Based on current research and development activities, a timeline with five stages of maturity levels for the development of the Digital Operating Room (DOR) during the first quarter of the twenty-first century will be outlined. In particular, there are several areas of technology development for the DOR such as (1) Devices, including signal detection and recording, robotics, navigation systems and simulation technologies, which allow more precision in the delivery of personalized interventional therapy; (2) Information and Communication Technology (ICT) Infrastructure and Standards, including Digital Imaging and Communications in Medicine (DICOM), Integrating the Healthcare Enterprise (IHE), the electronic medical record (EMR), and Therapy Imaging and Model Management System (TIMMS) infrastructure for the storage, integration, processing and transmission of patient specific data in and outside the operating room; and (3) Functionalities, including patient specific modeling for selected interventional processes, optimization of surgical workflow as well as TIMMS engines and repositories for improving the overall quality of surgical interventions. Patient specific modeling, work flow management and standards are key aspects for the development of DOR technologies. They will be the prerequisite for intelligent infrastructures and processes in the digital operating room of the future. Architectural aspects of an intelligent infrastructure, specifically a Therapy Imaging and Model Management System (TIMMS) and the Patient-Specific Model (PSM) as well as Standards and integration mechanisms are therefore briefly discussed in this paper.
Ionizing radiation from medical imaging now accounts for over 95% of all man-made radiation exposures and is the
single largest radiation source after natural background radiation. As a result, new techniques are under development for
reducing radiation exposure incurred in diagnostic radiography.
It was the purpose of this study to determine if a transmission X-ray tube and generator system in conjunction with a
flat-panel detector is capable of achieving diagnostic quality radiographic images at reduced radiation doses.
It was found that transmission tube technology, in combination with a flat-detector system, is capable of producing
radiographic images of sufficient quality for diagnostic medical imaging within certain parameters. It is postulated at this
time that when low mAs is required, as in imaging of neonatal and young pediatric patients, the transmission tube may
prove to be very effective in obtaining diagnostic images at reduced radiation dose.
Proc. SPIE. 6516, Medical Imaging 2007: PACS and Imaging Informatics
KEYWORDS: Modeling, Data modeling, Surgery, Imaging systems, Telecommunications, Printed circuit board testing, Systems modeling, Process modeling, Instrument modeling, Picture Archiving and Communication System
Appropriate use of Information and Communication Technology (ICT) and Mechatronic (MT) systems is considered by many experts as a significant contribution to improve workflow and quality of care in the Operating Room (OR). This will require a suitable IT infrastructure as well as communication and interface standards, such as DICOM and suitable extensions, to allow data interchange between surgical system components in the OR. A conceptual design of such an infrastructure, i.e. a Therapy Imaging and Model Management System (TIMMS) will be introduced in this paper.
A TIMMS should support the essential functions that enable and advance image, and in particular, patient model guided therapy. Within this concept, the image centric world view of the classical PACS technology is complemented by an IT model-centric world view. Such a view is founded in the special modelling needs of an increasing number of modern surgical interventions as compared to the imaging intensive working mode of diagnostic radiology, for which PACS was originally conceptualised and developed.
A proper design of a TIMMS, taking into account modern software engineering principles, such as service oriented architecture, will clarify the right position of interfaces and relevant standards for a Surgical Assist System (SAS) in general and their components specifically. Such a system needs to be designed to provide a highly modular structure. Modules may be defined on different granulation levels. A first list of components (e.g. high and low level modules) comprising engines and repositories of an SAS, which should be integrated by a TIMMS, will be introduced in this paper.