Grid Applications in Health

11

Valencia, SPAIN, 2009

Grid Grid Applications in Applications in

HealthHealthAndres Gómez, PhDAndres Gómez, PhD

CESGACESGA

[email protected]@cesga.es


http://eimrt.cesga.es

Provide terminology

Show real clinical real applications

Some legal issues

Future

OBJECTIVES



GRID INFRASTRUCTURE



HEALTH GRID REQUIREMENTS

Data confidentiality

Interactivity

Work-flow

Fast return of short jobs

Hide infrastructure details (portals)



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



CLINICAL RADIOTHERAPY

60-70% cancer

patients

Established methods

Many protocols





DATA ACQUISITION

DICOM-CT

INCLUDES PATIENT’S DATA

IMAGES

NEEDS ANONIMYZATION/SECURITY

ACCESS FROM GRID

TRENCADIS

MEDICAL DATA MANAGER (EGEE)



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



MEDICAL DATA MANAGER. Get data

Source: EGEE. Johan Montagnat



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



TREATMENT SELECTION

CONFORMAL RADIOTHERAPY (CRT)

INTENSITY MODULATED

RADIOTHERAPY (IMRT)

IMAGE GUIDE RADIOTHERAPY (IGRT)

BRACHITHERAPY

ETC.




TUMOUR

Organ at risk

Accelerator

Multileaf CollimatorCollimator takes the shape of the tumour

Tumour is irradiated from several angles

CONFORMAL RADRIOTHERAPY (CRT)



Organ at risk

TUMOUR

Collimator moves during beam-time, modulating intensity

Also from different angles

INTENSITY MODULATED RADIATION THERAPY (IMRT)



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



DOSE CALCULATION



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



eIMRT Proposal

CTs Treatment

• Commisioning• Verification < 5 hours • Optimization < minutes

Resu

lts

Results

TPS

BEFORE

WITH E-IMRT



ARCHITECTURE

Service Oriented Architecture

Based on GRID technologies

SERVERCLIENT

GRID + CLUSTER

PERSONAL DATA REMOVED FROM INPUT FILES BEFORE UPLOAD



ARCHITECTURE

SOA Architecture

Based on GRID technologies

SERVER SIDEDEMO CLIENT

GR

IDW

AY

SLA

DR

MA

A



DRMAA

Init/exit Job template interfaces Job submit

Individual jobs Jobs arrays (bulk)

Job monitoring and controlAuxiliary or system routines



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



SLA Negotiation overview

GRIDWAYGRIDWAYTREATMENTSERVICES

SLASLA

DRMAA

SLA Negotiator

client

SLA Negotiator

server

GRIDGRID

EXTERNALRESOURCES

PROVIDER



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



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



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

)



E-IMRT VERIFICATION (III)



PLAN OPTIMIZATION. EIMRT SERVICE

BASED ON MCDOSE

OPTIMIZE FLUENCES

RETURNS SEVERAL TREATMENT

POSSIBILITIES

GENERATE DVH FOR CHECK




PLAN OPTIMIZATION. EIMRT SERVICE




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



RESEARCH CHALLENGES HEALTHGRID

Source: http://eu-share.org/roadmap/SHARE_roadmap_long.pdf



RESEARCH CHALLENGES HEALTHGRID



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



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



Grid Computing vs Cloud Computing

Source:Trends.google.com

Cloud Computing



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“



Cloud Computing

3838


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Grid Applications in Health