Poster Acm

Development of a Collaborative Environment applied to Pediatric Oncology André L. M. da Rosa

Ilana de A. Souza

Adilson Yuuji Hira

Marcelo Knörich Zuffo

Laboratório de Sistemas Integráveis (LSI) Engenharia de Sistemas Eletrônicos da Escola Politécnica da USP Avenida Prof. Luciano Gualberto, travessa 3 nº 380 - CEP - 05508-900 - São Paulo/SP, Brasil. 55 (11) 3091-9739 {amiranda,iasouza,ayhira,mkzuffo}@lsi.usp.br

ABSTRACT This project aims to brighten up those problems in the brazilian area of Pediatric Oncology, making possible the simultaneous collaboration of medical information between professionals of childhood cancer remotely located. It's the implementation of a collaborative environment in which the users can benefit itself with resources as Chat, Video-conference, Bidimensional Collaborative Blackboard and Collaborative Volumetric Visualization of medical images, also being able to get second medical opinion for diagnosis at distance for one or more cases of childhood cancer.

Categories and Subject Descriptors H.5. INFORMATION INTERFACES AND PRESENTATION H.5.3. Group and Organization Interfaces - Collaborative computing and Computer-supported cooperative work.

General Terms Algorithms and Human Factors.

Keywords Computer Supported Collaborative Work, Second Medical Opinion, Pediatric Oncology.

1.

INTRODUCTION

The main goal of this project is the specification and implementation of a communication and controlling protocol that provides the Computer Supported Collaborative Work (CSCW) systems services, using Telemedicine to apply it to Childhood Cancer. It allows that health professionals, located remotely, may visualize and argue (collaborating through the Internet) about digital medical images, such as Computerized X-rays and CT scans. This way, it provides efficient and precise diagnosis, besides allowing the exchange of information and the acquirement of new knowledge. It consists of chat, videoconference, collaborative bi-dimensional blackboard and collaborative Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. SAC’06, April, 23-27, 2006, Dijon, France. Copyright 2006 ACM 1-59593-108-2/06/0004…$5.00.

volumetric visualization, allowing contribution between the users.

better

interaction

and

The system presented here makes use of the diverse data from a medical image database in DICOM (Digital Imaging Communication in Medicine) or JPEG formats. Thus, the medical specialist that participates of the collaborative meetings will be able to talk in the text mode and/or videoconference mode and to visualize and/or manipulate medical examinations images of its respective patients, stored in the database, through the Collaborative Environment (CE) presented in each meet. This work is related to the telemedicine in childhood cancer project developed by the Laboratory of Integrated Systems of the Polytechnical School of São Paulo University (LSI-EPUSP), called "Oncopediatria", that is the conception of a communication system and long-distance processing to support medical practice aiming the establishment of a tele-health pilot net in Pediatric Oncology.

2. METODOLOGY, ARCHITECTURE AND IMPLEMENTATION The communication protocol was implemented in Java language. It was developed of such form that the creation of many meetings is possible, in the same moment, between different participants located in different geographic regions. For the collaborative tool, two auto-complementary software were developed: a Server, that is responsible for the control of all the existing meetings, and a Client, that is executed in the remote machines of each using specialist participant of a meeting. To allow the collaboration between users, the Java RMI technology (Remote Method Invocation) was used. A centered topology was used, becoming more easily manageable. Figure 1 shows the system architecture, where we can observe the user access to the application server through the Internet and the link of the server with the database. The implemented collaborative protocol allows different meetings to occur at the same time. It can be obtained using Sessions (considered logical abstractions that differentiate all the meetings that are happening at the same time) completely independent ones of the others, that will be able to have different users and collaborative data. The update solicitations created by the users are sent first to the server, that processes them and then sends updates notifications messages to all users of the respective session.

protocol (Real Time Transportation Protocol) for the audio and video real time transmission flow. The management of the videoconference also is made by the server software that controls all the collaborative sessions, and each user play both videoconference client and server (through a peer-to-peer connection), that means that it will transmit images and sounds as much as receive them. Figure 1: System Architecture This way, to minimize the message traffic in the system and also to prevent the necessity of constant verification of new updates (received by the server from another session user) because it’s dealing with a RMI connection, the client also keeps a Socket connection with the server to be able to receive session updates notifications.

Figure 2 shows a screen of the implemented client application, where it is possible to visualize the system with three participant users.

The Control Messages implemented by the protocol can be divided in some types: Session message (allows to the creation or exclusion of sessions in the server); Log message (allows the entrance or exit of a user to an existing session); Update message (allows to update the CE properties); Notification message (informs all the users from one session about CE updates); Text message (allows the communication in text mode between the session participants); and Videoconference message (allows the communication in videoconference mode with audio and video between the session users). In the client application, the following collaboration modules had been developed: Chat, Videoconference, Bi-dimensional Collaborative Blackboard (2D-CE – 2D Collaborative Environment) and Collaborative Volumetric Visualization (3DCE – 3D Collaborative Environment). The 2D-CE is a bi-dimensional area that allows the users its visualization and modification in a collaborative way and any modification (as notations inclusion) can be instantly visualized by all users. The 2D-CE contains the many operation options, represented by a toolbar that can be done over the user layer in the collaborative image, such as brush, rubber, geometric models, arrows, ruler, lines, text, movements, zooming, effects (Brightness, Contrast, Clearness, Blur, Inverse image and Filter) and calculations as point distances, angles and areas. We also developed the 3D-CE that is a module for data volumetric rendering by software. We used 3D graphical accelerating boards that support the OpenGL library (Open Graphics Library). For the implementation of this module, we used a library for game implementation with professional quality in Java, called LWJGL (Lightweight Java Game Library). We aim to provide the volumetric visualization of some images, for example, acquired from Computed Tomography using DICOM or JPG formats, beyond others. To test the system, we used the segmented images of Visible Human head [1] in JPG format. The Chat or text mode collaboration allows, beyond the conversation between the users, the visualization of text messages of the server (useful for some updates verification of user entrance or exit). The videoconference module allows the audio communication, with microphones, and the visualization of the session users through video, with webcams. The videoconference module was implemented with JMF technology (Java Media Framework) that is an extension of the Java technology with which it uses RTP

Figure 2: Client Collaborative Application.

3.

RESULTS

Nowadays, the system has being tested and evaluated by SOBOPE (Brazilian Society of Pediatric Oncology) doctors. The system is currently in phase of integration with the “Oncopediatria Portal”, also in development in our University. The execution of the CE will occur transparently to the user who will be able to click in a link on the Portal’s collaborative environment and the CE will be automatically working. For the CE calls, Java WebStart (JWS) technology is being used. According to Srinivas [2], some of its advantages are if the remote application is modified, an automatic version update of the local cache is done in the next invocation of the application and it allows that the applications may be executed independent from the web browser (allowing a communication freedom).

4.

DISCUSSIONS AND CONCLUSIONS

One of the problems found in the implementation of this system was the videoconference transference flow for sub-nets passing through NAT (Network Address Translation). A suitable solution was the use of NAT doors redirection for a internal net machine, where the chosen door could be specified in the CE to be used by the system.

5.

REFERENCES

[1]

Souza, I.A., Sanches-Jr, C., Binatto, M.B., Lopes, T.T., Zuffo, M.K. (2004). Direct Volume Rendering of the Visible Human Dataset on a Distributed Multiprojection Immersive Environment, Anais do VII Symposium on Virtual Reality (SVR’04), São Paulo, SP, Outubro, 183-194.

[2]

Srinivas, R. N., “Java Web Start Rescue – Find out how Java Web Start aids client-side deployment”, Java World. Available at http://www.javaworld.com/javaworld/jw-07-2001/jw-0706webstart.html. 5th July 2005.