Global eye on TBI

By Peter Buxbaum
01:43 PM

Researchers studying traumatic brain injury (TBI) on behalf of the U.S. departments of Defense and Veterans Affairs have run into a problem. They must study clinical images of TBI, but the lack of compatibility among diverse clinical medical imaging systems has hampered efforts to visualize TBI data in one platform.TBI has emerged one of the more prevalent syndromes suffered by United States warfighters in the Iraq and Afghanistan campaigns. A study undertaken last year by the RAND Corporation found that 19 percent of returning service members may have suffered traumatic brain injury while deployed. The departments of Defense and Veterans Affairs are sponsoring several research efforts to understand the nature of TBI.Clinicians use a variety of technologies to assess neurological damage"CT scans, MRI, and ultrasound, among others. But the U.S.military uses multiple systems from vendors around the world when it cares for warfighters. An image created with one machine may not look the same or be viewable on other workstations or computers.

That is why the U.S. Army's Telemedicine and Advanced Technology Research Center (TATRC) is supporting a research project being conducted by the American College of Radiology (ACR) that seeks to handle this complexity by developing software that can bridge multiple imaging systems.

"The technology promises to provide a standardized platform for all to benefit from when studying TBI," said Anthony Pacifico, TATRC's medical imaging technologies manager.

The ACR project team, headed by ACR director Dr. Harvey Neiman, is developing neuro-imaging software that can run on any system adhering to an emerging application hosting standard known as the Digital Imaging and Communications in Medicine (DICOM) standard.

The software creates higher quality, more accurate 3D images from multiple imaging systems. The software also promotes interoperability, "enabling a military doctor in Iraq and a doctor at a hospital in the United States to use the same imaging software to look at the same image and consult over the best treatment," he said.

"Or a physician following up on an injured warfighter who has been sent home can access recent images with the same software used by the military instead of having to repeat the brain scan. Gaining one comprehensive image from all available data will aid decision making."

The neuro-imaging software is being created using the eXtensible Imaging Platform (XIP), an open source environment for rapidly developing DICOMcompliant medical imaging applications from a set of modular elements. XIP was jointly developed by the National Cancer Institute, Siemens Corporate Research Inc., and the Electronic Radiology Lab at the Washington University in St. Louis School of Medicine.

"Open-source software is an intriguing, cost-efficient way to enhance the potential of telemedicine to benefit warfighters," said Col. Ron Poropatich, deputy director of TATRC. "Software compatibility is also important in the military's move toward electronic health records that physicians can access no matter where the service member is deployed."

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