1. Decentralized Access to Medical Images in Research and Enterprise PACS Tomáš Kulhánek, Milan Šárek (tomaton@centrum.cz, ms@cesnet.cz)tomaton@centrum.czms@cesnet.cz TERENA NETWORKING CONFERENCE 2008

2. CESNET Czech NREN

3. Overview Sharing Medical images Decentralized solution based on grid

4. Data form and protocol – DICOM (Digital Imaging and Communications in Medicine) Storage, data flow – PACS (Picture Archiving and Communication Systems) Systems for medical image sharing

5. Sharing within 1 hospital or institution - PACS Sharing among (more than 1) institutions Secured communication User authorization Centralized systems MeDiMed (ICT, Masaryks University in Brno) Communication centre for sharing data ReDiMed (ICT, Masaryks University in Brno) ePACS (ICZ a.s.) Storage and communication distributed in grid Globus MEDICUS Medical Data Manager

6. MeDiMed Metropolitan Digital Imaging System in Medicine Central storage of medical images Located in Brno Connects hospitals and institutions Productive running & education

7. Distributed PACS - ReDiMed Server Servis Konzola Instituce Servis Konzola - Client software connects to local DICOM & PACS - Digital signature, asymetric encryption - Server works as message broker - ICT, Masaryks University in Brno - www.medimed.cz/redimed.htm www.medimed.cz/redimed.htm

8. ReDiMed

9. Example of enterprise distributed PACS - ePACS Software & hardware client DICOM over VPN (virtual private network) www.epacs.cz

10. General problem with central element network topology degrades to star topology

11. Load balancing Load balancing among homogenous nodes

12. decentralization Storage and services distributed in heterogenous network

13. Globus MEDICUS – DICOM over Grid DICOM Grid Interface Service - Gateway Meta Catalog Service Storage Service Provider Meta Catalog Service Gateway

14. Globus MEDICUS in CESNET Test nodes on high speed CESNET network Central Military Hospital, Charles University, MeDiMed

15. Globus MEDICUS - positives Data grid Standard based WSRF, OGSA SOA based Extending system with additional services (computational service) Existing open source implementation Globus toolkit, DICOM Grid Interface Service Repair or customize existing functionality

16. Issues DICOM images in several nodes Strong encryption Access to foreign DICOM images Federated authorization - Shibboleth Grid under-utilized in most real use cases

17. Plans for the future Enhance existing topology of local/metropolitan centralized systems Interconnect several existing local/metropolitan systems Education – live anonymized studies on current patients Enhance data grid with computational functionality

18. References http://dev.globus.org/wiki/Incubator/MEDICUS http://medicus.cesnet.cz

19. Thank you for your attention Tomáš Kulhánek tomas.kulhanek@hp.com Milan Šárek ms@cesnet.cz