IMAGE MANAGEMENT AND COMMUNICATIONS SYSTEM

美国国家癌症研究所放射肿瘤学科学计划（ROSP）正在积极赞助一项临床推广计划，即科学合作计划（TM）。此外，作为ROSP组成部分的NCI放射肿瘤学分会（ROB）正在继续开发专门的放射治疗计划系统，以满足其协议要求。最后，NCI ROB与沃尔特里德陆军医疗中心（WRAMC）和国家海军医疗中心（NNMC）联合支持临床培训项目。基于这三个原因，NCI ROSP对高速医学图像通信和远程医疗系统感兴趣。在一项单独的倡议中，美国国立卫生研究院临床中心（CC）先前实施了远程医疗诊所，以证明在管理式医疗和成本控制时代远程医疗服务的可行性，并促进涉及地理分布合作者的医疗协议。为此，CIT、NCI和CC正在合作开发探索图像通信和远程医疗技术的示范项目。CBEL开发了一个定制设计的医疗咨询工作站（MCWS），目前部署在NCI ROB和CIT环境中。NCI最近在TELESYNERGY（TM）标识下为NIH注册了MCWS系统的商标，并选择了TELESYNERGY（TM）作为其科学伙伴关系（TM）计划的使能技术。MCWS基于异步传输模式（ATM）技术，允许在分布式站点之间进行实时多媒体会议，该系统包括用于显示CT、MRI或胸片图像的高分辨率电子视图盒。还包括一个高分辨率视频链接，用于展示会诊医生的视图，显示录像医学图像或现场演示，或显示从遥控显微镜获得的组织病理学图像。MCWS系统最近得到增强，允许atm网关通过高速ISDN PRI电话服务访问远程站点。额外的MCWS系统将安装在新设计的CC 11楼远程医疗诊所、WRAMC和NNMC中。目前的计划还包括在同一时期与劳伦斯利弗莫尔国家实验室（LLNL）举行电话会议，以支持新的NCI ROB协议，通过使用LLNL PEREGRINE剂量计算引擎开发改进的剂量计算。此外，还实现了一个基于ATM交换技术的高速图像通信网络原型，该网络允许用户之间进行155 Mbit/s的多媒体通信。这个原型ATM网络连接到darpa资助的先进技术开发网络（ATDNet）。ATDNet链接将允许NIH和几个地方站点之间的合作，例如WRAMC和NNMC。ATDNet还将允许连接到NASA的NREN网络，以便与LLNL通信。-远程医疗、医疗咨询、诊断成像、放射治疗计划

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