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New web-based Smart Uploader allows DICOM preview and erasure of burned-in annotations without software installations

In many clinical projects like clinical trials or second opinion workflows, medical images in DICOM format are exchanged between different parties. For this reason, and in order to erase burned-in annotations, software installation is needed. The new and innovative Smart Uploader from Clinflows changes this now.

Exchanging medical images in DICOM format is the daily business of many people involved in for example developments of new medical devices, new medications and clinical trials, as well as clinical training and education respectively. However, exchanging those images often comes with obstacles: DICOM images that are typically very large in size need to be pseudonymized and burned-in annotations to be erased. Thus, usually, the installation of at least one software is necessary. 

No local software installation needed and de-identifications tools embedded

We are proud to say that after months of intense development, the Clinflows-development team has managed to solve these challenges in a web application. Now, on our platform decidemedical, users can not only enjoy a tool which enables them to exchange medical data by just using a browser and not needing to install any software that would require administrator rights to do so – this is an enormous advantage, especially in hospitals, where staff is often working from different PCs as they are moving between operating rooms, cath labs or offices – they can also preview and select or de-select DICOM files to be sent at a time. By using our web-based software, users can simply open the web-browser, log in and send DICOM images on the go.

Preview and selection of DICOM series assures user control with just one tool

When using the Smart Uploader of decidemedical, a DICOM preview is created, displaying the standard DICOM structure with the item’s patient, study, series and images.

This is a great advantage, as it allows the user to de-select images which shall not be sent, be it unnecessary series or images to reduce the upload volume, and more importantly with regard to data protection the user can de-select patient protocols or other dicomized files containing private health information (PHI) which shall not be transferred. Hence, instead of first checking the content of the DICOM images on a separate local viewer, the user can now just preview series and images in the Smart Uploader during the data selection step of the upload process.

This will not only save time by potentially reducing the data volume, but it provides full control to the responsible uploader – the data controller according to GDPR – about which data are sent and follows the basic data protection rule of minimizing the shared data volume.

Transferring medical images and clinical data always means the user is dealing with sensitive patient data and this must be done with caution and in a responsible manner. This starts with the selection of what to be sent and making sure to be entitled to do so, with the consent from the patient.

Web-based erasure of burned-in annotations in DICOM images

When dealing with medical images in DICOM format one needs to understand that there are two different areas where private information from the patient can be stored. On the one hand, medical images contain so-called DICOM headers or tags. These are clearly defined headers with text or numeric information containing all sorts of data, like the time when the exam was taken, the name of the manufacturer of the diagnostic machine, the image modality, like CT, X-Ray, MRI etc. as well as information about the patient. For example, the DICOM tag (0010:0010) is reserved for the patient’s name. In decidemedical, sensitive DICOM tags are individually defined per project and then automatically removed or de-identified depending on the needs of a project.

But there is another layer which can contain patient information. These are the so-called “burned-in annotations“, which is part of the pixel information itself. Often one can find them especially in echocardiographies where the patient’s name or the name of the hospital is visible on the upper part of the echo image. These burned-in annotations can only be removed if an erasure tool is available, allowing to manually draw black boxes over the information to be hidden. Often, we had study coordinators asking us for advice on how to erase burned-in annotations as they do not have software available. 

And yes, we can give advice now! We are proud that our development team has managed to offer a solution that we have not seen being offered by any other web-based service provider, in a web based, so-called zero footprint solution! In our new Smart Uploader, the user can draw a box easily, place it over the annotation and apply it to the entire DICOM series. This is very comfortable and time-saving!

Really smart tool for really comfortable processes

Yes, we know, we are doing a little bit of self-praise here, but we are very proud that our development team has come up with something really smart as our Smart Uploader. 

To sum up, here’s what’s in it for you when using our new Smart Uploader:

  • Full control of what is uploaded by allowing a proper preview and easy DICOM data selection. 
  • DICOM headers are automatically de-identified per project definition.
  • Even burned-in annotations can be erased in the browser based Smart Uploader.
  • No software installation needed.

That’s really unmatched. And we hope you can feel it, too: We really love what we do.

About the author: 

Uwe Gladbach is a biomedical engineer, who started his career as a perfusionist in open heart surgery back in the 90ties. In more than 25 years he gained experience in the medical device industry in various positions, covering clinical research, as well as sales and operations in global positions. Uwe is the CEO and founder of ClinFlows.