Clinical Trial Administrator's Manual

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This article describes how to configure a MIRC storage service for clinical trials. It applies to the RSNA MIRC implementation, and it is intended for MIRC site administrators.

A MIRC storage service includes several components specifically oriented to clinical trials. These components, called services, work together to support a single trial. When a MIRC site must support multiple clinical trials, multiple storage services are installed, one for each trial. Generally, if one or more teaching file components are required on a site, they are supported by separate storage services.

The key services related to clinical trials are:

  • DICOM Import Service - a DICOM Storage SCP that receives DICOM objects (typically from modalities or PACS) using the DICOM protocol.
  • HTTP Import Service - a service that receives DICOM, XML, or Zip objects (typically from remotely located imaging centers) using the HTTP or HTTPS protocol.
  • DICOM Export Service - a DICOM Storage SCU that forwards DICOM objects received by the HTTP Import Service to DICOM Storage SCPs using the DICOM protocol.
  • HTTP Export Service - a service that forwards DICOM objects received by the DICOM Import Service to HTTP Export Services (typically at other locations).
  • Database Export Service - a service that forwards DICOM, XML, Zip, or file objects to an interface to an external database, allowing athe construction of a trial-specific database outside the scope of MIRC.

For historical reasons, these are called the DICOM Service, even though they support more than DICOM objects.

To facilitate the management of a multi-site trial, MIRC also includes the Update Service, a service that provides the clinical trial administrator control over the software and configuration files at remotely located imaging centers.

The RSNA MIRC project has developed several supporting applications and tools that cooperate in the operation of a trial. The most important of these is the FieldCenter application, which runs at a remotely located imaging center and automatically transmits images to the principal investigator site.

1 Overview

In a typical trial, the principal investigator's site is a MIRC site and each of the imaging centers run the FieldCenter application. The flow of data is depicted in the diagram below.

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The diode symbols depict firewalls at each site. The ones at the imaging centers block all inbound connections. The one at the principal investigator blocks all inbound connections except for at least one port, which is used to allow imaging centers to upload images and data files and to make connections to the MIRC site for downloading configuration files and software updates.

Typically, all transfers are done across the internet using secure sockets layer (SSL). A separate article describes how to configure Tomcat to support SSL.

The overall layout of the components in a MIRC site is shown below.

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2 The DICOM Service

2.1 The DICOM Import Service

2.2 The HTTP Import Service

2.3 The DICOM Export Service

2.4 The HTTP Export Service

2.5 The Database Export Service

3 The Update Service

4 The FieldCenter Application