Incorporating Radiology Teaching Files and

Microsoft® PowerPoint® Files into a MIRC System

William Weadock, MDFrank LondySarah AbateJames Ellis, MD

Department of Radiology

University of Michigan

Introduction - MIRC

• Web-based teaching file system

• Upload images and text

• Search for text with web browser

– Free text search

– Database field

• Free software created and supported by RSNA.

MIRC Basic Concepts

• 3 Main Components

– Storage

– Query

– Case creation

•Web-based authoring tool

•Web-based editor

– Our institution uses RadPix as the authoring tool

Why do we use MIRC?

• Created and supported by RSNA

• John Perry very responsive to questions and suggestions

• Ability to create / edit / export cases

• Well documented

• Emerging standard for teaching files

• Integrates with other systems

– MyPACS.net, etc.

Why do we use RadPix?

• PC program

– DICOM client to receive images

– Cropping, annotating, window / leveling

– Slide creation

• MIRC database fields

– History, Diagnosis, Pathology, etc.

• Upload completed PowerPoint presentations

• Search for text in presentations

Why do we use RadPix?

• Supports our library of collected DICOM images

• Since 1997

• Logical and flexible workflow

• Does not require Java installation

– Locked down PC’s in reading rooms

Disclosure

William Weadock, MDOwner, Weadock Software, LLC

http://www.RadPix.com

Goals of Teaching File System

• Public area – accessible to the department

• Private area - accessible only to the individual

• Content

– Images and text

– PowerPoint® Files

– Movies, animations, PDF’s, etc.

– Quality control

• Simple to search

Teaching File System Requirements

• Easy to Install

• Easy to Use

• Retain High Quality Images

• Add Textual Material

• Edit Cases

• Output Cases

• Simple PowerPoint® Slide Creation

• HIPAA

RadPix and MIRC Meet these Goals

RadPix / MIRC Workflow

• Review case on PACS

• Send individual images to RadPix DICOM client from PACS

• Load images into RadPix

• Enter textual data for case

• Upload case to MIRC from RadPix

Workflow Example

Workflow Animation in Progress

STEP 1

Teaching images are exported from PACS

Step 1

Exported images

STEP 2

Images are opened in RadPix

Workflow Animation in Progress

Step 2

Images in RadPix

STEP 3 – Option A

Images can be placed directly into a PowerPoint® Presentation

Step 3a

Send to PPT

Workflow Animation in Progress

STEP 4a – Option A

Use Power 2 MIRC to upload text and images to MIRC server

Step 4a

Power 2 MIRC

Workflow Animation in Progress

STEP 5 – Option A

View on MIRC server

Step 5

View on MIRC

Workflow Animation in Progress

STEP 3b – Option B

Export to MIRC server

Step 3b

Export to MIRC

Workflow Animation in Progress

STEP 4b – Option B

Add information with MIRC Authoring Tool

Step 4b

MIRC Authoring Tool

Workflow Animation in Progress

Workflow Animation in Progress

Step 5

View on MIRC

STEP 5

View on MIRC server

Workflow Animation Complete

• Two levels of users

–Authors•Faculty, fellows, residents, others

•Contribute material

–Publishers•Approve authors’ submissions

•Faculty

User Roles - Public

• Private files only they can access

• Multiple owners of a document

• Proxy creators

–Secretaries, others can create documents for faculty

Document Ownership

Michigan PACS Configuration

• Separate DICOM client for each division

– NeuroPC, BonePC, ChestPC, etc.

• Single PC with multiple DICOM clients receives all images– Same IP address– Different AETitle– Different port

• Workstations configured to send images

• All images routed to department-wide Novell network (n:\)

Image Routing

AbdomenAbdomen

DICOM Image

Catcher

NeuroNeuro ChestChest

Image Routing

• Result

–Bone images -> n:\bone\images

–Chest images -> n:\chest\images…

• Could also be configured as separate system for each radiologist

Problems

• Images collect on server

• Inadvertent sending of very large data sets

– 1000 + Images

– Disk drives fill up!

• Users must choose representative images

MIRC Authoring with RadPix

RadPix• MIRC support

• Windows®-based

• Loads DICOM images from PC Network

RadPix

Upload to MIRC

MIRC Authoring – Patient Information

MIRC Authoring – Case

MIRC Authoring – Categories

MIRC Authoring - Images

MIRC Authoring – Images - Annotate

MIRC Authoring - Access

Other files, including PDF, TIFF, DOC, XLS, etc. can be included

Video Files can be included

MIRC Authoring - Access

MIRC Authoring - Quiz

Sample Case – Annotated Image

Sample Case - Quiz

Uploading PowerPoint® files to MIRC with

RadPix Power 2 MIRC

Power 2 MIRC Features

• Extracts text from PowerPoint® files– Includes titles, text boxes, notes

• Splits PowerPoint® files– For example, if there are 15

different cases in a presentation, they can each be uploaded separately into MIRC

• MIRC data fields– History, findings, pathology, etc.

Power 2 MIRC Features

• Creates MIRC-compatible file

• Uploads to MIRC server

– Includes:•Snapshot image of slide•Text & notes from presentation•AVI video files•Other embedded files•Original PPT file

Sample PowerPoint® Slide

Notice the text on slideand in slide notes area

Slide notes

Example Slide in Power 2 MIRC

MIRC Search – “TOF”

MIRC Query Results – “TOF”

4 Documents

found

Sample PowerPoint® Slide in MIRC

Extracted Notes

Extracted Text

PowerPoint®

MIRC

Extracted Text from Slide

Notes

Extracted Notes from Slide

Notes

Current Status of our System

• CT, US, MRI conferences– 2000-2004– AVI’s included

• PPT files split up - 1 for each case

• Standardized template for conferences

• Medical student lectures – upcoming article in Journal of Digital Imaging

Future

• Local PC / Laptop support– Extract certain cases to local PC

• Search Local PC

• External UM MIRC site?

• RSNA Radlex– Replacement for ACR coding

• Access from outside world via Internet– Virtual Private Network (VPN)

MIRC Admin

HardwareSoftware

Michigan MIRC Server - Hardware• Dell 2.4 GHz PC

• 512 Mb RAM

• (2) 250 Gb disk drives

• Mirrored RAID

•Back up system!!!

Server Configuration

• Inside UM firewall

• Private UM IP subnet (172.20._._)

– Available only inside Institution

– Accessible via secure VPN over Internet

MIRC Server - Software

• Windows® 2000 Server

• Network Associates VirusScan 7.1

• Microsoft® Security Patches

• MIRC (http://mirc.rsna.org/mirc/query)

–Sun® Java 1.4.2

–Apache Tomcat 4.1.29

RadPix - Software

• Download trial software from

• http://www.radpix.com

• Includes :– RadPix– DICOM client (RSNA SimpleStorage)– RadPix MIRC Authoring Tool– Power 2 MIRC

Conclusions

• MIRC is becoming an integral component of University of Michigan web-based teaching file system.

• RadPix and Power 2 MIRC are used as authoring tools.

• PowerPoint® presentations and case files can be uploaded to MIRC system.

• Content may be either public or private.