DICOM Image ANalysis and Archive (DIANA): an Open-Source System for Clinical AI Applications.

Journal: Journal of digital imaging
Published Date: Nov 2, 2021

Abstract

In the era of data-driven medicine, rapid access and accurate interpretation of medical images are becoming increasingly important. The DICOM Image ANalysis and Archive (DIANA) system is an open-source, lightweight, and scalable Python interface that enables users to interact with hospital Picture Archiving and Communications Systems (PACS) to access such data. In this work, DIANA functionality was detailed and evaluated in the context of retrospective PACS data retrieval and two prospective clinical artificial intelligence (AI) pipelines: bone age (BA) estimation and intra-cranial hemorrhage (ICH) detection. DIANA orchestrates activity beginning with post-acquisition study discovery and ending with online notifications of findings. For AI applications, system latency (exam completion to system report time) was quantified and compared to that of clinicians (exam completion to initial report creation time). Mean DIANA latency was 9.04 ± 3.83 and 20.17 ± 10.16 min compared to clinician latency of 51.52 ± 58.9 and 65.62 ± 110.39 min for BA and ICH, respectively, with DIANA latencies being significantly lower (p < 0.001). DIANA's capabilities were also explored and found effective in retrieving and anonymizing protected health information for "big-data" medical imaging research and analysis. Mean per-image retrieval times were 1.12 ± 0.50 and 0.08 ± 0.01 s across x-ray and computed tomography studies, respectively. The data herein demonstrate that DIANA can flexibly integrate into existing hospital infrastructure and improve the process by which researchers/clinicians access imaging repository data. This results in a simplified workflow for large data retrieval and clinical integration of AI models.

Authors

  • Thomas Yi
    Warren Alpert Medical School at Brown University, Providence, RI, USA.
  • Ian Pan
    Warren Alpert Medical School, Brown University, Providence, RI.
  • Scott Collins
    Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA.
  • Fiona Chen
    Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA.
  • Robert Cueto
    University of Florida, Gainesville, FL, USA.
  • Ben Hsieh
    From the Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, China (H.X.B., Z.X., D.C.W., W.H.L.); Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., M.K.A.); Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (R.W.); Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology. Massachusetts General Hospital, Boston, Mass (K.C.); Warren Alpert Medical School at Brown University, Providence, RI (H.X.B., K.H., T.M.L.T., J.W.C., I.P.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, China (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, China (Q.H.Z.); Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, China (P.F.H.); Department of Radiology, Zhuzhou Central Hospital, Zhuzhou, China (Y.H.L.); Department of Radiology, Yiyang City Center Hospital, Yiyang, China (F.X.F.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (R.Y.H.); Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (R.S.); and Department of Radiology, The First Hospital of Changsha, Changsha, China (Q.Z.Y.).
  • Celina Hsieh
    Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA.
  • Jessica L Smith
    Department of Emergency Medicine, Rhode Island Hospital, Providence, RI, USA.
  • Li Yang
    Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
  • Wei-Hua Liao
    From the Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, China (H.X.B., Z.X., D.C.W., W.H.L.); Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., M.K.A.); Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (R.W.); Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology. Massachusetts General Hospital, Boston, Mass (K.C.); Warren Alpert Medical School at Brown University, Providence, RI (H.X.B., K.H., T.M.L.T., J.W.C., I.P.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, China (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, China (Q.H.Z.); Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, China (P.F.H.); Department of Radiology, Zhuzhou Central Hospital, Zhuzhou, China (Y.H.L.); Department of Radiology, Yiyang City Center Hospital, Yiyang, China (F.X.F.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (R.Y.H.); Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (R.S.); and Department of Radiology, The First Hospital of Changsha, Changsha, China (Q.Z.Y.).
  • Lisa H Merck
    Warren Alpert Medical School of Brown University, Providence, RI, USA.
  • Harrison Bai
    Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
  • Derek Merck
    Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy St, Main, Floor 3, Providence, RI, 02903, USA.

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