Using JPEG 2000 Interactive Protocol to Stream a Large Image or a Large Image Set

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.     

基于存储服务的JPEG2000医学DICOM图像压缩的研究

由于医学图像所包含的数据量巨大,不利于存储和在现有网络上有效地传输,本研究使用VC++实现基于联合图像专家组2000(Joint Photographic Experts Group2000,JPEG2000)图像压缩算法对医学图像进行处理,根据医学数字图像通讯(Digital Imaging and Communicationin Medicine,DICOM)标准中存储服务的规则实现医学图像的存储服务。研究结果表明,使用JPEG2000压缩算法处理后的医学图像,不仅能大大节约存储空间,而且能降低传输时所需要的带宽。因此,JPEG2000压缩算法在DICOM推广及远程医疗的发展中具有积极意义。     

JPEG2000压缩算法及其在医学图像DICOM格式中的实现

本文描述了在医学图像DICOM格式中实现JPEG2000压缩算法的编程思路和方法.提供了部分VC++代码,对关键函数进行了较详细的注解,并对两种图像压缩格式进行了比较,给出了一个详细的实验结果.     

Security Protection of DICOM Medical Images Using Dual-Layer Reversible Watermarking with Tamper Detection Capability

Teleradiology applications and universal availability of patient records using web-based technology are rapidly gaining importance. Consequently, digital medical image security has become an important issue when images and their pertinent patient information are transmitted across public networks, such as the Internet. Health mandates such as the Health Insurance Portability and Accountability Act require healthcare providers to adhere to security measures in order to protect sensitive patient information. This paper presents a fully reversible, dual-layer watermarking scheme with tamper detection capability for medical images. The scheme utilizes concepts of public-key cryptography and reversible data-hiding technique. The scheme was tested using medical images in DICOM format. The results show that the scheme is able to ensure image authenticity and integrity, and to locate tampered regions in the images.     

Clinical Evaluation of Compression Ratios using JPEG2000 on Computed Radiography Chest Images

The efficient compression of radiographic images is of importance for improved storage and network utilization in support of picture archiving and communication systems (PACS) applications. The DICOM Working Group 4 adopted JPEG2000 as an additional compression standard in Supplement 61 over the existing JPEG. The wavelet-based JPEG2000 can achieve higher compression ratios with less distortion than the Discrete Cosine Transform (DCT)-based JPEG algorithm. However, the degradation of JPEG2000-compressed computed radiography (CR) chest images has not been tested comprehensively clinically. The authors evaluated the diagnostic quality of JPEG2000-compressed CR chest images with compression ratios from 5:1 to 200:1. An ROC (receiver operating characteristic analysis) and t test were performed to ascertain clinical performance using the JPEG2000-compressed images. The authors found that compression ratios as high as 20:1 can be utilized without affecting lesion detectability. Significant differences between the original and the compressed CR images were not recognized up to compression ratio of 50:1 within a confidence level of 99%.     

Security of Patient and Study Data Associated with DICOM Images when Transferred Using Compact Disc Media

The transmission of patient and imaging data between imaging centers and other interested individuals is increasingly achieved by means of compact disc digital media (CD). These CDs typically contain, in addition to the patient images, a DICOM reader and information about the origin of the data. While equipment manufacturers attach disclaimers to these discs and specify the intended use of such media, they are often the only practical means of transmitting data for small medical, dental, or veterinary medical centers. Images transmitted by these means are used for clinical diagnosis. This has lead to a heavy reliance on the integrity of the data. This report describes attempts to alter significant patient and study data on CD media and their outcome. The results show that data files are extremely vulnerable to alteration, and alterations are not detectable without detailed analysis of file structure. No alterations to the DICOM readers were required to achieve this; changes were applied only to the data files. CDs with altered data can be readily prepared, and from the point of view of individuals viewing the images, function identically to the original manufacturer’s CD. Such media should be considered unsafe where there is a potential for financial or other gain to be had from altering the data, and the copy cannot be cross-checked with the original data.     

Authentication and Data Hiding Using a Hybrid ROI-Based Watermarking Scheme for DICOM Images

Authenticating medical images using watermarking techniques has become a very popular area of research, and some works in this area have been reported worldwide recently. Besides authentication, many data-hiding techniques have been proposed to conceal patient’s data into medical images aiming to reduce the cost needed to store data and the time needed to transmit data when required. In this paper, we present a new hybrid watermarking scheme for DICOM images. In our scheme, two well-known techniques are combined to gain the advantages of both and fulfill the requirements of authentication and data hiding. The scheme divides the images into two parts, the region of interest (ROI) and the region of non-interest (RONI). Patient’s data are embedded into ROI using a reversible technique based on difference expansion, while tamper detection and recovery data are embedded into RONI using a robust technique based on discrete wavelet transform. The experimental results show the ability of hiding patient’s data with a very good visual quality, while ROI, the most important area for diagnosis, is retrieved exactly at the receiver side. The scheme also shows some robustness against certain levels of salt and pepper and cropping noise.     

Using Applet–Servlet Communication for Optimizing Window, Level and Crop for DICOM to JPEG Conversion

In the creation of interesting radiological cases in a digital teaching file, it is necessary to adjust the window and level settings of an image to effectively display the educational focus. The web-based applet described in this paper presents an effective solution for real-time window and level adjustments without leaving the picture archiving and communications system workstation. Optimized images are created, as user-defined parameters are passed between the applet and a servlet on the Health Insurance Portability and Accountability Act-compliant teaching file server.     

基于Visual C#语言的DICOM标准医学图像的显示和实现

介绍DICOM 3.0医学图像文件的格胶虲#语言的特点,首次利用Visual C#语言对该标准的图像进行显示和适处理,能够直接读取DICOM格式原始图像数据,并可批量转换成BMP等格式进行处理,此项工作可为医学图像处理研究及相关医学图像软件开发奠定基础.     

基于Oracle数据库的DICOM医学图像管理系统技术研究

目的：PACS是实现数字化医学影像存档与通讯的重要手段。近年随着数字医院系统在国内外的建设，规模由小型向大中型发展，以及医学信息区域化实施，选择一种功能强大、性能稳定、易于管理的数据库，支持PACS系统的构建已是实际之所需。方法：作者采用Oracle为后台数据库、visual C＋＋6．0开发工具，设计了以Oracle为支撑的DICOM医学图像管理系统，并对涉及的核心关键技术进行了研究，完成了检索应用程序开发。结果：该系统经在局域网运行，显示出明显的优势，证明其技术和方法有效可行。结论：此研究性设计为PACS系统进一步全面开发建立了基础，同时对医院信息化建设有着重要意义。     

Synchronized, Interactive Teleconferencing with Digital Cardiac Images

St James's Hospital is a tertiary referral center for percutaneous intervention and cardiothoracic surgery for a number of referring hospitals. This article reports on the development and implementation of a synchronized, interactive teleconferencing system for cardiac images that links St. James's Hospital with a remote site (Sligo General Hospital) and overcomes the problems of transmission of large image files. Teleconferencing was achieved by setting up lossless auto transmission of patient files overnight and conferencing the next morning with linked control signals and databases. As a suitable product was not available, a commercially new software was developed. The system links the imaging databases, monitors and synchronizes progress through imaging sequences, and links a range of image processing and control functions. All parties to the conference are ensured that they are looking at the same images as they are played or at specific aspects of an image that the other party is highlighting. The system allows patient management decisions to be made at a weekly joint teleconference with cardiothoracic surgeons and interventional cardiologists from both sites. Rapid decision making was facilitated with 70% of decisions obtained within 24 h, and 88% within 1 week of their procedure. In urgent cases, data can be transmitted within 20 min of the diagnostic procedure. The system allows increased access to angiography for patients living in rural areas, and provides a more focused referral for revascularization. Participation of the referring cardiologist has improved the quality of decision making.     

JPEG2000 for automated quantification of immunohistochemically stained cell nuclei: a comparative study with standard JPEG format

The Joint Photographic Experts Group (JPEG) standard format is one of the most widely used in image compression technologies. More recently, JPEG2000 format has emerged as a state-of-the-art technology that provides substantial improvements in picture quality at higher compression ratios. However, there has been no attempt to date to determine which of the two compression formats produces less variability in the automated evaluation of immunohistochemically stained digital images in agreement with their compression rates and complexity degrees. The evaluation of Ki67 and FOXP3 immunohistochemical nuclear markers was performed in a total of 329 digital images: 47 were captured in uncompressed Tagged Image File Format (TIFF), 141 were converted to three JPEG compressed formats (47 each with 1:3, 1:23 and 1:46 compression) and 141 were converted to three JPEG2000 compressed formats (47 each with 1:3, 1:23 and 1:46 compression). The count differences between images in TIFF versus JPEG formats were compared with those obtained between images in TIFF versus JPEG2000 formats at the three levels of compression. It was found that, using JPEG2000 compression, the results of the stained nuclei count are close enough to the results obtained with uncompressed images, especially in highly complex images at minimum and medium compression. Otherwise, in images of low complexity, JPEG and JPEG2000 had similar count efficiency to that of the original TIFF images at all compression levels. These data suggest that JPEG2000 could give rise to an efficient means of storage, reducing file size and storage capacity, without compromise on the immunohistochemical analytical quality.     

A Mobile Tele-Radiology Imaging System with JPEG2000 for an Emergency Care

The aim of this study was to design a tele-radiology imaging system for rapid emergency care via mobile networks and to assess the diagnostic feasibility of the Joint Photographic Experts Group 2000 (JPEG2000) radiological imaging using portable devices. Rapid patient information and image exchange is helpful to make clinical decisions. We assessed the usefulness of the mobile tele-radiology system by measuring both a quantitative method, PNSR calculation, for image qualities, and its transmission time via mobile networks in different mobile networks, respectively; code division multiple access evolution-data optimized, wireless broadband, and high-speed downlink packet access; and the feasibility of the JPEG2000 computed tomography (CT) images by qualitatively assessing with the Alberta stroke program early CT score method with 12 CT image cases (seven normal and five abnormal cases). We found that the quality of the JPEG2000 radiological images was satisfied quantitatively and was judged as acceptable qualitatively at 5:1 and 10:1 compression levels for the mobile tele-radiology imaging system. The JPEG2000-format radiological images achieved a fast transmission while maintaining a diagnosis quality on a portable device via mobile networks. Unfortunately, a PDA device, having a limited screen resolution, posed difficulties in reviewing the JPEG2000 images regardless of the compression levels. An ultra mobile PC was preferable to study the medical image. The mobile tele-radiology imaging systems supporting JPEG2000 image transmission can be applied to actual emergency care services under mobile computing environments.     

基于离散小波变换的JPEG 2000标准对肺部CT图像的无损压缩

探索基于小波变换对肺部CT图像进行无损雎缩的新方法.采用基于离散小波变换方法的JPEG2000标准对3019张肺部CT图像进行无损压缩,并针对压缩后图像效果进行统计分析.结果表明,该方法不但可以达到12.0的高压缩比,而且具有较高的图像尤损压缩质量,为临床CT医学影像的储存与诊断,提供了有益的技术与方法.     

BlueLight: An Open Source DICOM Viewer Using Low-Cost Computation Algorithm Implemented with JavaScript Using Advanced Medical Imaging Visualization

Journal of Digital Imaging - Recently, WebGL has been widely used in numerous web-based medical image viewers to present advanced imaging visualization. However, in the scenario of medical imaging,...     

墨汁注射到不同月龄兔膝关节腔后半月板的电镜及光镜研究

目的本研究运用扫描电镜和透射电镜及光镜对墨汁注射到不同月龄兔膝关节腔后半月板的结构进行观察,以进一步丰富半月板的基础知识及为中医药保守治疗半月板损伤提供理论依据。方法选取6只不同月龄的健康的日本大白兔,分别往每只大白兔膝关节腔内注射墨汁5毫升,一小时后,处死大白兔,剖取半月板,然后按常规方法制作扫描电镜、透射电镜及光镜观察标本。结果光镜观察：注射墨汁组可见墨汁进入滑膜层,却未深入到组织内部;滑膜层随年龄的增长逐渐变薄。电镜观察：①兔半月板的上、下表面均有滑膜被覆,且滑膜有大量孔洞。孔洞的直径随年龄的增长呈由大至小的趋势。②在半月板前后角及半月板体部的内部有形态不十分规则的管道,其无光滑的内壁,偶尔有些开口于上表面;并随月龄的增加而减少。③半月板表面可见许多平行排列的条状隆起和沟,胶原纤维呈束状存在,且胶原纤维及其束之间存在大量空隙。胶原纤维的间隙随年龄的增长呈从大到小的趋势。④注射墨汁组的半月板在透射电镜下可见靠近表面的基质中有墨汁颗粒存在。结论在半月板内部存在一个庞大的营养供给体系,并将其称之为＂半月板营养滑液弥散系统＂,由半月板表面滑膜上的孔洞、穿行在半月板中的管道、胶原纤维束及胶原纤维之间的空隙、软骨陷窝等结构组成。但这种系统结构随年龄的增长而发生退行性变化。     

Body Fat Assessment Method Using CT Images with Separation Mask Algorithm

In recent years, the number of obese population in Korea has been growing up along with the economic development, environmental factors, and the change in life style. Considering the growth of obese population and the adverse effect of obesity on health, it is getting more important to prevent and diagnose the obesity with the quantitative measurement of body fat that has become an important indicator for obesity. In this study, we proposed a procedure for the automated fat assessment from computed tomography (CT) data using image processing technique. The proposed method was applied to a single-CT image as well as CT-volume data, and results were correlated to those of dual-energy X-ray absorptiometry (DEXA) that is known as the reliable method for evaluating body fat. Using single-CT images, correlation coefficients between DEXA and the automated assessment and DEXA and the manual assessment were 0.038 and 0.058, respectively (P > 0.05). Hence, there was no significant correlation between three methods using the proposed method with single-CT images. On the other hand, in case of CT-volume data, the above correlation coefficients were increased to 0.826, 0.812, and 0.805, respectively (P < 0.01). Thus, DEXA and the proposed methods with CT-volume data showed highly significant correlation with each other. The results suggest that the proposed automated assessment using CT-volume data is a reliable method for the evaluation of body fat. It is expected that the clinical application of the proposed procedure will be helpful to reduce the time for the quantitative evaluation of patient’s body fat.     

Dental Pulp Tissue Engineering Using Mesenchymal Stem Cells: a Review with a Protocol

Mesenchymal stem cells (MSCs) are adult stem cells that can be isolated from human and animal sources such as rats. Recently, an in vivo protocol for pulp tissue engineering using implantation of bone marrow MSCs into rat pulpotomized molars was established by our research group. This coronal pulp regeneration model showed almost complete regeneration/healing with dentin bridge formation when the cavity was sealed with mineral trioxide aggregate (MTA) to create a biocompatible seal of the pulp. This method is a powerful tool for elucidating the processes of dental pulp tissue regeneration following implantation of MSCs. In the present review, we discuss the literature in the field of dental pulp tissue engineering using MSCs including dental pulp stem cells and stem cells from exfoliated deciduous teeth. In addition, we present a brief step-by-step protocol of the coronal pulp regeneration model focusing on the implantation of rat bone marrow MSCs, biodegradable scaffolds, and hydrogels in pulpotomized rat molars. The protocol may lay the foundation for studies aiming at defining further histological and molecular mechanism of the rat pulp tissue engineering.