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Interactive Medical Imaging
over the Network
Centre Hospitalier
Universitaire Vaudois
Lausanne
Raffaele Noro, Olivier Verscheure and Jean-Pierre Hubaux
Institute for computer Communications and Applications
phone: + 41 21 693.6791; fax: +41 21 693.6610
{noro, verscheure, hubaux}@epfl.ch
http://icawww.epfl.ch
Motivation behind this work
 Medical imaging: diagnosis, therapy and follow-up
 Hospital Information Systems (HIS): store and access images in digital
format
 Medical images: large amount of information (10-100 Mbits)
 Full image transfer over N-ISDN technology is implemented in current
systems: dowload time is not acceptable: 1-10 min
Problem: how to provide real interactivity?
HIS 2
HIS 1
4. Examination
3. Local storage
1. Request
LAN
N-ISDN
LAN
2.Transmission
Interactive Medical Imaging over the Network
R.Noro, O.Verscheure and J-P.Hubaux
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Framework
 Region of Interest:
 most of the image in low resolution
 a user selected portion of the original image in better
resolution
 Real-time through ATM technology
 Database access vs. transfer and storage of local copies
Interactive Medical Imaging over the Network
R.Noro, O.Verscheure and J-P.Hubaux
3
Prototype features




Client’s
display
Point-to-point ATM connection
User interface
MPEG-2 coding
Coordination: request-display synchronization
RoI
Hierarchical
access
MPEG-2 Decoding
MPEG-2
packing
RoI
selection
Client
request
Hierarchical
database
Network adaptation
Network adaptation
ATM
connection
Interactive Medical Imaging over the Network
R.Noro, O.Verscheure and J-P.Hubaux
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Live presentation: telepathology
 Inspection of a stomach specimen: four resolution levels, from low- to
high -resolution level
 Operations: dynamic selection of the RoI at client interface, synthetic
MPEG-2 stream generated by the server
 Server and client directly connected to the ATM switch: the display
terminal communicates with the client through IP.
Terminal
Server
Hierarchical
access
Client
IP
MPEG-2
RoI
decoding
selection
AAL 5
Interactive Medical Imaging over the Network
R.Noro, O.Verscheure and J-P.Hubaux
MPEG-2 Client
packing request
AAL 5
ATM switch
5
Conclusion
 Achievement:
We have developed a prototype for interactive tele-diagnosis
over high-speed network in close collaboration with medical
doctors
 Future research: extension to multi-point
 References:
 R. Noro et al., Real-Time Telediagnosis of Radiological
Images through an Asynchronous Transfer Mode network:
The ARTeMeD Project, Journal of Digital Imaging, vol. 10,
pp. 116-127, Aug. 1997
Interactive Medical Imaging over the Network
R.Noro, O.Verscheure and J-P.Hubaux
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