Figure 5 - uploaded by Olga Ferrer-Roca
Content may be subject to copyright.
Image at 4-MB resolution with preview sampling. File size is 3.9 MB at display and 1.43 MB stored. Top image: orthogonal plane slice 86. Bottom image: 3-D image
Source publication
Three-dimensional ultrasound images allow virtual sonography even at a distance. However, the size of final 3-D files limits their transmission through slow networks such as the Internet.
To analyze compression techniques that transform ultrasound images into small 3-D volumes that can be transmitted through the Internet without loss of relevant me...
Similar publications
A key advantage in the conversion from film-based to digital radiology is the possibility of a long-term on line electronic archival of patient studies. The popular approach based on optical disk jukeboxes for the long-term archive and magnetic disk storage for data caching is not economically attractive because of the cost of both the jukebox and...
Citations
... We found that maximum blood flow (FI) was related to the systolic pulse (RI) of the fetus (20% of its variance), while vessel density (VI) appeared to be related to the maternal lakes of the placenta where fetal vessels are too small to be detected. These findings indicate that anatomical and functional parameters justify the description of the technique as virtual placental biopsy; furthermore, they support its use for gestational evaluation at a distance, because standardized 3D capture provides virtual ultrasound images that can be processed remotely [21, 22] . In GDP, blood FI > 45 occurred in early pregnancy, in parallel with high vessel density (VI > 30%). ...
Telemedicine (TM) challenge is to create an intelligent tool that delivers personalized training to professionals with different backgrounds. We present an adaptive retrieval system that used vocabulary and ontologies founded on the telemedicine body of knowledge (TM-BoK) hierarchy and Medical Sub-headings (MeSH). The XML-manifest that contains a Navigable Knowledge Map and a separate Rule-extension executed by Agents during the process of navigation. The result is an adaptive and adaptable TM knowledge delivery tool.
... We found that maximum blood flow (FI) was related to the systolic pulse (RI) of the fetus (20% of its variance), while vessel density (VI) appeared to be related to the maternal lakes of the placenta where fetal vessels are too small to be detected. These findings indicate that anatomical and functional parameters justify the description of the technique as virtual placental biopsy; furthermore, they support its use for gestational evaluation at a distance, because standardized 3D capture provides virtual ultrasound images that can be processed remotely [21,22] . ...
Objectives: We used three-dimensional ultrasound with trans-abdominal Power-Doppler (3D-US PD) to determine placental vascular evolution in normal pregnancies (NP) and in insulin-dependent Gestational Diabetes Pregnancies (GDP).
Study design: We obtained 473 measurements from 43 NP at 20 weeks-40 weeks gestation and 122 measurements from 70 insulin-dependent GDP at 22 weeks-40 weeks. Standardization was achieved recording three successive placental vascular tree volumes, measuring the spherical volume between the chorionic and basal plates always under or near funicular insertion. Parameters analysed were: mean intensity of blood flow (Flow Index, FI); percentage of volume occupied by vessels (Vascularisation Index, VI); and intensity of blood flow in the volume occupied by vessels (Vascularisation-flow index, VFI).
Results: In NP, FI increased throughout early pregnancy and decreased before delivery and correlated with fetal parameters. In contrast, in GDP, FI was high from the onset, better correlated with placental parameters, and had a diagnostic cutoff value of 45, which was only found in 7% of NP at the end of the pregnancy. VI was variable and had a low diagnostic value, being related to placental parameters; VI values were significantly lower in NP (17.4 ± 7.4%) than in GDP (21 ± 12%) with a diagnostic cutoff point at 31%. In NP, FI-peak was at 32 weeks, two weeks after the VI-peak, while VFI showed no significant differences.
Conclusions: The results showed that placental blood flow (FI) was related to fetal circulation, while the percentage of vessels per volume (VI) was related to maternal circulation. 3D-US PD indicated a diagnosis of GDP for FI > 45 and VI > 30%. We also discuss the values of change in VI that predict changes in fetal FI.
... The introduction of 3D-probes will greatly improve hand-held devices used for telemedicine applications [5] because they will enable the creation of virtual sonography [6][7][8][9] in which any non-expert sonographer could record images that would have diagnostic validity in the hands of an expert, whether local or distant [6,10,11]. ...
... The introduction of 3D-probes will greatly improve hand-held devices used for telemedicine applications [5] because they will enable the creation of virtual sonography [6][7][8][9] in which any non-expert sonographer could record images that would have diagnostic validity in the hands of an expert, whether local or distant [6,10,11]. ...
Purpose:
The purpose of this work was to validate a new clinical obstetrics and gynecology (OB-GYN) application for a hand-held ultrasound (US) device. We modified the smallest hand-held device on the market and tested the system for transvaginal (TV) use. This device was originally conceived for abdominal scanning only.
Methods:
The validation involved 80 successive patients examined by the same operator: 25 obstetric and 55 gynecologic cases. US examination was performed transvaginally with two US systems: the hand-held Vscan (General Electrics; GE Vingmed Ultrasound; Norway) for which an intravaginal gadget TTGP-2010® (Troyano transvaginal gadget probe) was designed, and the Voluson 730 Expert (multifrequency transvaginal ultrasound of 3-9MHz; GE Healthcare, Milwaukee, WI, USA). We performed the same measurements with both US systems in order to confirm whether or not their diagnostic capability was similar. Quantitative difference in measurements between the systems was assessed, as well as the overall diagnostic detection rate and suitability for telemedicine.
Results:
Regarding lesion visibility with Vscan, optimal distance was 8-16cm depending on the examination type, and the total detection rate was 98.7%. The exception was an ovarian endometrioma, diagnosed as a follicular cyst using the hand-held device. Assessment of reproducibility in 180 measurements showed that the measurements obtained with Vscan were 0.3-0.4cm lower than those obtained with the high resolution US device (Voluson 730 Expert). Nevertheless, Pearson's correlation coefficient was high for biparietal diameter (0.72) and gynecological (GYN) (0.99) measurements, and for overall correlation (0.997). Image transport on USB and SD-flash cards proved convenient for telemedicine.
Conclusions:
A novel TV application of a hand-held US device is demonstrated for OB-GYN. Heart, abdominal and obstetrics presets of the Vscan together with color-Doppler enable a detection capability comparable to that of a high-definition US device. The lower values of the measurements obtained by the hand-held device (by 0.3-0.4cm) must be taken into account, although they have no effect on its diagnostic capability.
... The creation of the picture archiving and communication system and related Web-enabled interfaces for the Internet demonstrates the interest from the medical community in accessing information in a reliable, economical, and convenient way [1,2]. However, despite efforts in computer sciences (eg [3,4]), the processing of medical images is still computationally expensive for real-time use on most personal computers. Continuing efforts are being made toward personalized patient models for the predictive health care of the future [5], leading to new pathways in health care [6]. ...
Producing a rich, personalized Web-based consultation tool for plastic surgeons and patients is challenging.
(1) To develop a computer tool that allows individual reconstruction and simulation of 3-dimensional (3D) soft tissue from ordinary digital photos of breasts, (2) to implement a Web-based, worldwide-accessible preoperative surgical planning platform for plastic surgeons, and (3) to validate this tool through a quality control analysis by comparing 3D laser scans of the patients with the 3D reconstructions with this tool from original 2-dimensional (2D) pictures of the same patients.
The proposed system uses well-established 2D digital photos for reconstruction into a 3D torso, which is then available to the user for interactive planning. The simulation is performed on dedicated servers, accessible via Internet. It allows the surgeon, together with the patient, to previsualize the impact of the proposed breast augmentation directly during the consultation before a surgery is decided upon. We retrospectively conduced a quality control assessment of available anonymized pre- and postoperative 2D digital photographs of patients undergoing breast augmentation procedures. The method presented above was used to reconstruct 3D pictures from 2D digital pictures. We used a laser scanner capable of generating a highly accurate surface model of the patient's anatomy to acquire ground truth data. The quality of the computed 3D reconstructions was compared with the ground truth data used to perform both qualitative and quantitative evaluations.
We evaluated the system on 11 clinical cases for surface reconstructions and 4 clinical cases of postoperative simulations, using laser surface scan technologies showing a mean reconstruction error between 2 and 4 mm and a maximum outlier error of 16 mm. Qualitative and quantitative analyses from plastic surgeons demonstrate the potential of these new emerging technologies.
We tested our tool for 3D, Web-based, patient-specific consultation in the clinical scenario of breast augmentation. This example shows that the current state of development allows for creation of responsive and effective Web-based, 3D medical tools, even with highly complex and time-consuming computation, by off-loading them to a dedicated high-performance data center. The efficient combination of advanced technologies, based on analysis and understanding of human anatomy and physiology, will allow the development of further Web-based reconstruction and predictive interfaces at different scales of the human body. The consultation tool presented herein exemplifies the potential of combining advancements in the core areas of computer science and biomedical engineering with the evolving areas of Web technologies. We are confident that future developments based on a multidisciplinary approach will further pave the way toward personalized Web-enabled medicine.
... The integrated workstation used advanced techniques able to collect 3D U/S data, which were presented on (Sakas, 1993) and (Sakas et al., 2000). For T@lemed and for this research, the reason to work with ultrasound data is based on its support to a very large range of applications (Ferrer-Roca et al., 2001), varying from gynaecology and abdominal scans to cardiological examinations. Currently, it is the only economically and practically affordable imaging modality. ...
Access to medical care is sometimes difficult to be reached by citizens living in distant and underserved areas. The problem increases on high complexity medical cases that are not preventively identified. The recent advance of broadband communication, like Power Line (PLC), combined with state-of-the-art multimedia compression methods allowed reaching isolated areas that lacks of intra/internet connections. This paper presents the results of the POA_S@UDE Project, a research that aimed the improvement of patient quality of life in distant urban communities from high-complexity hospitals, focusing on obstetric ultrasonography (U/S) examinations during prenatal period. Statistics show an obstetric examination miss rate higher 60% at the Restinga peripheral district (100,000 inhabitants) in Brazil. The main reason is the time and financial difficulties to go to central hospitals to perform regular examinations; added with the time gap of 4 months between an exam request and its realization by the referral hospital. Based on that, we introduce a collaborative tele-U/S system over a PLC hybrid network based on multimedia data. The specialist doctor assists, guides, and interacts in real-time with the remote doctor who operates the U/S equipment. At Restinga, during a pilot of 3 months, the examination waiting time was decreased to 1 month and the miss rate of prenatal examinations to 30%.
... For T@lemed and for this case study project, the reason to work with ultrasound data is based on its support to a very large range of applications (Ferrer-Roca et al., 2001), varying from gynaecology and abdominal scans to cardiological examinations and it is currently the only economically and practically affordable imaging modality. However, the platform can deal with any other DICOM images acquired either through the DICOM network. ...
The growth of fast internet, including the recent advance on using PLC (Power Line Communication) for reaching rural and remote areas in Brazil, and the state-of-the-art of image compression methods allowed rapid teleconsultations and medical training based on medical images. At the present time, one of the challenging problems in telemedicine is the real-time teleconsultation in case of emergency and for the medical training at remote regions where the internet access is precarious. In this paper, we present the kick-off of the applied project PO@Health, which merges the European-Latin American T@lemed Project (telemedicine based on ultrasound images) and the Brazilian PLC Restinga Project (communication via Power Line in a remote district). The platform used for medical teleconsultations and residents training is able to perform both on-line (in real-time) and off-line image-based teleconsultations over the Internet connection. For the ultrasound cases, the platform is being adapted to work with the DICOM medical images synchronized with the physician hand position images of the examination in order to increase the diagnosis precision. In addition, we describe the hybrid network over PLC that is being used by the telemedical platform.
... A próxima seção explora o software utilizado, o qual se baseia nos conceitos apresentados em [6] e é utilizado no T@lemed. ...
Resumo - O crescimento da Internet rápida (a cabo e também sem fios, inclusive por satélite) no Brasil e o recente avanço de métodos de compressão de imagem permitiram a execução de tele-consultas interativas baseadas em imagens médicas. Atualmente, um dos problemas desafiadores em tele-medicina é a tele- consulta em tempo-real em casos de emergência. Neste artigo, descreve-se o Projeto T@lemed no Estado do Rio Grande do Sul e os resultados preliminares em dois anos de operação. Além disso, apresenta-se a extensão do projeto no Estado do Pará, através de comunicação via satélite. A plataforma de tele-medicina usada pode realizar tele-consultas baseadas em imagens do tipo on-line (tele-consulta em tempo-real) ou off-line . Palavras-chave : Tele-medicina, Tele-consulta, Imagens Médicas, Tempo-real, Comunicação via Satélite. Abstract - The growth of fast wired and wireless internet (including communication via satellite) in Brazil and the recent advance of image compression methods allowed rapid tele-consultation based on medical images. At the present time, one of the challenging problems in tele-medicine is the real-time tele- consultation in case of emergency. In this paper, the ongoing T@lemed Project in the State of Rio Grande do Sul is described and the preliminarily results acquired during two years of operation are presented. In addition, we describe its extension in the Pará State, through a satellite communication. The platform, used for medical tele-consultations, is able to perform both on-line (in real-time) and off-line image-based tele- consultations over the Internet connection.
... The application, used for tele-consultations, is called TeleConsult. It's based on the earlier developments of TeleInViVo [2] [3] [7]. ...
In this paper, we are going to depict a medical tele-consultation network for medical imaging that has been deployed in Brazil. Preliminary outcomes of the medical network will be presented. In addition, the medical application used for tele-consultations will be shown. Eighty nine ultrasound acquisitions took place in the period of five months of the operation of the medical network and five hundred fifty six medical consultations performed.
... Además, esta nueva GUI incluye funcionalidades para poder acceder de manera homogénea a las utilidades de la solución de e-Salud, ya que el framework de la norma ISO/IEEE11073 resuelve el proceso de comunicación interoperable de forma transparente. Así, este diseño se ha integrado en el motor de desarrollo de la solución con diversas tecnologías de transporte (como Bluetooth) y con otras normas de diseño de aplicaciones (por ejemplo, ISO9241-151), lo que permite su extensión a nuevos dispositivos (por ejemplo, ordenadores personales, dispositivos portátiles, SmartPhones o Tablet PCs) [13]- [15] y varios perfiles de usuario. Los perfiles de usuario considerados en este estudio han sido: ...
Resumen Los nuevos conceptos de e-Accesibilidad y diseño para todos, junto con los conocidos de usabilidad e interoperabilidad, han de servir para acercar las Tecnologías de la Información y las Comunicaciones a las personas con diversidad funcional constituyendo entornos de Inteligencia Ambiental. En este contexto, la norma ISO 9241 para la e-Accesibilidad y la norma ISO/IEEE11073 para proporcionar interoperabilidad de dispositivos médicos, han sido consideradas como pautas a seguir. Este artículo analiza los requerimientos técnicos necesarios en el diseño de entornos gráficos de aplicaciones de e-Salud sobre ordenadores personales, dispositivos móviles, SmartPhones o Tablet PCs.
