Health Telematics (AIM) Final Report


	Updated: Feb 1, 97
SAMMIE

Software Applied to Multimodal Images & Education

Project Code: A2032

Project value: 3388 KECU

EC contribution: 2200 KECU

No of partners: 7

No of countries: 6

Duration: 36 months

Contact:
Dr. Ursula Hübner-Löffler
Bull AG
Max-Planck-Str.17
D-4006 Erkrath, Germany
Tel.: +49-210-250.53.44
Fax: +49.211-250.53.00

Project overview

The project developed, tested and validated a modular software for a workstation for neuromedicine and radiology studies of the brain (BrainWorks). It presents and works on brain images from different modalities, incorporates brain atlases, allows comparisons and matching to be performed, includes other non-image types of medical data like textual reports, and has the backing of a purpose built database for storage and retrieval. The system is usable on a number of different hardware platforms.

Objectives

The objective of BrainWorks is to provide software for an integrated medical workstation to assist the neuroclinician and radiologist to make better use of medical images (CT, MR), time related signals (EEG, EP etc.) and other sources of medical knowledge on the (diseased) brain. It will assist the clinician in making diagnoses, and also in teaching diagnosis to students and young medical doctors. The objective embraces the development, testing and validation of the software.

Work has been also done to implement BrainWorks on different platforms (BULL, Sun, HP etc) so it can be tested in different settings and pilot sites. New developments have included 3D visualisation of the idealised atlas, matching tool, functional matching tool, statistical atlas, symbolic model, multimedia management system, and hypermedia facilities for education.

Clinical test sites have been planned and installed in four countries. Namely, in the University Hospital-Düsseldorf, Queen Elizabeth Hospital-Birmingham, Academisch Medisch Centrum - Amsterdam, Van Helmont Ziekenhuis-Brussel. Enhancement of software was carried out in response to feedback from clinical users. Full functional testing was performed before installation at test sites. This validations gave a wide exposure to BrainWorks. It is now being used both in diagnosis and in education, and in building up a case collection. Helpful comments have been received which have enabled fine tuning to be made to the software it make it that much more useful.

The clinicians currently testing BrainWorks confirmed its usefulness for their diagnostic and educational work The consortium nevertheless feels, that further and broader clinical testing and validation of BrainWorks is needed. Continuing clinical evaluation will lead to improved performance and stability of the entire system. Furthermore some additional features should be provided: two test sites expressed a strong need to make BrainWorks operable for teleconsultation across hospitals in a city.

Results

The result of SAMMIE is BrainWorks, a departmental workstation for the neuroclinician. BrainWorks has been implemented as a fully functioning integrated collection of tools for application to medical images and functional-data. The system functions in a-comprehensive manner embracing the acquisition, storage and retrieval of images from CT, MRI and film scanner, and time related EP and EEG data, the processing of images, the availability of atlases, their use in identifying anatomy and in matching with images, the provision of a multimedia database system, and the implementation of a hypermedia authoring application using material from all other components. There are many subsidiary -achievements that have contributed to this, being additional work done on the individual tools themselves, but very importantly the integration of these into a fully uniform environment.. It is an achievement also that this has been implemented on different hardware platforms, which proved more difficult than anticipated. The final achievement has been to implement the system at the four test sites where it is now full working and undergoing continued validation.

Validation is being performed at four differing test sites in four countries. This is giving a wide exposure to BrainWorks. It is now being used both in diagnosis and in education, and in building up a case collection. Helpful comments have been received which have enabled fine tuning to be made to the software it make it that much more useful.

The clinicians currently testing BrainWorks confirmed its usefulness for their diagnostic and educational work. Continuing clinical evaluation will lead to improved performance and stability of the entire system. Furthermore some additional features should be provided: two test sites expressed a strong need to make BrainWorks operable for teleconsultation across hospitals in a city.

Exploitation of BrainWorks will come in two phases.

Phase one starts aims at commercialising individual modules of BrainWorks. In addition commercial projects won by SAMMIE partners will commence. Ideally they will be in a similar area as SAMMIE and partners involved will profit from experience gained in system integration, consultancy and project management during the course of the current project. Two modules of BrainWorks are currently being negotiated.

Institutions professionally concerned with continuing education, e.g. the Aerztekammer Nordrhein wish to use BrainWorks.

Phase two will come after the end of another validation phase of BrainWorks. The goal of phase two will be to commercialise BrainWorks as a whole. Phase two builds on the expertise of commercialising individual parts of BrainWorks and it builds on the results of a wider and thus more representative validation phase. It is expected that conditions for marketing clinical workstations are much more favourable in 2 to 3 years from now on.

List of Deliverables

Year 1

Specifications of communication infrastructure (2/S/I)
Report on hardware requirements (6/R/I)
Specification of graphical interface (6/S/L)
Defining the clinical/educational requirements for brain (6/R/I)
Idealised 3D anatomical digital brain atlas (6/T/P)
Report on the system integration plan (8/R/I)
Toolbox for accessing, exchange, storage, retrieval, and more (9/T/I)
Tool for displaying curves and 2D maps (9/T/I)
Management report first year (12/R/I)
Imaging and modality models for a selected modality (12/T/I)
Toolbox for creation/update, manipulation of numeric (12/T/I)
Tool for storing radiological images in multimedia database (12/T/I)
Tool for display of images (12/T/I)
Report on current practice and future needs in neuroimaging (12/R/P)
Technical and functional specifications of interfaces (12/S/I)

Year 2

Prototype of an integrated personal and parallel system (3/P/I)
Report on infrastructure and clinical/teaching evaluation sites (3/R/P)
Demonstrator : BrainWorks I (6/P/I)
Report on system, Integration of BrainWorks I (8/R/I)
Tools for automated matching (9/T/I)
Management report second year (12/R/I)
Statistic anatomical digital brain model (12/T/P)
Report on localisation of MEG source using spherical model (12/R/I)
Tool for application programmable interfaces (12/T/I)
Tool for integration of hypermedia environment and user interface (12/T/I)
Tools for 3D visualisation of the brain atlas (12/T/I)
Tools for attribute based segmentation (12/T/I)

Year 3

Frame based symbolic model of brain (3/R/I)
Parallelized BrainWorks software (3/T/I)
Demonstrator: BrainWorks II (3/P/I)
Clinical and teaching evaluation of BrainWorks I (3/R/P)
Report on system integration of BrainWorks II (5/R/I)
Tool for integration of time related MR signals (6/T/I)
Report on advanced hypermedia user interface of data base (6/R/I)
Report on linking numeric and symbolic brain models (9/R/I)
Report on market viability of BrainWorks (9/R/I)
Management report third year (12/R/I)
Report on manual automatic segmentation and labelling (12/R/R)
Localisation using realistic model and MR images for EP (12/T/I)
Report on localisation of MEG sources using realistic model (12/R/I)
Clinical/teaching evaluation of BrainWorks II (12/R/P)
BrainWorks III (12/R/I)
3D visualisation of different modalities (12/R/I)

List of Participants

Dr. Franz Josef Schuier University Hospital Psychiatry Düsseldorf Division of Neurology Bergische Landstr. 2 D-4000 Düsseldorf, Germany Tel.: +49-211-280.12.23 Fax: +49-211-280.15.51	Dr. John Newell Dr. Ela Claridge University of Birmingham School of Computer Science Edgbaston Birmingham B15 2TT, U.K. Tel.: +44-21-414.47.78 Fax: +44-21-414.42.81 E-mail: newellja@bham.ac.uk
Ing. Martin Staemmler Fraunhofer Institut für Biomed. Technik Ensheimer Str. 48 D-6670 St. Ingbert, Germany Tel.: +49-6894-98.02.51 Fax: +49-6894-98.04.00	Prof. Jacques Pernier Inserm Unite 280 151 Cours Albert Thomas F-69424 Lyon, France Tel.: +33-72-33.08.84 Fax: +33-78-54.03.76
Prof. Jan Cornelis V.U.B. Faculty of Applied Sciences Etro Iris Pleinlaan 5 B-1050 Brussels, Belgium Tel.: +32-2-641.29.31 Fax: +32-2-641.28.83	Dr. Yiannis Galanos Intrasoft SA 2, Adrianiou Street GR-11525 Athens, Greece Tel.: +30-1-691.55.09 Fax: +30-1-692.52.59

[ SAMMIE (4 FW, 1994-1998) ]



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