Research On Key Technologies And System Construction Of Mobile Medical Image Reading

1 ObjectiveIn recent years, medical information technologies develop rapidly, health information construction in our country from scratch, from local to global. Hospital information work continuously penetrate inside and outside the hospital business, medical information system has gradually become an important part of medical and health service system.Picture Archiving and Communication Systems (PACS), is a set of information transmission system, solve the medical image display, archiving and management of hospital. The PACS system is to improve the level of hospital information, improve the hospital management process, and reduce the cost. The system solves the problem of storage and management, medical image file to realize the sharing of information resources, improve the hospital radiology workflow, reduce the film using film storage space, and the film is reduced, managers play an important role in clinical diagnosis and medical research.Handheld mobile devices of a revolutionary change, the emergence of a large number of high performance mobile smart phone and tablet market. Hardware manufacturers such as apple, Samsung, Lenovo, Huawei is dominant. The operating system like apple’s IOS, Google Inc.’s Android, Microsoft’s Windows Phone is dominant. The hardware configuration is generally a quad core processor, more than 1GB RAM, more than 1GB ROM, and support large capacity memory card as expansion. Using these high performance devices as the terminal of mobile PACS system, we can quickly access to image. Doctor can timely access to patient data provides a guarantee of imaging diagnosis.With the development of mobile communication products and technology, the remote and network exchange platform infrastructure improvement, the rapid development of network technology, the demand of regional medical, remote consultation and mobile medical treatment on the WEB access to medical image more and more strongly. Access to heterogeneous PACS systems image becomes more and more frequent, the traditional architecture of the C/S PACS image browse workstation challenges.At present, WEB access to medical images is realized by the ActiveX control embedded into IE browser. The control mode solves the problem of image reading, but there are many problems such as the installation, updating, management and maintenance etc.The main object of the project is to realize medical image transmission and display in universal mobile browser using WADO technology, to realize the browse system of medical imaging using in common mobile terminals. This project has very practical application significance in many aspects, such as the sharing platform of regional image, telemedicine image browsing system, clinical medical image workstation, mobile medical image workstation, and visits the Examination image at home.2 Techniques and MethodThe system uses B/S framework. It’s front end using jQuery and jQuery Mobile technology and asynchronous communication to achieve the page and the server using the Ajax asynchronous technology. System deploy in the high performance server. CGI program load DICOM image in the server with something processing and return JPEG image to the client and display. The medical image reading system can run in Microsoft Windows, Apply IOS, Android system and so on. Due to the cross platform running, the system of follow-up development and maintenance cost is greatly reduced.This project studies the following contents:The development of PACS Technology and the new challenges to the development of mobile technology, AJAX Technology and Application Research on j Query framework in mobile terminal, Research on the technology and framwork of image reading system based on WADO Technology. The following separately elaborated WADO, CGI, Ajax, j Query Technology.DICOM is a medical image transmission and communication of international standard. DICOM transmission mode in the previous standard is point-to-point transmission, has great limitations. NEMA and ISO introduce WADO to display and transfer DICOM medical imaging in Web network. WADO included in DICOM standard eighteenth parts in 2004. Development of DICOM standard, Web based PACS is an important development direction of future PACS system.WADO provides a feasible technical scheme for medical image communication, interaction and display in WEB. The WADO specification defines medical information systems like PACS, HIS, EMR etc. retrieve medical image data from web embed DICOM server. WADO standard defined in the DICOM Standard chapter 18 starts from 2004 version and Continuous improvement in the new version. It also defined in ISO/WD1.14. WADO is used as an important interface standard of information exchange between the DICOM server and the HIS, EMR and other information system.DCMTK which is developed in accordance with the standard of DICOM3.0 project is an open source project by the German OFFIS company. The project after 10 years of development and maintenance upgrades, have implemented almost all of the contents of the DICOM3.0 standard. DCMTK project is a C, C++ cross platform project and compatible with Windows, Linux system. Therefore, we use DCMTK as the underlying library to implement DICOM file loading, processing and transform.CGI is one of the most important internet interactive technologies, the standard interface between the external programs with WEB server, and one of the most fundamental means for users to interact and WEB server. We using C++ to develop compatible with WADO standard CGI program, and deployed to a WEB server. We use C++ analysis of URL parameters and processing DICOM files in the project.Ajax is proposed by Jesse James Garrett in 2005 February. Ajax is a Webpage development technology to create interactive webpage application. Using Ajax technology, we can realize the asynchronous update page instead of refreshing the entire page, thereby reducing the page loading time, improves the operation experience.j Query is an open source JavaScript library, and j Query Mobile is a mobile version of the j Query, compatible with most mainstream mobile browser running in IOS, Apple. The use of jQuery and jQuery Mobile solves DOM and Ajax complexity problem like compatibility etc... With its rich library, it can reduce the amount of code, help developers writing business process and quickly develop application of various across mobile operating system. It also increases the interface appearance and consistency, so that users have a better experience.Lib one is placed in the computer room of radiology department for internal use; while Lib two is placed in the Department of information center computer room, for all equipment in the hospital. Clinical workstation and mobile workstation using the clinical departments, access the image should be stored in the lib two. So, we deploy the WADO.cgi and related file to the Lib tow Server. When the client access to DICOM image, the image directly open on the server, and reduces the image repeats time.3 ResultsSystem uses the B/S structure, the front end using jQuery, the backend using CGI program written by C++ with DCMTK library, using data Oracle 9i and deploys in Microsoft IIS server.The system is tested in the IE, Firefox, Google and Chrome browsers running in Windows, and tested in Samsung GALAXY S5, iPhone 4S, and other mobile phones’ web browser. The medical image reading system can run in above systems’browser and finish W/C adjusts. The results achieve the desired effect.The system in China IHE testing, compatibility with other manufacturers, pass the test and get the certificate. The system is used in the Third Affiliated Hospital, Sun Yat-Sen University, and Guangzhou Women and Children Medical Center Hospital, with Application of scene is mobile pad, mobile phone terminal PACS image reading. The system combined with clinical system in hospital PACS use, is convenient for the doctor to consult clinical patient. 4 ConclusionsWith the development of the mobile communication products and technologies, remote and network technology platform infrastructure improvement, hardware facilities and technology needed for implementation of mobile medical service function has been ready. With the rapid development of network technology, the regional medical, remote consultation and mobile medical treatment on the WEB access to medical images is becoming more and more popular, the image of medical image research under the WEB access technology is suitable for the development needs of medical information technology. WADO for WEB mode access to medical imaging provide technical standard. Ajax, jQuery and jQuery Mobile front-end technology framework provides technical support for the development of unified medical image film reading systems in the browser in handheld mobile devices. Film reading technology based on Mobile terminal medical image is the key research direction in future PACS.Compare with traditional image reading system, the research project has the following advantages:(1) The system based on browser technology, compatible with Windows, Linux, IOS, and Android system, has nothing to do with the operating system.(2) The system based on DICOM Specification technology is advantageous to increase the compatibility of different PACS manufacturers.(3) The image format of the system is JPEG, can be used in hospital’s PACS system and regional image platform. The image is converted to JPEG which greatly reduce the image loading time.(4) Increasing the security of image. The returned image format is JPEG transformed by CGI with WADO, not the original DICOM image. The system prevents the image accessed directly and protects the security of image.