The rapid growth of digital technology in medical fields during the last few years has increased the need for applications able to manage patient medical records, imaging tests, and chart information. Technologies related with digital database architectures, storage and transmission protocols, management of large volumes of data, and security are being improved every day, allowing the possibility of reading, analyzing, and even diagnosing a case far from the medical center where the information was acquired.<\/p>\n
Furthermore, the inclusion of web-based applications applied to the medical imaging field has growing demand over the last few years in the medical community. The study of how applications can store and exchange this huge amount of information is becoming a new paradigm to solve present day limitations to managing medical data. Indexing tools based on the standard protocols allows a fast retrieval of the information and securities issues. Web-based applications in computational medicine have become increasingly important over the last few years. It supposed a new paradigm in the telemedicine and e-Health areas in order to assist and enhance the prevention, diagnosis and treatment of ailments. Furthermore, the training of radiologists and the management of medical databases are also becoming increasingly important issues in the field.<\/p>\n
In this domain, firstly, this thesis analyzes the main advantages and drawbacks of the reviewed work in web-based applications applied to the medical imaging field. Then, a web-based medical application including a system architecture based on digital imaging is presented. One of the main purposes of this PhD thesis is to offer an easy accessibility to web-based applications for users using a new system architecture. They can connect from any part of the world, providing this to be a time-saving and efficient mechanism to find information. In fact, this information can be saved directly in computers without the tiring task of searching in libraries or alternative databases. However, the access of the previous process is also available with the possibility of downloading medical annotations using query forms. Then collaborative work is possible by considering several opinions from different experts. Our system, being dedicated to medical imaging, manages the corresponding specific<\/p>\n
Digital Imaging and Communications in Medicine (DICOM) format. Finally, our web-based application also provides a high level security system.<\/p>\n
Prostate and breast cancer are the most common cause of cancers in men and women, respectively. Medical imaging plays an important role in breast and prostate cancer detection and evaluation. Then to prove that our web-based medical application could be applied in different medical disciplines, the main part of this thesis is the implementation of two frameworks as a Java applet interface designed as a web-based tool in the domains of mammography from X-rays in radiology, and of prostate imaging from an Magnetic Resonance Imaging (MRI). This aims to facilitate the diagnosis of new mammographic and prostate cases by providing a set of image processing tools that allow a better visualization of the images, and a set of drawing tools used to annotate the suspicious regions (overlays). Each annotation allows including the attributes considered by the experts when issuing the final diagnosis. The overall set of overlays is stored in a database as eXtensible Markup Language (XML) files associated with the original images. Finally, an exhaustive evaluation of the results is also discussed in this thesis. For the application on mammography, the experimental study is performed in order to evaluate the scalability, complexity and response speed at the proposed tool. For the application on MRI of prostate cancer, the evaluation focused on the decrease of the variability of the expert assessments when collaborative work is performed. To conclude, a new architecture with the main goal of managing patient databases with potentially multi-modal imaging is presented such as for an MRI of the prostate cancer and evaluation from potentially several experts.<\/p>\n
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El r\u00e0pid creixement de la tecnologia digital en el camp m\u00e8dic ha generat la necessitat de desenvolupar aplicacions que siguin capaces de gestionar grans volums de dades. Conseq\u00fcentment, les bases de dades digitals, els protocols d\u2019emmagatzement, la transmissi\u00f3 i seguretat es van millorant cada dia possibilitant la lectura, an\u00e0lisi i gesti\u00f3 de diagn\u00f2stics cl\u00ednics tant en el mateix centre m\u00e8dic o externament.<\/em><\/p>\n La inclusi\u00f3 d\u2019aplicacions web aplicades a la pr\u00e0ctica m\u00e8dica s\u2019ha incrementat notablement mitjan\u00e7ant els aven\u00e7os tecnol\u00f2gics dedicats a l\u2019an\u00e0lisi i processat d\u2019imatges digitals. En aquest sentit, el camp de la imatge m\u00e8dica te un rol molt important en aquesta \u00faltima d\u00e8cada gr\u00e0cies a eines basades en protocols que compleixen un format est\u00e0ndard i que permeten una r\u00e0pida recuperaci\u00f3 de la informaci\u00f3. Malgrat aix\u00f2, un dels majors inconvenients \u00e9s l\u2019intercanvi i emmagatzematge de gran quantitat d\u2019informaci\u00f3 provinent de centres m\u00e8dics. Ha suposat sens dubte un nou paradigma en el camp de la telemedicina en trobar aplicacions que puguin ajudar i millorar la prevenci\u00f3, diagn\u00f2stic i tractament de pacients. Aix\u00ed com la formaci\u00f3 de radi\u00f2legs i l\u2019aprenentatge per la gesti\u00f3 de base de dades m\u00e8diques cada vegada \u00e9s m\u00e9s necess\u00e0ria en el camp m\u00e8dic.<\/em><\/p>\n Hi ha molts avantatges en l\u2019\u00fas d\u2019aplicacions web en l\u2019\u00e0mbit m\u00e8dic. La principal avantatge es deu a la f\u00e0cil accessibilitat per als usuaris que poden connectar-se des de qualsevol lloc del m\u00f3n, l\u2019estalvi de temps i l\u2019eficient mecanisme per la gesti\u00f3 de la informaci\u00f3. A m\u00e9s, proporcionen eines que faciliten la desc\u00e0rrega d\u2019anotacions mediques aix\u00ed com alts nivells de sistema de seguretat. En el camp m\u00e8dic \u00e9s imprescindible tenir sistemes de seguretat i protecci\u00f3 de la informaci\u00f3 dels pacients. Per tant, les tecnologies d\u2019imatges digitals s\u2019han convertit beneficioses per les pr\u00e0ctiques m\u00e8diques modernes i sistemes d\u2019atenci\u00f3 de salut proporcionant ajuda per al diagn\u00f2stic, el tractament i la cirurgia.<\/em><\/p>\n Durant els \u00faltims anys, la taxa d\u2019incid\u00e8ncia en la detecci\u00f3 de c\u00e0ncer s\u2019ha reduit lleugerament en els homes i s\u2019ha mantingut estable en les dones, mentre que les taxes de mortalitat per c\u00e0ncer es va reduir en un 1,8% anual en els homes i un 1,4% per any en les dones. Aquesta reducci\u00f3 es deu en gran part a l\u2019an\u00e0lisi i processament d\u2019imatges m\u00e8diques i tot aquest conjunt d\u2019aplicacions d\u2019ajuda al diagn\u00f2stic del c\u00e0ncer. D\u2019una forma molt not\u00f2ria contribueix a la seva detecci\u00f3 preco\u00e7 mitjan\u00e7ant cribratge, diagn\u00f2stic, bi\u00f2psia guiada per imatges i arquitectures per la gesti\u00f3 de dades m\u00e8diques tals com base de dades d\u2019imatges digitals. En realitat, els c\u00e0ncers de pr\u00f2stata i mama s\u00f3n la causa m\u00e9s com\u00fa de mort per c\u00e0ncer comparat amb els altres. Per aquest motiu, el principal objectiu \u00e9s millorar les eines i aplicacions actuals per proporcionar una millor instrumentaci\u00f3 per obtenir una millor qualitat d\u2019imatges, aix\u00ed com, metodologies i procediments amb la finalitat de millorar la interpretaci\u00f3 de les lectures de la imatge.<\/em><\/p>\n En aquesta tesi es realitza una revisi\u00f3 bibliogr\u00e0fica de les principals publicacions recents en els \u00faltims anys en aplicacions m\u00e8diques basades en web. Aquest estudi analitza els avantatges i inconvenients dels treballs d\u2019investigaci\u00f3 en el camp de la imatge m\u00e8dica, aix\u00ed com les arquitectures de base de dades per a la gesti\u00f3 d\u2019imatges digitals. La part principal d\u2019aquesta tesi \u00e9s la implementaci\u00f3 d\u2019una eina basada en la web amb la finalitat de demostrar la integritat i aplicaci\u00f3 en diferents disciplines mediques. En aquest sentit, l\u2019aplicaci\u00f3 proposada en aquest projecte de tesis ha sigut implementada com a eina d\u2019ajuda al diagn\u00f2stic de c\u00e0ncer de mama i pr\u00f2stata. L\u2019objectiu \u00e9s facilitar el diagn\u00f2stic proporcionant un conjunt d\u2019eines de processat d\u2019imatge que permetin una millor visualitzaci\u00f3 de les imatges, i un conjunt d\u2019eines d\u2019anotaci\u00f3 de regions sospitoses o malignes (superposicions). Cada anotaci\u00f3 permet incloure tots els atributs i especificacions considerades pels experts a l\u2019emetre el diagn\u00f2stic final. S\u2019han dissenyat diferents arquitectures per a la gesti\u00f3 de base de dades (per exemple PACS per emmagatzemar imatges monogr\u00e0fiques). Per altra banda, el conjunt global d\u2019anotacions s\u2019emmagatzemen en una base de dades d\u2019arxius XML associats a les imatges originals. Conseq\u00fcentment, aquesta nova arquitectura es presenta amb l\u2019objectiu d\u2019obtenir una base de dades de casos diagnosticats i validats per radi\u00f2legs experts per a la formaci\u00f3 de radi\u00f2legs novells. Finalment, conclusions i noves l\u00ednies d\u2019investigaci\u00f3 associades al projecte com a treball futur s\u00f3n presentades en aquesta tesi.<\/em><\/p>\n <\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":"