e-MIR2: a public online inventory of medical informatics resources

Background. Over the last years, the number of available informatics resources in medicine has grown exponentially. While specific inventories of such resources have already begun to be developed for Bioinformatics (BI), comparable inventories are as yet not available for Medical Informatics (MI) field, so that locating and accessing them currently remains a hard and time-consuming task. Description. We have created a repository of MI resources from the scientific literature, providing free access to its contents through a web-based service. Relevant information describing the resources is automatically extracted from manuscripts published in top-ranked MI journals. We used a pattern matching approach to detect the resources? names and their main features. Detected resources are classified according to three different criteria: functionality, resource type and domain. To facilitate these tasks, we have built three different taxonomies by following a novel approach based on folksonomies and social tagging. We adopted the terminology most frequently used by MI researchers in their publications to create the concepts and hierarchical relationships belonging to the taxonomies. The classification algorithm identifies the categories associated to resources and annotates them accordingly. The database is then populated with this data after manual curation and validation. Conclusions. We have created an online repository of MI resources to assist researchers in locating and accessing the most suitable resources to perform specific tasks. The database contained 282 resources at the time of writing. We are continuing to expand the number of available resources by taking into account further publications as well as suggestions from users and resource developers.

Methodology for registration of distended recutms in pelvic CT studies

Purpose: Accurate delineation of the rectum is of high importance in off-line adaptive radiation therapy since it is a major dose-limiting organ in prostate cancer radiotherapy. The intensity-based deformable image registration (DIR) methods cannot create a correct spatial transformation if there is no correspondence between the template and the target images. The variation of rectal filling, gas, or feces, creates a noncorrespondence in image intensities that becomes a great obstacle for intensity-based DIR. Methods: In this study the authors have designed and implemented a semiautomatic method to create a rectum mask in pelvic computed tomography (CT) images. The method, that includes a DIR based on the demons algorithm, has been tested in 13 prostate cancer cases, each comprising of two CT scans, for a total of 26 CT scans. Results: The use of the manual segmentation in the planning image and the proposed rectum mask method (RMM) method in the daily image leads to an improvement in the DIR performance in pelvic CT images, obtaining a mean value of overlap volume index = 0.89, close to the values obtained using the manual segmentations in both images. Conclusions: The application of the RMM method in the daily image and the manual segmentations in the planning image during prostate cancer treatments increases the performance of the registration in presence of rectal fillings, obtaining very good agreement with a physician's manual contours.

Methodology for registration of distended rectums in pelvic CT studies

Purpose: Accurate delineation of the rectum is of high importance in off-line adaptive radiation therapy since it is a major dose-limiting organ in prostate cancer radiotherapy. The intensity-based deformable image registration (DIR) methods cannot create a correct spatial transformation if there is no correspondence between the template and the target images. The variation of rectal filling, gas, or feces, creates a noncorrespondence in image intensities that becomes a great obstacle for intensity-based DIR. Methods: In this study the authors have designed and implemented a semiautomatic method to create a rectum mask in pelvic computed tomography (CT) images. The method, that includes a DIR based on the demons algorithm, has been tested in 13 prostate cancer cases, each comprising of two CT scans, for a total of 26 CT scans. Results: The use of the manual segmentation in the planning image and the proposed rectum mask method (RMM) method in the daily image leads to an improvement in the DIR performance in pelvic CT images, obtaining a mean value of overlap volume index = 0.89, close to the values obtained using the manual segmentations in both images. Conclusions: The application of the RMM method in the daily image and the manual segmentations in the planning image during prostate cancer treatments increases the performance of the registration in presence of rectal fillings, obtaining very good agreement with a physician's manual contours.

Organ-focused mutual information for nonrigid multimodal registration of liver CT and Gd–EOB–DTPA-enhanced MRI

Accurate detection of liver lesions is of great importance in hepatic surgery planning. Recent studies have shown that the detection rate of liver lesions is significantly higher in gadoxetic acid-enhanced magnetic resonance imaging (Gd–EOB–DTPA-enhanced MRI) than in contrast-enhanced portal-phase computed tomography (CT); however, the latter remains essential because of its high specificity, good performance in estimating liver volumes and better vessel visibility. To characterize liver lesions using both the above image modalities, we propose a multimodal nonrigid registration framework using organ-focused mutual information (OF-MI). This proposal tries to improve mutual information (MI) based registration by adding spatial information, benefiting from the availability of expert liver segmentation in clinical protocols. The incorporation of an additional information channel containing liver segmentation information was studied. A dataset of real clinical images and simulated images was used in the validation process. A Gd–EOB–DTPA-enhanced MRI simulation framework is presented. To evaluate results, warping index errors were calculated for the simulated data, and landmark-based and surface-based errors were calculated for the real data. An improvement of the registration accuracy for OF-MI as compared with MI was found for both simulated and real datasets. Statistical significance of the difference was tested and confirmed in the simulated dataset (p < 0.01).

Hidrogeología e hidrodinámica del acuífero de los manantiales de Gormaz y su importancia en el caudal base del río Duero, España = Hydrogeology and hydrodynamic of the Gormaz Springs Aquifer and its importance to the base flow of the Duero River, Spain

Se cuantifican las descargas subterráneas de un acuífero a un río que lo atraviesa utilizando correlaciones estadísticas. El río Duero, España, incrementa su caudal base en varios m3/s, al atravesar unos afloramientos carbonatados mesozoicos en un pequeño tramo de su cabecera; esto es de especial importancia en época de estiaje, cuando la mayor parte del caudal base del río procede de manantiales que allí se sitúan. Dichos afloramientos corresponden a uno de los dos acuíferos calcáreos confinados, que se desarrollan en paralelo y están hidráulicamente desconectados por una capa impermeable, que forman el sistema acuífero de los manantiales de Gormaz. Este sistema se encuentra en estado de régimen natural y está apenas explotado. Se define el modelo conceptual de funcionamiento hidrogeológico, considerando el papel hidrogeológico de la falla de Gormaz, situada en la zona de descarga del sistema. Analizando información geológica antecedente y la geofísica exploratoria realizada, se obtuvo un mejor conocimiento de la geometría y los límites de los acuíferos, definiéndose un sistema acuífero con una zona de recarga en el sur, correspondiente a los afloramientos calcáreos, los cuales se confinan hacia el norte bajo el Terciario, hasta intersecar con la falla normal de Gormaz. El salto de falla genera una barrera para las formaciones permeables situadas al extremo norte (margen derecha del río Duero); a su vez, el plano de falla facilita el ascenso del agua subterránea del sistema acuífero en estudio y pone en conexión hidráulica los dos acuíferos. Se estimaron, además, los parámetros hidráulicos de los acuíferos en los alrededores de la falla. La buena correlación entre los niveles piezométricos y las descargas subterráneas al río Duero han permitido la reconstrucción del hidrograma de los manantiales de Gormaz en el periodo 1992-2006. Se calcula así que la contribución subterránea al río Duero es de 135.9 hm3/año, que supone el 18.9% de la aportación total del río. In a short stretch of its headwaters, the base flow of the River Duero increases by several m3/s as it traverses some Mesozoic carbonate outcrops. This is of special importance during the dry season, when the majority of the base flow of the river proceeds from springs in this reach. The outcrops correspond to one of two confined calcareous aquifers that developed in parallel but which are not hydraulically connected because of an impermeable layer. Together, they constitute the aquifer system of the Gormaz Springs. The system is still in its natural regime and is hardly exploited. This study defines the conceptual model of hydrogeological functioning, taking into consideration the role of the Gormaz Fault, which is situated in the discharge zone of the system. Analysis of both antecedent geological information and geophysical explorations has led to a better understanding of the geometry and boundaries of the aquifers, defining an aquifer system with a recharge zone in the south corresponding to in the calcareous outcrops. These calcareous outcrops are confined to the north below Tertiary formations, as far as their intersection with the normal fault of Gormaz. The throw of the fault forms the barrier of the permeable formations situated in the extreme north (right bank of the River Duero). In turn, the fault plane facilitates the upflow of groundwater from the aquifer system and creates hydraulic connection between the two aquifers. In addition, the study estimated the hydraulic parameters of the aquifer around the fault. The close correlation between piezometric levels and the groundwater discharges to the River Duero has enabled the reconstruction of the hydrogram of Gormaz springs over the period 1992-2006. By this means, it is calculated that the groundwater contribution to the River Duero is 135.9 hm3/year, or 18.9% of the total river inflow.

Numerical study of ultrasound induced non-linear shape and size bubble oscillations in viscoelastic media

The theoretical study of forced bubble oscillations is motivated by the importance of cavitation bubbles and oscillating encapsulated microbubbles (i.e. contrast agents) in medical sciences. In more details,theoretical studies on bubble dynamics addressing the sound-bubble interaction phenomenon provide the basis for understanding the dynamics of contrast agent microbubbles used in medical diagnosis and of non-linearly oscillating cavitation bubbles in the case of high-intensity ultrasound therapy. Moreover, the inclusion of viscoelasticity is of vital importance for an accurate theoretical analysis since most biological tissues and fluids exhibit non-Newtonian behavior.

p-medicine: a medical informatics platform for integrated large scale heterogeneous patient data

Secure access to patient data is becoming of increasing importance, as medical informatics grows in significance, to both assist with population health studies, and patient specific medicine in support of treatment. However, assembling the many different types of data emanating from the clinic is in itself a difficulty, and doing so across national borders compounds the problem. In this paper we present our solution: an easy to use distributed informatics platform embedding a state of the art data warehouse incorporating a secure pseudonymisation system protecting access to personal healthcare data. Using this system, a whole range of patient derived data, from genomics to imaging to clinical records, can be assembled and linked, and then connected with analytics tools that help us to understand the data. Research performed in this environment will have immediate clinical impact for personalised patient healthcare.