Imaging Workspace

An Overview and Roadmap

Eliot L. Siegel, MD

Imaging Workspace Lead SME

January 23, 2008

Introduction

• Imaging has been separate island with its own standards (DICOM)• DICOM allows high level of

interoperability among clinical imaging modalities such as CT and MRI

• Patient centered and very limited for data mining and research

• Completely separate from world of XML, service oriented architecture, Grid Computing

• Different vendors algorithms provide different results with no standards for annotation and image mark-up

caBIG IMG: A Brief History

The In Vivo Imaging Workspace was added to the caBIG program in April of 2005:

1.To advance imaging informatics for treatment of patients with cancer

2.To leverage caBIG technology such as the caGRID, Internet tools such as XML, and existing DICOM standards by creating “middleware,” to facilitate sharing of images in a variety of settings

3.To strive towards a standardized way to evaluate and annotate images, especially for evaluation of tumor burden and response

4.To facilitate secure and easy sharing of images and image analysis & visualization algorithms with an emphasis on the cancer community

caBIG IMG: A Brief History

Adoption activities

defined (CTTI/NTROI)

Interoperability of caBIG

Imaging tools

demonstrated

2005 2006 2007 2008

caBIG Imaging WS established

(110 years after the discovery of the

x-ray)

SMEs selected

NCIA development began/LIDC-use

case

Strategic plan set

XIP, Middleware, AIM

development began

First RSNA presentation

Adoption activities

planned

Next phase of

development

NLST IP

National Cancer Imaging Archive

• The NCIA network-accessible "in vivo image repository" provides image archives to assist development and validation of imaging software tools

• Multiple image libraries currently stored on archive including LIDC

• Not only repository, but software for NCIA is free and open source

• Federated system so single inquiry can produce responses from multiple repositories

• Includes visualization tool

What are the Imaging Workspace “Products”?

eXtensible Imaging Platform (XIP) Allows Easy Sharing of Image Enhancement/Analysis/Visualization Algorithms

XIP Application

(Can be replaced with any DICOM WG23-compatible Host)

XIP Host Adapter

XIP ModulesHost Independent

WG23

XIP HostWG23

WG23

Web-based Application

Medical Imaging Workstation

Standalone Application

Distribute

Distribute

DICOM, HL7, & otherservices per IHE

caGRID Services viaImaging Middleware

XIP Application Builder

XIP Class Library Auto Conversion Tool

Host-Specific Plug-in Libs

WG23

Distribute

ITK

VTK

XIP

LIB

. . .

A free and open source platform that facilitates the sharing not of images and other patient data but of image display, processing, and analysis algorithms themselves.

Imaging Middleware (including GridCAD and Virtual PACS)

• Middleware provides connection between DICOM and Grid computing

• The GRID has tremendous potential to promote interoperability, improve security, and support more efficient sharing of image data and software algorithms

• Middleware projects such as CAD (computer aided detection) for lung nodules on CT scans demonstrate the power and potential of GRID computing

Annotations and Imaging Markup (AIM)

The first project of its kind that we’re aware of to propose/create a “standard” means of adding information/knowledge to an image in a clinical environment in which there is currently chaos in order to create a future in which image content can be easily and automatically searched.

Algorithm Validation Tools (AVT)

BaselineMax Diameter 36.2mmVolume 6.1cm3

Baseline +20 weeksMax Diameter 32.6mmVolume 9.48cm3 55% increase

The purpose of AVT is to provide a set of tools capable of generating measurements using validated and consistent methods for detecting change; and to associcate information including clincial outcome data that would be helpful in assessing the performance of image-based change assessment tools

DICOM Ontology

DICON Ontology

• A single common reference information model for DICOM

• Unify and make explicit all the key entities and relations in DICOM in a human-usable but machine-processable format.

• Represent the existing DICOM model, whether it be implicit or explicit, as an ontology.

Query Formulation

• Create an Imaging Query Formulation tool

• Automates the creation of ontology-based queries to image resources

• Query Formulation Engine will translate user queries that are formulated using the QueryTool UI into an ontology-based query graph

“Mary J.”

Breast Cancer

Chemo-therapy

“Mary J’s CT Images”

Progressive Disease (RECIST)

PATIENT

DISEASE

TREATMENT

DISEASE STATUS

DISEASE IMAGING

has Disease Assessment

has RECIST Assessmenthas Disease

has TreatmentPhysical

Exam

has Disease Assessment

The caBIG Imaging Roadmap: Transitioning from Development to Real World Application

NCIAImage repository

XIPToolkit to build

sharable imagingapplications

MiddlewareConnect to the grid/bulk data transfer

AIMShare annotations

& markups

AVTMeasurement/

change detectionvalidation

Supported by caBIG vocabularies and ontologies such as RadLex, ACRIN Data Elements, and

DICOM Data Elements and Ontology

caBIGImaging

Suite

End users can select any or all of the tools to meet their research

or clinical needs

Query FormAllow for “Google”

type query of image data

In The Near Future: Practical Applications of Workspace Tools

Open Source

Imaging Viewer

Clinical Trials Tool

Integration

Other Adoption

Activities