidisciplinary approach—address clinical unmet needs. Key points Multiple factors are essential for radiological research to make a clinical and societal impact. Radiological research needs to go beyond diagnostic accuracy and address unmet clinical needs. Radiologists should take the lead in radiological studies with a multidisciplinary approach

Translating radiological research into practice — from discovery to clinical impact

At the European Society of Radiology (ESR), we strive to provide evidence for radiological practices that improve patient outcomes and have a societal impact. Successful translation of radiological research into clinical practice requires multiple factors including tailored methodology, a multidisciplinary approach aiming beyond technical validation, and a focus on unmet clinical needs. Low levels of evidence are a threat to radiology, resulting in low visibility and credibility. Here, we provide the background and rationale for the thematic series Translating radiological research into practice—from discovery to clinical impact, inviting authors to describe their processes of achieving clinically impactful radiological research. We describe the challenges unique to radiological research. Additionally, a survey was sent to non-radiological clinical societies. The majority of respondents (6/11) were in the field of gastrointestinal/abdominal medicine. The implementation of CT/MRI techniques for disease characterisation, detection and staging of cancer, and treatment planning and radiological interventions were mentioned as the most important radiological developments in the past years. The perception was that patients are substantially unaware of the impact of these developments. Unmet clinical needs were mostly early diagnosis and staging of cancer, microstructural/functional assessment of tissues and organs, and implant assessment. All but one respondent considered radiology important for research in their discipline, but five indicated that radiology is currently not involved in their research. Radiology research holds the potential for being transformative to medical practice. It is our responsibility to take the lead in studies including radiology and strive towards the highest levels of evidence. Critical relevance statement For radiological research to make a clinical and societal impact, radiologists should take the lead in radiological studies, go beyond the assessment of technical feasibility and diagnostic accuracy, and—in a multidisciplinary approach—address clinical unmet needs. Key points • Multiple factors are essential for radiological research to make a clinical and societal impact. • Radiological research needs to go beyond diagnostic accuracy and address unmet clinical needs. • Radiologists should take the lead in radiological studies with a multidisciplinary approach.</p

Aplicación web para la gestión de una base de datos pública de mamografía digital: MamoDB

Cada vez son más los hospitales que disponen de sistemas computarizados de adquisición y visualización de imágenes digitales , con las ventaj as que ello supone cu anto a acceso a la información , capacidad de diagnóstico y aprendizaje . Sin embargo, el volumen ingente de datos requiere de nuevas herramientas para su alm acenaje, gestión y recuperación . En este trabajo se propone un modelo de estructura basado en tecnol ogía web como herramienta de ayuda al diagnóstico de Cáncer de Mama. La estructura propuesta se basa en la administración de imágenes y estudios mamográfico s con el objetivo de ser un referente en la comunidad científica. Su arquitectura, metodología y aplicación en formato web se presentan en es te trabajo así como conclusiones y trabajos futurosPostprint (published version

Usefulness of collaborative work in the evaluation of prostate cancer from MRI

The aim of this study is to show the usefulness of collaborative work in the evaluation of prostate cancer from T2-weighted MRI using a dedicated software tool. The variability of annotations on images of the prostate gland (central and peripheral zones as well as tumour) by two independent experts was firstly evaluated, and secondly compared with a consensus between these two experts. Using a prostate MRI database, experts drew regions of interest (ROIs) corresponding to healthy prostate (peripheral and central zones) and cancer. One of the experts then drew the ROI with knowledge of the other expert’s ROI. The surface area of each ROI was used to measure the Hausdorff distance and the Dice coefficient was measured from the respective contours. They were evaluated between the different experiments, taking the annotations of the second expert as the reference. The results showed that the significant differences between the two experts disappeared with collaborative work. To conclude, this study shows that collaborative work with a dedicated tool allows consensus between expertise in the evaluation of prostate cancer from T2-weighted MRI.Peer ReviewedPostprint (published version

Increasing the Efficiency on Producing Radiology Reports for Breast Cancer Diagnosis by Means of Structured Reports

Background: 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. Material and Methods: 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. Results: 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&#8201;= 0.024) and Ultrasound (ANOVA p&#8201;=&#8201;0.008). The ANOVA test for each radiologist profile, indicated that there were significant differences on the high profile (ANOVA p&#8201;=&#8201;0.028) and medium (ANOVA p&#8201;=&#8201;0.045). Conclusions: 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.INDIGO - DataCloud receives funding from the European Union's Horizon 2020 research and innovation programme under grant agreement RIA 653549.Segrelles Quilis, JD.; Medina, R.; Blanquer Espert, I.; Marti Bonmati, L. (2017). Increasing the Efficiency on Producing Radiology Reports for Breast Cancer Diagnosis by Means of Structured Reports. Methods of Information in Medicine. 56:1-13. https://doi.org/10.3414/ME16-01-0091S1135