Bone age assessment is a procedure frequently performed in pediatric patients to evaluate their growth disorder. A commonly used method is atlas matching by a visual comparison of a hand radiograph with a small reference set of old Greulich-Pyle atlas. We have developed a new digital hand atlas with a large set of clinically normal hand images of diverse ethnic groups. In this paper, we will present our system design and implementation of the digital atlas database to support the computer-aided atlas matching for bone age assessment. The system consists of a hand atlas image database, a computer-aided diagnostic (CAD) software module for image processing and atlas matching, and a Web user interface. Users can use a Web browser to push DICOM images, directly or indirectly from PACS, to the CAD server for a bone age assessment. Quantitative features on the examined image, which reflect the skeletal maturity, are then extracted and compared with patterns from the atlas image database to assess the bone age. The digital atlas method built on a large image database and current Internet technology provides an alternative to supplement or replace the traditional one for a quantitative, accurate and cost-effective assessment of bone age.
KEYWORDS: Picture Archiving and Communication System, Medical imaging, Internet, Teleradiology, Medicine, Device simulation, Digital imaging, Computer simulations, Data centers, Information science
Tele-medical imaging applications require low cost, and high-speed backbone wide area networks (WAN) to carry large amount of imaging data for rapid turn around interpretation. Current low cost commercially WAN is too slow for medical imaging applications, while high speed WAN is too costly. The next generation Internet (NGI) or Internet2 is federal initiatives for the integration of higher speed backbone communication networks (up to 2.4 Gbits/sec) as a means to replace the current inadequate Internet for many applications including medical imaging. This paper describes our preliminary experience of connecting to Internet2 for teleradiology application. A case study is given for the NGI WAN connection between Childrens Hospital Los Angeles and National Library of Medicine. NGI WAN performance for different image modalities, measured in throughput rate and application response time, were obtained and then compared to the T1 WAN connection between Childrens Hospital Los Angeles and Saint John's Health Center Santa Monica.
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