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MIRC OverviewMIRC OverviewMedical Imaging Resource CenterMedical Imaging Resource Center
John PerryJohn PerryRSNA 2007RSNA 2007
Medical Imaging Resource CenterMedical Imaging Resource Center
John PerryJohn PerryRSNA 2007RSNA 2007

RSNA2007 MIRC CoursesRSNA2007 MIRC Courses
Overview of the RSNA MIRC SoftwareOverview of the RSNA MIRC Software
Installing MIRC on Your LaptopInstalling MIRC on Your Laptop
Using MIRC for Clinical TrialsUsing MIRC for Clinical Trials
Hands On: Using the RSNA Teaching FileHands On: Using the RSNA Teaching File

MIRC Project ObjectiveMIRC Project Objective
Support the production, storage, indexing Support the production, storage, indexing and distribution of medical imaging and distribution of medical imaging resources:resources:– Teaching filesTeaching files– Scientific & technical documentationScientific & technical documentation– Research images & datasetsResearch images & datasets– Clinical trials dataClinical trials data

MIRC ConceptsMIRC Concepts
The key concepts:The key concepts:– MIRCMIRC is a community of cooperating is a community of cooperating
librarieslibraries on the Internet. on the Internet.– The The librarieslibraries cooperate by supporting a cooperate by supporting a
common common queryquery mechanism. mechanism.– The The queryquery mechanism allows users to find mechanism allows users to find
information wherever it is stored.information wherever it is stored.
The key concepts:The key concepts:– MIRCMIRC is a community of cooperating is a community of cooperating
librarieslibraries on the Internet. on the Internet.– The The librarieslibraries cooperate by supporting a cooperate by supporting a
common common queryquery mechanism. mechanism.– The The queryquery mechanism allows users to find mechanism allows users to find
information wherever it is stored.information wherever it is stored.

MIRC Information FormatsMIRC Information Formats
Images: DICOM, GIF, JPEG, PNG, TIFFImages: DICOM, GIF, JPEG, PNG, TIFF
Anything displayable by a web browserAnything displayable by a web browser
Hyperlinks to other web contentHyperlinks to other web content
Pointers to files for downloadingPointers to files for downloading

The MIRC CommunityThe MIRC Community
ServerServer
IndexMIRC Sites
ServerServer
Index
RSNA
User
ServerServerIndexMIRC Storage Service:- Document Authoring- Document Storage- Document Indexing- Web Server
MIRC Query Service:- Access to the community
Internet

The RSNA MIRC SoftwareThe RSNA MIRC Software
Query ServiceQuery Service
Storage ServiceStorage ServiceDocument index and storageDocument index and storage
Author servicesAuthor services
DICOM servicesDICOM services
File ServiceFile ServicePublic and private file cabinetsPublic and private file cabinets

Query ServiceQuery Service
Standard search formStandard search form31 defined fields:31 defined fields:
Free textFree text Clinical contentClinical content
Document attributesDocument attributes Image attributesImage attributes
Document contentDocument content Patient attributesPatient attributes
Links to other servicesLinks to other services
Queries a single site, selected sites, or Queries a single site, selected sites, or the entire communitythe entire community

Query ServiceQuery Service

Query ServiceQuery Service
Two display formats for query results:Two display formats for query results:Standard query resultsStandard query results
Title (hyperlink)Title (hyperlink)
AuthorAuthor
AbstractAbstract
Case NavigatorCase NavigatorRandom or orderedRandom or ordered
Known and unknown presentationsKnown and unknown presentations

Standard Search ResultsStandard Search Results

Intended for teaching file cases
The Case NavigatorThe Case Navigator

Storage ServiceStorage Service
Stores and indexes documents Stores and indexes documents
A single MIRC site can have multiple A single MIRC site can have multiple Storage Services for different purposesStorage Services for different purposes
– Teaching files for each Teaching files for each department/specialtydepartment/specialty
– Individual services for each clinical trialIndividual services for each clinical trial

XML ServerXML Server
Serves documents to users on the webServes documents to users on the web
Transforms XML files to other formatsTransforms XML files to other formats
Multiple display formats (page, tab, mstf)Multiple display formats (page, tab, mstf)
Exports documents and datasets to usersExports documents and datasets to users

XML ServerXML Server
Provides access control for:Provides access control for:– read, update, exportread, update, export
Restricts access for:Restricts access for:– owners, users, roles (user groups), owners, users, roles (user groups),
publicpublic
Supports private (owner-only) sections Supports private (owner-only) sections of otherwise public documentsof otherwise public documents

Display FormatsDisplay Formats
PagePage
TabTab
MSTFMSTF
PagePage
TabTab
MSTFMSTF

Author ServicesAuthor Services
•Basic Authoring ToolBasic Authoring Tool– For rapid creation of documents from files on For rapid creation of documents from files on
the client computerthe client computer
•Advanced Authoring ToolAdvanced Authoring Tool– Supports multiple document templatesSupports multiple document templates– Links to the File Service for inserting links to Links to the File Service for inserting links to
images and other files on the serverimages and other files on the server

What goes in a teaching file case?What goes in a teaching file case?
Whatever you want:Whatever you want:HistoryHistory Differential DiagnosisDifferential Diagnosis
Findings Findings DiscussionDiscussion
DiagnosisDiagnosis QuizzesQuizzes
ReferencesReferences
Images, drawings, videos, audios, …Images, drawings, videos, audios, …

TCE ServiceTCE Service
Supports the IHE Teaching Files and Supports the IHE Teaching Files and Clinical Trials Export integration profileClinical Trials Export integration profile– Allows image selection and text entry Allows image selection and text entry
directly on PACS diagnostic workstations directly on PACS diagnostic workstations (Agfa, Fuji, GE)(Agfa, Fuji, GE)
– Receives submissions from IHE TCE Export Receives submissions from IHE TCE Export Manager applications (Agfa, MIRC) and Manager applications (Agfa, MIRC) and automatically creates MIRC documentsautomatically creates MIRC documents

Zip ServiceZip Service
Supports the creation of multiple MIRC Supports the creation of multiple MIRC documents from zip filesdocuments from zip files– Folder hierarchy with each folder representing a Folder hierarchy with each folder representing a
single case or group of casessingle case or group of cases– Special processing for images and text filesSpecial processing for images and text files
Originally intended for preloading large numbers Originally intended for preloading large numbers of cases from pre-MIRC teaching filesof cases from pre-MIRC teaching files

Submit ServiceSubmit Service
Allows users to upload MIRC documents Allows users to upload MIRC documents to a storage serviceto a storage service– Supports connections from client-side Supports connections from client-side
authoring toolsauthoring tools– Supports uploading MIRC documents Supports uploading MIRC documents
through a browserthrough a browser– Accepts uploads in the format exported by Accepts uploads in the format exported by
the XML Serverthe XML Server

DICOM ServiceDICOM Service
Receives DICOM objects from PACS, Receives DICOM objects from PACS, workstations, modalities, etc.workstations, modalities, etc.Automatic document generationAutomatic document generation– Images grouped into documents by studyImages grouped into documents by study– Template-drivenTemplate-driven– Automatic JPEG generation from DICOMAutomatic JPEG generation from DICOM– Programmable anonymization (de-Programmable anonymization (de-
identification and re-identification)identification and re-identification)

Admin ServiceAdmin Service
Allows administrators to manage a MIRC site Allows administrators to manage a MIRC site through a browserthrough a browser– Control the documents on the Storage ServiceControl the documents on the Storage Service– Adjudicate the input queue for non-publishersAdjudicate the input queue for non-publishers– Configure the Storage Service and DICOM ServiceConfigure the Storage Service and DICOM Service– Control and monitor the DICOM ServiceControl and monitor the DICOM Service– Manage users and rolesManage users and roles

File ServiceFile Service
Each authenticated user has a private file Each authenticated user has a private file cabinet for storage of files of any kindcabinet for storage of files of any kind
One public file cabinet for the siteOne public file cabinet for the site
Public file cabinet receives DICOM objects Public file cabinet receives DICOM objects from PACS, modalities, workstationsfrom PACS, modalities, workstations– Separate anonymizerSeparate anonymizer
Author Service connectionAuthor Service connection

The File ServiceThe File Service

XMLServerXMLServer
OS FileOS FileSystemSystem
InputInputQueueQueue
StorageStorageServiceService
MIRCMIRCIndexIndex
AdminAdminServiceService
AuthorAuthorServicesServices
FileFileServiceService
Ob
jec
t P
roc
es
so
rO
bje
ct
Pro
ce
ss
or
MIRCMIRCAnonymizerAnonymizer
DICOMDICOMImportImport
QueryQueryServiceService
MIRC Site ServicesMIRC Site ServicesSubmitSubmitServiceService
ZipZipServiceService
TCETCEServiceService
HTTPHTTPExportExport
HTTPHTTPImportImport
DICOMDICOMExportExport
DICOMDICOMImportImport
MIRCMIRCAnonymizerAnonymizer
DatabaseDatabaseExportExport

DICOM ServiceDICOM Service
Receives DICOM objects from PACS, Receives DICOM objects from PACS, workstations, modalities, …workstations, modalities, …Automatic document generationAutomatic document generation– Images grouped into documents by studyImages grouped into documents by study– Template-drivenTemplate-driven– Automatic JPEG generation from DICOMAutomatic JPEG generation from DICOM– Programmable anonymization (de-Programmable anonymization (de-
identification and re-identification)identification and re-identification)

DICOM ServiceDICOM Service
Automatic trial patient ID generationAutomatic trial patient ID generationConnection to other DICOM Services for Connection to other DICOM Services for clinical trialsclinical trials– Support for encrypted communications Support for encrypted communications
(SSL)(SSL)
DICOM import / DICOM exportDICOM import / DICOM exportHTTP(S) import / HTTP(S) exportHTTP(S) import / HTTP(S) exportDatabase exportDatabase export

Database InterfaceDatabase Interface
Links to an externally developed databaseLinks to an externally developed database
Provides classes for interrogating:Provides classes for interrogating:– DICOM objectsDICOM objects– Metadata files:Metadata files:• XMLXML• ZIP (with manifest)ZIP (with manifest)
Anonymization of DICOM and XML objectsAnonymization of DICOM and XML objects

FCDICOM
FCDICOM
FCDICOM
PIDICOM
PI
DICOM
Clinical Trial ConfigurationClinical Trial Configuration
MIRC FieldCenter Application:- Image reception- Anonymization- Transmission to PI
MIRC Site:- Image reception- Image Storage- Transfer to PACS and/or workstations
Firewalls
InternetHTTPHTTPS
Database
HTTP
HTTP
DICOM

Lessons from Field CentersLessons from Field Centers
IT departments are overworked.IT departments are overworked.
Network configuration can be a problem.Network configuration can be a problem.
– Firewalls, proxy servers, VPNsFirewalls, proxy servers, VPNs
Running a MIRC site at a Field Center Running a MIRC site at a Field Center just for image acquisition is overkill.just for image acquisition is overkill.
Therefore…Therefore…

The FieldCenter ApplicationThe FieldCenter Application
Runs at the image acquisition siteRuns at the image acquisition site
Receives images and metadata files via the Receives images and metadata files via the DICOM and HTTP(S) protocolsDICOM and HTTP(S) protocols
Anonymizes images and metadata filesAnonymizes images and metadata files
Transmits to the PI MIRC site via HTTP(S)Transmits to the PI MIRC site via HTTP(S)
Automatically links to the PI MIRC site for Automatically links to the PI MIRC site for remapping tables and software updatesremapping tables and software updates

AnonymizationAnonymization
Removal of Protected Health Information (PHI)Removal of Protected Health Information (PHI)
Remapping of PHI to trial-specific identifiersRemapping of PHI to trial-specific identifiers
Central vs. distributed remapping tables are Central vs. distributed remapping tables are an issue in a multi-site trialan issue in a multi-site trial
Metadata anonymization may also be required Metadata anonymization may also be required in some trialsin some trials

The RSNA MIRC SoftwareThe RSNA MIRC Software

The RSNA MIRC SoftwareThe RSNA MIRC Software
Runs on Windows, Mac, Linux, SolarisRuns on Windows, Mac, Linux, SolarisThree components:Three components:
Java / Tomcat / MIRCJava / Tomcat / MIRC
All components are freeAll components are freeMIRC Users Group meetings:MIRC Users Group meetings:
11/2511/25 1:30 - 3:30 1:30 - 3:30 E251E25111/2911/29 12:15 – 1:4512:15 – 1:45 E257E257

Questions/Answers & HelpQuestions/Answers & Help
The MIRC WikiThe MIRC Wiki– http://mircwiki.rsna.orghttp://mircwiki.rsna.org
RSNA Forums:RSNA Forums:– http://forums.rsna.orghttp://forums.rsna.org
– User Comments, Questions and AnswersUser Comments, Questions and Answers– RSNA MIRC Software AnnouncementsRSNA MIRC Software Announcements– MIRC Implementers’ CornerMIRC Implementers’ Corner
Subscribe on the Forums siteSubscribe on the Forums site