Real-Time Healthcare Collaboration with Medical Imaging

Who is Electrosonic and how do your imaging solutions improve the capabilities of healthcare organizations?
Electrosonic is a manufacturer of electronic image streaming products applied to real-time telemedicine applications. Our lossless compression and network delivery technology have been applied in our VN-MATRIX encoder / decoder which is used to distribute computer visualization and high-definition video imagery in real-time across networks. Motion imagery originating from computers or medical imaging devices with very high resolutions such as WUXGA (1920x1200 pixels) or high-definition video of medical procedures or surgery is distributed across networks for presentation to colleagues at local or distant viewing locations. Applications such as Sonography, Pathology, Endoscopy, Flouroscopy or Ultrasound in particular benefit from this capability as they rely on use of both motion and static imagery. The application of these products has enabled the reach of individual expert medical professionals and specialist equipment to be extended far beyond the walls of a hospital or medical practice. Travel time and expense is avoided and analysis and decision making can be accelerated applying VN-MATRIX to professional collaboration.

What do you think is the most surprising capability that Electrosonic’s image streaming technology provides for medical imaging applications?

Electrosonic’s VN-MATRIX encoder/decoder supports real-time image presentation. Many radiology and medical imaging applications require that very large data files are forwarded across networks to distant colleagues. The large size of these files relative to common network connection capacities can require hours or minutes of transfer time. Large data sets also frequently overload computing devices which are not specifically designed to render motion images. These conditions frequently leave medical professionals with the impression that real time motion is rarely achievable. Applying VN-MATRIX streaming products avoids the need for files to be transferred. Medical professionals in multiple locations can view identical, full-motion imagery simultaneously across a network. The real-time performance allows professionals to interact while viewing identical imagery.

Is the VN-MATRIX solution operated on a Computer? Does it use a Microsoft Windows or Linux operating system?

Many applications which distribute medical imaging are software based and must reside on computing platforms. Electrosonic’s VN-MATRIX is an electronic hardware interface. These network devices provide the flexibility to interface many different medical imaging devices or video sources independently of any operating system platform such as Microsoft Windows or Linux.

Figure 1: Hardware image interfacing.

Effective telemedicine applications require that there is instantaneous (low latency) delivery of imagery. Is any kind of delay experienced streaming imagery between locations using VN-MATRIX?

Image delivery is performed in a fraction of a second, with minimal delay. VN-MATRIX requires only 35 milliseconds to encode or decode imagery. Network latency is typically microseconds on Local Area Networks (LAN’s) and milliseconds on Wide Area Networks (WANs) or Virtual Private Networks (VPN’s). Real-time high-definition video imagery has been streamed in real time across the United States on enterprise WAN’s using only a fraction of a second for end-to-end delivery. This fraction of a second delay allows two distant professionals to view and refer to identical imagery making the collaborative or consultative interaction natural and easy. No compromises are made viewing and analyzing visual data between distant locations.

Don’t medical applications require high-fidelity reproduction of imagery?

Yes, medical applications do require use of high quality images. VN-MATRIX is able to distribute imagery originating from large data sets presented on high resolution displays by applying a method of lossless compression. The Discrete Wavelet Transform (DWT) is applied in VN-MATRIX providing an efficient means to compact real-time image data. The DWT provides a platform that supports real-time processing while maintaining image quality (lossless or visually lossless) and real time performance when applied to high resolution images.
Wavelets are increasingly applied to medical imaging applications given the ability they provide to produce greater image compression efficiency and quality over classical Fourier methods and the Discrete Cosine Transform (DCT). Wavelets are also applied in the JPEG2000 compression standard which is popular in still image compression applications and digital cinema applications, both of which have the luxury of not requiring aggressive real-time compression to support real-time image distribution across networks.

How far can apart can collaborating medical professionals be located?

Medical professionals 1000’s of miles apart can collaborate with high resolution imagery in real time. High-definition video and computer graphic images are digitally captured and encoded by VN-MATRIX and standard Internet Protocol is used to distribute them. Because the images are distributed digitally they can maintain the detail and fidelity as they are as long as they remain in the digital, networked domain. Imagery can be distributed in real-time across buildings, cities, countries or across the world, wherever a network reaches.

Do medical imaging devices or computers require the use of any special software applications to collaborate using VN-MATRIX?

VN-MATRIX image streaming uses hardware signal interfaces such as the Digital Video Interface (DVI) frequently used to connect computing or medical imaging devices to flat panels. A BNC connector may also be used to interface high-definition video signals. The use of hardware image interfaces means that no special application software or operating systems are required to capture or distribute application imagery.

Do you see any trends in distributing live camera video in Telepresence or HD Operating Theater applications?

Yes, high-definition video has quickly become the preferred format for transmission of medical procedures and surgery from cameras. High definition video resolutions such as 720p (1280x720) or 1080p (1920x1080) are used. The fine, visual detail in high definition video systems produces imagery that creates a far greater lifelike experience for distant viewers in teleconferencing, and distance learning applications. Distributing high definition video to remote operating theaters across networks provides the following advantages:
• Sterile fields in the operating theater are not compromised
• Students and professionals can experience the procedure in a more relaxed remote location
• Surgeons are not distracted by the devices and thereby can remain focused on the surgical procedure
• Time and expense of travel is avoided by students

Figure 2: High Definition Operating Theater Application

What other image resolutions or image types can be captured and distributed in healthcare collaboration applications using VN-MATRIX?

Computer resolutions such as SVGA (800x600), XGA (1024x768), SXGA (1280x1024), SXGA+ (1400x1050) and WUXGA (1920x1200) can be interface through the DVI connector on a computer or medical imaging device. Data screens and graphic visualizations can be captured and distributed efficiently across networks preserving both the fine pixel detail and motion. Multimedia content that includes mixed data and video can also be efficiently captured and distributed with high efficiency.

How much network bandwidth might be required for healthcare collaboration applications that stream live imagery?

High definition video imagery may require 20 – 30 megabits per second to distribute full motion, lossless image content. High resolution computer graphic visualization imagery may require between 500 kilobits per second to 5 megabits per second. Controls exist in VN-MATRIX to cap or limit the network bandwidth produced by an encoder to fit within the specific limits of a LAN or WAN connection.

Do any concerns exist with using VN-MATRIX to transmit imagery on networks while they exposed to Electromagnetic interferences produced by medical scanning devices?

No, there are no concerns operating VN-MATRIX in locations where Electromagnetic interference may exist. Imagery is immediately converted to a digital, networked format and it can be distributed across optical fiber connections avoiding any risk of damaging the image detail.

Are there any special security or DICOM standards that need to be considered when applying VN-MATRIX to visual collaboration?

Real-time visual collaboration using VN-MATRIX avoids transfer of any confidential patient data. Live visual imagery is all that is distributed to the distant colleague and once an image is no longer presented from the origination site, it is no longer visible at the collaboration site. Data is maintained only in the original storage location, avoiding duplication of storage space and risk of unauthorized sharing of confidential patient data. VN-MATRIX is only applied to visual collaboration, consultation and education applications and it is not applied to direct diagnosis functions.

What do you see as the future for Electrosonic’s VN-MATRIX networked image distribution products?

The Electrosonic range of streaming and visual collaboration solutions will continue to grow into supporting high performance capture and presentation of real-time healthcare imagery. The product range will produce more specific application support and greater flexibility to support collaboration on a variety of hardware and computing platforms providing greater cost efficiency.