IMAGE MANAGEMENT AND COMMUNICATIONS SYSTEM

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The National Cancer Institutes Radiation Oncology Sciences Program (ROSP) is actively sponsoring a clinical outreach program, known as the Partnership in Science Program(TM). In addition, The NCI Radiation Oncology Branch (ROB), which is a component of ROSP, is continuing the development of a specialized radiotherapy treatment planning system, to suit their protocol requirements. Finally, the NCI ROB supports a clinical training program jointly with the Walter Reed Army Medical Center (WRAMC) and the National Naval Medical Center (NNMC). For these three reasons, the NCI ROSP is interested in high-speed medical image communication and telemedicine systems. In a separate initiative, the NIH Clinical Center (CC) has previously implemented a Telemedicine Clinic to demonstrate the feasibility of remote health care delivery in the age of managed care and cost containment, as well as to facilitate medical protocols involving geographically distributed collaborators. Toward these ends, CIT, NCI, and the CC are collaborating to develop demonstration projects which explore image communication and telemedicine technologies. A custom-designed Medical Consultation WorkStation (MCWS) has been developed by CBEL, and is currently deployed in the NCI ROB and the CIT environments. The NCI has recently Trademarked the MCWS System for the NIH, under the TELESYNERGY(TM) Logo, and has selected TELESYNERGY(TM) as the enabling technology for their Partnership in Science(TM) Program. The MCWS, which is based upon Asynchronous Transfer Mode (ATM) technology, allows real-time multimedia conferencing between distributed sites, and the systems includes high-resolution electronic view boxes for the display of CT, MRI or chest film images. Also included is a high-resolution video link for the presentation of a view of the consultant, the display of video- taped medical images or live presentations, or the display of histopathology images obtained from remote-controlled microscopes. The MCWS System was recently enhanced to allow ATM-gateway access to remote sites via high-speed ISDN PRI telephone service. Additional MCWS Systems will be installed in the newly redesigned CC 11th floor Telemedicine Clinic, the WRAMC, and the NNMC during the first third of FY00. Current plans also include teleconferencing with the Lawrence Livermore National Laboratory (LLNL), in the same time period, to support a new NCI ROB protocol for the development of improved dose calculations through the use of the LLNL PEREGRINE Dose Calculation Engine. Also implemented, is a prototype high-speed image communication network, based on ATM Switch technology, which allows 155 Mbit/sec multi-media communication between users. This prototype ATM network is connected to the DARPA-funded Advanced Technology Development Network (ATDNet). The ATDNet link will allow collaboration between the NIH and several local sites, such as the WRAMC and the NNMC. ATDNet will also allow a connection to the NASA NREN network, for communication to the LLNL. - Telemedicine, Medical Consultation, Diagnostic Imaging, Radiotherapy Treatment Planning