Simple, effective deployment of Web viewers for medical imaging in an open platform

Jodogne, Sébastien [UCL]

Objective: Web viewers of medical images are important as they allow for convenient access, sharing, and analysis of medical images across healthcare professionals and systems. In recent years, free and open-source Web viewers have emerged and become highly popular. For instance, OHIF proposes advanced visualization features, such as annotations, 3D segmentation, and hanging protocols, with applications to oncology [1]. As another example, Kitware VolView provides clinical professionals with interactive, cinematic volume rendering of DICOM data [2]. Unfortunately, such viewers may be difficult to deploy by physicians due to the required technical expertise, as well as to the complexity of integration with existing PACS and imaging modalities. In this work, a simple, effective way of deploying OHIF and VolView by a more general audience is investigated. Methods: Stone Web Viewer is another free and open-source teleradiology solution with deep learning capabilities [3]. Similarly to OHIF and VolView, the static assets of the Stone Web viewer (HTML, JavaScript, and CSS files) can be deployed on a standalone Web server and interfaced with any DICOMweb data source. However, Stone Web Viewer has the distinctive feature to also be available as a plugin for Orthanc, a lightweight, open, vendor-neutral DICOM server. By installing this plugin, Stone Web Viewer enables the immediate visualization of the images stored inside the local Orthanc database, without necessitating additional software. This is possible thanks to the fact that Orthanc comes with an embedded Web server, which plugins can use to serve their own static assets. We propose to use the same strategy to distribute OHIF and VolView as plugins for Orthanc. Results: Two new cross-platform plugins have been developed to deploy OHIF and VolView through Orthanc [4,5]. The source code of these plugins is publicly released under the GPLv3 license. Once installed, these plugins extend the Orthanc Explorer Web interfaces with dedicated buttons that directly open OHIF and VolView. This allows physicians to easily review the DICOM images that are stored on their own personal computer, without any complex setup. The official installers of Orthanc ship these plugins. Conclusion: Three complementary advanced Web viewers are now packaged as plugins for Orthanc, which greatly simplifies their deployment by non-technical audience, and avoids the need for IT support. By providing a smooth integration with an open PACS, these plugins lower the barrier to entry to explore the numerous possibilities offered by free and open-source viewers for medical imaging. In the future, other Web viewers such as Weasis will be packaged. [1] Ziegler, E. et al. (2020). Open Health Imaging Foundation Viewer: An Extensible Open-Source Framework for Building Web-Based Imaging Applications to Support Cancer Research. JCO Clinical Cancer Informatics, 4, 336–345. https://doi.org/10.1200/cci.19.00131 [2] Xu, J. et al. (2022). Interactive, in-browser cinematic volume rendering of medical images. Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 11(4), 1019–1026. https://doi.org/10.1080/21681163.2022.2145239 [3] Jodogne, S. (2023). Client-Side Application of Deep Learning Models Through Teleradiology. Medical Informatics Europe 2023. Studies in Health Technology and Informatics, Vol. 302, no.1, p. 997-1001 (2023). https://doi.org/shti230325. [4] https://book.orthanc-server.com/plugins/ohif.html [5] https://book.orthanc-server.com/plugins/volview.html