An efficient architecture to support digital pathology in standard medical imaging repositories.

In the past decade, digital pathology and whole-slide imaging (WSI) have been gaining momentum with the proliferation of digital scanners from different manufacturers. The literature reports significant advantages associated with the adoption of digital images in pathology, namely, improvements in diagnostic accuracy and better support for telepathology. Moreover, it also offers new clinical and research applications. However, numerous barriers have been slowing the adoption of WSI, among which the most important are performance issues associated with storage and distribution of huge volumes of data, and lack of interoperability with other hospital information systems, most notably Picture Archive and Communications Systems (PACS) based on the DICOM standard. This article proposes an architecture of a Web Pathology PACS fully compliant with DICOM standard communications and data formats. The solution includes a PACS Archive responsible for storing whole-slide imaging data in DICOM WSI format and offers a communication interface based on the most recent DICOM Web services. The second component is a zero-footprint viewer that runs in any web-browser. It consumes data using the PACS archive standard web services. Moreover, it features a tiling engine especially suited to deal with the WSI image pyramids. These components were designed with special focus on efficiency and usability. The performance of our system was assessed through a comparative analysis of the state-of-the-art solutions. The results demonstrate that it is possible to have a very competitive solution based on standard workflows.

Web Validation Service for Ensuring Adherence to the DICOM Standard.

The DICOM Standard has been fundamental for ensuring the interoperability of Picture Archive and Communications Systems (PACS). By compiling rigorously to the standard, medical imaging equipment and applications from different vendors can share their data, and create integrated workflows which contributes to better quality healthcare services. However, DICOM is a complex, flexible and very extensive standard. Thus, it is difficult to attest the conformity of data structures produced by DICOM applications resulting in unexpected behaviors, errors and malfunctions. Those situations may be critical for regular PACS operation, resulting in serious losses to the healthcare enterprise. Therefore, it is of paramount importance that application vendors and PACS administrators are confident that their applications follow the standard correctly. In this regard, we propose a method for validating the compliance of PACS application with the DICOM Standard. It can capture the intricate dependency structure of DICOM modules and data elements using a relatively simple description language. The modular nature of our method allows describing each DICOM module, their attributes, and dependencies on a re-usable basis. As a result, our validator is able to encompass the numerous modules present in DICOM, as well as keep up with the emergence of new ones.