Integrating TRENCADIS components in gLite to share DICOM medical images and structured reports.

The problem of sharing medical information among different centres has been tackled by many projects. Several of them target the specific problem of sharing DICOM images and structured reports (DICOM-SR), such as the TRENCADIS project. In this paper we propose sharing and organizing DICOM data and DICOM-SR metadata benefiting from the existent deployed Grid infrastructures compliant with gLite such as EGEE or the Spanish NGI. These infrastructures contribute with a large amount of storage resources for creating knowledge databases and also provide metadata storage resources (such as AMGA) to semantically organize reports in a tree-structure. First, in this paper, we present the extension of TRENCADIS architecture to use gLite components (LFC, AMGA, SE) on the shake of increasing interoperability. Using the metadata from DICOM-SR, and maintaining its tree structure, enables federating different but compatible diagnostic structures and simplifies the definition of complex queries. This article describes how to do this in AMGA and it shows an approach to efficiently code radiology reports to enable the multi-centre federation of data resources.

Using grid-enabled distributed metadata database to index DICOM-SR.

Integrating medical data at inter-centre level implies many challenges that are being tackled from many disciplines and technologies. Medical informatics have applied an important effort on describing and standardizing Electronic Health Records, and specially standardisation has achieved an important extent on Medical Imaging. Grid technologies have been extensively used to deal with multi-domain authorisation issues and to provide single access points for accessing DICOM Medical Images, enabling the access and processing to large repositories of data. However, this approach introduces the challenge of efficiently organising data according to their relevance and interest, in which the medical report is a key factor. The present work shows an approach to efficiently code radiology reports to enable the multi-centre federation of data resources. This approach follows the tree-like structure of DICOM-SR reports in a self-organising metadata catalogue based on AMGA. This approach enables federating different but compatible distributed repositories, automatically reconfiguring the database structure, and preserving the autonomy of each centre in defining the template. Tools developed so far and some performance results are provided to prove the effectiveness of the approach.

TRENCADIS - secure architecture to share and manage DICOM objects in a ontological framework based on OGSA.

Today most European healthcare centers use the digital format for their databases of images. TRENCADIS is a software architecture comprising a set of services as a solution for interconnecting, managing and sharing selected parts of medical DICOM data for the development of training and decision support tools. The organization of the distributed information in virtual repositories is based on semantic criteria. Different groups of researchers could organize themselves to propose a Virtual Organization (VO). These VOs will be interested in specific target areas, and will share information concerning each area. Although the private part of the information to be shared will be removed, special considerations will be taken into account to avoid the access by non-authorized users. This paper describes the security model implemented as part of TRENCADIS. The paper is organized as follows. First introduces the problem and presents our motivations. Section 1 defines the objectives. Section 2 presents an overview of the existing proposals per objective. Section 3 outlines the overall architecture. Section 4 describes how TRENCADIS is architected to realize the security goals discussed in the previous sections. The different security services and components of the infrastructure are briefly explained, as well as the exposed interfaces. Finally, Section 5 concludes and gives some remarks on our future work.

TRENCADIS--a WSRF grid MiddleWare for managing DICOM structured reporting objects.

The adoption of the digital processing of medical data, especially on radiology, has leaded to the availability of millions of records (images and reports). However, this information is mainly used at patient level, being the extraction of information, organised according to administrative criteria, which make the extraction of knowledge difficult. Moreover, legal constraints make the direct integration of information systems complex or even impossible. On the other side, the widespread of the DICOM format has leaded to the inclusion of other information different from just radiological images. The possibility of coding radiology reports in a structured form, adding semantic information about the data contained in the DICOM objects, eases the process of structuring images according to content. DICOM Structured Reporting (DICOM-SR) is a specification of tags and sections to code and integrate radiology reports, with seamless references to findings and regions of interests of the associated images, movies, waveforms, signals, etc. The work presented in this paper aims at developing of a framework to efficiently and securely share medical images and radiology reports, as well as to provide high throughput processing services. This system is based on a previously developed architecture in the framework of the TRENCADIS project, and uses other components such as the security system and the Grid processing service developed in previous activities. The work presented here introduces a semantic structuring and an ontology framework, to organise medical images considering standard terminology and disease coding formats (SNOMED, ICD9, LOINC..).

Clinical Decision Support Systems (CDSS) in GRID Environments.

This paper presents an architecture defined for searching and executing Clinical Decision Support Systems (CDSS) in a LCG2/GT2 Grid environment, using web-based protocols. A CDSS is a system that provides a classification of the patient illness according to the knowledge extracted from clinical practice and using the patient's information in a structured format. The CDSS classification engines can be installed in any site and can be used by different medical users from a Virtual Organization (VO). All users in a VO can consult and execute different classification engines that have been installed in the Grid independently of the platform, architecture or site where the engines are installed or the users are located. The present paper present a solution to requirements such as short-job execution, reducing the response delay on LCG2 environments and providing grid-enabled authenticated access through web portals. Resource discovering and job submission is performed through web services, which are also described in the article.