Medical Image Resource Center

What is MIRC? Medical Image Resource Center Makes it easier to locate and share electronic medical images and related information –On your PC –In your Department –Throughout the world

MIRC: Why? MIRC can help: –Teaching and decision support in clinical patient care –Make research databases more freely available to the imaging community –Clinical trials

The Evolution of MIRC Originally conceived as a large database of images and related clinical information that would be maintained by the RSNA on one or more large servers for free access by the medical imaging community

The Evolution of MIRC It soon become clear to us that a more effective strategy would be to: Create a standard that would tie together virtual communities of new and existing medical image libraries

Key MIRC Concepts Libraries cooperate by supporting a common query mechanism. A Query mechanism allows users to find information within these libraries MIRC supports multiple information storage formats

MIRC Libraries MIRC libraries archive a wide variety of text, images, and other multimedia information –Teaching files –Research and reference image repositories Collection of disease specific radiographs Normal variants Functional brain MR data sets Clinical trials images and related data Journal articles Textbooks PowerPoint and other types of presentations

MIRC Components Query Service Entry point into the MIRC community for a user on the Internet, Query service can be created by site using the MIRC query schema.

MIRC Components Storage Service: Cooperating information library – a web archive or a database, designed to support the MIRC query mechanism. Index: The librarys card catalog – an XML document that identifies content of a storage service. Server: The librarys shelves – where the content of a MIRC site is stored or saved.

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

MIRC Query Service: User Fills in Query Form Need a new slide with Bobbys new Query page

MIRC Query Results: Displays Hits from MIRC Sites Need a new slide with Bobbys new Query Results page

MIRC Teaching File Display: MIRC-TF Display Format Maybe two or three screen shots in a stack showing the different display modes

MIRC Authoring Tools One or two slides showing the author service screens

MIRC Clinical Trials Features Image acquisition from modalities and PACS Image and metadata anonymization Secure image and metadata transport Automatic storage and indexing of all data, with the standard MIRC search and display functions Interfacing to external databases for trial- specific analysis

FC DICOM FC DICOM FC DICOM PI DICOM PI DICOM MIRC Clinical Trial Configuration Modalities MIRC FieldCenter Application: - Image reception - Anonymization - Transmission to PI Workstations MIRC Site: - Image reception - Image Storage - Transfer to PACS and/or workstations Firewalls Internet HTTP HTTPS

MIRC in Clinical Trials Comment on the NCI plans Comment on other current trials using MIRC Something to show how MIRC is being used in clinical trials.

Open Source Project All source code is available on-line –Zip archive through the RSNA MIRC site –CVS repository Actively maintained MIRC project list MIRC user meeting at RSNA2005 –Monday 1:30-3:00 E262 –Thursday 12:30-2:30 E257

The RSNA Teaching File Plans for the RSNAs teaching file system, based on MIRC

How to Participate? Use MIRC to perform searches for images and information Be an author Set up a MIRC site: –Connect your existing Teaching File system –Build your own Teaching File system: Use the RSNA MIRC Site implementation Use someone elses Come up with your own and make it MIRC compatible

Need More Information? Go to There is a link to Downloads where you can find all the documents, software and installation instructions for setting up a MIRC site and creating content.

The rest of the slides are from the board presentation in case you might want to get some information from them

1. Public Internet MIRC Sites Casimage (Switzerland) Indiana University Mallinckrodt MedPix [RSNA] MyPACS National MIRC (Singapore) Thomas Jefferson University [RSNA] University of California at San Francisco University of Padova (Italy) [RSNA] GlobalRad

1. Private Intranet MIRC Sites Bundeswehrzentralkrankenhaus Koblenz (Germany) Children's Hospital of Philadelphia Children's Hospital of Northwestern University Cleveland Clinic Geisinger Clinic Mallinckrodt Institute of Radiology (research dataset acquisition) Mass General (connected with University of Dusseldorf) University of Alabama at Birmingham University of California at San Diego University of Dusseldorf University of Maryland University of Michigan (the largest site running RSNA code) University of Pennsylvania (MJR Veterinary Hospital)

1. Far East MIRC Sites National University Hospital, Singapore Tan Tock Seng Hospital, Singapore National Neuroscience Institute, Singapore [ leader in the Far East ] Taiwan PRC

2. NCI Collaboration Successful demonstration in early 2005 Support of current trials (RIDER, LIDC) Decision to use MIRC in caBIG I2 project Development of MIRC extensions to support the NCI imaging database

3. ACR Discussions ACRIN clinical trials process for anonymizing and transferring images and associated data Maintain consistency with NIH-NCI MIRC methodology Major role in sharing of images and documentation for the review process in accreditation programs

Clinical Trials – WHIMS [1] University of Pennsylvania (PI) Wake Forest University (PI) Central Massachusetts Imaging Center Froedtert Pavilion Jacksonville Medical Imaging Montefiore Medical Center Reno Diagnostic Imaging Center

Clinical Trials – WHIMS [2] Stanford University The Ohio State University University Diagnostics MC (NY) University of California at Davis University of California at Los Angeles University of Iowa University of Florida

Clinical Trials – WHIMS [3] University of Minnesota University of North Carolina at Chapel Hill University of Pittsburgh

Clinical Trials - WHI CT Study WHI – Womens Health Initiative CT Study – –30 Field Centers in all –Sites using MIRC for transport: Wake Forest University (PI) Northwestern University and University of Illinois University of Alabama at Birmingham Kaiser (USCF) at Walnut Creek University of Minnesota –All 30 sites images are entered into the PI MIRC site and processed.

Clinical Trials - CARDIA Coronary Artery Risk Development in Young Adults –Wake Forest University (PI) –Northwestern University and University of Illinois –University of Alabama at Birmingham –Kaiser (USCF) at Walnut Creek –University of Minnesota

Clinical Trials – RIDER Reference Image Database to Evaluate Response to Therapy –National Cancer Institute (PI) –Cornell University –MD Anderson Cancer Center –Memorial Sloan Kettering –University of California at Los Angeles –University of California at San Diego –University of Chicago –University of Iowa

Other Trials Using MIRC CIREN – Crash Injury Research & Engineering Network –Wake Forest (PI) CAMPS – Carotid Atherosclerosis MRI Progression Study –University of Washington (PI) ACCORD – Action to Control Cardiovascular Risk in Diabetes –Case-Western University was used to test interfacing MIRC with ACRIN

Research Dataset Acquisition MIRC feature developed with Mallinckrodt Institute of Radiology Allows internal researchers to acquire DICOM images from modalities, store and manage them without using the clinical PACS –Bridges internal networks –Tracks access of PHI for HIPAA compliance

Research Dataset Acquisition Sites Mallinckrodt Institute of Radiology Wake Forest University –GCRC – WFUBMC General Clinical Research Center –CBI – WFUSM Center for Biomolecular Imaging –BME – WFUSM Dept Biomedical engineering –SBES – VT-WFU School of Biomedical Engineering and Sciences –WFUBMC – WFU Baptist Medical Center –Rad – WFUSM Dept of Radiology Oakland