Transcript 10Oct_1440_Melo_V2.ppt
DICOM INTERNATIONAL CONFERENCE & SEMINAR
Oct 9-11, 2010 Rio de Janeiro, Brazil
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS WITH LOW SPEED, COST, SECURITY AND QUALITY.
Leonardo Melo Diagnext.com
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Motivation:
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Physicians are poorly distributed in Brazil, both geographically and by specialty; 80% of the states have over 1,000 inhabitants per physicians. 5 (five) are above 4,000 inhabitants per physicians; The reason between the number of physicians and radiologist is about 1.10% in Brazil; According the Ministry of Health, less than 10% of Brazilian cities have computed tomography and / or MRI. 77% of x-ray equipment.
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Then....
The widespread use of technology can reduce the distance, prompting the healthcare professional of any segment more closest to the patient.
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
By the way...
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Radiological exams are made of a quantity of images, digitalized preferably in DICOM standards;
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The technological development of radiological equipment, such as multislice computed tomography, magnetic resonance imaging with large capacity, CRs and DRs are directly connected of the generation to large volume of images, and,consequently their size in bytes;
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This development has been generating exponential increases in data volume, making the need for major technological structures and telecommunications networks to transmit.
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
However, in Brazil:
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Transport of these images within the context of telecommunications networks in Brazil - a high cost with low speeds and quality, large quantity of errors and interruptions, and poor coverage in the country - make a difficult task or almost impossible at some places to enable telemedicine;
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Moreover, the total cost of ownership of technological solutions that operationalize DICOM (hardware and software) for a continental and poor country like Brazil is incompatible.
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Objectives: Beyond a engineering concept of communications:
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Study the technology involved in radiologic medicine, looking for a way to transmit; The entire review process set up with medical measurement of quality; Use communication's media with low cost of ownership and maintenance. For example: aDSL, 3G, low cost satelites solutions and others with the same features; The computers equipment envolved in all the process need to have low costs.
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
How to do these objectives?
The complete solution is founded with a algorithms that:
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First: Make treatments of communications media, for accomplishing the solutions proposed;
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Second: Works making a adjusted compression of the data DICOM transfer, in real time.
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Boundary conditions:
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We used the same communication structure (a low speed and poor Internet access integrated with Technological Data Center) at all times;
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Comparison the reduction in time was obtained with the transmission of test data (DICOM with null images) via conventional method of transmission (SCP/SCU);
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Any assessment of quality was done using the healthcare team;
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Boundary conditions:
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Seeking to meet the needs that a communication system with the special characteristics of the transmission of medical images, we identified several potential problems. Consequently, solutions were proposed. We present below a sample of the most relevant;
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The evaluations were done sampling, using more than 2,500 tests, with different technical origins;
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Boundary conditions:
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DICOM Data Submission: a) Source: Simulation of equipment conventional radiology (CT); b) Destination: Our remote PACS server, at Data Center. We created our systems!
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Problem identified Proposed Solution
Transmission unstable between communication networks.
a) Data Center within reliable, operating uninterruptedly; b) Networks at high speed; c) When the start of transmition data release: doing it continuously; d) Transfer continues through synchronous data protocols; e) Separation between the sending of data from radiological device and medium (storage); f) Preparation of a local server for multi communication media (diversity of communication networks with low speed) with automatic reconnections.
Electronic intrusion a) Use inside the connection strong cryptographic keys (1024 2048 bits); b) Web's digital signature for information exchange; c) Systems use, internaly, encryption's securities passwords to access yours algorithm's tables..
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Problem identified Proposed Solution
Frequent interruptions.
a) Bundling compressed files in order to use the windows between interruptions (algorithm that made prediction); b) In case of error, restart at the exact place of transmtion's interruption.
Failures of transmission.
a) Central system carefully controls the traffic of information, maximizing the speed and not allowing traffic invasions or spurious; b) Reprogramming of communication's routers.
Large volume of data generated by the images in Data Centers's servers.
a) Automatic Control Systems of disk space; b) Data compression for unused; c) Reports containing information of disk capacity and prediction of backups.
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Problem identified Proposed Solution
Data compression unfeasible radiological interpretation a) Assessment of compress's quality system with a specialized group, composed of radiologists, dentists and veterinarians; b) At the end, process of returning to the original image, with quality tests; c) Adjustments of the equipment: - In general, the newer equipments has a great compress's capacity; - The screen resolution needed across the medical exam should be the same, carefully obeying the established rules.
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
NOW, FINALLY, THE ENTIRE WORK'S RESULTS!
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Compress Features
Simple a) Any change in the bit stream and images; b) Only communication's solutions.
Minimum a) Minimal changes in the bit stream; b) Changes in images was invisible to the human eye.
Reduction in time transmition
35% 65%
Median a) Changes in the bit stream; b) Slightly perceptible to zoom: 12x - 16x.
Maximum a) Changes in the bit stream; b) Noticeable to Zoom: 4x - 8x.
91%
93%
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Original 0,26 Mbps (average speed, aDSL connection) After compress
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Analysis of results:
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The compression level could be higher, however, it's not reflect in expressive reduction of transmission time;
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The younger generation of image's equipment creates a better results in these algorithms;
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In CR and DR images, we obtained very good results, reducing the transmission time by up to 95%.
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Conclusions:
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Tests with conventional compression algorithms, it was noted that the DICOM file is vulnerable to reduction, especially in its header; The image, as expected, is not reduced significantly; Obviously, the conventional compression does not solve the many problems intrinsic to the medium used (security, instability, etc.);
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Conclusions:
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To this moment, there was no significant change in transmission time when we overcomed a limit lineup of 93%;
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The treatment of the communications media, their suitability for smart data exchange, and advanced image reconstruction processes, make up a real difference in our system design;
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Conclusions:
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Our studies translates into a DICOM's communications router, which treats data transported and divides its processing with the receiver and transmitter;
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The processing costs are reduced, minimizing the total costs involved.
A SOLUTION FOR RADIOLOGICAL EXAMS TRANSMISSION USING DICOM STANDARDS IN INTERNET ACCESS.
Thank's a lot for your attention.
Any doubt?