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Development of a free knowledge base to support the use of differential diagnosis information in PET-CT imaging. June 3, 2010

Posted by tomography in Conference, Nuclear Medicine, Radiology, SNM 2010.
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Here is the second project I am involved with that will be presented at SNM 2010 in Utah.

Development of a free knowledge base to support the use of
differential diagnosis information in PET-CT imaging.

Zoltán Tóth, Zoltán Barta, András Székely, Nikoletta Pócsi, Ildikó Garai.

OBJECTIVES

Our aim was to create an application integrated into the reporting
workflow to provide quick and easy access to relevant scientific
publications, facilitate the use of differential diagnosis information
and support evidence-based decision making. This project is part of a
larger project targeting the development of a structured reporting
system (ReportAssistant) for oncological whole-body PET-CT studies.
(See accompanying poster).

METHODS

Creation of a PET-CT gamut list

The gamut list was created by combining the results of two independent
methods. First we selected 160 representative reports from our
practice. These were processed sentence-by-sentence by two physicians
in order to extract the most common and less frequent findings in
whole-body PET-CT studies. Copies of the original report text were
modified inline: sentences describing relevant lesion types were
“tagged” with “location – lesion – diagnosis” triples. These tags were
collected and summarised as potential gamut items with the help of a
software script. Parallel with these, a second list was created by
processing and sytntetising various scientific literature sources.
After reviewing, these two lists were merged to form the first edition
of a PET-CT gamut list. These version of the list covers chest,
abdomen and pelvis related lesions and consists of 400 gamut items.

Collecting and tagging publications

Systematic literature searches using a comprehensive list of keyword
expressions distilled from the PET-CT gamut list were conducted. The
main target journals were Radiology, Radiographics (both official
journals of RSNA), Journal of Nuclear Medicine (the official journal
of SNM) and European Journal of Nuclear Medicine & Molecular imaging
(the official journal of EANM). A total of 745 articles were selected.
The URL addresses of the full text articles were recorded and manually
tagged with proper gamut triples. Further processing, including
downloading and indexing of PDF articles, was automatically done by
custom software written by one of the authors (Z Barta).

Software development

All software development was done by using the X4Tk toolkit. X4Tk is
an open source (LGPL), object-oriented MVC-framework for easy desktop
application development and more, including support for standard
enterprise messaging protocols, TCP/IP based server-client development
and various interprocess communication solutions. X4Tk is written in
Perl by one of the authors (Z Barta), with the first release in 2005,
it is actively maintained and field-tested.

RESULTS

Database of tagged publications

A comprehensive collection of high-quality, manually selected,
properly reviewed and tagged radiology and nuclear medicine
publications was generated by using the methods described earlier with
the help of our custom RA PaperManager software. This list can be
exported to an external file. By loading this list one can easily
rebuild the database on his own computer without violating copyright
restrictions.

RA PaperManager software

The main features of RA PaperManager are:

* extensive support for collecting scientific papers ranging
from dragging-and-dropping of files to direct web browser integration through
bookmarklets, respectively import of list of URLs pointing to full
text PDFs and scanning & monitoring of hard drive directories.

* “free” and gamut-list based tagging of papers

* full text search support

* easy linking & interprocess communication with other
applications (STOMP, Windows MMF, HTTP)

CONCLUSION

We have designed, implemented and tested a highly useable, general
purpose, point-n-click SR software. Our software system can serve for managing personal collections of scientific publications and it can be easily integrated into structured reporting softwares through it’s REST API. The
software is available under various licenses, including free licenses
for personal and academic institutional usage.

Look for Zoltán Barta and Zoltán Tóth on site for more details!

– András

ReportAssistant: a highly useable structured reporting system for PET-CT studies June 3, 2010

Posted by tomography in Conference, Nuclear Medicine, SNM 2010.
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Here is the first poster I am involved with:

ReportAssistant: a highly useable structured reporting system
for PET-CT studies

Zoltán Barta, Zoltán Tóth, András Székely, Nikoletta Pócsi, Nikol
Fedinecz, Bernadett Szűcs, Ildikó Garai

OBJECTIVES
Structured reporting (SR) solutions may have many practical benefits compared to conventional reporting. While SR systems are widely used in various diagnostic settings (in gastroenterology, cardiology and obstetrics), their use in general radiology and nuclear medicine is very limited due to the complexity of the domains and the lack of useable software products. The main objective of our project was to develop a practical SR system for whole-body oncological PET-CT studies, which can be easily adapted to general nuclear medicine and diagnostic CT imaging studies later on.

METHODS

Requirements

We defined the following main requirements:

* easy creation of multimedia reports

* context-sensitive and quick access to relevant decision
support materials

* user-friendly support of academic – research and education – activities

* flexible and simple integration with custom DICOM image
processing softwares

Concepts and prototyping

We used the concept of tagging as the basis of the design for our
softwares. We hypothetised that tagging – as used by many contemporary popular web services – can be the unifying component in interlinking lesion data, patient history, relevant scientific publications, etc. Our initial studies proved that
using composite tags of “location + lesion type + disease”
(the classic gamut formula), we can eliminate the deep hierarchical
navigational lists found in several commercial radiology point-n-click SR softwares. After experimenting with various decision support models, we concluded that a simple and cost-effective solution would be to use tagged, high quality, and freely accessible review and CME articles as decision support resources. (This work is presented in an accompanying poster). During the whole project we considered software usability as the most important problem to be solved. Therefore many throw-away prototypes were built and tested in order to find simple and effective UIs to streamline the workflow. We invested significant effort in reducing the time required to perform key repetitive tasks to the minimum. It is
obvious that even a two-second reduction in the completion time of a moderately frequent task can save many hours or days per person at a year scale.

Final design & architecture

The ReportAssistant platform consists of three independent, but
interconnected programs: an “editor” responsible for the creation of structured reports, a “viewer” application for archiving, teaching
file viewing and querying of the report database, and a custom
“papermanager” program, for collecting, full text indexing and tagging of scientific papers.

Software development

All software development was done by using the X4Tk toolkit. X4Tk is an open source (LGPL), object-oriented MVC-framework for easy desktop application development and more, including support for standard enterprise messaging protocols, TCP/IP based server-client development and various interprocess communication solutions. X4Tk is written in Perl by one of the authors (Z Barta), with the first release in 2005, it is actively maintained and field-tested.

RESULTS
RA Editor

RA Editor is the key application of the ReportAssistant platform: it
provides all the functionalities needed to create structured reports.
Other important features are:

* report template editing

* flexible, adaptable text macro subsystem

* study metadata and patient data viewing/importing/editing

* connection to our legacy RIS database

* communication with Mediso InterviewFusion image processing
software, through standard TCP/IP connection, by using a simple
XML-based declarative mini-language.

RA Viewer

RA Viewer is responsible for the viewing and searching of structured reports created with RA Editor. RA Viewer features include:

* search based on “free” and Dx tags, patient and study metadata

* export of ROI/VOI data combined with patient and study data
(MS Excel format)

* display of key images, report text, report summaries for quick reviewing

* annotation of images and export to PDF and MS PowerPoint formats

* digital signing and email distribution of the electronic
reports (in PDF format)

RA PaperManager

The main features of RA PaperManager are:

* extensive support for collecting scientific papers ranging
from dragging-and-dropping of files to direct web browser integration through bookmarklets, respectively import of list of URLs pointing to full text PDFs and scanning & monitoring of hard drive directories.

* “free” and gamut-list based tagging of papers

* indexing for full text search

* easy linking & interprocess communication with other
applications (STOMP, Windows MMF, HTTP)

CONCLUSION

We have designed, implemented and tested a highly useable, general purpose, point-n-click SR software. Our solution provides decision support directly integrated in the workflow. We believe (suggest) that access to “solved” cases and relevant evidence-based papers (reviews, CME articles from top journals) increases confidence in decision making, facilitates learning, deepens experience, which indirectly can lead to a better and more effective/reliable medical practice and is specially useful for resident students. Academic research and education activities are also supported by the software in the form of easy search & export of lesion data to spreadsheets, calculation of likelihood ratios, respectively a searchable structured report database of studies. Undergoing work will integrate speech-to-text solutions and will provide support for the conversion of the reports to DICOM SR (Suppl 23) standard format.

Look for Zoltán Barta and Zoltán Tóth on site for more details!

– András

SNM 2010 Kicks off tomorrow June 3, 2010

Posted by tomography in Conference, Nuclear Medicine.
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logo.gif

SNM 2010, the annual meeting of the Society of Nuclear Medicine starts tomorrow in Salt Lake City, Utah, and it will last till the 9th of this month.

Nestled against the Wasatch Mountains, Salt Lake offers an urban oasis just minutes away from an alpine escape.  Known for its clean, accessible downtown and friendly citizens, the city also blooms with rich artistic offerings and

boundless recreational options.  Salt Lake is where big-city culture meets sublime outdoor beauty.

Make your plans today to join over 3,900 of your colleagues, plus over 150 exhibiting companies, in Salt Lake City! SNM’s Annual Meeting is the world’s largest event focused exclusively on the latest developments in molecular imaging.  Come to Salt Lake City and soak up knowledge to advance your career—all while you experience the cultural riches of this unique destination.

I am part of two posters that will be presented during this meeting, and I will post our abstracts here soon.

I hope to hear from you, if you are in Utah! 🙂

Absract submission for ECR 2010 July 5, 2009

Posted by tomography in ECR 2010.
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2_ecrAbsract submission is now open for ECR 2010 the annual congress of the European Society of Radiology.
More info: My ESR

-Andras

MONT Conference: day two July 5, 2009

Posted by tomography in Mont 2009.
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I apologize for putting this up so late but I was busy the past two days. So the second day of the conference passed very quickly. Presentations from 8-12, including mine at 11:36, great lunch, poster session, afternoon presentations and a fabulous dinner at the Hotel Aranybika.

My presentation was in a very physics oriented section. I guess it would not have fit in anywhere any better, but I was happy to see that the lecture hall began To fill up with people just in time for my presentation.

At the end I was glad to have it overwith, and I was more relaxed when talking To people afterwards. I hope To give this presentation somewhere else also.

So I will end this post just the way that day ended; with pictures from the dinner party.
– Andras

MONT Congress 2009 June 26, 2009

Posted by tomography in Conference, MONT Congress 2009, Nuclear Medicine.
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The 16th biennial congress of the György Hevesy Hungarian society of nuclear medicine, MONT, will take place between the 2-4 of July, 2009 in Debrecen. On the first day the new Nuclear Medicine Center and the first Hungarian developed, multi modality, hibrid scanner will be shown to the public.

Dear Colleague,

The György Hevesy Hungarian Society of Nuclear Medicine (MONT) will organize its next national congress between 2 and 4 of July, 2009, in Debrecen. The venue will be the Health Science Building of the University of Debrecen.

On behalf of the organizing committee I would like to invite you and your colleagues to participate on our congress. We hope again to attract a large multidisciplinary audience as on previous congresses of MONT.

The official languages of the congress are Hungarian and English.

The scientific abstracts will be published in the Nuclear Medicine Review.

Debrecen, June 2009

Best Regards,

Prof. László Galuska, MD, PhD
Congress President

Schedule of the congress may be found on the MONT website.

See you there!

– Andras

MONT Congress 2009 Debrecen May 16, 2009

Posted by tomography in Conference, Nuclear Medicine.
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The 16th congress of the Magyar Orvostudományi Nukleáris Társaság (MONT – Hungarian Nuclear Medicine Society) is going to take place between the 2-4th of July, 2009 in Debrecen, Hungary.

I will give a presentation about how Web 2.0 may facilitate patient education, medical education and intercollegial communication within Nuclear Medicine. My presentation will focus on TomographyBlog, SEEKRadiology and NuklearisMedicina.hu, my blog, search page, and community site respectively.

Here is my abstract in English that will appear in Nuclear Medicine Review:

Novel opportunities in Nuclear Medicine provided by the Internet

András Székely, DEOEC ÁOK VI.

Background:

The birth of Web 2.0 opened a new chapter in  the history of the Internet. Since 2004, a large number of services have been developed which emphasize collaboration, communication and creativity. Facilities provided by this „social Web” may be utilized in higher education and patient education. To examine these opportunities, we founded our diagnostic imaging blog, called Tomographyblog.com, in 2007. Later, we developed a search page and a community portal.

Materials and methods:

We registered our blog with a free service provider, and since then we have been informing our audience about the latest in diagnostic imaging. We hosted a four-week educational quiz in partnership with the University of Debrecen Nuclear Medicine Department during the Fall semester of 2007/2008. Our search page, SeekRadiology.com, puts all the relevant search engines in diagnostic imaging on an easy-to-use webpage. Our community site, NuklearisMedicina.hu, aims to provide information for patients and to facilitate learning, but it also offers content for professionals.

Results

Our blog is one of the most popular diagnostic imaging blogs with over 7000 visitors per month. The quiz got 561 visitors and 26 students sent in answers at least once. Traffic on SeekRadiology.com is around 150 per day, while NuklearisMedicina.hu is currently in beta testing.

Conclusion

Web 2.0 may facilitate medical education and it can help improve the efficiency of patient education as well. These opportunities may be employed in any area of medicine, but it is vital that doctors and other experts create this content.

Hope to see you at the conference, in fact, anybody who is reading this, and will attend the conference, please drop me a comment below!

– Andras

ECR Special March 11, 2009

Posted by tomography in Conference, ECR 2009.
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It has been brought to my attention that GE has prepared with a special ECR blog and webcam so that those not attending the 2009 conference may keep up with all that is happening in Vienna.

Here is an excerpt from their press release:

We will be blogging from the GE Healthcare ECR blog: an opportunity to meet luminaries and industry experts
sharing their experiences as to how they are re-imagining healthcare today.
Surf our pressroom and get access to the latest announcements.
Not enough? Then follow along real-time with our booth webcam. Seeing is believing!

For further information check out these links:

I am delighted to see that companies and conference organizers are realizing that with the help of the Web it is easier to connect to future conference attendees and to those who cannot be present at the conference. I would strongly recommend these parties use Twitter, the microblogging tool, when reporting from various events, so that their audience can receive updates even more frequently.

– Andras