A Cloud-ready Architecture for Shared Medical Imaging Repository
This addresses the problem of secure, scalable medical imaging sharing for healthcare institutions and cloud services, though it is incremental as it builds on existing open-source archives.
The paper tackled the need for vendor-neutral, multi-repository medical imaging archives by proposing an ownership concept and access control mechanisms, resulting in a system that integrates with standard protocols and demonstrates robustness with acceptable temporal costs in production environments.
Background and Objective: Nowadays usage paradigms of medical imaging resources are requesting vendor-neutral archives, accessible through standard interfaces, with multi-repository support. Regional repositories shared by distinct institutions, teleradiology as a service at Cloud, teaching and research archives, are illustrative examples of this new reality. However, traditional production environments have a server archive instance per functional domain where every registered client application has access to all studies. This paper proposes an innovator ownership concept and access control mechanisms that provide a multi-repository environment and integrates well with standard protocols. Methods: A secure accounting mechanism for medical imaging repositories were designed and instantiated as an extension of a well-known open-source archive. A new Web services layer was implemented to provide a vendor-neutral solution complaint with modern DICOM-Web protocols for storage, search and retrieve of medical imaging data. Results: The concept validation was done through the integration of proposed architecture in an open-source solution. A quantitative assessment was performed for evaluating the impact of the mechanism in the usual DICOM Web operations. Conclusions: This article proposes a secure accounting architecture able to easily convert a standard medical imaging archive server in a multi-repository solution. The proposal validation was done through a set of tests that demonstrated its robustness and usage feasibility in a production environment. The proposed system offers new services, fundamental in a new era of Cloud-based operations, with acceptable temporal costs.