Web PACS浏览工作站的构建

目的：作为B／S客户端的Web浏览器实现了Web PACS浏览工作站分布式的特点，但它却不支持DICOM格式，本文利用Java技术构建基于DICOM标准的web PACS浏览工作站，扩展了常用Web浏览器（以IE为主）对医学影像的处理功能。方法：首先根据DICOM3．0标准编写DICOM核心类以实现对DICOM文件的解析，在此基础上利用Java开发环境JDK1．6及Java开发工具Eclipse3．2优化Applet界面布局，在Applet中加载图像并实现图像及病人基本信息的显示，完成基本的图像处理功能．最后利用Java Plug-in技术将Applet加载至Web浏览器，从而实现了分布式Web PACS浏览工作站的构建。结果：本研究开发的具有DICOM图像浏览功能的Java Applet，用户界面友好，操作简便，能将每一台连网的PC机变成“浏览工作站”，能高效加载DICOM图像至Web浏览器，单幅、多幅、动态放映等显示模式间可灵活切换．实现了窗宽／窗位调整、图像平滑、锐化等基本图像处理操作。结论：DICOM图像浏览的Java Applet实现是构建Web PACS浏览工作站的关键．为医学影像的广域共享，远程影像教学和远程会诊提供了思路，将推动PACS工作模式进入新的纪元。     

基于Pocket PC的医学图像浏览器

目的：利用绑定精简版．NET开发框架的Visual Studio 2003．NET编程平台开发一个基于Pocket PC的医学图像浏览器。材料与方法：智能移动设备客户端通过安装应用程序，实现对Web服务器端医学信息的查询、提取、更新，以及对医学图像的浏览和处理。结果：在基于Windows CE的智能移动设备端，通过采用C／S（client／server）构架，利用医学图像浏览器，初步实现了医学图像的无线远程共享。结论：与大多数传统的PACS相比，基于Pocket PC的移动PACS组建简单，易于安装和使用。利用其独有的移动上网功能，突破了医学图像浏览的时间性和地域性的限制。     

构筑基于Web技术的远程医疗网的方案研究

本文针对基本Web技术的远程医疗系统的构筑问题，尝试采用网站形式建立基于浏览器／服务器模式（Browser/Server)的远程医疗会诊系统，希望通过使用高效率的Java语言编程，使用户能够只需使用一个WWW浏览器，就可以达到实现远程医疗会诊的目的。     

基于Web的医学断层图像远程重建

实现Internet上Web模式的医学图像三维重建及显示.基于Java Appler编程，利用数字签名解决Java安全限制，读取本地图像。采用体绘制法完成二维图像的三维重建与显示。由超高速CT获得人体器官的断层图像，在Web上重建出了、冠状动脉、头颅、颈椎、骨盆的三维解剖结构。重建可在Internet上以Web模式跨平台运行，且在三维图像上可进行切割模拟操作。结论：①用Java Applet实现基于Web的医学图像三维重 建是可行的，并对三维图像的临床应用起重要推动作用；②基于Web重建的三维医学图像，其精度能够满足临床要求，尤其是冠状动脉的解剖 结构在临床上有很大参考价值。     

基于嵌入式Web服务器的心电远程监护系统

目的设计一种基于嵌入式Web服务器的心电远程监护系统。方法采用低功耗ARM9微处理器为核心的开发板,移植嵌入式Linux系统和Web服务器,通过JavaApplet和CGI设计开发,利用动态网页实现心电信号的远程实时监护。结果设计的心电记录器能准确地采集和显示各类心电信号,浏览器端能动态显示心电波形和分析结果,可准确实时地进行远程监护。结论本系统操作方便、成本低,实现了现有动态心电监护仪缺乏的实时监测,适合家庭和社区的心电监护。     

PACS系统的Web访问方案设计

本文结合PACS系统的特点,分析了PACS系统Web方式浏览的体系结构和实现模式．确立了一种在B／S模式下用Java Applet技术实现PACS系统的Web访问的设计方案,并给出了实现过程。此方案具有平台独立、稳定、易维护、易升级等优点,对构筑远程医疗系统具有一定的实用价值。     

医学图像远程诊断系统的一种新型设计与实现

目的:将Internet以及无线通信网络技术引入医学图像远程诊断系统,开发同PACS相结合的医学图像远程诊断系统。材料和方法:在VS.NET2005平台下使用ASP.NET技术制作网站系统,采用JAVA开发影像APPLET,Web服务器使用IIS5.0服务器,数据库使用Microsoft SQL Server,采用短信Modem利用无线网络在线通知专家。结果:提供两种途径进入医学图像远程诊断系统,医生只要具备一台能够上网的电脑或者移动智能手机便可实现对影像资料的提取、浏览以及诊断。结论:该系统可投入实际使用,使诊断过程突破时间空间的限制,是远程诊断全方位发展的一次新尝试。虽然目前此种诊断形式不具备法律效力,却为远程医疗以及远程教学提供了一种新思路。     

基于web技术的医学图像远程诊断系统的设计与实现

目的：将web技术引入医学图像远程诊断系统，同时利用无线通信GPRS网络。开发建立在B／S模式下同PACS系统相结合的医学图像远程诊断系统。材料和方法：在VS．NET2003平台下使用ASP．NET技术制作网站系统．web服务器使用IIS5．0服务器，数据库使用Microsoft SQL Server，采用短信Modem利用无线网络在线通知专家。结果：将基于Internet的医学图像远程诊断系统完成为一个完整的在线注册与登录系统，同时也成为在线学习与讨论网站，利用无线通信技术使远程诊断方便快捷。结论：该系统可投入实际使用，为广大中小医院建设远程诊断系统提供了一种新思路，不仅可以方便地移植，而且给以后的维护带来了极大的方便。可提高医院的工作效率、病人治疗的质量。     

802．11g无线局域网在PACS系统中的应用

目的测试PACS医学图像在802．11g无线局城网的实际传输情况，探讨无线局域周在建设医院PACS系统中的应用前景和存在的主要问题。方法使用NetIQ Chariot软件测试医生工作站和服务器之间的传输速率；结果利用医生工作站PACS客户稿软件从PACS服务器下载医学图像数据，测量下载时间。结论采用802．11g无线局域网和千兆以太网相结合的网络系统在传输速度、稳定性和安全性方面能满足医院PACS系统的需求。     

基于CORBA的医院信息系统与PACS的分布式集成研究

在实际医学应用中 ,医生需要及时获得病人的有关图像和文本记录信息。这些信息有助于医生进行病历诊断 ,临床试验和研究分析。但是这些信息分布零乱 ,并且位于不同的系统上 ,如图像管理和通信系统 (Picturearchiving and comm unication information systems,PACS) ,医院信息系统 (Hospital inform ation systems,HIS)等 ,这些系统使用不同的标准和协议 ,并且都不支持分布式操作 ,使系统间信息不能完全共享。为了实现各种医学系统间的分布式操作和信息的共享 ,本文结合当前流行的 WWW技术 ,利用分布式处理软件 (Common object requestbroker architecture,CORBA) ,提出了一种基于 WEB的 PACS和 HIS分布式集成方法 ,该方法将图像和文本信息系统及各种医学应用都看作是 CORBA组件对象 ,把对这些系统和应用的操作都当作是对应用对象的处理 ,利用面向对象的技术实现了对 PACS和 HIS系统的分布式集成和互操作 ,并且利用 WEB技术实现了信息的共享     

PACS Viewer Based on Java Applet in B／S Architecture

PACS can be applied in the network architecture of Client/Server (C/S) and Browser/Server (B/S) in current application of hospital information system. PACS Viewer of B/S model is realized by means of the browser commonly, but web browser does not support DICOM standard. In this article, how to use Java Applet to realize the display and operations of DICOM images will be discussed. The lightweight method to view DICOM images is very fit for telemedical treatment, and the situations not require strong ability in image operations。     

Use of a Rich Internet Application Solution to Present Medical Images

Browser with Rich Internet Application (RIA) Web pages could be a powerful user interface for handling sophisticated data and applications. Then the RIA solutions would be a potential method for viewing and manipulating the most data generated in clinical processes, which can accomplish the main functionalities as general picture archiving and communication system (PACS) viewing systems. The aim of this study is to apply the RIA technology to present medical images. Both Digital Imaging and Communications in Medicine (DICOM) and non-DICOM data can be handled by our RIA solutions. Some clinical data that are especially difficult to present using PACS viewing systems, such as ECG waveform, pathology virtual slide microscopic image, and radiotherapy plan, are as well demonstrated. Consequently, clinicians can use browser as a unique interface for acquiring all the clinical data located in different departments and information systems. And the data could be presented appropriately and processed freely by adopting the RIA technologies.     

Enterprise-scale image distribution with a Web PACS

The integration of images with existing and new health care information systems poses a number of challenges in a multi-facility network: image distribution to clinicians; making DICOM image headers consistent across information systems; and integration of teleradiology into PACS. A novel, Web-based enterprise PACS architecture introduced at Massachusetts General Hospital provides a solution. Four AMICAS Web/Intranet Image Servers were installed as the default DICOM destination of 10 digital modalities. A fifth AMICAS receives teleradiology studies via the Internet. Each AMICAS includes: a Java-based interface to the IDXrad radiology information system (RIS), a DICOM autorouter to tape-library archives and to the Agfa PACS, a wavelet image compressor/decompressor that preserves compatibility with DICOM workstations, a Web server to distribute images throughout the enterprise, and an extensible interface which permits links between other HIS and AMICAS. Using wavelet compression and Internet standards as its native formats, AMICAS creates a bridge to the DICOM networks of remote imaging centers via the Internet. This teleradiology capability is integrated into the DICOM network and the PACS thereby eliminating the need for special teleradiology workstations. AMICAS has been installed at MGH since March of 1997. During that time, it has been a reliable component of the evolving digital image distribution system. As a result, the recently renovated neurosurgical ICU will be filmless and use only AMICAS workstations for mission-critical patient care.     

An efficient architecture to support digital pathology in standard medical imaging repositories

In the past decade, digital pathology and whole-slide imaging (WSI) have been gaining momentum with the proliferation of digital scanners from different manufacturers. The literature reports significant advantages associated with the adoption of digital images in pathology, namely, improvements in diagnostic accuracy and better support for telepathology. Moreover, it also offers new clinical and research applications. However, numerous barriers have been slowing the adoption of WSI, among which the most important are performance issues associated with storage and distribution of huge volumes of data, and lack of interoperability with other hospital information systems, most notably Picture Archive and Communications Systems (PACS) based on the DICOM standard.This article proposes an architecture of a Web Pathology PACS fully compliant with DICOM standard communications and data formats. The solution includes a PACS Archive responsible for storing whole-slide imaging data in DICOM WSI format and offers a communication interface based on the most recent DICOM Web services. The second component is a zero-footprint viewer that runs in any web-browser. It consumes data using the PACS archive standard web services. Moreover, it features a tiling engine especially suited to deal with the WSI image pyramids. These components were designed with special focus on efficiency and usability. The performance of our system was assessed through a comparative analysis of the state-of-the-art solutions. The results demonstrate that it is possible to have a very competitive solution based on standard workflows.     

SmartWADO: an Extensible WADO Middleware for Regional Medical Image Sharing

Medical image sharing is an important problem in modern radiology, with wide applications in Internet and mobile devices. Some important features need to be added and optimized to medical image sharing. In this paper, we present an extensible Web Access to DICOM Persistent Objects (WADO) middleware based on image cache and real-time Web monitor technology for regional medical image sharing. We first develop the extension method of WADO standard and workflow of extended WADO service. Then, we design a medical image cache method to improve the performance of medical image on-demand transmission. Using the real-time monitor can discover the performance bottlenecks and optimized critical points. The experimental results show that the middleware effectively delivers medical images and reports to Web clients over the Internet, regardless of the platform used for access. It can be deployed in one hospital to provide WADO service to medical workers and also can be applied to regional picture archiving and communication systems (PACS) to transmit medical images and reports to Internet users in a way that is transparent to end-user applications.     

Dicoogle - an Open Source Peer-to-Peer PACS

Picture Archiving and Communication Systems (PACS) have been widely deployed in healthcare institutions, and they now constitute a normal commodity for practitioners. However, its installation, maintenance, and utilization are still a burden due to their heavy structures, typically supported by centralized computational solutions. In this paper, we present Dicoogle, a PACS archive supported by a document-based indexing system and by peer-to-peer (P2P) protocols. Replacing the traditional database storage (RDBMS) by a documental organization permits gathering and indexing data from file-based repositories, which allows searching the archive through free text queries. As a direct result of this strategy, more information can be extracted from medical imaging repositories, which clearly increases flexibility when compared with current query and retrieval DICOM services. The inclusion of P2P features allows PACS internetworking without the need for a central management framework. Moreover, Dicoogle is easy to install, manage, and use, and it maintains full interoperability with standard DICOM services.     

The Orthanc Ecosystem for Medical Imaging

This paper reviews the components of Orthanc, a free and open-source, highly versatile ecosystem for medical imaging. At the core of the Orthanc ecosystem, the Orthanc server is a lightweight vendor neutral archive that provides PACS managers with a powerful environment to automate and optimize the imaging flows that are very specific to each hospital. The Orthanc server can be extended with plugins that provide solutions for teleradiology, digital pathology, or enterprise-ready databases. It is shown how software developers and research engineers can easily develop external software or Web portals dealing with medical images, with minimal knowledge of the DICOM standard, thanks to the advanced programming interface of the Orthanc server. The paper concludes by introducing the Stone of Orthanc, an innovative toolkit for the cross-platform rendering of medical images.     

Establishing a Web-Based DICOM Teaching File Authoring Tool Using Open-Source Public Software

Online teaching files are an important source of educational and referential materials in the radiology community. The commonly used Digital Imaging and Communications in Medicine (DICOM) file format of the radiology community is not natively supported by common Web browsers. The ability of the Web server to convert and parse DICOM is important when the DICOM-converting tools are not available. In this paper, we describe our approach to develop a Web-based teaching file authoring tool. Our server is built using Apache Web server running on FreeBSD operating system. The dynamic page content is produced by Hypertext Preprocessor (PHP). Digital Imaging and Communications in Medicine images are converted by ImageMagick into Joint Photographic Experts Group (JPEG) format. Digital Imaging and Communications in Medicine attributes are parsed by dicom3tools and stored in PostgreSQL database. Using free software available from the Internet, we build a Web service that allows radiologists to create their own online teaching file cases with a common Web browser.