FLARE™ Data Management

2010-06-08

inviCRO and Beth Israel Deaconess Medical Center (BIDMC), a teaching hospital of Harvard Medical School, are collaborating on a special project to develop a data management system for the FLARE™ (FLuorescence-Aided Resection and Exploration) imaging system. The FLARE instrument, developed by Dr. John Frangioni of BIDMC, is an image-guided surgery tool that uses near-infrared light to visualize cancerous tissue in real-time. The collaboration addresses the need for a streamlined data storage, retrieval, viewing and analysis for large-scale image data generated by FLARE systems undergoing testing at multiple clinical sites worldwide.

For this project, inviCRO successfully adapted its web-based data management software, the iPACS®, to accommodate FLARE’s clinical data. All data will be stored in the iPACS image database in well-established PNG format with an expanded footer structure containing relevant study- and patient-specific information as well as a unique hierarchical identifier (UID) indicating study, series and image instance. The footer structure mimicks the DICOM standard for medical images, thus enabling easy transition between PNG and DICOM in the longer term. The iPACS® image database is capable to hold and seemlesly integrate DICOM and PNG images, even allowing to mix them within a project. The PNG format has the additional advantage that it requires no special software to view and process, since every modern operating system and web browser supports displaying the data. Also the additional meta-information is stored in a standardized way to allow for access by other applications.

Managing imaging studies on the iPACS enables FLARE users to organize and query data with a project-driven relational database outfitted with audit trail, role-based authorization, built-in reporting and analysis modules and simple right-click image and movie preview functionality. The integrated preview feature enables the rapid screening of large-scale FLARE video frames such that users can identify a specific range of footage to work with and/or disseminate. The web-based application allows users to access their data without any special software, just with their favorite web browser. Results can be exported as images or movies.

Above: Example from the iPACS Previewer function. A color video image in the top left panel shows a portion of the small bowel of a pig stomach.  A methylene blue fluorophore (700nm, top right panel) collects across all lymph nodes of the small bowel while an indocyanine green (ICG) fluorophore (800nm, lower left panel) is used to visualize both a lymphatic and associated sentinel lymph node.  The merged image in the lower right panel uses false color -- red for methylene blue, green for ICG -- to enable clear visualization of the ICG migration from the injection site through the lymphatic to the lymph node.