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Application Hosting


									Lawrence Tarbox, Ph.D.
Washington University in St. Louis School of Medicine
Mallinckrodt Institute of Radiology, Electronic Radiology Lab

Provocative Statement

DICOM WG-23 hopes to fundamentally change
the way the medical imaging world thinks in
regards to the distribution and deployment of
medical imaging applications.
Status Quo

 Medical imaging workstations generally are
  closed systems.
 There is no common, standardized method
  for adding new functionality to a medical
 The key stakeholders who wish to see new
  functionality added often are not the
  workstation provider.
 New ‘cool’ tools often require adding entire
  workstations to a site’s infrastructure.
From the SIIM 2007
Workflow Demonstrations

 Cardio Workflow – Dr. Anwer Quershi
  “… going back and forth to various workstations and
  the use of different equipment is disruptive and
  slows treatment …”
 Nuclear Workflow – Dr. Eliot Siegel
  “... This case illustrates the disruptions that can be
  introduced due to multiple systems and the need to
  go back and forth. ...”
A Brave New World?

Separate the provision of infrastructure from
the application.
 Infrastructure providers concentrate on the
  movement and storage of data and results,
  and on workflow management.
 Application providers concentrate on the
  processing and analysis of that data,
  providing results back to the infrastructure.
Minimize the ‘reinvention of the wheel’.
Proposed Solution

 Create a mechanism where applications
  written by one party could be launched and run
  on systems created by multiple other parties.
 Allow launched applications to efficiently
  access images and other resources controlled
  by the hosting system.
 Provide a framework for exchanging
  information about those applications.
 Support both research and clinical
Typical Plug-in Concept

  A     B     C       D

             E            F
 DICOM WG-23 Goal
Portable applications that ‘plug into’ any host that
implements the standardized ‘socket’

                                                   any WG23 Host


                     Cedara         Advantage
Idealized Goals

A Standardized API that is:

 Easy to learn and use
 Language independent
 Platform independent
 Based on publicly available technology
 Extensible
 Secure
Reality Check

“Life is a compromise”
 Language and platform independence often
   translates into reduced performance.
 Choice of development environment often
   restricts portability.
The real goal is to come as close to the ideal as
practical, and minimize the impact where we
fall short. Take one step at a time.
Suggested Staging

 Stage one – Access to DICOM Datasets and
  Results Recording
 Stage Two – Access to Non-Interactive
  Application Services (e.g. print, archive)
 Stage Three – Access to Interactive Application
  Services (e.g. GUI, ‘skins’, rendering)
 Stage Four – Standard Workflow Descriptions,
  and Interactions Between Hosted Software
Targets for Stage One

 Basic Launch and Control of a Hosted
   Load, Unload, Start, Abort
 Simple Interchange of Data Between a Hosting
  System and Hosted Applications
   File-based data exchange for existing applications
   Model-based data exchange for new applications
 Manual Configuration
 Java and .net technology bindings
Model-Based Data Exchange

                        Data Subset

  Data     Conversion     Native
 Objects                   Data

                         Bulk Data
                        (e.g. voxels)
Abstract vs. Native Models
 Abstract Models
   Includes data common to multiple formats
    (e.g. DICOM, Analyze)
   Application need not know the format of the native
   Does include references to the native data from which
    the abstract model was derived
 Native Models
   Gives full access to all information available in the
    native data
   Allows an application to just access those parts of the
    native data that are of interest
 Bulk Data Access
   File name (URI) plus offset (for performance)
Pushing for Adoption

 Standardization being done via DICOM with
  participation from both medical imaging
  vendors and users
 Open-source, commercial friendly reference
  implementation being created
   XIP – the eXtensible Imaging Platform
 WG-23 participants (vendors and the XIP
  developers) exchange test implementations
  to insure interoperability
       WG23 / XIP Relationship
      WG-23 addresses clinical integration
       and vendor inter-operability by
       defining standardized “plugs” and
       “sockets” (APIs)                                                        XIP developed
      caBIG XIP addresses an open-
       architecture, open-source, integrated
       environment for rapid application                        Standard API
       development based on
       WG 23 APIs

Commercial Vendor #1     Commercial Vendor #2   Unix, Mac, PC                  Internet Server

                  Clinical                       Prototype & Collaboration 
What is the                                  ?
 The eXtensible Imaging Platform (XIP™) is the image
    analysis and visualization tool for caBIG.
   XIP is an open source environment for rapidly
    developing medical imaging applications from an
    extensible set of modular elements.
   XIP may be used by vendors to prototype or develop
    new applications.
   Imaging applications developed by research groups will
    be accessible within the clinical operating
    environment, using a new DICOM Plug-in interface first
    implemented in XIP.
   XIP serves as a reference implementation of the DICOM
    WG-23 Application Hosting interfaces.
Major Parts of the

 XIP Reference Host
 XIP Libraries
 XIP Reference Applications

 XIP Development Tools

The top 3 combine to form an XIP
XIP Application Builder                                                                 Medical Imaging
                          XIP Development Process

                                      XIP Application
                          XIP Modules
                          Host Independent                                                   Web-based
                                                        XIP Host Adapter                     Application

                                      XIP LIB

                                                       WG    WG    WG      WG
                                                       23    23    23      23   Distribute
                            XIP Host
                          (Can be replaced with
                          any DICOM WG23-       Host-Specific Plug-in Libs
                          compatible Host)
                          DICOM, HL7, & other         caGRID Services via
                          services per IHE            Imaging Middleware


  XIP Class Library
  Auto Conversion Tool
 An Application
Developer may
   use the XIP
   Builder tool
 from Siemens
  Research to
create the app’s
  scene graph
and processing
 pipelines from
  XIP Libraries
  The XIP Builder
tool can be used to
test and debug the
   scene graph
  controls the
scene graph by
 creating a GUI
 program (e.g.
via Java Swing)
• Provides the infrastructure in which XIP or DICOM WG-23 Applications run
       • Authenticates user
       • Manages installation, launching, and termination of XIP Applications
       • Provides data and services to XIP Applications
       • Accepts status information and results back from XIP Applications
       • Deals with auditing and controls access to services and data
• Isolates the XIP application from the nature of databases, archives, networks,
  and possibly image data formats
       • Manages access to DICOM networks, objects, and services
       • Creates Abstract Models from input data
• Handles workflow issues
       • IHE General Purpose Worklist support
• Supports any application that follows the
  DICOM WG-23 Application Hosting
  Interface Standard

 XIP provides the ability to create rapidly create
  applications customized to specific tasks.
 The DICOM WG-23 Application Hosting interfaces
  allow those applications to run on any workstation
  that supports the standard interfaces
   XIP includes a reference host implementation
   Other vendors may eventually host applications
 XIP with DICOM WG-23 represent new paradigm for
  writing and distributing medical imaging

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