Conclusion Information Technology in Radiology Dr. Adegbenga Ismail Rays & Waves Radiology Clinic October 30, 2014 Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Table of Contents 1 Introduction 2 Radiology 3 Information Technology 4 Application of Information Technology to Radiology 5 Conclusion Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Radiology Definition Medical specialty that uses imaging to diagnose diseases [Wikipedia] Fundamental Concerns Just two things: 1 Image acquisition 2 Interpretation of Images viz-a-viz Disease states Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Radiology Definition Medical specialty that uses imaging to diagnose diseases [Wikipedia] Fundamental Concerns Just two things: 1 Image acquisition 2 Interpretation of Images viz-a-viz Disease states Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Information Technology Definition Application of Computers and Telecommunications equipment to store, retrieve, transmit and manipulate data, often in the context of a business or other enterprise [Wikipedia] Fundamental Concern Automation Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Information Technology Definition Application of Computers and Telecommunications equipment to store, retrieve, transmit and manipulate data, often in the context of a business or other enterprise [Wikipedia] Fundamental Concern Automation Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Modalities Sound Ultrasound X-rays Radiography, Fluoroscopy and Computed Tomography Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Modalities Sound Ultrasound X-rays Radiography, Fluoroscopy and Computed Tomography Magnets Magnetic Resonance Imaging Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Modalities Sound Ultrasound X-rays Radiography, Fluoroscopy and Computed Tomography Magnets Magnetic Resonance Imaging Sub-atomic particles Nuclear Medicine, and Positron Emission Tomography Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Modalities Sound Ultrasound X-rays Radiography, Fluoroscopy and Computed Tomography Magnets Magnetic Resonance Imaging Sub-atomic particles Nuclear Medicine, and Positron Emission Tomography Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Modalities Hardware Typical Configuration: Client – Server Architecture: Server + Dedicated Multi-modality viewing Work-station Server + General-purpose PC Networks 1GB or faster ethernet hardware. Fast routers. Implementations: Local Area Network Wide Area Network Virtual Private Network Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Modalities Hardware Typical Configuration: Client – Server Architecture: Server + Dedicated Multi-modality viewing Work-station Server + General-purpose PC Networks 1GB or faster ethernet hardware. Fast routers. Implementations: Local Area Network Wide Area Network Virtual Private Network Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Modalities Software Stored Instructions and procedures. DICOM is the underlying protocol Server + Fat client Server and Dedicated Client: ConQuest DICOM-server + k-PACS image-viewer Osirix Server + Osirix Image-viewer Server + Thin client Server and Web browser Clear Canvas Image Server + Web-browser Orthanc Server + Web-browser Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Radiology already involves an intense use of Science, Technology and Information. Can Computers, Tele-communication and Information systems still add value? Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Applications Computed Radiography Computerized Radiography Picture Archiving and Communication System (PACS) Provides economical storage of, and convenient access to, images from multiple modalities. Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Applications Computed Radiography Computerized Radiography Picture Archiving and Communication System (PACS) Provides economical storage of, and convenient access to, images from multiple modalities. Radiology Information System (RIS) Computerized database used to store, manipulate and distribute patient radiological data and imagery. Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Applications Computed Radiography Computerized Radiography Picture Archiving and Communication System (PACS) Provides economical storage of, and convenient access to, images from multiple modalities. Radiology Information System (RIS) Computerized database used to store, manipulate and distribute patient radiological data and imagery. Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Applications Teleradiology Transmission of radiological images from one location to another for the purpose of sharing studies with other radiologists and physicians. Voice Recognition System Translation of spoken words into text Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Applications Teleradiology Transmission of radiological images from one location to another for the purpose of sharing studies with other radiologists and physicians. Voice Recognition System Translation of spoken words into text Computer-aided Diagnosis Pattern-recognition softwares highlight suspicious areas on images, and draws the attention of the radiologist to suspicious areas Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Applications Teleradiology Transmission of radiological images from one location to another for the purpose of sharing studies with other radiologists and physicians. Voice Recognition System Translation of spoken words into text Computer-aided Diagnosis Pattern-recognition softwares highlight suspicious areas on images, and draws the attention of the radiologist to suspicious areas Decision Support Systems Particularly useful in assisting decision for appropriate Imaging and follow-up Imaging Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Applications Teleradiology Transmission of radiological images from one location to another for the purpose of sharing studies with other radiologists and physicians. Voice Recognition System Translation of spoken words into text Computer-aided Diagnosis Pattern-recognition softwares highlight suspicious areas on images, and draws the attention of the radiologist to suspicious areas Decision Support Systems Particularly useful in assisting decision for appropriate Imaging and follow-up Imaging Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Computed Radiography Combines four steps involved in radiographic film development into just one step: Developer A base (alkali) and metal solution used in reducing ionized silver bromide crystals on radiographic films to black metallic silver crystals Stopper A glacial acetic acid solution used to neutralize any excessive development of the film Fixer Solution used to preserve radiographic image over time Rinsing and Drying Dry off water to allow film to be reported Using a laser scanner to directly acquire images from a photostimulable phospor imaging plate Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Computed Radiography Combines four steps involved in radiographic film development into just one step: Developer A base (alkali) and metal solution used in reducing ionized silver bromide crystals on radiographic films to black metallic silver crystals Stopper A glacial acetic acid solution used to neutralize any excessive development of the film Fixer Solution used to preserve radiographic image over time Rinsing and Drying Dry off water to allow film to be reported Using a laser scanner to directly acquire images from a photostimulable phospor imaging plate Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Picture Archiving and Communication System Uses the DICOM standard to acquire images and data from different HL7-compliant radiological imaging modalities Stores images on RAIDs. RAID 5 in particular Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Picture Archiving and Communication System Uses the DICOM standard to acquire images and data from different HL7-compliant radiological imaging modalities Stores images on RAIDs. RAID 5 in particular Makes images available to reporting radiologists and clinicians over high-speed broadband networks Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Picture Archiving and Communication System Uses the DICOM standard to acquire images and data from different HL7-compliant radiological imaging modalities Stores images on RAIDs. RAID 5 in particular Makes images available to reporting radiologists and clinicians over high-speed broadband networks Same image is simultaneously available over a LAN, a WAN or the internet for reporting and clinical decision making Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Picture Archiving and Communication System Uses the DICOM standard to acquire images and data from different HL7-compliant radiological imaging modalities Stores images on RAIDs. RAID 5 in particular Makes images available to reporting radiologists and clinicians over high-speed broadband networks Same image is simultaneously available over a LAN, a WAN or the internet for reporting and clinical decision making Long term storage is ensured by periodic off-site back-ups Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Picture Archiving and Communication System Uses the DICOM standard to acquire images and data from different HL7-compliant radiological imaging modalities Stores images on RAIDs. RAID 5 in particular Makes images available to reporting radiologists and clinicians over high-speed broadband networks Same image is simultaneously available over a LAN, a WAN or the internet for reporting and clinical decision making Long term storage is ensured by periodic off-site back-ups Provides fast image retrieval and redundant image availability Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Picture Archiving and Communication System Uses the DICOM standard to acquire images and data from different HL7-compliant radiological imaging modalities Stores images on RAIDs. RAID 5 in particular Makes images available to reporting radiologists and clinicians over high-speed broadband networks Same image is simultaneously available over a LAN, a WAN or the internet for reporting and clinical decision making Long term storage is ensured by periodic off-site back-ups Provides fast image retrieval and redundant image availability Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Radiologic Information System Specialized instance of a Health Information System addressing the peculiar needs of a radiology department One-time input of patient data such as: name, age, gender, registration number etc Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Radiologic Information System Specialized instance of a Health Information System addressing the peculiar needs of a radiology department One-time input of patient data such as: name, age, gender, registration number etc Patient data can also be acquired from a hospital-wide HIS Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Radiologic Information System Specialized instance of a Health Information System addressing the peculiar needs of a radiology department One-time input of patient data such as: name, age, gender, registration number etc Patient data can also be acquired from a hospital-wide HIS Can Communicate via a Dicom Modality Work-list with imaging equipments [Grainger & Allison, 2008] Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Radiologic Information System Specialized instance of a Health Information System addressing the peculiar needs of a radiology department One-time input of patient data such as: name, age, gender, registration number etc Patient data can also be acquired from a hospital-wide HIS Can Communicate via a Dicom Modality Work-list with imaging equipments [Grainger & Allison, 2008] Same patient data can be linked with multiple images from different imaging modalities Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Radiologic Information System Specialized instance of a Health Information System addressing the peculiar needs of a radiology department One-time input of patient data such as: name, age, gender, registration number etc Patient data can also be acquired from a hospital-wide HIS Can Communicate via a Dicom Modality Work-list with imaging equipments [Grainger & Allison, 2008] Same patient data can be linked with multiple images from different imaging modalities Reduces clerical errors by eliminating multiple entry of same patient information in different imaging equipment Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Radiologic Information System Specialized instance of a Health Information System addressing the peculiar needs of a radiology department One-time input of patient data such as: name, age, gender, registration number etc Patient data can also be acquired from a hospital-wide HIS Can Communicate via a Dicom Modality Work-list with imaging equipments [Grainger & Allison, 2008] Same patient data can be linked with multiple images from different imaging modalities Reduces clerical errors by eliminating multiple entry of same patient information in different imaging equipment Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Teleradiology Images transmitted over broadband networks to off-site reporting radiologist Enables off-site reporting of radiological images Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Teleradiology Images transmitted over broadband networks to off-site reporting radiologist Enables off-site reporting of radiological images Enables virtual Multi-disciplinary Team Meetings Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Teleradiology Images transmitted over broadband networks to off-site reporting radiologist Enables off-site reporting of radiological images Enables virtual Multi-disciplinary Team Meetings Emerging area of Tele-education Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Teleradiology Images transmitted over broadband networks to off-site reporting radiologist Enables off-site reporting of radiological images Enables virtual Multi-disciplinary Team Meetings Emerging area of Tele-education Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Voice Recognition System Seeks to automate stenography Typical Reporting Work-flow: Radiologist’s Dictation ⇒ Secretary ⇒ Typed Report Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Voice Recognition System Seeks to automate stenography Typical Reporting Work-flow: Radiologist’s Dictation ⇒ Secretary ⇒ Typed Report Automated Reporting Work-flow: Radiologist’s Dictation ⇒ Voice Recognition Software ⇒ Computerized Report [Grainger & Allison, 2008] Faster Report is instantly verified and signed by radiologist author Interfaces with the RIS and PACS Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Voice Recognition System Seeks to automate stenography Typical Reporting Work-flow: Radiologist’s Dictation ⇒ Secretary ⇒ Typed Report Automated Reporting Work-flow: Radiologist’s Dictation ⇒ Voice Recognition Software ⇒ Computerized Report [Grainger & Allison, 2008] Faster Report is instantly verified and signed by radiologist author Interfaces with the RIS and PACS Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Computer-aided Diagnosis (CADx) Uses pattern recognition to identify disease patterns in images Machine learning technology is utilized to optimize algorithm Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Computer-aided Diagnosis (CADx) Uses pattern recognition to identify disease patterns in images Machine learning technology is utilized to optimize algorithm Images compared with anatomic databank of normal and abnormal images Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Computer-aided Diagnosis (CADx) Uses pattern recognition to identify disease patterns in images Machine learning technology is utilized to optimize algorithm Images compared with anatomic databank of normal and abnormal images Uses Artificial Neural Network and Bayesian statistics in analyzing images for probability of disease [Stivaros et al, 2010] Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Computer-aided Diagnosis (CADx) Uses pattern recognition to identify disease patterns in images Machine learning technology is utilized to optimize algorithm Images compared with anatomic databank of normal and abnormal images Uses Artificial Neural Network and Bayesian statistics in analyzing images for probability of disease [Stivaros et al, 2010] Technology also used in Computer-aided Simple Triage (CAST) Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Computer-aided Diagnosis (CADx) Uses pattern recognition to identify disease patterns in images Machine learning technology is utilized to optimize algorithm Images compared with anatomic databank of normal and abnormal images Uses Artificial Neural Network and Bayesian statistics in analyzing images for probability of disease [Stivaros et al, 2010] Technology also used in Computer-aided Simple Triage (CAST) Supplements and assists, not replace, human evaluation Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Computer-aided Diagnosis (CADx) Uses pattern recognition to identify disease patterns in images Machine learning technology is utilized to optimize algorithm Images compared with anatomic databank of normal and abnormal images Uses Artificial Neural Network and Bayesian statistics in analyzing images for probability of disease [Stivaros et al, 2010] Technology also used in Computer-aided Simple Triage (CAST) Supplements and assists, not replace, human evaluation Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Decision Support Systems Uses bayesian statistics to make a weighted combination of: Evidence in peer-reviewed publications Information from Domain Experts National Specialty Guidelines Patient Information in the HIS To Make Appropriate Imaging Requests Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Decision Support Systems Aimed at Automating the work of a Radiology Benefit Manager Assists clinicians in making appropriate Evidence-based Image ordering Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Decision Support Systems Aimed at Automating the work of a Radiology Benefit Manager Assists clinicians in making appropriate Evidence-based Image ordering Increasingly being used by radiologists in making informed imaging recommendations Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Decision Support Systems Aimed at Automating the work of a Radiology Benefit Manager Assists clinicians in making appropriate Evidence-based Image ordering Increasingly being used by radiologists in making informed imaging recommendations More objective and transparent replacement of the job of a Radiology Benefit Manager [ACR-RBMA, 2011] Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Decision Support Systems Aimed at Automating the work of a Radiology Benefit Manager Assists clinicians in making appropriate Evidence-based Image ordering Increasingly being used by radiologists in making informed imaging recommendations More objective and transparent replacement of the job of a Radiology Benefit Manager [ACR-RBMA, 2011] Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Increased Productivity What difference does automation make in productivity? What is the difference in productivity between a manual worker and an automated worker? A mathematical metaphor: Lazy Manual worker: ⇒ 0.2365 = 0 Efficient Manual worker: ⇒ 0.99365 = 0.026 Automated Worker: ⇒ 1.01365 = 37.78 Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Increased Revenue Directly from the Increased Productivity From accreted Value. Data Client Database Data Image Repositories Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion Increased Revenue Directly from the Increased Productivity From accreted Value. Data Client Database Data Image Repositories Dr. Adegbenga Ismail Information Technology in Radiology
Conclusion References Wikipedia http://en.wikipedia.org/wiki/Radiology Wikipedia http://en.wikipedia.org/wiki/Information technology Stivaros SM, Gledson A, Nenadic G, Zeng XJ, Keane J, Jackson A. Decision support systems for clinical radiological practice – towards the next generation. Br J Radiol. 2010 Nov;83(995):904-14. doi: 10.1259/bjr/33620087. Review. PMID:20965900 [PubMed - indexed for MEDLINE] Adam Smith (1776) An Inquiry into the Nature and Causes of the Wealth of Nations http://www2.hn.psu.edu/faculty/jmanis/adam-smith/wealth-nations.pdf 12(3), 45 – 678. Dr. Adegbenga Ismail Information Technology in Radiology
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