1. William Weadock, MD Frank Londy Sarah Abate James Ellis, MD
Incorporating Radiology Teaching Files and Microsoft® PowerPoint® Files into a MIRC System
Department of Radiology
University of Michigan

2. Introduction - MIRC Web-based teaching file system
Upload images and text
Search for text with web browser
Free text search
Database field
Free software created and supported by RSNA.

3. MIRC Basic Concepts 3 Main Components Storage Query Case creation
Web-based authoring tool
Web-based editor
Our institution uses RadPix as the authoring tool

4. Why do we use MIRC? Created and supported by RSNA
John Perry very responsive to questions and suggestions
Ability to create / edit / export cases
Well documented
Emerging standard for teaching files
Integrates with other systems
MyPACS.net, etc.

5. Why do we use RadPix? PC program DICOM client to receive images
Cropping, annotating, window / leveling
Slide creation
MIRC database fields
History, Diagnosis, Pathology, etc.
Upload completed PowerPoint presentations
Search for text in presentations

6. Why do we use RadPix? Supports our library of collected DICOM images
Since 1997
Logical and flexible workflow
Does not require Java installation
Locked down PC’s in reading rooms

7. Owner, Weadock Software, LLC
Disclosure
William Weadock, MD
Owner, Weadock Software, LLC

8. Goals of Teaching File System
Public area – accessible to the department
Private area - accessible only to the individual
Content
Images and text
PowerPoint® Files
Movies, animations, PDF’s, etc.
Quality control
Simple to search

9. Teaching File System Requirements
Easy to Install
Easy to Use
Retain High Quality Images
Add Textual Material
Edit Cases
Output Cases
Simple PowerPoint® Slide Creation
HIPAA

10. RadPix and MIRC Meet these Goals

11. RadPix / MIRC Workflow Review case on PACS
Send individual images to RadPix DICOM client from PACS
Load images into RadPix
Enter textual data for case
Upload case to MIRC from RadPix

12. Workflow Example

13. Workflow Animation in Progress
Step 1 Exported images
STEP 1
Teaching images are exported from PACS

14. Workflow Animation in Progress
Step 2 Images in RadPix
STEP 2
Images are opened in RadPix

15. Workflow Animation in Progress
Step 3a Send to PPT
STEP 3 – Option A
Images can be placed directly into a PowerPoint® Presentation

16. Workflow Animation in Progress
Step 4a Power 2 MIRC
STEP 4a – Option A
Use Power 2 MIRC to upload text and images to MIRC server

17. Workflow Animation in Progress
Step 5 View on MIRC
STEP 5 – Option A
View on MIRC server

18. Workflow Animation in Progress
Step 3b Export to MIRC
STEP 3b – Option B
Export to MIRC server

19. Workflow Animation in Progress
Step 4b MIRC Authoring Tool
STEP 4b – Option B
Add information with MIRC Authoring Tool

20. Workflow Animation in Progress
Workflow Animation Complete
Step 5 View on MIRC
STEP 5
View on MIRC server

21. User Roles - Public Two levels of users Authors Publishers
Faculty, fellows, residents, others
Contribute material
Publishers
Approve authors’ submissions
Faculty

22. Document Ownership Private files only they can access
Multiple owners of a document
Proxy creators
Secretaries, others can create documents for faculty

23. Michigan PACS Configuration
Separate DICOM client for each division
NeuroPC, BonePC, ChestPC, etc.
Single PC with multiple DICOM clients receives all images
Same IP address
Different AETitle
Different port
Workstations configured to send images
All images routed to department-wide Novell network (n:\)

24. Image Routing
DICOM Image Catcher
Abdomen
Neuro
Chest

25. Image Routing Bone images -> n:\bone\images
Result
Bone images -> n:\bone\images
Chest images -> n:\chest\images…
Could also be configured as separate system for each radiologist

26. Problems Images collect on server
Inadvertent sending of very large data sets
Images
Disk drives fill up!
Users must choose representative images

27. MIRC Authoring with RadPix

28. RadPix
MIRC support
Windows®-based
Loads DICOM images from PC Network

29. RadPix
Upload to MIRC

30. MIRC Authoring – Patient Information

31. MIRC Authoring – Case

32. MIRC Authoring – Categories

33. MIRC Authoring - Images

34. MIRC Authoring – Images - Annotate

35. MIRC Authoring - Access
Video Files can be included
Other files, including PDF, TIFF,
DOC, XLS, etc. can be included

36. MIRC Authoring - Access

37. MIRC Authoring - Quiz

38. Sample Case – Annotated Image

39. Sample Case - Quiz

40. Uploading PowerPoint® files to MIRC with RadPix Power 2 MIRC

41. Power 2 MIRC Features Extracts text from PowerPoint® files
Includes titles, text boxes, notes
Splits PowerPoint® files
For example, if there are 15 different cases in a presentation, they can each be uploaded separately into MIRC
MIRC data fields
History, findings, pathology, etc.

43. Power 2 MIRC Features Creates MIRC-compatible file
Uploads to MIRC server
Includes:
Snapshot image of slide
Text & notes from presentation
AVI video files
Other embedded files
Original PPT file

44. Sample PowerPoint® Slide
Notice the text on slide
and in slide notes area
Slide notes

45. Example Slide in Power 2 MIRC

46. MIRC Search – “TOF”

47. MIRC Query Results – “TOF”4
Documents
found

48. Sample PowerPoint® Slide in MIRC
Extracted Text
Extracted Notes
MIRC

49. Extracted Text from Slide
Notes

50. Extracted Notes from Slide

51. Current Status of our System
CT, US, MRI conferences
AVI’s included
PPT files split up - 1 for each case
Standardized template for conferences
Medical student lectures – upcoming article in Journal of Digital Imaging

52. Future Local PC / Laptop support Extract certain cases to local PC
Search Local PC
External UM MIRC site?
RSNA Radlex
Replacement for ACR coding
Access from outside world via Internet
Virtual Private Network (VPN)

53. MIRC Admin
Hardware
Software

54. Michigan MIRC Server - Hardware
Dell 2.4 GHz PC
512 Mb RAM
(2) 250 Gb disk drives
Mirrored RAID
Back up system!!!

55. Server Configuration Inside UM firewall
Private UM IP subnet ( _._)
Available only inside Institution
Accessible via secure VPN over Internet

56. MIRC Server - Software Sun® Java 1.4.2 Apache Tomcat 4.1.29
Windows® 2000 Server
Network Associates VirusScan 7.1
Microsoft® Security Patches
MIRC (
Sun® Java 1.4.2
Apache Tomcat

57. RadPix - Software Download trial software from http://www.radpix.com
Includes :
RadPix
DICOM client (RSNA SimpleStorage)
RadPix MIRC Authoring Tool
Power 2 MIRC

58. Conclusions
MIRC is becoming an integral component of University of Michigan web-based teaching file system.
RadPix and Power 2 MIRC are used as authoring tools.
PowerPoint® presentations and case files can be uploaded to MIRC system.
Content may be either public or private.