1. DICOM INTERNATIONAL CONFERENCE & SEMINAR Oct 9-11, 2010 Rio de Janeiro, Brazil WADO: a useful tool for remote visualization of large DICOM files Bmed. Eng. Pedro Pablo Escobar Fac. Of Engineering / Univ. Nac.del Centro Health Technologies Group

2. Introduction Increased digital medical equipment availability that produce DICOM images Applications for Computer-Aided Diagnosis (CAD) Picture Archiving and Communication Systems (PACS)

3. Web-PACS Enable to query PACS server from a Web Site Only need a WEB browser

4. Medical images Web Viewer Web browsers do not have capacity to display DICOM studies Web-PACS includes DICOM viewer Java, Flash, ActiveX

5. Medical images Web Viewer Time-to-display (TTD) Lossless Compression 1:3 Lossy Compression 1:100 Progressive image transmission (PIT) Deployment

6. Dcm-Ar: System Architecture WADO (Web Access DICOM Objects) Easy Web PACS Viewer integration

7. Dcm-Ar Client Developed in OpenLaszlo -> Flash App. Has implemented the PIT strategy

8. Dcm-Ar Client Image divided in fixed size tiles

9. Dcm-Ar Client IOPIT Interactive - Optimized PIT

10. Dcm-Ar Server Multithreads Java2EE Application. Use Dcm4Che library Run over Jetty Java Servlet Container Tasks: –get images from PACS –make image tiles –send to client requested data information and tiles –manage image data cache

11. Results Multiplatform system has developed Reduce TTD in: –14 times than RAW images –5 times than PNG (lossless) images E.g. Image 25Mb Bandwidth 512kbps ~=64 kb/s Raw400s~= 06:40 PNG80s~= 01:20 IOPIT26s~= 00:26

12. Future Works Development of Web-PACS viewer using WADO TTD strongly reduced -> IOPIT technique Suitable solution for: –rural areas with narrow Internet connections –emergency or disasters situations –remote online diagnostics Future works Build generic WEB-PACS that work with any DICOM PACS server Adapt the viewer solution for mobile devices

13. Future Works Thank You... PD1: Apologizes for my rude english... PD2: Rio is a great place for a congress PD3: you can ask me whatever you want... probably I do not have all the answers, but I can give you my email address :)

14. Authors Pedro Escobar Faculty of Engineering, UNICEN. Emanuel Arguiñarena Doths Engineering S.A. José Macchi Tsavo Group S.R.L. Mariana del Fresno PLADEMA, UNICEN. José M. Massa INTIA, UNICEN. Martin Santiago IFAS, UNICEN. Contact: pescobar@fio.unicen.edu.ar