1. How to Set Up a System for Teaching Files and Clinical Trials Medical Imaging Resource Center

2. MIRC InfoRad Courses How to Set Up a System for Teaching Files and Clinical Trials How to Author MIRC Teaching Files MIRC Case Studies: Using MIRC for Education and Research Web Classroom Sessions

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

4. 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.

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

6. The MIRC Community Internet 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

7. The RSNA MIRC Software Query Service Storage Service - Storage Service- XML Server - Submit Service- Author Service - DICOM Service - Admin Service File Service Private and public file cabinets

8. Query Service Standard query form 31 defined query fields: Free textClinical content Document attributesImage attributes Document contentPatient attributes Links to Storage Service Functions Queries a single site, selected sites, or the entire community

9. Query Service

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

11. Standard Query Results

12. The Case Navigator Intended for teaching file cases

13. 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

14. 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

15. 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

16. Display Formats Page Tab MSTF

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

18. Author Service Allows users to create MIRC documents directly on the Storage Service Supports multiple templates to allow for the creation of different kinds of documents Links to the File Service for inserting links to images and other documents

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

20. Admin Service Allows administrators to manage a Storage Service 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

21. 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

22. The File Service

23. Demonstration

24. XMLServer OS File System SubmitServiceInputQueue StorageServiceMIRCIndex AdminService HTTPExport HTTPImport AuthorServiceFileService DICOMExport DICOMImport Object Processor MIRCAnonymizerMIRCAnonymizerDICOMImport QueryService DatabaseExport The Components of a MIRC Site

25. 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)

26. 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

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

28. FC DICOM FC DICOM FC DICOM PI DICOM PI DICOM MIRC 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

29. 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…

30. 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

31. 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

32. The FieldCenter Application

39. The RSNA MIRC Software Available on the RSNA MIRC site (mirc.rsna.org) –Click the Downloads link in the header

40. The RSNA MIRC Software Runs on Mac, Windows, Linux Three components: Java / Tomcat / MIRC All components are free MIRC Users Group meetings: 11/281:30 - 3:30 12/112:30 - 2:30

41. Questions/Answers & Help RSNA Forums: –http://forums.rsna.orghttp://forums.rsna.org –User Comments, Questions and Answers –RSNA MIRC Software Announcements –MIRC Implementers Corner –MIRC Technical Review Committee Subscribe on the Forums site