SCT 35th Annual Meeting (2014) PHILADELPHIA, PENNSYLVANIA, USA - MAY 18-21, 2014

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1 Big File Client: Cloud medical Image Exchange for Image-based Clinical Trials Marisa De Rosa, Anna Covezzoli Health Care Department Cineca, Interuniversity Consortium - Italy SCT 35th Annual Meeting (2014) PHILADELPHIA, PENNSYLVANIA, USA - MAY 18-21, CINECA Who we are CINECA (www.cineca.it), established in 1969, is a non-profit Consortium of 69 Italian Universities iti for High Performance Computing and ICT, founded by the Ministry of University and Research CINECA is the most important supercomputing centre in Italy and one of the most advanced in Europe, ranked 15th among the supercomputing worldwide institutions Bologna B l (HQ) Top500 (http://www.top500.org) Rome Milan 1

2 The Clinical Consultation platform Cineca together with SIOPEL, the Childhood Liver Tumour Study Group, has developed a platform for exchanging large diagnostic image files for a clinical consultation forum on rare diseases. The platform has been developed on behalf of ENCCA (European Network for Cancer Research in Children and Adolescents). 3 Restricted Access The platform will be accessible through a personal account (username and password) from the Siopel website using an encrypted connection. 4 2

3 Flow chart Case Submission Panel Assignment Case Discussion Publication of results A clinician requests consultation Moderator approves and assigns case to relevant panels Panelists Review and reach consensus Moderator can reopen cases to discussion Moderator sends final recommendations to submitting clinician 5 Clinical Cosultation Forum CASE SUBMISSION BY CLINICIANS IT PLATFORM PANEL ASSIGNMENT BY MODERATORS PANEL REVIEW ONCOLOGY PATHOLOGY RADIOLOGY SURGERY CONCLUSIONS BY MODERATORS 6 3

4 User Profiles Clin nician Submit new cases Receive recommendations ators Moder Assign cases to relevant panel (Radiology, Pathology, Surgery, Oncology) Discuss recommendations with panel leaders Pane elists Individual review of the case Discuss recommendations with other panelists and panel leader Panel Lea aders Finalize panel review Discuss final recommendations with moderators Finalize recommendations and send them back to submitting clinician 7 Request for consultation Submitting a case In order to submit a case it is necessary to follow a three step process: Clinical Case registration Provide age, gender and open issue description Data, ecrf, images Fill in forms on radiology, pathology, surgery and oncology. Upload images (e.g. CT Scan, X- Ray, etc) Submit and ask for consultation Send the request for consultation to moderators 8 4

5 Platform Features Patient Summary for Moderators Final review management shared among the group alerts for new cases and final reviews Large Files Transfer Tool to support uploading large image files Big Data infrastructure to store patients diagnostic images & clinical information 9 Large Files Transfer Application Due to the size of clinical files to be shared (e.g. DICOM images) a dedicated client was developed The dedicated client will perform anonimization of DICOM images before uploading them on the server in Cineca 10 5

6 Large Files Transfer Application Users can easily transfer files or folders (entire CDs or DVDs) Advanced technology to easily enable stop and resume of active file transfers 11 Clinician user s interface 12 6

7 Large Files Transfer Application upload from your computer 13 Large Files Transfer Application: multiple files upload 14 7

8 Large Files Transfer Application: Transfer Configuration for uploading Limit upload bandwidth Set a transfer time window Clinical Cosultation Forum CASE SUBMISSION BY CLINICIANS PANEL ASSIGNMENT BY MODERATORS Data Base (Clinical data & Images) PANEL REVIEW ONCOLOGY PATHOLOGY RADIOLOGY SURGERY CONCLUSIONS BY MODERATORS 16 8

9 Moderators Forum Moderators will access to the platform to get patient information and to visualize the images, with two possibilities: 1) downloading the images from the web using the platform and then using local visualization tool 2) using direcly the platform on the web to visualize the images CINECA 17 Panel assignment Moderator Approval When case information is uploaded the Forum Moderators will access to thedatabasetostudythecaseandassignthecasetooneormore consultation panels: Radiology, Pathology, Surgery, Oncology 9

10 IT Tools for visualization of images online CINECA Radiology images management online 20 10

11 Panel Review Every panelist will fill in the review directly online based on images and information uploaded on the platform (without seeing what other reviewers have written). When all panelists have reviewed the case, panel Leader can open individual reviews to all panelists to discuss the case and create preliminary final panel review that will be sent to Moderators Clinical Case closure The Moderators will summarize recommandations coming from different panels and send the conclusion to the submitting clinician. 11

12 Conclusions The IT platform develloped d in the ENCCA Framework for sharing diagnostic images and CRFs for remote medical consultation around the world on rare tumours isveryusefulandcanbeused in other clinical settings for a real-time centralized diagnosis among specialists worldwide. CINECA 23 Thank you for your attention Marisa De Rosa, Anna Covezzoli Health Care Department Cineca, Interuniversity Consortium Italy The research leading to these results has received funding from the European Union's Seventh Framework Programme (FP7/ ) under the project ENCCA, grant agreement HEALTH-F

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