Network Security in Medical

Imaging
RAKESH SHARMA

FSU-TCC Intern 2009 at TMH

Biomedical Imaging Program
 Networking in Medical Imaging
• Medical and Personal Health data security
• Networking devices
• Manpower in networking and data sharing
• Network servers and remote data sharing
• Examples of data sharing in medical imaging
• Practices of secured data, medical data safety
 Network Security in Medical Imaging
Why it is needed?

• Critical Medical Information

• Patient Family Data
• Insurance and Bank Accounts
• Health benefits
• Benefactors’ Information

Everybody wants his/her data confidential

 Networking in Medical Data
• DICOM images PACS image storage and transfer is
DICOM (Digital Imaging and Communications in
Medicine) by communications and information
technologies
• PACS consists of four major components:
1. The imaging modalities such as CT and MRI,
2. Secured network (SSH, SETWIN, eFilm) for the
transmission of patient medical information,
3. Workstations for interpreting and reviewing
images, and archives for the storage and retrieval
of images and reports (Solaris, Octane, HP)
 Data Sharing in Medical Imaging
• store-and-forward, remote monitoring and
interactive services among: Juke Box 
Technicians Radiologists Main Server
• Send radiographic images from one location to
another by:
1. image sending station JUKE BOX,
2. a transmission network,
3. a receiving / image review station.
• The most typical implementation are two
computers connected via Internet.
 Network Servers
• Internet server is a conventional internet
web Linux IA server.
• Local Wiki system is installed in Linux
bootable USB flash memory drive.
• Server is based on FedoraCore2
(http://fedora.redhat.com/)
• Linux distribution of bootable USB flash
memory is based on Berry Linux
(http://yui.mine.nu/linux/eberry.html)
Data Sharing Among Remote Users
• Intranet system pen-based Mobile wireless Linux PC (Sony C1 VAIO 80 GB)
with IEEE 802.11 g
• Internet system Mojilla FireFox
• Local system Personal Digital Assistants (PDA) with LAN connectivity IEEE
802.11b or Palm OS 5.0 PDA(SONY Clue UX-50) or pocket PC 2002(Toshiba
e830) or Linux PDA(Sharp Linux Zaurus SL-C760)
• Laptop wireless Windows PC, a pen-based ultra-portable small Windows
PC (SONY VAIO type U) with weight 550 g, other conventional wired PCs,
and several personal digital assistants (PDAs) with wireless local area
network (LAN) connectivity (IEEE 802.11b) including Palm OS PDA (SONY
Clue UX-50 with Palm OS version 5.0), PocketPC2002 (Toshiba e830), and
Linux PDA (Sharp Linux Zaurus SL-C760).
• Mobile DICOM server had both wired LAN (100B-T) and wireless LAN
(IEEE 802.11 g) connectivity.
• PDA clients and wireless laptop PCs were connected with a mobile Linux
server using wireless LAN.
 DICOM Wiki: Knowledge Web Markup
Language: Database System for Radiologists
PRESS: H-1 MRI of Hippocampus

Sharma et al(2005)Slovenia Medica Informatica 11(2) 55-72.

Feature maps of different regions in MS
brain: Minimization of false lesion

Correction

False Lesion

Sharma et al (2005) Ad Seg Algorth Chapter 5

 How to Keep Security at Place?
• Network security using basic authentication of
web server, extended service set identifier (ESS-
ID), and wired equivalent privacy (WEP) key,
media access control (MAC) address filtering
• Each registered users (radiologists) manage the
DICOM images and attributed information using
Wiki pages and PHP scripts.
• Wiki allowed users to freely create and edit web
pages in any web browsers.
 How Data on Website is Safe?
• Wiki websites were secured using Message
Digest 5 encryption and basic authentication
of Apache web server.
• Safe measures against website attacks, such as
Cross Site Scripting (XSS) and Cross-Site
Request Forgeries (CSRF) attacks.
 User-friendly Communication
• Web conferences using intranet DICOM Wiki
website
• Add comments and discuss about educational
cases online.
• Wiki contents and image manipulation plugin
of DICOM Wiki
• interactive and easy to use, both image- and
text-based dynamic communication in the
web conference.
Education through Network Safety
• Web-based textbook of emergency
ultrasonography and lecture manuscripts
• Store DICOM image data using the DICOM
Wiki server.
• Wiki contents were easy and time-saving for
Radiologists
• Authenticated users own websites of teaching
files for easy and dynamic access
Teaching File: How Data is Safe
 MR-PET Applications
• Neurology
– Surgery and RT: delineation
of functionally significant
brain sections and tumor mass
– Movement disorders:
Delineation of gray matter
with receptor density
– Dementia: Structure
volumetry and metabolism
(FDG) or even Plaque Imaging
(FDDNP)
– Stroke: improve MR
perfusion by functional PET
– Epileptic foci: accurate
localization

Sharma(2005) Slov Inform.Med.1(2)55 .

 Anisotropy for Fiber Tracking:
Precursor of Alzheimer’s disease ?

Sharma et al (2005) Ad Seg

Algorth Chapter 5
AD: Where are sites of poor glycolysis?

Poor Glucose metabolism in both Temporal sites due to amyloid plaques

Sharma (2002) Adv. Segmentation Chapter 7,187
 Examples of Password Protection
• Data file (.doc, .pdf, .dicom, .tif, .jpeg, avg files)
• Executive program (DiCOM and MRIAP software)
• Image trafficking folder (.zip folder)
• Documentation files (.fpf)
• Owner protected internet files
• Owner protected documents with executable
software (ADOBE FLASH, AIR, MEDEX, ImageJ)
 Devices Used in Networking
• Mobile wireless DICOM server: secured
radiologists could access Wiki websites using the
mobile wireless DICOM server using the built-in
access point. through dynamic editable websites
using PDA.
• Mobile personal PACS
• Large-scale conventional DICOM server is
essential for hospital PACS. Personal PACS is a
useful supplementary system for radiologists
• Internet connectivity is safe but third-generation
(3G) cellular phones
 Conclusion
• DICOM Wiki web-based is content management system (CMS). Useful in:
• Internet website management is easy for portal site about radiology and
other collaboration work through (http://www.Wikiroom.com/kashiwa/).
• Efficient management of heavy, lossless diagnostic medical image data,
medical education.
• Web-based communication for group works for radiologists with high
scalability and accessibility.
• Web-based tools, templates, and database to create and manage the web
pages on a site.
• Enables a variety of (centralised) technical and (de-centralised) non-
technical staff to create, edit, manage, and finally publish (in a number of
formats) a variety of content (such as text, graphics, video, documents,
etc.)
 Resources
• http://www.adsc.com/ris.asp
• http://www.dicomsolutions.com/clinical-
specialties/radiology/radiology-pacs
• http://www.mckesson.com/
• http://precedings.nature.com/documents/3485/version/1
• A centralised set of rules, process, and networkflow to ensure
coherent, validated electronic contents. International
Congress Series Volume 1281, May 2005, Pages 980-985
• CARS 2005: Computer Assisted Radiology and Surgery