1. mint-user MINT Technical Overview October 8 th, 2010

2. mint-user Agenda MINT Goals DICOM Challenges, MINT Solutions MINT Realized

3. mint-user MINT Goals Improve Transfer Speed for DICOM Studies Eliminate need for DICOM routing / application specific caches Centralize QC Logic

4. mint-user Typical Enterprise Architecture Today Acquisition Device DICOM Router PACS Archive Enterprise Viewer Server Advanced Visualization Workstation VNA DICOM PACS Workstation Proprietary Enterprise Viewer Proprietary

5. mint-user Typical Viewer and Archive Architectures Today Viewer DICOM I/O Processing / Clinical Validation Viewer (2D, 3D, etc) HL7 Data Validation/QC/Admin Archive (PACS, VNA, etc) DICOM I/O DICOM P10Calculated Data Storage Data Validation/ QC/Admin Note: Many components are duplicated which creates complexity and cost DICOM P10 Storage Web

6. mint-user DICOM Encoding Study Series DICOM has a normalized data model: But transmission is organized at the SOP Instance level: SOP Instance Pixel Data SOP Instance Pixel Data Study Series SOP Instance Pixel Data SOP Instance Pixel Data Study Series Challenge #1: When an instance is transmitted, the study and series level information Is denormalized (replicated) in each SOP Instance. This causes validation problems Challenge #2: There is no way to access the metadata (non pixel data) without pulling the pixel Data. The pixel data is 99% of the size of the study, yet not all pixel data is always required. The viewer usually needs access to all metadata to understand the study. Challenge #3: DICOM uses a custom encoder that requires a special library to understand.

7. mint-user DICOM Transport PACS Viewer Get Image #1 Return Image #1 …. Several minutes over Gig/E Once all images have been received, the viewer can figure out how to display them Get Image #2000 Return Image #2000 Challenge #4: DICOM is a chatty protocol which prevents it from fully utilizing the bandwidth available in high speed networks Challenge #5: The DICOM protocol is specific to medical imaging and does not benefit from the ongoing technology advances found in standard protocols like HTTP Get Image #2 Return Image #2

8. mint-user MINT Encoding Study Series SOP Instance Pixel Data SOP Instance Pixel Data Benefit #1: MINT matches the DICOM logical model which is normalized – no data is duplicated Benefit #2: MINT allows access to the metadata independently from the pixel data Benefit #3: MINT encodes the metadata in XML – the enterprise standard for encoding information

9. mint-user MINT Transport PACS Viewer Get Metadata Return metadata Several seconds over Gig/E Once metadata is received, the viewer can figure out what images it needs Benefit #4: MINT can fully leverage high speed networks by supporting batch requests. Individual images can also be requested (batch of size 1) to support streaming or on demand use cases Benefit #5: MINT leverages HTTP – the enterprise standard technology for information transport. This allows it to benefit from related technology advances and general understanding by IT Get Image #1-2000 Return Images #1 - 2000

10. mint-user Other MINT Features Basic search capabilities –Client can search on specific keys –Not intended to directly support workflow Changelog mechanism –Client can determine what has changed on a MINT server (new studies, images added, etc) Support for proprietary data –Client can store proprietary data (e.g. volumes, snapshots, etc) Data Dictionary –Stores the schema for each study type including normalization rules Support for modifying studies –Add, update, delete normalized entities

11. mint-user MINT Realized Improve Transfer Speed for DICOM Studies –Leverage HTTP –Separate metadata from pixel data –Batch and streaming mechanisms for pixel data Eliminate need for DICOM routing / application specific caches –Storage of non DICOM (proprietary) objects at the study level –Changelog simplifies synchronization –Query mechanism supports common on demand loading strategies Centralize QC Logic –Normalized entity modification mechanism simplifies this –Elimination of data caches results in updates only needing to take place in one location

12. mint-user MINT Study Types Metadata Binary Data Metadata Binary Data Metadata Binary Data Metadata Binary Data DICOM Vendor A ProprietaryAIM MINT is based on an extendable type system that is study oriented. One of the standardized MINT types is DICOM which specifies a mapping from DICOM to MINT encoding. Proprietary types can be added to store application specific data such as vendor specific 3D Volumes, XML documents, AIM documents, etc. MINT Study Vendor B Proprietary

13. mint-user x Logical View of the DICOM MINT Type Patient Study Metadata Includes all non binary attributes found in all DICOM SOP instances in a given study Normalized attributes according to DICOM Information Model Is accessed independently from the binary data References binary data items using their id Binary Items Can be retrieved in batch or individually Are identified by study scoped ids (bids or binary ids) Metadata Binary Data Series SOP Instances Voice Clip Image Private Attributes

14. mint-user A Study’s History Time P10 Instance 1 Instance Sequence 1 Series 1, 2 & 3 (From DICOM GW) Instance Sequence 2 Series 4 (From DICOM GW) Metadata Item Patient Name Change (From Client) Studies are not created at one single point in time New SOP Instances may be added to a study at any time Changes to existing instances may be made at any time Applications may add proprietary data to a study at any time 5 min1 Hour Patient Instance Sequence 3 Presentation State Added (From Client) 2 Days P10 Instance 2 P10 Instance 3 P10 Instance 4 P10 Instance 5 P10 Instance 8 P10 Instance 6 P10 Instance 7 P10 Instance 9 P10 Instance 10 P10 Instance 11 P10 Instance 12 P10 Instance 13 P10 Instance 14 P10 Instance 15

15. mint-user MINT Based Enterprise Architecture Acquisition Device Archive MINT PACS Workstation MINT Enterprise Viewer MINT Enterprise Viewer Server MINT Advanced Visualization Workstation MINT PACS Server MINT Proprietary

16. mint-user MINT Impact on both Architectures Viewer Processing / Clinical Validation Data Validation/QC/Admin Archive (PACS, VNA, etc) DICOM P10Calculated Data Storage MINT Viewer (2D, 3D, etc) HTTP Admin HL7DICOM I/OWeb