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RD201 MedicalImaging ROOM,MACHINE SETUP.

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Case Study: Medical Imaging; From Toolbox to Product to
Platform
by Gerrit Muller
University of South-Eastern Norway-NISE
e-mail: gaudisite@gmail.com
www.gaudisite.nl
Abstract
Medical Imaging was an early large scale Object Oriented product. Originally
intended to become a re-useable set of toolboxes, it evolved in a family of medical
workstations and servers.
This article describes the evolution from different viewpoints, to serve as
background material for a number of case studies of the Gaudí project.
MR
"MPR"
Distribution
This article or presentation is written as part of the Gaudí project. The Gaudí project
philosophy is to improve by obtaining frequent feedback. Frequent feedback is pursued by an
open creation process. This document is published as intermediate or nearly mature version
to get feedback. Further distribution is allowed as long as the document remains complete
and unchanged.
September 6, 2020
status:
preliminary
draft
version: 0.4
Printer
Reading
Room
CT
URF
RAD
RAD
Radiologist at
other hospital
teaching
Radiology department
Operating
theatre
Radiologist
somewhere
in the hospital
Office
Vascular
RAD
Radiologist
at home
Recepti
on
CT
Referring
Physician
Referring
Physician
trauma
room
Conference room
IT infrastructure
in basement
Philips Medical Systems, schematic organization
Philips Medical Systems
US
Non X-ray
modalities
MR
CT
Conventional
X-ray
Cardio
Vascular
Medical
Imaging
Common
X-ray
Components
Case Study: Medical Imaging; From Toolbox to Product to Platform
2
Gerrit Muller
version: 0.4
September 6, 2020
PMSorganization
URF
Surgery
Generic drivers of Radiology Departments
Image quality
Diagnosis
Relaxed patient
ease of use
automation
patient accessibility
patient handling
patient entry, exit
Department
Efficiency
universality
integrated information flow
minimal film cost
up time
Safety
Compliant with Standards and Regulations
minimal evasive
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
dose reduction
version: 0.4
September 6, 2020
RadiologyDrivers
Phases of Medical Imaging
• 1987-1991 Advanced Development (”Common Viewing”), result: Basic Application plus toolboxes
• 1991-1992 Development of 1stproduct: Medical Imaging R/F
• 1992-1994 Parallel Development of 2nd product: Medical Imaging CT/MR
• 1994-1997 Family Development
• 1997-2000 Transformation in re-useable components
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
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HistoricPhasesList
Technology innovations by Common Viewing
• Standard UNIX based workstation
• Full SW implementation, more flexible
• Object Oriented design and implementation (Objective-C)
• Graphical User Interface, with windows, mouse et cetera
• Call back scheduling, fine-grained notification
• Data base engine, fast, reliable and robust
• Extensive set of toolboxes
• Property based configuration
• Multiple coordinate spaces
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
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September 6, 2020
CVinnovations
Idealized layers september 1991
Basic Application
Image
Gfx
UI
DB
SunOS, SunView
Standard Sun workstation
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
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September 6, 2020
MIlayers1991
X-ray rooms from examination to reading around 1990
Examination
Room
Control
Room
Examination
Room
Control
Room
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
Corridor
or closet
Reading
Room
version: 0.4
September 6, 2020
XRayRoomsOld
X-ray rooms with Medical Imaging applied as printserver
Examination
Room
X ray
Control
Room
source
console
Corridor
or closet
printer
detector
Examination
Room
Control
Room
Reading
Room
light box
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
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September 6, 2020
XRayRoomsPlusPrintServer
Comparison screen copy vs optimized film
old: screen copy
new: SW formatting
20 to 50% less film needed
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
version: 0.4
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MIfilmComparison
Idealized layers september 1992
Medical Imaging R/F
dev.
tools
Print
service
Spool
HCU
Store
SW keys
RC
driver
HC
driver
DOR
driver
RC
interf
HC
interf
DOR
Store
Image
View
Gfx
Cluster
UI
DB
PMSnet in
NIX
SunOS
Config
Install
Start up
Standard IPX workstation
Desk, cabinets, cables, etc.
3M
RC
DSI
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
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September 6, 2020
MIlayers1992
PMSnet out
Example Multi Planar Reconstruction
oblique
slices
curved
slice
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
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September 6, 2020
MIexampleMPR
Idealized layers june 1994
Medical Imaging CT/MR
dev.
tools
Rad
Specialized applications
(Dental, etcetera)
MR
CT
remote
access
customi
zation
Medical Imaging R/F
Spool
Specialized applications
RF
Compose
Print
Store
Image
HCU
service
SW keys
Vascular
Store MPR
Gfx
Cardio
View
UI
PCR
Export Cluster
PMSnet in
DB
PMSnet out
CDSpack
RC dials
driver
HC
driver
DOR
driver
HC
interf
DOR
NIX
Solaris
Config
Install
RC dials
interf
Standard IPX or Sparcstation 5 workstation
Start up
Desk, cabinets, cables, etc.
3M
RC
dials
new
HCU
MR
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
CT
DSI
version: 0.4
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MIlayers1994
DCAS
PCR
Example CT/MR department
MR Examination
room
Control
room
"MPR"
room
CT Examination
room
Control
room
Reading
Room
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
version: 0.4
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MIdepartmentCTMR
Differences between modality images
X-ray
CT
MR
image
projection
slice
slice
structure
single image
stack
stack
or time series
or volume
or more complex
contrast
window width
window width
brightness
window level
window level
resolution
10242
5122
2562
contrast noise ratio
10 bit
12 bit
8 bit
absolute
acquisition dependent
greylevel mapping
value
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
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ImageCharacteristics
Specification Differences
• viewing and print preparation
• navigation support
• multi-image view
• greylevel control
• specialized clinical functions
• vascular and cardio analysis (X-ray)
• dental (CT)
• print protocols
• information model
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
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ModalitySpecifics
Workflow value
Medical Imaging Competitive Positioning
PACS
products
Medical Imaging
Review
GE
Siemens
workstations
Medical Imaging
R/F and CT/MR
clinical or
modality value
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
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MIpositioning
Radiology Department
MR
"MPR"
Reading
Room
CT
URF
Printer
Reception
CT
Vascular
RAD
RAD
Office
RAD
teaching
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
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MIradiologyDepartment
Vision: Medical Imaging in Healthcare
MR
"MPR"
Printer
Reading
Room
CT
URF
RAD
RAD
Radiologist at
other hospital
teaching
Radiology department
Operating
theatre
Radiologist
somewhere
in the hospital
Office
Vascular
RAD
Radiologist
at home
Recepti
on
CT
Referring
Physician
Referring
Physician
trauma
room
Conference room
IT infrastructure
in basement
Case Study: Medical Imaging; From Toolbox to Product to Platform
18
Gerrit Muller
version: 0.4
September 6, 2020
MIhealthcare
Idealized layers 1996
Back-ends
dev.
tools
Image Guided
Surgery
MR
CT
Spool
RF
Compose
Print
Store
Image
HCU
service
SW keys
Rad
CT/MR
Specialized applications
(Dental, bolus chase, cardio analysis, etcetera)
remote
access
customi
zation
Review
Interfacing
RIS, etcetera
Vascular
Store MPR
Gfx
XRay
Cardio
View
UI
PCR
Export Cluster
PMSnet in
DB
PMSnet out
CDSpack
RC
driver
HC
driver
DOR
driver
RC dials
interf
HC
interf
DOR
NIX
Solaris
Config
Install
Standard Sparcstation 5 workstation
Start up
Desk, cabinets, cables, etc.
3M
RC
dials
new
HCU
MR
Case Study: Medical Imaging; From Toolbox to Product to Platform
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Gerrit Muller
CT
DSI
version: 0.4
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MIlayers1996
DCAS
PCR
System Level Documents: Root
• List of system level document lists
• System level requirements, specification and design documents
• System aspect documents
• Feasibility reports
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SystemLevelRootDocument
Lists
• Cluster, interoperability documents
• Functional Specifications X-ray
• Functional Specifications CT/MR
• Application SW design
• System Software design
• Hardware documents
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Gerrit Muller
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SystemLevelDocumentLists
Documents
• Product Structure
• System Engineering requirements
• Design overview
• Hazard analysis
• Verification specification X-ray
• Verification specification CT/MR
Case Study: Medical Imaging; From Toolbox to Product to Platform
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SystemLevelDocuments
Aspect Documents
• Cluster design
• HW Configuration
• CPU resource usage
• Disk resource usage
• Memory resource usage
• Requirements system monitor
• Safety
• Security
• SW process structure
• Testability and Service tools
• Installation, Configuration and Start-up design
• CT/MR image quality
• R/F image quality
• CT/MR typical load
• R/F typical load
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SystemLevelAspectDocuments
Example Memory Budget
budget in MBytes
X-ray
CT/MR
code
14
14
non bulk data
14
18
bulk data
36
88
Unix
13
13
total used
77
133
physical memory
64
128
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MemoryBudget
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