Abstract

The picture archiving and communications system (PACS) is currently the standard platform to manage medical images but lacks analytical capabilities. Staying within PACS, the authors have developed an automatic method to retrieve the medical data and access it at a voxel level, decrypted and uncompressed that allows analytical capabilities while not perturbing the system’s daily operation. Additionally, the strategy is secure and vendor independent. Cerebral ventricular volume is important for the diagnosis and treatment of many neurological disorders. A significant change in ventricular volume is readily recognized, but subtle changes, especially over longer periods of time, may be difficult to discern. Clinical imaging protocols and parameters are often varied making it difficult to use a general solution with standard segmentation techniques. Presented is a segmentation strategy based on an algorithm that uses four features extracted from the medical images to create a statistical estimator capable of determining ventricular volume. When compared with manual segmentations, the correlation was 94% and holds promise for even better accuracy by incorporating the unlimited data available. The volume of any segmentable structure can be accurately determined utilizing the machine learning strategy presented and runs fully automatically within the PACS.

Highlights

  • The Picture Archiving and Communications System (PACS) is currently the standard platform to manage medical images [1] but lacks analytical and quantification capabilities [2, 3]

  • Manual segmentations of the ten studied images selected were performed for comparison with the automatic ventricular volume estimator (AVVE)

  • Other meaningful features can be considered in the future, including those associated with age factors that are available in the DICOM headers within the PACS [29]

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Summary

Introduction

The Picture Archiving and Communications System (PACS) is currently the standard platform to manage medical images [1] but lacks analytical and quantification capabilities [2, 3]. Staying within the PACS, the authors have developed an automatic method to retrieve the medical data and access it at a voxel level, decrypted and uncompressed that enables analytical procedures to be applied to the data while not perturbing the system’s daily operation. Being able to segment the cerebral ventricles to determine the quantity of cerebrospinal fluid (CSF) within the ventricles has widespread applicability in many neurological conditions.

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