Extensible open-source zero-footprint web viewer for oncologic imaging research

 描述（由首席研究员提供）：管理肿瘤学临床试验日益复杂的工作流程和成像分析以提供及时、符合方案的评估需要复杂的信息学工具。为了解决这些问题，在过去 10 年里，肿瘤成像指标核心 (TIMC)（丹娜法伯/哈佛癌症中心 (DF/HCC) 的 CCSG 共享资源）开发了一个软件信息学系统，用于管理肿瘤临床试验的工作流程和图像测量。该系统目前在 5 家 DF/HCC 哈佛医院使用，管理 600 多项活跃的临床试验，拥有 800 名用户，并已在其他几个癌症中心获得许可和实施，包括耶鲁大学、犹他州/亨斯曼癌症研究所和威斯康辛大学/西雅图癌症护理联盟。工作流程管理信息系统包括用于协议注册、订单输入、工作列表管理、报告和计费/管理功能的网络应用程序/数据库。然而，集成的开源图像分析平台是基于工作站的，需要在将执行成像测量的每台计算机上安装和更新。因此，开源成像系统是部署的限制因素，需要在每个执行成像评估的位置增加 IT 桌面支持和维护。通过将图像分析功能调整到基于网络的开源平台中，将有助于和促进该系统在 NCI 癌症中心的广泛采用。目前的建议是 1) 创建一个供应商中立、开源、可扩展、零占用空间的 Web 查看器和支持服务器，用于显示和分析 DICOM 图像，2) 创建一个插件架构，使我们能够用这个用于 TIMC 临床试验管理系统的零占用空间 Web 查看器替换当前的开源图像工作站。为了使该系统广泛用于肿瘤学研究社区，除了开发 TIMC Web 应用程序的接口之外，我们还将实现 AIM（注释和图像标记）接口，以便 caBIG 研究人员和其他 AIM 框架研究项目可以轻松地与我们的 Web 查看器集成。查看器将满足特定于肿瘤学临床试验需求的放射学肿瘤测量的所有基本要求，同时也足够灵活，可以根据用户偏好进行配置，并通过插件进行扩展，以作为共享研究资源支持不同的研究工作流程。为了实现这些设计目标，查看器及其所有功能将通过 Web 浏览器专门交付给客户端计算机，无需在客户端计算机或移动设备上安装任何内容，这大大简化并降低了软件部署的成本和支持要求，并提高了可访问性。所提议的查看器将使研究人员、成像软件开发人员、临床医生和患者能够在免费可用和公开可扩展的环境中访问肿瘤临床试验图像。这将促进广泛的成像专业人员之间的远程图像查看和协作图像咨询。 Web-DICOM 查看器将与 TIMC 临床试验信息学管理系统完全集成，以便这两个系统可以在完全基于网络的实施中跨 NCI 癌症中心部署，无需桌面 IT 支持。还将提供 AIM 界面，以便网络查看器可以广泛集成到 caBIG/AIM 癌症研究社区。

 DESCRIPTION (provided by principal investigator): Managing the increasingly complex workflow and imaging analyses for oncology clinical trials to provide timely, protocol-compliant assessments requires sophisticated informatics tools. To address these issues, over the past 10 years the Tumor Imaging Metrics Core (TIMC), a CCSG Shared-Resource of the Dana-Farber/Harvard Cancer Center (DF/HCC), has developed a software informatics system for managing the workflow and image measurements for oncology clinical trials. This system currently is in use across the 5 DF/HCC Harvard hospitals to manage over 600 active clinical trials, with 800 users, and has been licensed and implemented at several other Cancer Centers, including Yale, Utah/Huntsman Cancer Institute, and UW/Seattle Cancer Care Alliance. The workflow management informatics system includes a web-application/database for protocol registration, order entry, work list management, reporting, and billing/administrative functions. However, the integrated, open-source image analysis platform is workstation-based and needs to be installed and updated on each computer where imaging measurements will be performed. Thus, the open- source imaging system is a limiting factor in deployment, requiring added IT desktop support and maintenance at each location where imaging assessments will be performed. The widespread adoption of this system across NCI Cancer Centers will be aided and facilitated by adapting the image analysis functionality into a web-based open-source platform. The current proposal is to 1) create a vendor-neutral, open-source, extensible, zero-footprint web-viewer and supporting server for display and analysis of DICOM images, and 2) create a plug-in architecture to allow us to replace our current open-source image workstation with this zero-footprint web-viewer for our TIMC clinical trials management system. In order to make the system broadly available to the oncology research community, in addition to developing an interface to our TIMC web-application, we will also implement an AIM (Annotation and Image Markup) interface so that caBIG investigators and other AIM framework research projects can integrate easily with our web-viewer. The viewer will meet all of the basic requirements for radiology tumor measurements specific to the needs of oncology clinical trials, yet also be flexible enough to be configured for user preferences and extended via plug-ins to support varied research workflows as a shared research resource. To achieve these design goals, the viewer and all of its functionality will be delivered to client machines exclusively through the web browser with nothing to install on client computers or mobile devices, which greatly simplifies and reduces the cost and support requirements of software deployments, and increases accessibility. The proposed viewer will enable researchers, imaging software developers, clinicians, and patients to access oncology clinical trials images in a freely availabl and openly extensible environment. This will facilitate remote image viewing and collaborative image consultations among a wide-range of imaging professionals. The web-DICOM viewer will be fully integrated with the TIMC clinical trials informatics management system so that both systems can be deployed across NCI Cancer Centers in a completely web-based implementation without desktop IT support. An AIM interface will also be provided so that the web-viewer can be integrated broadly across the caBIG/AIM cancer research community.