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Grid Applications in Health. Andres Gómez, PhD CESGA [email protected]. OBJECTIVES. Provide terminology Show real clinical real applications Some legal issues Future. GRID INFRASTRUCTURE. HEALTH GRID REQUIREMENTS. Data confidentiality Interactivity Work-flow Fast return of short jobs - PowerPoint PPT Presentation
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Valencia, SPAIN, 2009
Grid Grid Applications in Applications in
HealthHealthAndres Gómez, PhDAndres Gómez, PhD
CESGACESGA
[email protected]@cesga.es
Valencia, SPAIN, 2009
http://eimrt.cesga.es
Provide terminology
Show real clinical real applications
Some legal issues
Future
OBJECTIVES
Valencia, SPAIN, 2009
http://eimrt.cesga.es
GRID INFRASTRUCTURE
Valencia, SPAIN, 2009
http://eimrt.cesga.es
HEALTH GRID REQUIREMENTS
Data confidentiality
Interactivity
Work-flow
Fast return of short jobs
Hide infrastructure details (portals)
Valencia, SPAIN, 2009
http://eimrt.cesga.es
GRID HEALTH APPLICATIONS
Surgical simulation
Image processing
In silico drug discovery
Share patient’s images and data
Many more (EELA-2)Source: Crossgrid project
Source:EGEE
Source: EELA-2
Valencia, SPAIN, 2009
http://eimrt.cesga.es
CLINICAL RADIOTHERAPY
60-70% cancer
patients
Established methods
Many protocols
Valencia, SPAIN, 2009
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Valencia, SPAIN, 2009
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DATA ACQUISITION
DICOM-CT
INCLUDES PATIENT’S DATA
IMAGES
NEEDS ANONIMYZATION/SECURITY
ACCESS FROM GRID
TRENCADIS
MEDICAL DATA MANAGER (EGEE)
Valencia, SPAIN, 2009
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MEDICAL DATA MANAGER. Insert data
Source: EGEE. Johan Montagnat
J. Montagnat, et.al. ”A Secure Grid Medical Data Manager Interfaced to the gLite Middleware” in Journal of Grid Computing (JGC), 6 (1), pages 45–59, Kluwer, march 2008
Valencia, SPAIN, 2009
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MEDICAL DATA MANAGER. Get data
Source: EGEE. Johan Montagnat
Valencia, SPAIN, 2009
http://eimrt.cesga.es
ANATOMIC MODEL
DICOM-STRUCT
GTV
CTV
PTV TV
IV
GTV: Gross Target VolumeExtent of Tumour Visible on Scan
CTV: Clinical Target VolumeExtension of GTV to include possible microscopic disease or additional structures (e.g. seminal vesicles in prostate ca)
PTV: Planned Target VolumeInclude margins for organ motion, set-up inaccuracies (may be non-uniform i.e. larger margin AP than Inf-Sup)
Ensures CTV will be covered despite variables.
TV: Target or Treatment VolumeVolume Irradiated (if possible PTV=TV)
IV: Irradiated VolumeVolume, which receives a ‘significant’ dose
Valencia, SPAIN, 2009
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TREATMENT SELECTION
CONFORMAL RADIOTHERAPY (CRT)
INTENSITY MODULATED
RADIOTHERAPY (IMRT)
IMAGE GUIDE RADIOTHERAPY (IGRT)
BRACHITHERAPY
ETC.
Valencia, SPAIN, 2009
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TUMOUR
Organ at risk
Accelerator
Multileaf CollimatorCollimator takes the shape of the tumour
Tumour is irradiated from several angles
CONFORMAL RADRIOTHERAPY (CRT)
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Organ at risk
TUMOUR
Collimator moves during beam-time, modulating intensity
Also from different angles
INTENSITY MODULATED RADIATION THERAPY (IMRT)
Valencia, SPAIN, 2009
http://eimrt.cesga.es
DOSE CALCULATION.
SOFTWARE: TREATMENT PLANNING SYSTEM
USE FAST ALGORITHMS
RUN LOCALLY: WORKSTATIONS/CLUSTER
OUTPUTS (OPTIONAL)
DICOM-RTDOSE. CALCULATED DOSE
o Dose Matrix,
o Dose Points (2D & 3D),
o Isodoses,
o DVH
DICOM-RTPLAN: TREATMENT PLAN
o Fractionation,
o Tolerance,
o Patient Setup,
o Beams, & Sources
Valencia, SPAIN, 2009
http://eimrt.cesga.es
DOSE CALCULATION
Valencia, SPAIN, 2009
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PLAN VERIFICATION. EIMRT SERVICE
BASED ON BEAMnrc and DOSXYZ
MONTE CARLO
CALCUTES DOSE DISTRIBUTIONS FOR
AN EXISTING TREATMENT
ADDS TOOLS FOR COMPARING
REFERENCE AND CALCULATED
DOSES (3D GAMMA MAPS)
J. Pena, et. al. “eIMRT: a web platform for the verification and optimization of radiation treatment plans”, in press in Journal of Applied Clinical Medical Physics
Valencia, SPAIN, 2009
http://eimrt.cesga.es
eIMRT Proposal
CTs Treatment
• Commisioning• Verification < 5 hours • Optimization < minutes
Resu
lts
Results
TPS
BEFORE
WITH E-IMRT
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ARCHITECTURE
Service Oriented Architecture
Based on GRID technologies
SERVERCLIENT
GRID + CLUSTER
PERSONAL DATA REMOVED FROM INPUT FILES BEFORE UPLOAD
Valencia, SPAIN, 2009
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ARCHITECTURE
SOA Architecture
Based on GRID technologies
SERVER SIDEDEMO CLIENT
GR
IDW
AY
SLA
DR
MA
A
Valencia, SPAIN, 2009
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DRMAA
Init/exit Job template interfaces Job submit
Individual jobs Jobs arrays (bulk)
Job monitoring and controlAuxiliary or system routines
Valencia, SPAIN, 2009
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DRMAA
import org.ggf.drmaa.*;public class DrmaaRunJob {public static void main (String[] args) {
SessionImpl session = new SessionImpl();JobTemplateImpl jt = new JobTemplateImpl();session =(SessionImpl) SessionFactory.getFactory().getSession();try{
session.init(null);jt = (JobTemplateImpl) session.createJobTemplate();jt.setWorkingDirectory("wdir");//Basic parametersjt.setJobName("taskname.jt");jt.setRemoteCommand(“/bin/ls");jt.setArgs(“-al”);//Output files, from local to remote (including protocol)jt.setOutputPath("stdout." + SessionImpl.DRMAA_GW_JOB_ID+".txt");jt.setErrorPath("stderr." + SessionImpl.DRMAA_GW_JOB_ID+".txt");//Job submission to GridWayStgring id = session.runJob(jt);session.exit();
} catch (DrmaaException e) {e.printStackTrace();
} }}
Example
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SLA Negotiation overview
GRIDWAYGRIDWAYTREATMENTSERVICES
SLASLA
DRMAA
SLA Negotiator
client
SLA Negotiator
server
GRIDGRID
EXTERNALRESOURCES
PROVIDER
Valencia, SPAIN, 2009
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SLA components interaction
Provider List
Pre SLA
Broker Broker GW-SLAGW-SLA
GW Internal Struct
SLANegotiator
client
SLA Evaluation
SLANegotiator
server
Plugin GW-SLADB Services
GRIDWAY
Resourcesprovider
Valencia, SPAIN, 2009
http://eimrt.cesga.es
E-IMRT VERIFICATION
Phase 1: Accelerator simulation. Phase 2: Accelerator treatment head
simulation (GRID) Phase 3: Patient simulation. Phase 4: Dose delivered to the patient
(GRID) Phase 5: Dose collection and end of process.
Radiotherapist manuallycompares TPS and e-IMRT Monte Carlo
dosesUsing different maps
Valencia, SPAIN, 2009
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E-IMRT VERIFICATION (II)
Execution Time
193,5
21,3
5,0 4,1
1
10
100
1000
1 10 40 50N. CPUs
Tim
e (H
ours
)
Valencia, SPAIN, 2009
http://eimrt.cesga.es
E-IMRT VERIFICATION (III)
Valencia, SPAIN, 2009
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PLAN OPTIMIZATION. EIMRT SERVICE
BASED ON MCDOSE
OPTIMIZE FLUENCES
RETURNS SEVERAL TREATMENT
POSSIBILITIES
GENERATE DVH FOR CHECK
J. Pena, et. al. “eIMRT: a web platform for the verification and optimization of radiation treatment plans”, in press in Journal of Applied Clinical Medical Physics
Valencia, SPAIN, 2009
http://eimrt.cesga.es
PLAN OPTIMIZATION. EIMRT SERVICE
J. Pena, et. al. “eIMRT: a web platform for the verification and optimization of radiation treatment plans”, in press in Journal of Applied Clinical Medical Physics
Valencia, SPAIN, 2009
http://eimrt.cesga.es
INPUT/OUTPUT SUMMARY
Input:
DICOM RTplan
DICOM RTstruct
DICOM CT
DICOM RTdose (from TPS, optional)
Output:
DICOM RTdose (MCarlo)
Input: DICOM RTstruct
DICOM CT
Other data: Prescriptions
Output: DICOM RTplan
VERIFICATION OPTIMIZATION
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http://eimrt.cesga.es
RESEARCH CHALLENGES HEALTHGRID
Source: http://eu-share.org/roadmap/SHARE_roadmap_long.pdf
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RESEARCH CHALLENGES HEALTHGRID
Valencia, SPAIN, 2009
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LEGAL ISSUES
2007/47/EC of 5 September 2007 http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2007:247:0021:0055:EN:PDF
Medical device: “medical device” means any instrument, apparatus, appliance, software, material
or other article, whether used alone or in combination, together with any accessories, including
the software intended by its manufacturer to be used specifically for diagnostic and/or therapeutic
purposes and necessary for its proper application, intended by the manufacturer to be used for
human beings for the purpose of:
o diagnosis, prevention, monitoring, treatment or alleviation of disease,
o diagnosis, monitoring, treatment, alleviation of or compensation for an injury or handicap,
o investigation, replacement or modification of the anatomy or of a physiological process,
o control of conception
For devices which incorporate software or which are medical software in themselves, the software
must be validated according to the state of the art taking into account the principles of
development lifecycle, risk management, validation and verification
Valencia, SPAIN, 2009
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LEGAL ISSUES
Directive 95/46/EC of the European Parliament and of the
Council of 24 October 1995 on the protection of individuals
with regard to the processing of personal data and on the
free movement of such data
the processing of data concerning health is prohibited by default
Only allowed for clinical usage by health professional with
obligation of secrecy
Anyother case, patient consent
Valencia, SPAIN, 2009
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Grid Computing vs Cloud Computing
Source:Trends.google.com
Cloud Computing
Valencia, SPAIN, 2009
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Cloud Computing
“Clouds are a large pool of easily usable and accessible virtualized resources
(such as hardware, development platforms and/or services). These resources
can be dynamically reconfigured to adjust to a variable load (scale),
allowing also for an optimum resource utilization. This pool of resources is
typically exploited by a pay-per-use model in which guarantees are offered
by the Infrastructure Provider by means of customized SLAs.”
Luis M. Vaquero, et.al.: “A Break in the Clouds: Towards a Cloud
Definition“
Valencia, SPAIN, 2009
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Cloud Computing
3838
Valencia, SPAIN, 2009
THANK YOUTHANK YOU
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