Introduction

Medical imaging in the broadest sense encompasses the key diagnostic techniques upon which modern medical treatment depends. The information carried in these images is crucial to treatment, cardiology, neurology, surgery, obstetrics, orthopedics, and pulmonary medicine. Yet there is today no successful and accepted means of supporting this broad range of medical data with digital image transmission, analysis, archiving, and interactive display.

The overall objective of the ICMIT is to develop and implement medical imaging technology which will lead to improved diagnosis and health care delivery as well as reduction in costs. The key to achieving this goal is to exploit new advances in imaging modalities, computer hardware and software, and network technology to store, retrieve, analyze, and deliver image data to the diagnosing physician.

Figure 1 represents the formidable medical imaging work volume defined by the intersection of the Applications, Technologies, and Modalities that encompass medical imaging. The ICMIT strategy is to identify commonalities among the Applications and similar features of the different Modalities such that the workspace given in the figure can literally be compressed to a small volume along the Technologies axis. This requires a detailed understanding of the individual clinical applications as well as broad access to many different medical imaging modalities. The Members and Sponsors of the ICMIT have been chosen to insure this coverage.

Benefits and Deliverables

Sponsors benefit by having access to ICMIT research that can be important in creating a favorable environment for their products and services. They have access to and can guide the development of technology within the Consortium. Ultimately, this technology will be delivered to the public domain where it will be proposed as a platform from which national and international standards can be constructed.

The Consortium envisions significant deliverables in the following areas:

• integration of the different medical data modalities into a unified framework;
• consistent support of open computer systems for medical imaging and information systems;
• comprehensive software support tools for national, international, and de facto image standards;
• open database designs that support multi-media hospital information requirements, including medical images and legacy SQL applications;
• bandwidth-on-demand networking designs that can deliver the performance required of medical imaging applications in a cost-effective manner;
• compression algorithms that optimize the information content in each individual medical imaging modality;
• multi-platform generic user interface designs for medical image delivery that have been thoroughly tested in clinical application.

Strategic Initiatives

Activities of the ICMIT may be divided into Strategic Initiatives and Tactical Initiatives. Strategic technology created by the ICMIT represents a platform from which Members and Sponsors can organize tactical implementations that will be directed to specific needs of the medical community.

The Core Strategic Initiatives are:

• image object software for supporting emerging industry standards;
• advanced image analysis and compression;
• patient information systems;
• economic modeling.

These four areas are key to the successful implementation of new paradigms in the cost-effective delivery of health care. By concentrating on specific strategic problems common to all medical imaging applications, the results will broad applicability to both existing and future health care systems. Figure 2 illustrates how medical imaging plays a vital role in health care delivery, assessment, and control.

Research, development, and implementation in these strategic areas will be performed by the Members and will be funded primarily by the Sponsors. The products of this strategic investment are available to the Members and Sponsors on an ongoing basis. They can be incorporated by the members and sponsors into products, or used in research programs and other endeavors at any time.

The strategic efforts of the consortium are designed to support open systems and industry standardization efforts. For this reason, all software and other strategic intellectual property porduced by the ICMIT will ultimately be distributed to the public, and the ICMIT will make every effort to bring these works forward for adoption as international standards. A detailed list of strategic objectives and deliverables is the subject of continuing refinement by the Members and Sponsors at biannual meetings.

Tactical Initiatives

The Tactical Initiatives undertaken by the ICMIT make use of the common strategic base developed by the Members. This makes it possible for Members and Sponsors to collaborate in approaching new applications that have previously been difficult for them to approach alone. Such collaborations - between non-profit institutions and corporations, between academic institutions and research laboratories, between engineering groups and medical practitioners - are an important paradigm for future advances in the type of multidisciplinary space which we know as health care. These projects generally rely on governmental, foundation, corporate, or other outside funding.

Examples of Tactical Initiatives of interest to the ICMIT are:

• image databases in a DCE/CORBA distributed computing environment;
• automated real-time analysis of mammograms using networked massively-parallel processors;
• telerobotics to support ultrasound diagnosis;
• consistent viewing stations for primary care, image diagnosis and image analysis;
• unified support for emerging medical data standards (DICOM-3, SNOMED, HL-7 and IP-9).