1. Georgetown University Chuck Wolfe wolfec@georgetown.edu

2. Campus Description Medical Center (GUMC) –8 Research Buildings Main Campus –32 Campus Buildings including Dorms,Staff and Academic –6 Ancillary Buildings connected via 100Mbps

3. GUMC Network Gigabit Core Building Distribution Frames (BDFs) have a Dual Gigabit connection to the core Floor Switches have a Gigabit connection to the BDFs User provided with 10/100 connection

5. Main Campus Network OC-12 ATM core Server Farm has OC-12 connections to the core BDFs have dual OC-3 connections to the core Floor Switches have 100-200Mbps links to the BDFs User provided with 10 or 10/100 connection

7. Remote Site Connections OC-3 ATM Frame-Relay FNS (10Mbps) T-1

8. Internet 2 Connected via ATM utilizing Unspecified Bit Rate (UBR) Primary connection to Abilene through MAX Currently being used to test teleradiology application in the study of ALD

9. What is ALD? Adrenoleukodystrophy is a rare genetic disorder that is often fatal in young boys. It affects 1 in 20,000 people world-wide A neurological disorder that destroys the myelin in the brain Myelin insulates nerves and allows conduction of impulses between parts of the body MRI permits early detection of nervous system damage and is a sensitive indicator of disease progression

10. Why are Multi-Center Clinical Trials Needed No institution has enough patients to perform a randomized control study ALD trained physicians are few due to the rarity of disease Sharing of film images is difficult in an analogue world

11. Solution – Digital ALD MRI Network Multiple sites can send data to a centralized database Consolidation of data provides sufficient patient pool for therapy evaluation ALD trained physicians have immediate remote access to the exams

12. Project Description Development of DICOM network DICOM database resides at KKI Receives MRI studies from multiple institutions in US and world-wide Permits query/retrieve of studies by ALD trained physicians for review Utilizes secure technologies to ensure patient confidentiality and data integrity Works over standard Internet and NGI

13. UMN –ISIS – KKI Requested data from UMN over NGI Upon receipt, immediately sent it to KKI over standard Internet Recorded transmission times Ran the test 7 times Results: –ISIS – UMN averaged 242.5 seconds –ISIS – KKI averaged 2062.2 seconds

14. Transmission Time UMN – ISIS – KKI (Seconds) ISIS – KKI 45 miles UMN – ISIS 1100 miles

15. ISIS – KKI Requested studies from KKI DICOM server to ISIS Ran the test 78 times over standard Internet Ran the test 83 times over NGI

16. Throughput: Internet vs. NGI NGI =296 n=83 Internet =67 N=78

17. Results Moving digital images is better than using film for sharing information Standard Internet is unpredictable for moving large data sets NGI supports real-time teleradiology Future enhancements of the NGI will be evaluated

18. Current Projects at GU Wireless Testing with authentication to LDAP VoIP Multicasting QOS Gigabit Connection to the Internet

19. Thanks to Betty Levine and MaryLou Ingeholm in ISIS for ALD testing info