Network Security in Medical Imaging

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Network Security in Medical Imaging
FSU-TCC Intern 2009 at TMH Biomedical Imaging Program

Networking in Medical Imaging
• • • • • • Medical and Personal Health data security Networking devices Manpower in networking and data sharing Network servers and remote data sharing Examples of data sharing in medical imaging Practices of secured data, medical data safety

Network Security in Medical Imaging Why it is needed?
• • • • • Critical Medical Information Patient Family Data Insurance and Bank Accounts Health benefits Benefactors’ Information Everybody wants his/her data confidential

Networking in Medical Data
• DICOM images PACS image storage and transfer is DICOM (Digital Imaging and Communications in Medicine) by communications and information technologies • PACS consists of four major components: 1. The imaging modalities such as CT and MRI, 2. Secured network (SSH, SETWIN, eFilm) for the transmission of patient medical information, 3. Workstations for interpreting and reviewing images, and archives for the storage and retrieval of images and reports (Solaris, Octane, HP)

Data Sharing in Medical Imaging
• store-and-forward, remote monitoring and interactive services among: Juke Box  Technicians Radiologists Main Server • Send radiographic images from one location to another by:
1. image sending station JUKE BOX, 2. a transmission network, 3. a receiving / image review station.

• The most typical implementation are two computers connected via Internet.

Network Servers
• Internet server is a conventional internet web Linux IA server. • Local Wiki system is installed in Linux bootable USB flash memory drive. • Server is based on FedoraCore2 ( • Linux distribution of bootable USB flash memory is based on Berry Linux (

Data Sharing Among Remote Users
• Intranet system pen-based Mobile wireless Linux PC (Sony C1 VAIO 80 GB) with IEEE 802.11 g • Internet system Mojilla FireFox • Local system Personal Digital Assistants (PDA) with LAN connectivity IEEE 802.11b or Palm OS 5.0 PDA(SONY Clue UX-50) or pocket PC 2002(Toshiba e830) or Linux PDA(Sharp Linux Zaurus SL-C760) • Laptop wireless Windows PC, a pen-based ultra-portable small Windows PC (SONY VAIO type U) with weight 550 g, other conventional wired PCs, and several personal digital assistants (PDAs) with wireless local area network (LAN) connectivity (IEEE 802.11b) including Palm OS PDA (SONY Clue UX-50 with Palm OS version 5.0), PocketPC2002 (Toshiba e830), and Linux PDA (Sharp Linux Zaurus SL-C760). • Mobile DICOM server had both wired LAN (100B-T) and wireless LAN (IEEE 802.11 g) connectivity. • PDA clients and wireless laptop PCs were connected with a mobile Linux server using wireless LAN.

DICOM Wiki: Knowledge Web Markup Language: Database System for Radiologists

PRESS: H-1 MRI of Hippocampus

Sharma et al(2005)Slovenia Medica Informatica 11(2) 55-72.

Feature maps of different regions in MS brain: Minimization of false lesion


False Lesion

Sharma et al (2005) Ad Seg Algorth Chapter 5

How to Keep Security at Place?
• Network security using basic authentication of web server, extended service set identifier (ESSID), and wired equivalent privacy (WEP) key, media access control (MAC) address filtering • Each registered users (radiologists) manage the DICOM images and attributed information using Wiki pages and PHP scripts. • Wiki allowed users to freely create and edit web pages in any web browsers.

How Data on Website is Safe?
• Wiki websites were secured using Message Digest 5 encryption and basic authentication of Apache web server. • Safe measures against website attacks, such as Cross Site Scripting (XSS) and Cross-Site Request Forgeries (CSRF) attacks.

User-friendly Communication
• Web conferences using intranet DICOM Wiki website • Add comments and discuss about educational cases online. • Wiki contents and image manipulation plugin of DICOM Wiki • interactive and easy to use, both image- and text-based dynamic communication in the web conference.

Education through Network Safety
• Web-based textbook of emergency ultrasonography and lecture manuscripts • Store DICOM image data using the DICOM Wiki server. • Wiki contents were easy and time-saving for Radiologists • Authenticated users own websites of teaching files for easy and dynamic access

Teaching File: How Data is Safe

MR-PET Applications
• Neurology
– Surgery and RT: delineation of functionally significant brain sections and tumor mass – Movement disorders: Delineation of gray matter with receptor density – Dementia: Structure volumetry and metabolism (FDG) or even Plaque Imaging (FDDNP) – Stroke: improve MR perfusion by functional PET – Epileptic foci: accurate localization

Sharma(2005) Slov Inform.Med.1(2)55


Anisotropy for Fiber Tracking: Precursor of Alzheimer’s disease ?

Sharma et al (2005) Ad Seg Algorth Chapter 5

AD: Where are sites of poor glycolysis?

Poor Glucose metabolism in both Temporal sites due to amyloid plaques
Sharma (2002) Adv. Segmentation Chapter 7,187

Examples of Password Protection
• • • • • • Data file (.doc, .pdf, .dicom, .tif, .jpeg, avg files) Executive program (DiCOM and MRIAP software) Image trafficking folder (.zip folder) Documentation files (.fpf) Owner protected internet files Owner protected documents with executable software (ADOBE FLASH, AIR, MEDEX, ImageJ)

Devices Used in Networking
• Mobile wireless DICOM server: secured radiologists could access Wiki websites using the mobile wireless DICOM server using the built-in access point. through dynamic editable websites using PDA. • Mobile personal PACS • Large-scale conventional DICOM server is essential for hospital PACS. Personal PACS is a useful supplementary system for radiologists • Internet connectivity is safe but third-generation (3G) cellular phones

• DICOM Wiki web-based is content management system (CMS). Useful in: • Internet website management is easy for portal site about radiology and other collaboration work through ( • Efficient management of heavy, lossless diagnostic medical image data, medical education. • Web-based communication for group works for radiologists with high scalability and accessibility. • Web-based tools, templates, and database to create and manage the web pages on a site. • Enables a variety of (centralised) technical and (de-centralised) nontechnical staff to create, edit, manage, and finally publish (in a number of formats) a variety of content (such as text, graphics, video, documents, etc.)

• • • • • A centralised set of rules, process, and networkflow to ensure coherent, validated electronic contents. International Congress Series Volume 1281, May 2005, Pages 980-985 • CARS 2005: Computer Assisted Radiology and Surgery

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