MIRC Overview Medical Imaging Resource Center John Perry RSNA 2007 Medical Imaging Resource Center John Perry RSNA 2007

RSNA2007 MIRC Courses Overview of the RSNA MIRC Software Installing MIRC on Your Laptop Using MIRC for Clinical Trials Hands On: Using the RSNA Teaching File

MIRC Project Objective Support the production, storage, indexing and distribution of medical imaging resources: –Teaching files –Scientific & technical documentation –Research images & datasets –Clinical trials data

MIRC Concepts The key concepts: –MIRC is a community of cooperating libraries on the Internet. –The libraries cooperate by supporting a common query mechanism. –The query mechanism allows users to find information wherever it is stored. The key concepts: –MIRC is a community of cooperating libraries on the Internet. –The libraries cooperate by supporting a common query mechanism. –The query mechanism allows users to find information wherever it is stored.

MIRC Information Formats Images: DICOM, GIF, JPEG, PNG, TIFF Anything displayable by a web browser Hyperlinks to other web content Pointers to files for downloading

The MIRC Community Server Index MIRC Sites Server Index RSNA User Server Index MIRC Storage Service: - Document Authoring - Document Storage - Document Indexing - Web Server MIRC Query Service: - Access to the community Internet

The RSNA MIRC Software Query Service Storage Service Document index and storage Author services DICOM services File Service Public and private file cabinets

Query Service Standard search form 31 defined fields: Free textClinical content Document attributesImage attributes Document contentPatient attributes Links to other services Queries a single site, selected sites, or the entire community

Query Service

Two display formats for query results: Standard query results Title (hyperlink) AuthorAbstract Case Navigator Random or ordered Known and unknown presentations

Standard Search Results

Intended for teaching file cases The Case Navigator

Storage Service Stores and indexes documents A single MIRC site can have multiple Storage Services for different purposes –Teaching files for each department/specialty –Individual services for each clinical trial

XML Server Serves documents to users on the web Transforms XML files to other formats Multiple display formats (page, tab, mstf) Exports documents and datasets to users

XML Server Provides access control for: –read, update, export Restricts access for: –owners, users, roles (user groups), public Supports private (owner-only) sections of otherwise public documents

Display Formats PageTabMSTFPageTabMSTF

Author Services Basic Authoring ToolBasic Authoring Tool –For rapid creation of documents from files on the client computer Advanced Authoring ToolAdvanced Authoring Tool –Supports multiple document templates –Links to the File Service for inserting links to images and other files on the server

What goes in a teaching file case? Whatever you want: HistoryDifferential Diagnosis Findings Discussion DiagnosisQuizzes References Images, drawings, videos, audios, …

TCE Service Supports the IHE Teaching Files and Clinical Trials Export integration profile –Allows image selection and text entry directly on PACS diagnostic workstations (Agfa, Fuji, GE) –Receives submissions from IHE TCE Export Manager applications (Agfa, MIRC) and automatically creates MIRC documents

Zip Service Supports the creation of multiple MIRC documents from zip files –Folder hierarchy with each folder representing a single case or group of cases –Special processing for images and text files Originally intended for preloading large numbers of cases from pre-MIRC teaching files

Submit Service Allows users to upload MIRC documents to a storage service –Supports connections from client-side authoring tools –Supports uploading MIRC documents through a browser –Accepts uploads in the format exported by the XML Server

DICOM Service Receives DICOM objects from PACS, workstations, modalities, etc. Automatic document generation –Images grouped into documents by study –Template-driven –Automatic JPEG generation from DICOM –Programmable anonymization (de- identification and re-identification)

Admin Service Allows administrators to manage a MIRC site through a browser –Control the documents on the Storage Service –Adjudicate the input queue for non- publishers –Configure the Storage Service and DICOM Service –Control and monitor the DICOM Service –Manage users and roles

File Service Each authenticated user has a private file cabinet for storage of files of any kind One public file cabinet for the site Public file cabinet receives DICOM objects from PACS, modalities, workstations –Separate anonymizer Author Service connection

The File Service

XMLServer OS File System InputQueue StorageServiceMIRCIndex AdminService AuthorServicesFileService Object Processor MIRCAnonymizerDICOMImport QueryService MIRC Site Services SubmitService ZipService TCEService HTTPExport HTTPImport DICOMExport DICOMImport MIRCAnonymizerDatabaseExport

DICOM Service Receives DICOM objects from PACS, workstations, modalities, … Automatic document generation –Images grouped into documents by study –Template-driven –Automatic JPEG generation from DICOM –Programmable anonymization (de- identification and re-identification)

DICOM Service Automatic trial patient ID generation Connection to other DICOM Services for clinical trials –Support for encrypted communications (SSL) DICOM import / DICOM export HTTP(S) import / HTTP(S) export Database export

Database Interface Links to an externally developed database Provides classes for interrogating: –DICOM objects –Metadata files: XMLXML ZIP (with manifest)ZIP (with manifest) Anonymization of DICOM and XML objects

FC DICOM FC DICOM FC DICOM PI DICOM PI DICOM Clinical Trial Configuration MIRC FieldCenter Application: - Image reception - Anonymization - Transmission to PI MIRC Site: - Image reception - Image Storage - Transfer to PACS and/or workstations Firewalls Internet HTTP HTTPS Database HTTP DICOM

Lessons from Field Centers IT departments are overworked. Network configuration can be a problem. –Firewalls, proxy servers, VPNs Running a MIRC site at a Field Center just for image acquisition is overkill. Therefore…

The FieldCenter Application Runs at the image acquisition site Receives images and metadata files via the DICOM and HTTP(S) protocols Anonymizes images and metadata files Transmits to the PI MIRC site via HTTP(S) Automatically links to the PI MIRC site for remapping tables and software updates

Anonymization Removal of Protected Health Information (PHI) Remapping of PHI to trial-specific identifiers Central vs. distributed remapping tables are an issue in a multi-site trial Metadata anonymization may also be required in some trials

The RSNA MIRC Software

Runs on Windows, Mac, Linux, Solaris Three components: Java / Tomcat / MIRC All components are free MIRC Users Group meetings: 11/25 1:30 - 3:30E251 11/2912:15 – 1:45E257

Questions/Answers & Help The MIRC Wiki – RSNA Forums: – –User Comments, Questions and Answers –RSNA MIRC Software Announcements –MIRC Implementers’ Corner Subscribe on the Forums site