An Intelligent Cloud Storage Gateway for Medical Imaging.

Historically, medical imaging repositories have been supported by indoor infrastructures. However, the amount of diagnostic imaging procedures has continuously increased over the last decades, imposing several challenges associated with the storage volume, data redundancy and availability. Cloud platforms are focused on delivering hardware and software services over the Internet, becoming an appealing solution for repository outsourcing. Although this option may bring financial and technological benefits, it also presents new challenges. In medical imaging scenarios, communication latency is a critical issue that still hinders the adoption of this paradigm. This paper proposes an intelligent Cloud storage gateway that optimizes data access times. This is achieved through a new cache architecture that combines static rules and pattern recognition for eviction and prefetching. The evaluation results, obtained from experiments over a real-world dataset, show that cache hit ratios can reach around 80%, leading to reductions of image retrieval times by over 60%. The combined use of eviction and prefetching policies proposed can significantly reduce communication latency, even when using a small cache in comparison to the total size of the repository. Apart from the performance gains, the proposed system is capable of adjusting to specific workflows of different institutions.

A Routing Mechanism for Cloud Outsourcing of Medical Imaging Repositories.

Web-based technologies have been increasingly used in picture archive and communication systems (PACS), in services related to storage, distribution, and visualization of medical images. Nowadays, many healthcare institutions are outsourcing their repositories to the cloud. However, managing communications between multiple geo-distributed locations is still challenging due to the complexity of dealing with huge volumes of data and bandwidth requirements. Moreover, standard methodologies still do not take full advantage of outsourced archives, namely because their integration with other in-house solutions is troublesome. In order to improve the performance of distributed medical imaging networks, a smart routing mechanism was developed. This includes an innovative cache system based on splitting and dynamic management of digital imaging and communications in medicine objects. The proposed solution was successfully deployed in a regional PACS archive. The results obtained proved that it is better than conventional approaches, as it reduces remote access latency and also the required cache storage space.

Pattern recognition for cache management in distributed medical imaging environments.

PURPOSE: Traditionally, medical imaging repositories have been supported by indoor infrastructures with huge operational costs. This paradigm is changing thanks to cloud outsourcing which not only brings technological advantages but also facilitates inter-institutional workflows. However, communication latency is one main problem in this kind of approaches, since we are dealing with tremendous volumes of data. To minimize the impact of this issue, cache and prefetching are commonly used. The effectiveness of these mechanisms is highly dependent on their capability of accurately selecting the objects that will be needed soon. METHODS: This paper describes a pattern recognition system based on artificial neural networks with incremental learning to evaluate, from a set of usage pattern, which one fits the user behavior at a given time. The accuracy of the pattern recognition model in distinct training conditions was also evaluated. RESULTS: The solution was tested with a real-world dataset and a synthesized dataset, showing that incremental learning is advantageous. Even with very immature initial models, trained with just 1 week of data samples, the overall accuracy was very similar to the value obtained when using 75% of the long-term data for training the models. Preliminary results demonstrate an effective reduction in communication latency when using the proposed solution to feed a prefetching mechanism. CONCLUSIONS: The proposed approach is very interesting for cache replacement and prefetching policies due to the good results obtained since the first deployment moments.

A framework for integration of heterogeneous medical imaging networks.

Medical imaging is increasing its importance in matters of medical diagnosis and in treatment support. Much is due to computers that have revolutionized medical imaging not only in acquisition process but also in the way it is visualized, stored, exchanged and managed. Picture Archiving and Communication Systems (PACS) is an example of how medical imaging takes advantage of computers. To solve problems of interoperability of PACS and medical imaging equipment, the Digital Imaging and Communications in Medicine (DICOM) standard was defined and widely implemented in current solutions. More recently, the need to exchange medical data between distinct institutions resulted in Integrating the Healthcare Enterprise (IHE) initiative that contains a content profile especially conceived for medical imaging exchange: Cross Enterprise Document Sharing for imaging (XDS-i). Moreover, due to application requirements, many solutions developed private networks to support their services. For instance, some applications support enhanced query and retrieve over DICOM objects metadata. This paper proposes anintegration framework to medical imaging networks that provides protocols interoperability and data federation services. It is an extensible plugin system that supports standard approaches (DICOM and XDS-I), but is also capable of supporting private protocols. The framework is being used in the Dicoogle Open Source PACS.

XDS-I outsourcing proxy: ensuring confidentiality while preserving interoperability.

The interoperability of services and the sharing of health data have been a continuous goal for health professionals, patients, institutions, and policy makers. However, several issues have been hindering this goal, such as incompatible implementations of standards (e.g., HL7, DICOM), multiple ontologies, and security constraints. Cross-enterprise document sharing (XDS) workflows were proposed by Integrating the Healthcare Enterprise (IHE) to address current limitations in exchanging clinical data among organizations. To ensure data protection, XDS actors must be placed in trustworthy domains, which are normally inside such institutions. However, due to rapidly growing IT requirements, the outsourcing of resources in the Cloud is becoming very appealing. This paper presents a software proxy that enables the outsourcing of XDS architectural parts while preserving the interoperability, confidentiality, and searchability of clinical information. A key component in our architecture is a new searchable encryption (SE) scheme-Posterior Playfair Searchable Encryption (PPSE)-which, besides keeping the same confidentiality levels of the stored data, hides the search patterns to the adversary, bringing improvements when compared to the remaining practical state-of-the-art SE schemes.

Dicoogle Mobile: a medical imaging platform for Android.

Mobile computing technologies are increasingly becoming a valuable asset in healthcare information systems. The adoption of these technologies helps to assist in improving quality of care, increasing productivity and facilitating clinical decision support. They provide practitioners with ubiquitous access to patient records, being actually an important component in telemedicine and tele-work environments. We have developed Dicoogle Mobile, an Android application that provides remote access to distributed medical imaging data through a cloud relay service. Besides, this application has the capability to store and index local imaging data, so that they can also be searched and visualized. In this paper, we will describe Dicoogle Mobile concept as well the architecture of the whole system that makes it running.

A RESTful image gateway for multiple medical image repositories.

Mobile technologies are increasingly important components in telemedicine systems and are becoming powerful decision support tools. Universal access to data may already be achieved by resorting to the latest generation of tablet devices and smartphones. However, the protocols employed for communicating with image repositories are not suited to exchange data with mobile devices. In this paper, we present an extensible approach to solving the problem of querying and delivering data in a format that is suitable for the bandwidth and graphic capacities of mobile devices. We describe a three-tiered component-based gateway that acts as an intermediary between medical applications and a number of Picture Archiving and Communication Systems (PACS). The interface with the gateway is accomplished using Hypertext Transfer Protocol (HTTP) requests following a Representational State Transfer (REST) methodology, which relieves developers from dealing with complex medical imaging protocols and allows the processing of data on the server side.