View Point

Image Area

Medical Imaging
Advanced Imaging Solutions for Diagnosis, Localization, Treatment
Planning and Monitoring

www.infosys.com

Over the years, medical imaging has become vital in the early detection, diagnosis and treatment of various critical diseases. Today several
imaging modalities exist from the well-known x-ray, ultrasound, computed tomography (CT) and magnetic resonance (MRI) to more
recent nuclear imaging techniques such as position emission tomography (PET) and single-photon emission computed tomography
(SPECT) that target structural and functional body imaging. With the advent of hybrid imaging technologies like PET/CT and SPECT/
CT, and continued innovations in image processing and image analysis, the diagnostic imaging field is certainly slated for revolutionary
applications. In fact, advances in medical imaging technology are said to be the catalyst for the remarkable progress in cancer care and
research over the last two decades. A key development in this regard has been the creation of high speed networks that enable the
transfer, sharing and archiving of images and related data.

An imaging device in a radiology center or a hospital is connected with other systems in the hospital enterprise through a well-established,
automated workflow that typically includes the ordering of radiology exams, image acquisition, archiving, and data access by clinician
applications. The challenge and complexity of automated workflow lies in the processing and interpretation of the images. Software
plays a vital role in this regard. Applications such as image processing that register pre-operative and post-operative image data, can be
used to guide radiation therapy or surgical procedures, or for providing effective localization and treatment of neurological disorders such
as epilepsy and Parkinsons. Hybrid systems that leverage fusion of structural and functional data into single image (fusion modalities)
reduce inaccuracies caused by variations in patient positions and possible internal changes over time, however it remains to be seen if it is
physically possible to build additional hybrids other than PET-CT, SPECT-CT and MR-PET. Software based solutions have fewer constraints
and have the potential to combine data from different desired modalities whenever a suitable clinical application requires it. Software
image registration systems have been extremely useful in the fusion of data to plan therapy or to assess responses to therapy such as MRI/
CT registration for guiding deep brain stimulation therapy for Parkinsons disease. Similar solutions are also under investigation. Thus, as
hybrid modalities become more popular, image processing software solutions continue to provide new advances and clinical benefits that
are useful in many scenarios yet addressed by hybrid modalities.

02 | Infosys

Imaging Device, Connected Systems and Diagnostic Applications Overview

Reports
Creation

Re

po

rt

Patient

DICOM

Hospital Information
Systems (HIS)

Diagnostic
workstations, Clinical
applications, Image
guided therapy apps
etc.

Automatic
detection of
regions

PACS Storage
DICOM

Console App
Scan Interface
Patient Data Display

RIS Order
Filler

Advanced
measurements
e.g. Volume,
Thickness etc.

Multi-modal
co-registration
techniques

Diagnosis, Guide
treatment/surgical
intervention,
monitor treatment
progress

Computer
Aided
Diagnosis

Comparison of
Pre and Post
treatment data

Image
Processing
Algorithms

Image Processing
Standardization and Storage

Imaging
Modality

DICOM Digital imaging communication in medicine

Infosys PoV
Infosys believes that medical imaging software solutions are going to be increasingly used for diagnosis of diseases and guiding patient
treatment and surgery as well as monitoring the response to the treatment. In recent years, imaging solutions have gone beyond better
diagnosis to provide treatment planning, response evaluation and guiding intervention in areas such as pre-operative planning for
neurosurgeries. Hybrid modalities such as PET/CT and SPECT/CT and software based fusion imaging solutions that merge structural and
functional images are becoming more common, providing benefits in localization of tumors/cancer and neurological disorders. Infosys
position is that there is a growing need of focused software based image processing solutions and clinical applications for

Pre-surgical evaluation and planning

Surgical/treatment guidance

Quantitative assessment of treatment response

Research and development of custom image registration and

fusion technologies for more accurate localization of problem
areas

Efficient and faster ways to search clinical archives as evidence

based medicine gains more popularity

Effective communication of information

physicians, other clinicians/researchers

Evaluation of needs in emerging markets and create solutions

locally

to

referring

Infosys | 03

Challenges / Trends in Medical Imaging

Fusion modalities

Success of PET/CT has created a strong case for fusion modalities as they provide high sensitivity towards
cancer detection and more accurate localization.

Image guided
treatment

The use of image guided procedures provide a dependable reference and show a great potential in the
treatment of cancer, cardiac and neurological disorders.

Content Based
Image retrieval

Radiologist and researchers need frequent access to past radiological archives. Content based image retrieval
(CBIR) techniques such as query by image are being developed as a useful tool.

Image
processing R&D

There is a greater interest in software based image registration and fusion solutions since they combine the
benefits of dual modalities while helping to visualize and localize post-operative implants. New solutions
will continue to be R&D based as research for new algorithms continue to be vital to finding solutions for
certain clinical problems.

Improved User
Experience and
optimized workflow

Medical device manufacturers want to develop optimized workflows and intuitive GUIs for next generation
software applications in close collaboration with users. Next generation tablet devices such as IPads with
retina displays are being considered for use in imaging workflows.

04 | Infosys

Infosys Value Proposition

Infosys has affiliations with research institutes and hospitals in the areas of neurology, cardiology and radiology, in-house subject matter
experts and a research lab involved in creating medical imaging solutions.
These resources define the ecosystem used to create a broad range of services including:

2D/3D application development,

image processing algorithm research and development including image registration and fusion solutions,

DICOM-based image data interoperability management.

Infosys is also focused on building specific custom neuro-imaging solutions for registration of pre-and post-operative images such as
MRIs and CT scans for treatment guidance of neurological disorders. Our in-house research lab has created a solution for clinical data
mining featuring a query by image search. This solution incorporates a novel process and framework for quick navigation and search of
archived medical images, providing radiologists with the additional background information needed for delivering efficient diagnosis and
treatment. Infosys also offers digital watermarking and fingerprinting solutions for the security of images and videos. Clients can leverage
our ecosystem to access local hospitals and research institutions which can help enhance their solutions as well as tap emerging markets
like India.

Infosys | 05

Infosys Medical Imaging Service Offerings

06 | Infosys

Product
development/Reengineering

Applications for diverse modalities such as CT, SPECT, MRI and

ultrasound imaging
New GUI development and web based radiology workflow for improved
user experience
2D, 3D imaging and visualization
Imaging applications for mobile devices

Image Processing

Image processing algorithm development

Pre-processing filters and noise reduction
Post-processing algorithms Image registration etc
Custom image processing and image analysis solutions and diagnostic
measurements for clinical purposes
Content based Image retrieval (CBIR)
Algorithms for patient data security and privacy
Digital watermarking and fingerprinting

DICOM Standard
based
interoperability

DICOM format (Part 10 file) implementation for various IODs

DICOM communication services - Service Class Users (SCUs) and
Service Class Providers (SCPs)
Image Management - archive/retrieve, distribution to media (CD/DVD)
and image compression etc.
DICOM standard reports
Interfacing with other systems (PACS/RIS)

Verification and
Validation

Services across the complete V&V lifecycle including:

Functional testing, User acceptance testing, performance testing
etc.
Interoperability testing DICOM/IHE compliance
Test automation services
Test requirements development - alliance with users/ medical
domain experts in the relevant area
Test scripts and test automation framework development
Integration of 3rd party test automation tools e.g. Ranorex

Technology
Adoption Services

Assessment of existing technology solutions in the area of medical

imaging (candidate technologies)
Analysis and proof of concept (POC) development for candidate
technology solutions for a product application
Impact analysis and product migration to the new technology or
product enhancement using the new technology

Medical Imaging
Success Stories

Medicoms Clinical data

mining solution

Radiologists and researchers need frequent access to past clinical data. Existing medical
imaging solutions deployed in hospitals lack the capability of query by image search.
Infosys has created a solution to retrieve visually similar images using CBIR techniques
by organizing and classifying images based on user preferences using metadata. It also
supports region of interest ROI (ROI) and segmenting images, extracting image features
for enabling ROI-based CBIR.

For a leader in radiology products, infosys worked on the development and verification
of a web based radiology workflow system. This system helped automate the overall
workflow with significant reduction in per case time for radiologists.

Web-based
Radiology
Workflow System

Infosys | 07

About Infosys
Infosys partners with global enterprises to drive their innovation-led growth.
That's why Forbes ranked Infosys 19 among the top 100 most innovative
companies. As a leading provider of next-generation consulting, technology
and outsourcing solutions, Infosys helps clients in more than 30 countries
realize their goals. Visit www.infosys.com and see how Infosys (NYSE: INFY),
with its 150,000+ people, is Building Tomorrow's Enterprise today.

For more information, contact askus@infosys.com

www.infosys.com

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