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Medical image database for diagnosis and surgery

MediMedia: Stand 23

Computers are playing an ever-important role in assisting doctors and surgeons in their work. The MediMedia project has developed a database of medical cases that provides them with quick access to medical images to support diagnosis and surgical interventions. The original media (images, sounds, films, 4D models, text and hypermedia) may be in a variety of formats, such as X-ray, CT scans, etc.
The MediMedia system is based on Internet technology and XML, and its search engine enables users to query individual images and, at a higher level, case histories and surgical procedures. The information may be stored on a network of distributed servers - although the user is unaware of this. At present there are seven such databases, covering: 4D cardiac images, radiological images of the ear, digestive endoscopy, 3D pathology, orthopaedic surgery, patient records, and radiation therapy planning made with image sets such as NMR, X-rays and CT scans.

Hip Surgery
MediMedia provides an extensive database of medical case histories and surgical procedures. An example of the application of the MediMedia database is in pre-operative planning for the execution of medical interventions, such as hip surgery. Hip surgery, like other surgical interventions, requires precise alignment of the surgical instruments in 3D. In conventional surgery (i.e. non-IT supported), the surgeon aligns the instruments either visually or by recourse to real-time x-ray imaging. Although the latter provides precise alignment, it has the drawback of subjecting the patient to a relatively high radiation dose.
The IGOS project provides a number of different low-dose solutions. X-ray images and CT scans taken prior to the operation are processed by the IGOS system to make 3D computerized models of the patient's bones. The IGOS system enables the surgeon to visualize the area of interest and plan the precise details of the surgical intervention, such as the orientation and alignment of the various cuts. To help the surgeon make the various cuts intra-operatively (i.e. in real-time), the DISOS system provides plastic cutting guides (called templates) which are produced automatically using a computer-controlled milling machine. The template exactly fits the area of bone where it will be located, because the IGOS system has milled it to the precise 3D shape of the bone. During the operation, the surgeon attaches the template to the bone and uses it to guide the alignment of the cut.
MediMedia has been supported by the European Commission's Telematics Application Programme.

Adrian Rawlings, Euronet Associates, 22.11.99