1. Mumbai February, 16 th, 2006CHEP2006 1 Piergiorgio Cerello cerello@to.infn.it Grid Computing in Medical Applications

2. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 2 Some General Remarks…  A general approach to Medical Applications on Grids rather than a listing of existing applications  The implementation choices will not be addressed Will there ever be a standard? Or will there be interoperability? Or none of the two?  Development (or at least Deployment) must be customer driven  Authorisation & Authentication is not discussed, but obviously required, for all the use cases in the following

3. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 3 and…  Sites = Hospitals Hard to convince them to accept users from other VOs Strict rules on protected patient data  End Users = Medical Doctors Interfaces must be as user-friendly as possible Ideally, no difference between the local environment and the Virtual Organisation scale  Users = Application (e.g. Algorithm) Developers

4. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 4 Overview  Why Medical Applications on Grids?  What kind of Medical Applications on Grids?  Use Cases / Requirements  How should they look like for an (end-)user?  Some Examples (Apologies, it’s not a complete list …)  How far are we from a widespread use? What’s missing in terms of: >Infrastructure >Services #Functionality, Stability, Scalability, Interfaces #Deployment

5. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 5 Why Medical Applications?  Or… is there any added value coming from the use of Grid Services? Most likely, YES Medical Applications would benefit from the: >Availability of a large amount of computing resources #Simulations #Analysis >Capability to manage distributed Data (& MetaData!!!) #Medical Imaging #MetaData Management (Patient Record…)

6. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 6 What kind of Medical Applications?  Computing Intensive Applications Treatment planning Medical Imaging Analysis  Distributed Data Management and Analysis Medical Imaging Analysis >Mammograms >CT scans >PET/SPECT scans >MRI

7. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 7 Raw GOLEM CT-SCAN Automatically assigned materials FLUKA can embed voxel structures within its standard combinatorial geometry Transport through the voxels is optimized and efficient Raw CT-scan outputs can be imported Automatic voxel type assignment Courtesy of L. Pinsky

8. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 8 A Real Case at MGH*…  PET scans can be done immediately after therapeutic irradiation in proton beams to visualize the region in which the dose was delivered. The decay of 11 C target fragments are the source of the e + s.  Comparison of Treatment Planning Software and FLUKA Simulation for application of proton therapy to a spinal tumor.  Comparison of measurement of PMMA phantom with 2 orthogonal fields and FLUKA simulation of post irradiation PET scan. FLUKA Simulation Treatment Planning Predictions FLUKA Actual Measurement K. Parodi, H. Paganetti and T. Bortfeld, MGH Massachusetts General Hospital Courtesy of L. Pinsky

9. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 9 Use Cases / Requirements  Treatment Planning / Feedback And, in general, any simulation-based application >Small Input >Large Computing Capacity (possibly parallel) >No requirements on DB access >No use of Protected Data

10. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 10 6 - Send results 4 - Transfer Image 3 - Ask for Execution 5 - Run algorithm Computing Element GRID Service Provider Image Analysis on demand 1 - Data Acquisition 2 - Data Registration Computing Element Storage Element Client

11. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 11 Use Cases / Requirements  Single Image Analysis / Computer Assisted Detection (CAD) on demand (clinical practice) Local Client - Graphic User Interface >Storage & Computing Element Grid Provider >Computing Element >Network bandwidth It could be the access mode for small / medium hospitals

12. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 12 GRID Service Provider Teleradiology & Epidemiology 1 - Data Selection 4 - Remote Analysis 3 - Spawn/Submit Processes 5 - Analyze/Retrieve Selected Image(s) 2 - Start Analysis Client

13. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 13 Use Cases / Requirements  Teleradiology (training or clinical practice) Clients - Graphic User Interface >Storage & Computing Element Grid Provider >Computing Element >Data & MetaData Catalogue (also Protected Data!) >Distributed Analysis Capability (dynamic) >File Transfer, Network bandwidth (in case you must transfer images)

14. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 14 Use Cases / Requirements  Epidemiology Studies Local API to the Data & MetaData Catalogue >Queries + Local Analysis Grid Provider >Data & MetaData Catalogue (also Protected Data!)

15. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 15 Screening (breast, lung) CAD selection to minimize data transfers Data Collection CentreDiagnostic Centre 1 - Data Collection 2 - Data Registration 3 - Run CAD remotely 4 - Transfer Selected Data 5 - Interactive Diagnosis GRID Service Provider

16. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 16 Use Cases / Requirements  Screening Programs All >Network bandwidth (in case you must transfer images) Data Collection Clients >Graphic User Interface to Data Acquisition and Registration >Storage & Computing Element >File Transfer Data Analysis Clients >Graphic User Interface to Data Mining & Retrieval >File Transfer >Local Analysis Grid Provider >Job Submission >Data & MetaData Catalogue (also Protected Data!)

17. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 17 Image Comparison-based Statistical Analysis WEB Portal UPLOAD IMAGE to be analysed (PET or SPECT) SET of CONTROLS 1 (PET, SPECT IMAGES) SET of CONTROLS 2 (PET, SPECT IMAGES) SET of CONTROLS 3 (PET, SPECT IMAGES) SET of CONTROLS n (PET, SPECT IMAGES) STATISTICAL TOOL (SPM) STATISTICAL ANALYSIS RESULTS

18. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 18 Use Cases / Requirements  Distributed Analysis by Image Comparison Client >Web Access Grid Provider >Secure Web Portal >Data & MetaData Catalogue (also Protected Data!) >Distributed Analysis Capability (static?) #The comparison database is slowly changing

19. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 19 The End User’s View…  Distributed Data (Image) Analysis Patient history (query to the MetaData Catalogue) >Protected data accessible only #if the patient code is known #if owned (i.e., registered in the catalogue) by the user who sends the query Exam Comparison (download the previous exam(s)) >Transparent from the local application GUI An example: >Mammogram analysis (MAGIC-5/INFN)

20. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 20 Query on Patient Data Find (& Retrieve) Exams An example of a GUI to Grid Services Login: User Authentication Register a new Exam (& Patient) in the Data Catalogue MAGIC-5 Analysis Station

21. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 21 The Algorithm Developer’s View…  Distributed Data Analysis Larger DataBase Opportunity to improve the analysis algorithm performance No requirements on Patient protected data But the set of exam-related MetaData must include all those that are needed to train the algorithm

22. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 22 Search for Images matching a set of requirements

23. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 23 User Community  Is there a coordinated community of Grid Medical Application developers? In Europe >EGEE-BioMed could be an embrio >HealthGrid conference every year >… In the US >Biomedical Informatics Research Network (BIRN) >… In Asia >medGRID project >… … should the coordination move to a global scale?

24. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 24 The EGEE-BioMed VO  GATE Radiotherapy planning for improving the treatment of cancer by ionizing radiations of the tumours Computed from pre-treatment MR scans by simulating radiation doses applied to the patient  Pharmacokinetics Contrast Agent Diffusion can characterize tumour tissues without requiring biopsy Co-registration & Analysis of a time sequence of MRI volumetric images generation of diffusion maps for the 3D MRI Studies Courtesy of J. Montagnat

25. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 25 The EGEE-BioMed VO  SiMRI3D Better understand MR physics Validate MR Image processing algorithms on synthetic yet realistic images  gPTM3D Interactive tool for 3D segmentation and volume reconstruction and measurement Reconstruction of complex organs (e.g. lung) or entire body from modern CT-scans Courtesy of J. Montagnat

26. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 26 e-Diamond, MAGIC-5, Mammogrid  a European(Nation)-wide database of mammograms pool and distribute information on breast cancer treatment enable early screening and diagnosis MAGIC-5

27. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 27 MAGIC-5  Development of Lung CT Computer Assisted Detection algorithms based on artificial intelligence techniques  Reconstruct bronchial and vascular tree, remove, look for nodules MAGIC-5

28. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 28 How far are we from…  Research Working prototypes? Many have been (are being) developed for the different kinds of applications  Service in Hospitals? It could be easily implemented for simulation-based application (small input, large amount of computing) >All you need is a (Web) GUI to configure and submit jobs Some (a lot?) more work for distributed data management and (interactive) analysis >What is missing in terms of…

29. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 29 in terms of…  Infrastructure Network Bandwidths are not uniform >Minimise Data Transfers Many more sites for a EU-, US- or XX-wide HealthGrid compared to HEP Grids >Deployment Issue  Services / Functionality Focus on MetaData management (with special attention to protected MetaData!) Develop a Storage Element interface to the standard storage tools used in Hospitals

30. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 30 in terms of…  Stability To be improved, but not the biggest issue in my opinion >The target will (have to) be achieved for LCG fits HealthGrid requirements  Interfaces Ideally the use of Grid Services should not turn into additional complexity for the End-User >Everything must happen behind the scene #Hidden by: »a Web Interface »a Local Graphic User Interface #Depending on the kind of Application

31. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 31 Scalability / Deployment Model  It MUST be efficient in order to be economically sustainable >Easy service installation & configuration >Ideally: one VO, one administrator  One (“The”) Grid vs. many Grids… Remember: hospitals are very strict about data access My personal experience: No Hospital we collaborate with would accept data access/resources sharing by users from other applications (it is actually difficult to convince them to grant access to users of the same VO)  At least for now: one VO, one Grid instantiation  If we will have a standard and cross validation of applications, it will be easy to merge them

32. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 32 Deployment Topology VO Grid Server System Configuration Users Database Data & MetaData Catalogue File Transfer Service Monitoring Server Master Server Distributed cluster access Other… Compute Element Storage Element File Transfer Service Monitoring Client Worker Client Application Node VO Client Node VO Client Node VO Client Node VO Client Node VO Client

33. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 33 How far should HEP go?  working prototypes offered to the “end users” should be a reasonable achievement  after that, HEP should hand them to other entities which will take care of expanding them and turning them into Services, acting as Grid Services Providers  In my opinion, that would be the metric of success

34. P. Cerello Grid Computing in Medical Applications CHEP2006 Mumbai, February. 16 th, 2006 34 If you fell asleep, it’s time to wake up :-)