A Web Based Medical Image Data Processing and Management System Jinman Kim1, David D. Feng1,2, Tom Weidong Cai1,2 1. Biomedical and Multimedia Information Technology (BMIT) Group, Basser Department of Computer Science, The University of Sydney, Australia 2. Center for Multimedia Signal Processing (CMSP) Department of Electronic & Information Engineering, Hong Kong Polytechnic University Abstract Medical services in current-time rely heavily on digital imaging technology due to image modalities utilized in medical field such as the computer tomography and magnetic resonance imaging. These techniques require imageprocessing tools and digital management has been the primary reason for development of Picture Archiving and Communication Systems (PACS). The limitation to PACS is that the system architecture limits itself to be only used as a local area network, which at times causes inconvenience towards physicians requiring the system in the outside environment. With the rapid advances in the network speed, computer processing capabilities, and the support for online software development, the potential to bridge the gap between the hospital and outside environment to share and work in conjunction may be realized. In this paper, we present an application of database and functional imaging that runs through the Internet network (WWW) and Internet browser that has similar ability to the PACS yet having the advantages of being an online system. Keywords: World Wide Web (WWW), PACS, Java Applet, Medical Image, and Image Processing. I. INTRODUCTION Recent advances in imaging technology allow evaluation of medical images in depth, which are now the requirement when studying and diagnosing an image. This depth in medical imaging is the image processing, techniques that manipulate the image to transform, enhance, and restore information. It is the technique of improving information for human interpretation, and processing of scene data for autonomous machine perception. Until recently the possibility of studying and diagnosing of medical images beyond the dedicated workstations within the working department has not been fully exposed that restricted the usage and convenience. Current network technology allows for image processing and data retrieval efficiently, reliably, and economically. Allowance of such ability to be accessible online with the usage of standard Internet network and browser can be of a great beneficial towards medical imaging. Past researches in the field of online imaging has produced many researches into this field. The ability to retrieve medical data and basic image processing on the Internet has shown great potential and functionality. For instance, Slomka, Elliot, and Driedger[3] developed a system that is capable of online database retrieval and image processing of nuclear medical imaging using the Internet browser and the World Wide Web. Medical imaging plays a significant role in the study and understanding of patient’s diagnostic examinations. The demand for online medical imaging systems that allow visualization and processing has increased significantly. These systems allow the tools for visualization and image processing to be accessible outside the working environment of the physicians and also accessible at all times and in any location. The aim of this research was to explore the potential of the Internet and the browser technology, and to maximize the use of the browser to eliminate the requirement of the dedicated workstation in the field of medical imaging while still maintaining the image processing functions and imaging tools. Incorporated with this aim for the research has been the goal to ensure that the system being developed will actually be usable and functional to the potential user audience of the system. This study attempts to address the above issues and provide a solution, which is the construction of the application ‘Functional Imaging Web’ (FIWeb). II. SYSTEM ARCHITECTURE AND FUNCTIONALITY A. System Components The system architecture shown in Figure 1 comprises of five components that are namely; Active Database, Graphical User Interface, Image processing, Image Analysis, and Imaging tools. There are two advantages associated with this architecture. First, it is flexible in the database structure where the system can be used with any kind of database setup such as the SQL system or the text-based system (the one used in the FIWeb). Second, the system is designed to be extensible so that new component may be added to the system to enhance and customize the system. In the following, each component together with how they interact with each other to deliver the functionality is briefly described. Staff – having access to all the patient information, Patient – ability to view their own records, and Guest – guest user to evaluate the system. Depending on the access level, there are restrictions on the usage of the functions to the database. For example, the patient access can not create/delete any accounts and also are restricted to allow searching of their own data set whereas Staff access can create/delete and search all the patient information. Others functions that are available is the ‘view log’ for administrator user that records all the access and events that has occurred in the database. Also the ability to change the password of the user is implemented for further security. Figure 1. System architecture displaying major the component of the FIWeb. The ‘graphical user interface’ (GUI) is the component that allows the interaction of the users to the system. The GUI is possible by the use of the browser and the Java Applet, a software-developing tool that allows for on-line development. ‘Database’ is the database setup that is used by the system to store and retrieve medical information. It allows for data management that is beneficial in searching, retrieval and modifying. Component ‘Region of Interest’, ‘Image processing’, ‘Image analysis’ and ‘Imaging tools’ are used to manipulate and extract information from images in study or diagnosis. These components along with features of the database are explained below. B. System functionality 1.) Patient Information and Image Database The database developed is web-based database using JavaScript, Python script, and HTML that can be used on-line with any Internet browser that supports scripting language. It uses python (ver 6.1) script language on the server side to execute all the user commands such as login service and data search and data retrieval. The security of the users is assured by using the 16-bit rotor encryption to store sensitive data from tempering and illegal access. The database allows searching by several key words such as the patient name, study type, and study date. Database also allows for creation of accounts of the users and the patient. There are access levels between the users. Four levels exist that are the Administrator – maintaining the database system, Figure 2. Sample window of the result from the Database query searching. 2.) Functional Imaging System FIWeb applet applications include beneficial medical image processing techniques and tools. These consist of the following. Region of Interest (ROI) ROI is to select a region of an image and study that segment of the image further. The user can make selection by drawing a circle, rectangle, or a shape on the image. There is no loss of information on the process of ROI and all of the image’s attributes are maintained. Once the region is selected, it is cropped and scaled (optional) before being displayed as a new image. The cropping of the image is archived by the masking of the pixels of the image, setting every pixel to be true or false (true being the pixel in the selected region) before removing the false pixels. (Fig.4) Image analysis Analyzing of an image is a requirement when studying to extract details such as pixel count, pixel mean, standard deviation, color bin selection, and histogram. These statistical informations are available in the FIWeb. Figure 3. Functional Imaging Web, showing the main User Interface and some of the features like the Cine player, Image selection panel, Image transformation, and the ROI. Imaging tools Cine player (sequence of image displayed at variable frame rate) can be used to view the image data set as a movie. Comment tool allows for users to note down study results that can be loaded and appended at another time. Compare operator which is used to visually compare two images by fusing two images using methods such as ‘XOR’, ‘OR’, ‘AND’ and ‘SUBTRACT’. Image processing FIWeb include common medical imaging operation such as ‘interactive color table manipulation’, ‘Blur/Sharp’, ‘Color filter’, ‘Upper/Lower bound’ and ‘Median (3x3, 5x5, and 7x7 kernel) filtering’. Transformation methods are also present with the ability to Scale, Rotate and Translate. magic’ that are for image processing. Hence the design of the FIWeb has been the product of extracting interface design from such applications and applying on to the medical imaging. FIWeb conforms to these standard specifications with the usage of metaphor, adequate user feedback and visual appearance while focusing on the potential user audience and medical image properties. III. DISCUSSION Overall design of the system is present in Fig.3. The implementation of user interface has been an important aspect in the development of the FIWeb and careful evaluation has been conducted to ensure usability. There are no standard in medical image processing but there has been many commercial applications such as the ‘photoshop’ and ‘paint Figure 4. Region of Interest selected on the main picture (left) and a new picture only consisting of the slected region (right). The described system to access and diagnose medical images has several advantages. No software is required on the viewing site, thus being cost-effective and no installation of software. This also means that the system can be used outside the hospital environment and at all time of the day. Also with the medical imaging, there are the requirements of image processing to extract useful information that can not be satisfied by transportable format such as printed/film media copies but possible with the FIWeb. This paper can be viewed as archiving one step closer towards total online medical imaging system and online imaging in general. It is hoped that the application developed will provoke more interest in the enormous potential of being online and the exponential growth of power in computers to improve the field of medical imaging. The main reason for the selection of Java as the programming language is the support of online development via the Applet software running within the Internet browser. The extensive image processing libraries available in Java along with tools for graphical user interface development, ease of development, and object-oriented programming; use of Java is very ideal for such system as the FIWeb. There are other alternatives such as the C++ language but none offered the similar functionality of the Java when Internet programming was the criteria. The use of python scripting language over others such as 'Perl' and 'shell script' for the FIWeb database is primarily due to the database being object-oriented and filebased which Python scripting languages are best suited. This research is partially supported by ARC and UGC grants. The evaluation of network to be used for the system has produced positive results. Using the standard 56K dial-up modem, there are slight delays due to downloading of images and Applet class files but with Cable modem (tested with 'telstra' and 'optus' cable [5]), the result has been adequate. With the rapid growth in networking technology and the introduction of broad bandwidth network, the FIWeb system becomes very accessible and economical. V. Acknowledgement REFERENCE [1] Najjar, L.J, “Using Color Effectively (or Peacocks Can’t fly)”,Atlanta, GA: IBM Corporation, 1990 [2] Habib Zaidi, “Medical Imaging: Current status and future perspective” [3] Piotr J. Slomka, Edward Elliot, and Albert A. Driedger , “Java-Based Remote viewing and processing of Nuclear Medicine Images: Towards ‘the Imaging Department Without Walls’”, The journal of Nuclear Medicine, Vol. 41, No.1, pp111-118, January 2000 [4] Piotr J. Slomka, Edward Elliot, and Albert A. Driedger – Java-based PACS and reporting system for Nuclear Medicine. IV. Future work and Conclusion In this paper, we have presented the potential of archiving on-line PACS system that is both efficient and functional. We addresses a broad range of issues relating to online medical imaging such as the storage and retrieval of medical data in a well-structured and manageable database to the ability of online image processing and imaging tools. The creation of FIWeb is to provide real users with the ability to perform above conditions through an easy and practical experience. The area of research of this paper is new and exciting, with constant improvement in computer performance allowing the realization of new concepts and technology. Several new features are planned for development that will make the system more complete and powerful. The inclusion of integrated database to the FIWeb, meaning that the query to the database can be done within the FIWeb system rather than independently, could enhance performance and usability. With the strong growth in the 3-D imaging such as the volume representation, the support for such technique will provide greater resource to the physicians to perform diagnosis and study. [5] Jerold W. Wallis, “Java and Teleradiology (Invited commentary)”, The journal of Nuclear Medicine, Vol. 41, No.1, pp119-122, January 2000 [6] Prashant Jain, Seth Widoff, and Douglas C. Schmidt, “The Design and Performance of MedJava” [7] H.K. Huang, “PACS: Basic Principle and Applications”, Wiley-Liss, NY, 1999. [8] Yanxi Liu, Frank Dellaert and William E. Rothfus, “Classification Driven Semantic Based Medical Image Indexing and Retrieval.”, 1998 [9] J. Hu, S. Mungee, and D. C. Schmidt, “Principle for developing and Measuring High-performance Web Servers over ATM,” in Proceedings of INFOCOM ’98, March/April 1998. [10] J.Hu, I. Pyarali, and D. C. Schmidt, “Measuring the Impact of Event Dispatching and Concurrency Models on Web Server Performance Over High-speed Networks”, in Proceedings of the 2nd Global Internet Conference, IEEE, November 1997. [11] Venkat N. Gudivada and Vijay V. Raghavan, “Picture Retrieval Systems: A Unified Perspective and Research Issues” [12] W. Stallings. Cryptography and Network Security: Principle and Practice, 2nd edition, Prentice Hall1995, 1999. [13] Chronaki, Tsiknakis, Zabulis, and Stathiakis, Leiscg, Orphannoudakis, “A Katehakis, Web-based Environment for Medical Collaboration in a Regional Healthcare Network”, Elsevier Science B.V, 1997 [14] R. C. Gonzalez, Richard E. Woods. Digital Image Processing, Addison Wesley, 1993 [15] Walrath K, Campione M. The JFC Swing Tutorial, Addison-Wesley, 1999. [16] R. Dumas, A practical guide to usability testing, 2nd edition, Ablex Publishing Corporation, 1994.