Integrating research and clinical neuroimaging for the evaluation of traumatic brain injury recovery

Advanced MRI research and other imaging modalities may serve as biomarkers for the evaluation of traumatic brain injury (TBI) recovery. However, these advanced modalities typically require off-line processing which creates images that are incompatible with radiologist viewing software sold commercially. AGFA Impax is an example of such a picture archiving and communication system(PACS) that is used by many radiology departments in the United States Military Health System. By taking advantage of Impax’s use of the Digital Imaging and Communications in Medicine (DICOM) standard, we developed a system that allows for advanced medical imaging to be incorporated into clinical PACS. Radiology research can now be conducted using existing clinical imaging display platforms resources in combination with image processingtechniques that are only available outside of the clinical scanning environment. We extracted the spatial and identification elements of theDICOM standard that are necessary to allow research images to be incorporatedinto a clinical radiology system, and developed a tool that annotates research images with the proper tags. This allows for the evaluation of imaging representations of biological markers that may be useful in theevaluation of TBI and TBI recovery.