1. Interactive Medical Imaging over the Network Centre Hospitalier Universitaire Vaudois Lausanne Raffaele Noro, Olivier Verscheure and Jean-Pierre Hubaux Institute for computer Communications and Applications phone: + 41 21 693.6791; fax: +41 21 693.6610 {noro, verscheure, hubaux}@epfl.ch http://icawww.epfl.ch

2. 2 Interactive Medical Imaging over the NetworkR.Noro, O.Verscheure and J-P.Hubaux Motivation behind this work  Medical imaging: diagnosis, therapy and follow-up  Hospital Information Systems (HIS): store and access images in digital format  Medical images: large amount of information (10-100 Mbits)  Full image transfer over N-ISDN technology is implemented in current systems: dowload time is not acceptable: 1-10 min Problem: how to provide real interactivity? 2.Transmission LAN N-ISDN 1. Request 3. Local storage 4. Examination HIS 1 HIS 2

3. 3 Interactive Medical Imaging over the NetworkR.Noro, O.Verscheure and J-P.Hubaux Framework  Region of Interest:  most of the image in low resolution  a user selected portion of the original image in better resolution  Real-time through ATM technology  Database access vs. transfer and storage of local copies

4. 4 Interactive Medical Imaging over the NetworkR.Noro, O.Verscheure and J-P.Hubaux Prototype features  Point-to-point ATM connection  User interface  MPEG-2 coding  Coordination: request-display synchronization MPEG-2 packing Network adaptation Hierarchical access Client request Hierarchical database RoI selection MPEG-2 Decoding Network adaptation ATM connection Client’s display RoI

5. 5 Interactive Medical Imaging over the NetworkR.Noro, O.Verscheure and J-P.Hubaux Live presentation: telepathology  Inspection of a stomach specimen: four resolution levels, from low- to high -resolution level  Operations: dynamic selection of the RoI at client interface, synthetic MPEG-2 stream generated by the server  Server and client directly connected to the ATM switch: the display terminal communicates with the client through IP. MPEG-2 packing AAL 5 Hierarchical access Client request IP ATM switch Server RoI selection MPEG-2 decoding AAL 5 Client Terminal

6. 6 Interactive Medical Imaging over the NetworkR.Noro, O.Verscheure and J-P.Hubaux Conclusion  Achievement: We have developed a prototype for interactive tele-diagnosis over high-speed network in close collaboration with medical doctors  Future research: extension to multi-point  References:  R. Noro et al., Real-Time Telediagnosis of Radiological Images through an Asynchronous Transfer Mode network: The ARTeMeD Project, Journal of Digital Imaging, vol. 10, pp. 116-127, Aug. 1997