Journal List > J Korean Soc Radiol > v.76(3) > 1087769

Ko, Choi, Kim, Lee, Shin, Woo, Cho, Kim, Lee, and LOCAT Group: Central Image Archiving and Management System for Multicenter Clinical Studies: Lessons from Low-dose CT for Appendicitis Trial

Abstract

This special report aimed to document our experiences in implementing the Central Imaging Archiving and Management System (CIAMS) for a multicenter clinical trial, Low-dose CT for Appendicitis Trial (LOCAT), supported by the Korean Society of Radiology and Radiology Imaging Network of Korea for Clinical Research. LOCAT was a ran-domized controlled trial to determine whether low-dose CT is non-inferior to standard-dose CT with respect to the negative appendectomy rate in patients aged from 15 to 44 years. Site investigators downloaded the CT images from the site picture archiving and communication system servers, and uploaded the anonymized images to the primary server. CIAMS administrators inspected the images routed to the secondary server by a cross-check against image submission worksheets provided by the site investigators. The secondary server was automatically synchronized to the tertiary backup server. Up to June 2016, 2715 patients from 20 sites participated in LOCAT for 30 months. A total of 2539 patients’ images (93.5%, 2539/2715) were uploaded to the primary server, 2193 patients’ worksheets (80.8%, 2193/2715) were submitted, and 2163 patients’ data (79.7%, 2163/2715) were finally monitored. No data error occurred.

Index terms

Data Archiving, Medical Imaging, Multicenter Trials, Data Base Management Systems, Appendicitis

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Fig. 1.
CIAMS architecture paragraph. Site investigators download the image data from the site PACS servers, anonymize the personal informa-tion, and upload the image data to the primary server. CIAMS administrator inspects the images routed to the secondary server by a cross-check against image submission worksheets provided by the site investigators. The secondary server is automatically synchronized to the tertiary server. CIAMS = Central Imaging Archiving and Management System, eCRF = electronic case report form, PACS = picture archiving and communication system, PC = personal computer
jksr-76-165f1.tif
Fig. 2.
Image submission.
jksr-76-165f2.tif
Table 1.
Participating Sites in LOCAT
Site Site Principle Investigator
Daejin Medical Center, Bundang Jesaeng General Hospital Hyuk Jung Kim
Soonchunhyang University Bucheon Hospital Min Hee Lee
Seoul National University Bundang Hospital Ji Hoon Park
Hallym University Sacred Heart Hospital Min-Jeong Kim
Gachon University Gil Medical Center Seung Joon Choi
Chung-Ang University Hospital Sung Bin Park
Wonkwang University Hospital Young Hwan Lee
Soonchunhyang University Seoul Hospital Seong Sook Hong
The Catholic University of Korea, College of Medicine, Seoul St. Mary's Hospital Sung Eun Rha
Korea University Ansan Hospital Han Jin Cho
Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Mi Sung Kim
Hallym University Kangnam Sacred Heart Hospital Ji Young Woo
Severance Hospital Mi-Suk Park
Korea University Guro Hospital Jongmee Lee
Kangwon National University Hospital Seong Whi Cho
Keimyung University Dongsan Medical Center Mi Jeong Kim
Wonkwang University Sanbon Hospital Nurhee Hong
Chonnam National University Hospital Sang Soo Shin
Jeju National University Hospital Bong Soo Kim
Seoul National University Hospital Cheong-Il Shin

LOCAT = Low-dose CT for Appendicitis Trial

Table 2.
Required CT Imaging Parameters in LOCAT
Intravenous contrast enhancement
 Intravenous access
 Contrast material
 Scan timing
Scan
 Range
 Collimation
 Dose modulation program
Reconstruction
 Thin-client image distribution solution is available
  Thick transverse images
  Thin transverse images
 Thin-client image distribution solution is not available
  Thick transverse images
  Thick coronal images

LOCAT = Low-dose CT for Appendicitis Trial

Table 3.
Platforms and Functions for CIAMS Servers
Server Platform Function
Primary cloud image viewing server USA) TeraRecon iNtuition CLOUD (TeraRecon, Foster City, CA, User interface for site investigators' image data upload and image viewing. Routing image data to the secondary case registry server.
Secondary case registry server IRM Sandwich (IRM, Seongnam, Korea) Administrators' management of individual image files.
Tertiary backup server IRM Health Web Service (IRM, Seongnam, Korea) running on Amazon Web Services (Amazon Web Services, Seattle, WA, USA) Image data backup by synchronizing with the secondary case registry server.

CIAMS = Central Imaging Archiving and Management System

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