Abstract
Purpose
Healthcare institutions worldwide have adopted picture archiving and communication system (PACS) for enterprise access to images, relying on Digital Imaging Communication in Medicine (DICOM) standards for data exchange. However, communication over a wider domain of independent medical institutions is not well standardized. A DICOM-compliant bridge was developed for extending and sharing DICOM services across healthcare institutions without requiring complex network setups or dedicated communication channels.
Methods
A set of DICOM routers interconnected through a public cloud infrastructure was implemented to support medical image exchange among institutions. Despite the advantages of cloud computing, new challenges were encountered regarding data privacy, particularly when medical data are transmitted over different domains. To address this issue, a solution was introduced by creating a ciphered data channel between the entities sharing DICOM services.
Results
Two main DICOM services were implemented in the bridge: Storage and Query/Retrieve. The performance measures demonstrated it is quite simple to exchange information and processes between several institutions. The solution can be integrated with any currently installed PACS-DICOM infrastructure. This method works transparently with well-known cloud service providers.
Conclusions
Cloud computing was introduced to augment enterprise PACS by providing standard medical imaging services across different institutions, offering communication privacy and enabling creation of wider PACS scenarios with suitable technical solutions.
Article PDF
Similar content being viewed by others
Explore related subjects
Discover the latest articles, news and stories from top researchers in related subjects.Avoid common mistakes on your manuscript.
References
Huang HK (2004) PACS and imaging informatics: basic principles and applications. Wiley & Blackwell, Hoboken
DICOM-P18 (2009) Digital imaging and communications in medicine (DICOM), Part 18: Web Access to DICOM Persistent Objects (WADO). National Electrical Manufacturers Association
Rimal B, Choi E (2009) A Conceptual approach for taxonomical spectrum of cloud computing. Ubiquitous information technologies & applications. In: ICUT ’09—proceedings of the 4th international conference Fukuoka, pp 1–6
Rosenthal A, Mork P, Li MH, Stanford J, Koester D, Reynolds P (2010) Cloud computing: a new business paradigm for biomedical information sharing. J Biomed Inform 43(2): 342–353
Huang HK (2010) PACS and imaging informatics: basic principles and applications. 2nd edn. New Jersey, Wiley & Blackwell, Hoboken
Vaquero LM, Rodero-Merino L, Caceres J, Lindner M (2008) A break in the clouds: towards a cloud definition. ACM SIGCOMM Comput Commun Rev 39(1): 50–55
Ribeiro LS, Bastião L, Costa C, Oliveira JL (2010) EMAIL-P2P GATEWAY to distributed medical imaging repositories. In: HealthInf. Valencia: Spain
Hajjat M, Sun X, Sung Y-WE, Maltz D, Rao S, Sripanidkulchai K, Tawarmalani M (2010) Cloudward bound: planning for beneficial migration of enterprise applications to the cloud. SIGCOMM Comput Commun Rev 40(4): 243–254
Amazon Simple Storage Service. https://s3.amazonaws.com/ Available in: June 2011
Google App Engine (GAE). http://code.google.com/appengine/Available in: June 2011
Windows Azure Platform. http://www.microsoft.com/windowsazure/ Available in: June 2011
Weisser G, Engelmann U, Ruggiero S, Runa A, Schr^ter A, Baur S, Walz M (2007) Teleradiology applications with DICOM-e-mail. Eur Radiol 17(5): 1331–1340
Hernandez JA, Acuna CJ, de Castro MV, Marcos E, López M, Malpica N (2007) Web-PACS for multicenter clinical trials. Inf Technol Biomed IEEE Trans 11(1): 87–93
Yang C, Chen C, Yang M (2010) Implementation of a medical image file accessing system in co-allocation data grids. Future Gener Comput Sys 26(8): 1127–1140
Sharma A, Pan T, Cambazoglu BB, Gurcan M, Kurc T, Saltz J (2009) VirtualPACS–a federating gateway to access remote image data resources over the grid. J Digit Imaging 22(1): 1–10
Liu BJ, Zhou MZ, Documet J (2005) Utilizing data grid architecture for the backup and recovery of clinical image data. Comput Med Imaging Graph 29(2–3): 95–102
Huang H, Zhang A, Liu B, Zhou Z, Documet J, King N, Chan L (2005) Data grid for large-scale medical image archive and analysis. ACM, New York, NY, USA pp 1005–1013
Chen C, Wang W (2010) Implementation of a medical image file accessing system on cloud computing. In: Computational science and engineering (CSE). Hong Kong, China
(IHE) ItHE: Cross-Enterprise Document Sharing for Imaging (XDS-I)
Ribeiro LS, Costa C, Oliveira JL (2011) Current trends in archiving and transmission of medical images, medical imaging. In: Erondu OJ (ed) In tech. ISBN 978-953-307-774-1
Zhang J, Zhang K, Yang Y, Sun J, Ling T, Wang G, Ling Y, Peng D (2011) Grid-based implementation of XDS-I as part of image-enabled EHR for regional healthcare in Shanghai. Int J Comput Assist Radiol Surg 6(2): 273–284
DICOM-P7 (2009) Digital Imaging and Communications in Medicine (DICOM), Part 7: message exchange. National Electrical Manufacturers Association
Pianykh OS (2008) Digital imaging and communications in medicine (DICOM): a practical introduction and survival guide. Springer, Berlin
Osirix DICOM Viewer. http://www.osirix-viewer.com/ Available in: 2011
Ratib O, Rosset A (2006) Open-source software in medical imaging: development of OsiriX. Int J Comput Assist Radiol Surg 1(4): 187–196
DCMTK http://dicom.offis.de/ Available in: (2011)
Conquest DICOM Software. http://ingenium.home.xs4all.nl/dicom.htmlAvailable in: June 2011
PubNub. http://www.pubnub.com/. Available in: June 2011
Costa C, Ferreira C, Bastião L, Ribeiro L, Silva A, Oliveira J (2010) Dicoogle-an Open Source Peer-to-Peer PACS. J Digit Imaging 24(5): 848–856
Ribeiro LS, Costa C, Oliveira JL. A proxy of DICOM services. In: SPIE Medical Imaging. Diego, CA, USA, 76280L
Marcus DS, Olsen TR, Ramaratnam M, Buckner RL (2007) The extensible neuroimaging archive toolkit. Neuroinformatics 5(1): 11–33
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Silva, L.A.B., Costa, C. & Oliveira, J.L. DICOM relay over the cloud. Int J CARS 8, 323–333 (2013). https://doi.org/10.1007/s11548-012-0785-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11548-012-0785-3