The objective of radiologic image compression is to reduce the data volume of and to achieve a low bit rate in the digital representation of radiologic images without perceived loss of image quality. However, the demand for transmission bandwidth and storage space in the digital radiology environment, especially picture archiving and communication systems (PACS) and teleradiology, and the proliferating use of various imaging modalities, such as magnetic resonance imaging, computed tomography, ultrasonography, nuclear medicine, computed radiography, and digital subtraction angiography, continue to outstrip the capabilities of existing technologies. The availability of lossy coding techniques for clinical diagnoses further implicates many complex legal and regulatory issues. This paper reviews the recent progress of lossless and lossy radiologic image compression and presents the legal challenges of using lossy compression of medical records. To do so, we first describe the fundamental concepts of radiologic imaging and digitization. Then, we examine current compression technology in the field of medical imaging and discuss important regulatory policies and legal questions facing the use of compression in this field. We conclude with a summary of future challenges and research directions. >

Radiologic image compression-a review

Clinical assessment of skeletal maturity is based on a visual comparison of a left-hand wrist radiograph with atlas patterns. Using a new digital hand atlas an image analysis methodology is being developed. To assist radiologists in bone age estimation. The analysis starts with a preprocessing function yielding epiphyseal/metaphyseal regions of interest (EMROIs). Then, these regions are subjected to a feature extraction function. Accuracy has been measured independently at three stages of the image analysis: detection of phalangeal tip, extraction of the EMROIs, and location of diameters and lower edge of the EMROIs. Extracted features describe the stage of skeletal development more objectively than visual comparison.

Computer-assisted bone age assessment: image preprocessing and epiphyseal/metaphyseal ROI extraction

This paper proposes a three-dimensional (3-D) medical image compression method for computed tomography (CT) and magnetic resonance (MR) that uses a separable nonuniform 3-D wavelet transform. The separable wavelet transform employs one filter bank within two-dimensional (2-D) slices and then a second filter bank on the slice direction. CT and MR image sets normally have different resolutions within a slice and between slices. The pixel distances within a slice are normally less than 1 mm and the distance between slices can vary from 1 mm to 10 mm. To find the best filter bank in the slice direction, the authors use the various filter banks in the slice direction and compare the compression results. The results from the 12 selected MR and CT image sets at various slice thickness show that the Haar transform in the slice direction gives the optimum performance for most image sets, except for a CT image set which has 1 mm slice distance. Compared with 2-D wavelet compression, compression ratios of the 3-D method are about 70% higher for CT and 35% higher for MR image sets at a peak signal to noise ratio (PSNR) of 50 dB, In general, the smaller the slice distance, the better the 3-D compression performance.

Medical image compression by using three-dimensional wavelet transformation

Displacement estimated interframe (DEI) coding, a coding scheme for 3-D medical image data sets such as X-ray computed tomography (CT) or magnetic resonance (MR) images, is presented. To take advantage of the correlation between contiguous slices, a displacement-compensated difference image based on the previous image is encoded. The best fitting distribution functions for the discrete cosine transform (DCT) coefficients obtained from displacement compensated difference images are determined and used in allocating bits and optimizing quantizers for the coefficients. The DEI scheme is compared with 2-D block discrete cosine transform (DCT) as well as a full-frame DCT using the bit allocation technique of S. Lo and H.K. Huang (1985). For X-ray CT head images, the present bit allocation and quantizer design, using an appropriate distribution model, resulted in a 13-dB improvement in the SNR compared to the full-frame DCT using the bit allocation technique. For an image set with 5-mm slice thickness, the DEI method gave about 5% improvement in the compression ratio on average and less blockiness at the same distortion. The performance gain increases to about 10% when the slice thickness decreases to 3 mm. >

Statistical distributions of DCT coefficients and their application to an interframe compression algorithm for 3-D medical images

We applied three different model observers (non-prewhitening matched filter with an eye filter, Hotelling and channelized Hotelling) to predict the effect of JPEG image compression on human visual detection of a simulated lesion (clinically known as thrombus) in single frame digital x-ray coronary angiograms. Since the model observers' absolute performance is better than human, model performance was degraded to match human performance by injecting internal noise proportional to the external noise. All three model-observers predicted reasonably well the degradation in human performance as a function of JPEG image compression, although the NPWEW and the channelized Hotelling models (with internal noise proportional to the external noise) were better predictors than the Hotelling model.

Effect of image compression in model and human performance

Transform based compression methods achieve their effect by taking advantage of the correlations between adjacent pLtels in an image. The increasing use of three-dimensional imaging studies in radiology requires new techniques for image compression. For time-sequenced studies such as digital subtraction angiography, pixels are correlated between images, as well as within an image. By using three-dimensional cosine transforms, correlations in time as well as space can be exploited for image compression. Sequences of up to eight 512 x 512 x 8-bit images were compressed using a single full volume three-dimensional cosine transform, followed by quantization and bit-allocation. The quantization process is a uniform thresholding type and an adaptive three-dimensional bit-allocation table is used. The resultant image fidelity vs. compression ratio was shown to be superior to that achieved by compressing each image individually.© (1990) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Three-dimensional transform compression of images from dynamic studies

The purpose of this study was to assess the effect of ATM network capabilities on the clinical practice of regional teleradiology, by providing immediate interactive radiology consultations between subspecialists and general radiologists at affiliated academic institutions. PACS installed at three affiliated hospitals (UCLA Medical Center, West LA VAMC and UCLA Olive-View Medical Centers) were connected via an ATM network. Two commercial PACS (Agfa) systems, one at the VAMC and one in an ultrasound outpatient clinic at UCLA were connected via ATM switches (Newbridge, Inc.) and a Santa Monica GTE central office switch. We evaluated this initial system configuration and measured image transfer performance, including memory-to-memory, disk-to-disk, disk-to-archive with and without DICOM protocols. Although the memory-to-memory data rate was 25 Mbps, the average remote disk-to-disk image transfer performance, using DICOM 3.0 communications protocols on SUN SPARCstation 10 servers, was 3 to 5 Mbps. Using these capabilities, timely interactive subspecialty consultations between radiologists was successfully performed while both were at different physical locations. We present the use of ATM technology in a realistic clinical environment and evaluate its impact on patient care and clinical teaching within the radiology departments of 2 institutions. Image communications over a regional PACS using an ATM network can allow interactive consultations between different subspecialist and general radiologists or other specialized radiologist spread over three different medical centers.

Assessment of asynchronous transfer mode (ATM) networks for regional teleradiology

Transmission of high quality images between hospitals would be of value by exposing residents at individual institutions to a greater mix of disease processes. This problem is particularly serious in ultrasound where individual hospitals may not perform the entire range of examinations. We undertook this study to assess the effectiveness of image transmission via a PACS/ATM global network in improving ultrasound education among residents at affiliated hospitals. Image management was performed by AGFA PACS; global network was Asynchronous Transfer Mode. Selected cases from the two hospitals (OB/GYN cases at one, vascular at the other) were transmitted. Readout/teaching sessions included cases performed at base hospital and those received via network. Evaluation forms were collected from participants at both institutions. No image degradation occurred with transmission. Residents' exposure to ultrasound cases increased at the two hospitals. The system was considered an excellent teaching tool by all faculty and residents surveyed.© (1996) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Enhancement of resident education in sonography using high-speed PACS/ATM image transmission: work in progress

We assessed the effect of high background light on observer performance for the detection of a variety of chest radiographic abnormalities. Five observers reviewed 66 digital hard copy chest images formatted to 1 1 x 14 inch size under two display conditions: 1) on a specially prepared 1 1 x 14 inch illuminated panel with no peripheral light and 2) on a standard viewing panel designed for 14 x 17 inch radiographs. The images contained one - or more of the following conditions: pneumothorax, interstitial disease, nodules, alveolar process, or no abnormality. The results of receiver operator characteristic analysis show that extraneous light does reduce observer performance and the detectability of nodules, interstitial disease.© (1990) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Display conditions and lesion detectability: effect of background light

A high-definition, high-performance display station for reading and review of digital radiological images is introduced The station is based on a Sun SPARC Station 4 and employs X window system for display and manipulation of images A mouse-operated graphic user interface is implemented utilizing Motif-style tools The system supports up to four MegaScan gray-scale 2560 X 2048 monitors A special configuration of frame and video buffer yields a data transfer of 50 M pixels/s A magnetic disk array supplies a storage capacity of 2 GB with a data transfer rate of 4-6 MB/s The system has access to the central archive through an ultrahigh-speed fiber-optic network and patient studies are automatically transferred to the local disk The available image processing functions include change of lookup table, zoom and pan, and cine Future enhancements will provide for manual contour tracing, length, area, and density measurements, text and graphic overlay, as well as composition of selected images Additional preprocessing procedures under development will optimize the initial lookup table and adjust the images to a standard orientation© (1991) COPYRIGHT SPIE--The International Society for Optical Engineering Downloading of the abstract is permitted for personal use only

Alek S. Hayrapetian

Papers

Three-dimensional transform compression of images from dynamic studies

Assessment of asynchronous transfer mode (ATM) networks for regional teleradiology

Enhancement of resident education in sonography using high-speed PACS/ATM image transmission: work in progress

Display conditions and lesion detectability: effect of background light

X-window-based 2K display workstation