mirc clinical trials medical imaging resource center
TRANSCRIPT
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MIRC Clinical TrialsMIRC Clinical Trials
Medical Imaging Resource CenterMedical Imaging Resource Center
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RSNA2006 MIRC CoursesRSNA2006 MIRC Courses
Overview of the RSNA MIRC Software
Installing MIRC on Your Laptop
Using MIRC for Clinical Trials
Hands ON: Using the RSNA Teaching File
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MIRC Project ObjectiveMIRC Project Objective
Support the production, storage, indexing and distribution of medical imaging resources:
– Teaching files– Scientific & technical documentation– Research images & datasets– Clinical trials data
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MIRC ConceptsMIRC Concepts
The key concepts:– MIRC is a community of cooperating libraries
on the Internet.– The libraries cooperate by supporting a
common query mechanism.– The query mechanism allows users to find
information wherever it is stored.
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The RSNA MIRC SoftwareThe RSNA MIRC Software
Query Service
Storage ServiceDocument index and storage
Author services
DICOM services
File ServicePublic and private file cabinets
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XMLServerXMLServer
OS FileOS FileSystemSystem
InputInputQueueQueue
StorageStorageServiceService
MIRCMIRCIndexIndex
AdminAdminServiceService
AuthorAuthorServicesServices
FileFileServiceService
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Pro
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MIRCMIRCAnonymizerAnonymizer
DICOMDICOMImportImport
QueryQueryServiceService
MIRC Site ServicesMIRC Site Services
SubmitSubmitServiceService
ZipZipServiceService
TCETCEServiceService
HTTPHTTPExportExport
HTTPHTTPImportImport
DICOMDICOMExportExport
DICOMDICOMImportImport
MIRCMIRCAnonymizerAnonymizer
DatabaseDatabaseExportExport
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DICOM ServiceDICOM Service
Receives DICOM objects from PACS, workstations, modalities, …Automatic document generation
– Images grouped into documents by study– Template-driven– Automatic JPEG generation from DICOM– Programmable anonymization (de
identification and re-identification)
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DICOM ServiceDICOM Service
Automatic trial patient ID generationConnection to other DICOM Services for clinical trials
– Support for encrypted communications (SSL)
DICOM import / DICOM exportHTTP(S) import / HTTP(S) exportDatabase export
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Database InterfaceDatabase Interface
Links to an externally developed database
Provides classes for interrogating:– DICOM objects– Metadata files:
• XML• ZIP (with manifest)
Anonymization for DICOM and XML objects
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FCDICOM
FCDICOM
PIDICOM
MIRC Clinical Trial Data FlowMIRC Clinical Trial Data Flow
FieldCenter Application:- Image reception- Anonymization- Transmission to PI
MIRC Site:- Image reception- Image Storage- Transfer to PACS and/or workstations
Database
HTTP
InternetHTTP / HTTPS
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Anonymization & Anonymization & PseudonymizationPseudonymization
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Real-World Data ModificationReal-World Data Modification
• Anonymization– Removal of PHI– Replacement of PHI with values that are the
same for all patients
• Pseudonymization– Replacement of PHI with values that are
specific to the patient and the trial but which are not available anywhere else
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PseudonymizationPseudonymization
Element types– Patient ID– Dates
• Birth• Study
– UIDs– Accession, non-unique IDs
Central vs distributed remapping
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The HIPAA 18The HIPAA 18
1. Name 2. Location; all geographic subdivisions smaller than a state, including street
address, city, county, precinct, zip code, and their equivalent geocodes. 3. Dates (all dates related to the subject of the information, e.g. birth dates,
admission dates, discharge dates, encounter dates, surgery dates, etc.) 4. Telephone numbers 5. Fax numbers 6. Electronic mail addresses 7. Social security numbers 8. Medical record numbers 9. Health plan beneficiary numbers 10. Account numbers 11. Certificate / license numbers 12. Vehicle identifiers and serial numbers, including license plate numbers 13. Device identifiers and serial numbers 14. Web Universal Resource Locators (URLs) 15. Internet Protocol (IP) address numbers 16. Biometric identifiers, including finger and voice prints 17. Full face photographic images and any comparable images 18. Any other unique identifying number, characteristic, or code
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Anonymizer ScriptingAnonymizer Scripting
• Modality-specific
• Manufacturer-specific
• MIRC-defined script languages– DICOM– XML
• Shared remapping tables– Self-consistency
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DICOM AnonymizationDICOM Anonymization
Parameter access@param(@ParameterName)
Date/time@date(separator) @time(separator)
Element access@contents(ElementName) @contents(ElementName,"regex") @contents(ElementName,"regex","replacement")
Element creation and deletion@require() @require(ElementName) @require(ElementName,"default value") @empty() @blank(n) @remove() @keep()
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DICOM AnonymizationDICOM Anonymization
Special purpose data modification@initials(ElementName) @scramble(ElementName,word1skip,word1take,word2skip,word2take,...) @alphabetichash(ElementName,maxCharsOutput) @alphabetichash(ElementName,maxCharsOutput,maxWordsInput) @numerichash(ElementName,maxCharsOutput) @numerichash(ElementName,maxCharsOutput,maxWordsInput) @ptid(siteid,ElementName,prefix,first,width,suffix) @ptid(@SITEID,ElementName,@PREFIX,first,width,@SUFFIX) @hashptid(siteid,ElementName,prefix,suffix) @hashptid(@SITEID,ElementName,@PREFIX,@SUFFIX) @offsetdate(siteid,ElementName,basedate) @offsetdate(@SITEID,ElementName,@BASEDATE) @incrementdate(ElementName,incInDays) @round(ElementName,groupsize) @round(ElementName,@ParameterName)
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DICOM AnonymizationDICOM Anonymization
UID functions@uid(root,ElementName) @uid(@UIDROOT,ElementName) @hashuid(root,ElementName) @hashuid(@UIDROOT,ElementName)
Non-unique identifier functions@accession(ElementName) @id(ElementName) @integer()
Conditional functions@if(ElementName,exists){true clause}{false clause} @if(ElementName,isblank){true clause}{false clause} @if(ElementName,matches,"regex"){true clause}{false clause} @quarantine() @skip()
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XML AnonymizationXML Anonymization
Comment: #comment
Identifier: $name
Path: /tag[n]/.../tag[n]/…/@attr
with wildcards [*]
Methods:Remapping: $uid( expression )Creation: $require( expression )Destruction: $remove()Debugging: $print( expression )
Expression: path “text” identifier $method() etc.
Assignment: identifier = expression
path = expression
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Mapping / HashingMapping / Hashing
• Central vs local mapping– Central mapping is more controlled, but it
requires that PHI be kept at the PI’s site.– Local mapping is more susceptible to data
loss, but has a different security profile.
• Hashing– Very convenient in a multi-center trial and
very secure, but inversion can only be done through a dictionary attack.
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Data Formats:Data Formats:Beyond DICOMBeyond DICOM
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Clinical Trial Data FilesClinical Trial Data Files
•Images
– DICOM, multi-media
•Text data
– XML
•Trial-specific file collections
– Zip
•Undefined file type
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Data Object ClassesData Object Classes
• FileObject• File management methods• Common data access methods overridden by
subclasses:– getUID– getStudyUID– getDescription
– Subclasses• DicomObject
• XmlObject
• ZipObject
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DicomObjectDicomObject
• Encapsulates a DICOM file
• Key methods:– getMircImage– getBufferedImage– getElementValue– 41 methods in all
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XmlObjectXmlObject
• Encapsulates an XML file
• Key methods:– getDocument– getText– getDocumentElementName– getValue– 7 methods in all
• Problem: lack of standardization for UID, StudyUID, and Description
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ZipObjectZipObject
• Encapsulates a zip file containing:• An XML file named manifest.xml
– MIRC-defined schema for key elements
• Any other files
• Key methods:– getManifestDocument– getEntries– extractFile– extractFileText– 15 methods in all
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Managing SoftwareManaging Softwareand Configuration Updatesand Configuration Updates
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Lessons from Field CentersLessons from Field Centers
• IT support is almost unavailable.
• Initial software installation requires a human being, but it should be simple.
• Software updates should require a person to trigger them.
• Anonymizer scripts should be automatically updated.
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MIRC Update ServiceMIRC Update Service
MIRCMIRCUpdateUpdateServletServlet
HTTP(S)HTTP(S)
FieldCenterFieldCenterStorage SCPHTTP ServerAnonymizerStorage SCUS/W Update
S/WS/W
Config 1Config 1
Config 2Config 2
Config nConfig n
FieldCenter SitesFieldCenter Sites
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FieldCenterFieldCenter
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Typical Imaging DataflowTypical Imaging Dataflow
PrincipalPrincipalInvestigatorInvestigator
PACSPACS
MIRCMIRC
ModalityModality
Field CenterField Center
DatabaseDatabase
Work-Work-stationsstations
PACSPACS
FieldCenterFieldCenterStorage SCPHTTP ServerAnonymizer
Storage SCUS/W Update
DICOMDICOM
HTTP(S)HTTP(S)
DIC
OM
DIC
OM
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The FieldCenter ApplicationThe FieldCenter Application
Runs at the image acquisition site
Receives images and metadata files via the DICOM and HTTP(S) protocols
Anonymizes images and metadata files
Transmits to the PI MIRC site via HTTP(S)
Automatically links to the PI MIRC site for remapping tables and software updates
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The FieldCenter ApplicationThe FieldCenter Application
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The RSNA MIRC SoftwareThe RSNA MIRC Software
Available on the RSNA MIRC site (mirc.rsna.org)– Click the Downloads link in the header
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The RSNA MIRC SoftwareThe RSNA MIRC Software
Runs on Windows, Mac, Linux, SolarisThree components:
Java / Tomcat / MIRC
All components are freeMIRC Users Group meetings:
11/27 1:30 - 3:30 E26211/30 12:15 - 2:15 E257
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Questions/Answers & HelpQuestions/Answers & Help
The MIRC Wiki– http://mircwiki.rsna.org
RSNA Forums:– http://forums.rsna.org
– User Comments, Questions and Answers– RSNA MIRC Software Announcements– MIRC Implementers’ Corner
Subscribe on the Forums site