RSNA 2013 Preview

We are presenting a number of posters and orals from our group at the RSNA 2013 in Chicago later this year. Some of the topics made it to Auntminnie.

Check out the coverage at the AuntMinnie website:

Caution should be used with DICOM data deidentification

and

Before migrating your PACS, do a test run

Hiding sensitive patient data in the information stream

RMIT University from Melbourne, Australia, has developed a method to hide sensitive information about patients inside the normal data stream using steganography, the practice of embedding secret information inside a larger bit of data without noticeably affecting the size or character of the larger data.

Check out the IEEE Spectrum coverage at:

Hiding Data in a Heartbeat

RSNA 2012 - ISP: Informatics (Image Sharing, Management and Display)

ISP: Informatics (Image Sharing, Management and Display)

SSA11-01 • 10:45 AM
Informatics Keynote Speaker: Image Sharing

Network based sharing, probably using cloud services, is mainly the replacement of the sneaker net (CD transfer) and comes with the same challenges. One has to be careful not to use tools that are used daily like Dropbox for patient related data sharing. Standards like XDR and XDM should be used to ensure safe transfer of patient data. Cloud services have to be standards based (IHE XDS.i) as implemented in the RSNA image sharing project. The exchange is based in a money transfer system where the patient gets an eight digit code and password. With these codes the patient can access the data and grant access to healthcare providers.

SSA11-02 • 10:55 AM
The RSNA’s Image Sharing Project: Initial Challenges from the Patients’ Perspective
Yousaf Awan et al

Traditionally patients are not involved in data sharing. The push to patient centered healthcare lead to the implementation of the RSNA image sharing project where the patient has control over his/her own data. Inability to access their images was the biggest issue with the current system looking at the helpdesk calls. In general, not many problems occurred.

SSA11-03 • 11:05 AM
Outcomes of an Automated System of Importation of Outside Imaging Studies into the Radiology Information System
Jonelle Marie Petscavage et al 

Patient data from CDs is uploaded decentrally and recorded in RIS and PACS. Sending AE title is set to 'OUTSIDE CD'. The error rate was less than 1%. interesting report, check our publications by van Ooijen et al in the Journal of Digital Imaging where we demonstrated something similar quite some years ago (free fulltext available)

SSA11-04 • 11:15 AM
Introducing Intuitive Simplicity in a New Type of Browser-based Dicom-Viewer for Non-Radiologists' Daily Clinical Routine
Sebastian Bickelhaupt et al

Many users are presented with non intuitive viewers that either have too much or too little functionality. The new viewer presented by this group is based on the body regions on an anatomic picture of a human. A model of human anatomy is given with colored dots on the model where the color indicates the modality and the datasets are shown next to it. After selecting the dataset of interest the DICOM data is shown and direclt connected to a 3D anatomical atlas. They showed that the new prototype speeds up and simplifies DICOM image viewing.

SSA11-05 • 11:25 AM
Influence of Medical Display System on Productivity and Eye-strain of Radiologists
Mony Weschler et al

This group compared setups with two 3MP screens to one 6MP screen both from Barco. Factors like eyestrain are evaluated using a questionnaire. It is show by this study that 6MP provides significantly less eyestrain and higher reading speeds. Although this is only based on manual registration of findings by the radiologists on a questionnaire.

Cross enterprise data sharing

In radiology the data sharing between healthcare enterprises is a growing challenge and concern. Large amounts of CDs and DVDs are being shipped daily with big problems concerning the handling, viewing, upload, etc. Health Imaging has published a short article about 5 tips for optimizing image sharing. It is worth to read for those involved.

Publication: Implementation of an anonymisation tool for clinical trials

Since we do a lot of clinical research we are constantly working trying to facilitate the easy transfer of data from one hospital to the other. In this paper we presented the integration of the CTP tool from the RSNA, used for automated anonymization of imaging data, into an existing trial database that did not support imaging. The abstract is provided below along with a link to the open access paper.
 


Implementation of an anonymisation tool for clinical trials using a clinical trial processor integrated with an existing trial patient data information system.
Aryanto KY, Broekema A, Oudkerk M, van Ooijen PM.

Eur Radiol. 2012 Jan;22(1):144-51. Epub 2011 Aug 14. 

Abstract

OBJECTIVES:
To present an adapted Clinical Trial Processor (CTP) test set-up for receiving, anonymising and saving Digital Imaging and Communications in Medicine (DICOM) data using external input from the original database of an existing clinical study information system to guide the anonymisation process.
METHODS:
Two methods are presented for an adapted CTP test set-up. In the first method, images are pushed from the Picture Archiving and Communication System (PACS) using the DICOM protocol through a local network. In the second method, images are transferred through the internet using the HTTPS protocol.
RESULTS:
In total 25,000 images from 50 patients were moved from the PACS, anonymised and stored within roughly 2 h using the first method. In the second method, an average of 10 images per minute were transferred and processed over a residential connection. In both methods, no duplicated images were stored when previous images were retransferred. The anonymised images are stored in appropriate directories.
CONCLUSIONS:
The CTP can transfer and process DICOM images correctly in a very easy set-up providing a fast, secure and stable environment. The adapted CTP allows easy integration into an environment in which patient data are already included in an existing information system.

Is the end of the CD era approaching?

The distribution of patient imaging data on CDs and DVDs is commonplace in almost every hospital in developed countries. However, with the increasing demand on imaging and the increase in the amount of data generated at each acquisition, the number of CDs and DVDs is increasing dramatically and the flood of portable media is almost impossible to handle. Network based sharing over the internet using secure protocols and profiles such as XDS(i) could solve the problem. Read the story from the HIMSS by Healthcare Technology Management for more information. HIMSS: Is the end of the CD era approaching?

RSNA: Putting patients in charge of image sharing makes for better care

A discussion I raised earlier on this Blog (here) is the fact that it would be well feasible to make patients responsible for their own data and remove the data sharing problem from the list of hospital IT. In the US, pilots are running to assess the possibilities of having the patient share his or her own data. One of the pilots is supported by the RSNA and mentioned here.

Check out the story on this topic on Health Imaging:
RSNA: Putting patients in charge of image sharing makes for better care

RSNA: Informatics Education and Research

A mixed session with very different presentations on informatics.

First presentation from Leipzig, Germany about CT guided tumour ablation. A consortium of institutions developed a patient specific liver tumor ablation simulation. Clinical evaluation still has to be performed.

Next two presentations by our group from Groningen, the Netherlands on the use of the RSNA informatics tools in clinical studies and anonymization tools. One of these were also highlighted by AuntMinnie. Both studies show how to accurately implement anonymization into clinical setting.

Presentation four by a group from Baltimore, USA covered AIM and RadLex which should take care of standardization in clincal radiology reporting. Image base annotations are used to enable an intelligent atlas to facilitate the review of anatomy.

Other topics included were on reporting and e-learning. See the first link on this page for all presentations and abstracts of this session.