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1.  Teaching DICOM by Problem Solving 
Journal of Digital Imaging  2012;25(5):653-661.
The Digital Imaging and Communications in Medicine (DICOM) is the standard for encoding and communicating medical imaging information. It is used in radiology as well as in many other imaging domains such as ophthalmology, dentistry, and pathology. DICOM information objects are used to encode medical images or information about the images. Their usage outside of the imaging department is increasing, especially with the sharing of medical images within Electronic Health Record systems. However, learning DICOM is long and difficult because it defines and uses many specific abstract concepts that relate to each other. In this paper, we present an approach, based on problem solving, for teaching DICOM as part of a graduate course on healthcare information. The proposed approach allows students with diversified background and no software development experience to grasp a large breadth of knowledge in a very short time.
PMCID: PMC3447100  PMID: 22476384
Digital Imaging and Communications in Medicine; DICOM; Medical imaging; Healthcare information; Teaching; Problem solving
2.  Using JPEG 2000 Interactive Protocol to Stream a Large Image or a Large Image Set 
Journal of Digital Imaging  2010;24(5):833-843.
The electronic health record (EHR) is expected to improve the quality of care by enabling access to relevant information at the diagnostic decision moment. During deployment efforts for including images in the EHR, a main challenge has come up from the need to compare old images with current ones. When old images reside in a different system, they need to be imported for visualization which leads to a problem related to persistency management and information consistency. A solution consisting in avoiding image import is achievable with image streaming. In this paper we present, evaluate, and discuss two medical-specific streaming use cases: displaying a large image such as a digital mammography image and displaying a large set of relatively small images such as a large CT series.
PMCID: PMC3180554  PMID: 20978921
Medical imaging; Electronic health record; Image communication; Image streaming; JPIP; JPEG 2000
3.  Pseudonymization of Radiology Data for Research Purposes 
Journal of Digital Imaging  2006;20(3):284-295.
Medical image processing methods and algorithms, developed by researchers, need to be validated and tested. Test data would ideally be real clinical data especially that clinical data is varied and exists in large volumes. Nowadays, clinical data is accessible electronically and has important value for researchers. However, the usage of clinical data for research purposes should respect data confidentiality, patient right to privacy, and patient consent. In fact, clinical data is nominative given that it contains information about the patient such as name, age, and identification number. Evidently, clinical data needs to be de-identified to be exported to research databases. However, the same patient is usually followed during a long period of time. The disease progression and the diagnostic evolution represent extremely valuable information for researchers as well. Our objective is to build a research database from de-identified clinical data while enabling the data set to be easily incremented by exporting new pseudonymous data, acquired over a long period of time. Pseudonymization is data de-identification, such that data belonging to an individual in the clinical environment still belong to the same individual in the de-identified research version. In this paper, we explore various software architectures to enable the implementation of an imaging research database that can be incremented in time. We also evaluate their security and discuss their security pitfalls. As most imaging data accessible electronically is available with the digital imaging and communication in medicine (DICOM) standard, we propose a de-identification scheme that closely follows DICOM recommendations. Our work can be used to enable electronic health record (EHR) secondary usage such as public surveillance and research, while maintaining patient confidentiality.
PMCID: PMC3043895  PMID: 17191099
Research database; confidentiality; security; privacy; de-identification; pseudonymization; nominative health care data; radiology; medical imaging
4.  Benefits of the DICOM Structured Report 
Journal of Digital Imaging  2006;19(4):295-306.
Recently, the digital imaging and communications in medicine (DICOM) standard introduced rules for the encoding, transmission, and storage of the imaging diagnostic report. This medical document can be stored and communicated with the images in picture archiving and communication system (PACS). It is a structured document that contains text with links to other data such as images, waveforms, and spatial or temporal coordinates. Its structure, along with its wide use of coded information, enables the semantic understanding of the data that is essential for the Electronic Healthcare Record deployment. In this article, we present DICOM Structured Report (SR) and discuss its benefits. We show how SR enables efficient radiology workflow, improves patient care, optimizes reimbursement, and enhances the radiology ergonomic working conditions. As structured input significantly alters the interpretation process, understanding all its benefits is necessary to support the change.
PMCID: PMC3045165  PMID: 16752206
Digital Imaging and Communications in Medicine (DICOM); structured report; interpretation; Picture Archiving and Communication System (PACS); Radiology Information System (RIS); Integrating the Healthcare Enterprise (IHE)
5.  Benefits of the DICOM Modality Performed Procedure Step 
Journal of Digital Imaging  2005;18(4):260-269.
A few years ago, the Digital Imaging and Communications in Medicine standard introduced a network transaction that is initiated by modality equipment, mainly at the beginning and at the end of the acquisition. This transaction, the Modality Performed Procedure Step (MPPS), is sent to the Picture Archiving and Communication System and/or to the Radiology Information System. It carries information about what really has been performed by the modality equipment during acquisition. In this paper, we present MPPS and discuss its benefits. We show how MPPS enables efficient radiology workflow and how it ensures accuracy and completeness of imaging information. We think our paper helps bridge the gap between MPPS implementation and deployment. By understanding all the MPPS benefits, the end user becomes aware of the great enhancement in patient care that this transaction provides.
PMCID: PMC3046723  PMID: 15988627
Digital Imaging and Communications in Medicine, DICOM; Modality Performed Procedure Step, MPPS; Workflow; Picture Archiving and Communication System, PACS; Radiology Information System, RIS; Integrating Healthcare Enterprise, IHE

Results 1-5 (5)