UICC World Cancer Congress 2006

Objective: The National Cancer Institute's Radiation Oncology Sciences Program (ROSP) has been an active NCI component within the Ireland-Northern Ireland-NCI Cancer Consortium, which combines the cancer treatment capabilities of Dublin, Belfast, and Bethesda in an initial five-year relationship aimed at a multilevel attack on cancer in Ireland, since the Consortium's inception in September 1999. The Memorandum of Understanding, which legitimized the Ireland-Northern Ireland-NCI Cancer Consortium, specifically called for the implementation of an information technology infrastructure to support the aims of the Consortium.

The NCI has also supported the re-vitalization of the King Hussein Cancer Center (KHCC), in Amman, Jordan. Finally, the NCI supports the activities of both the International Network for Cancer Treatment and Research (INCTR) and the European Organization for Research and Treatment of Cancer (EORTC), in Brussels, Belgium, which led to another high-speed telemedicine application.

For these reasons, among others, the NCI is interested in high-speed medical image communication and telemedicine systems. The NIH's Center for Information Technology (CIT) and the NCI have, therefore, collaborated in the further development of a telemedicine architecture that was originally pioneered by CIT staff.

Methods: The TELESYNERGY® Medical Consultation WorkStation (MCWS) development was initially begun by CIT in the mid 1990s, and was first deployed in the NCI Radiation Oncology Branch and the CIT environments, on the NIH campus, in early 1997. The MCWS, which was originally based upon high-speed fiberoptic network technology, allowing real-time multimedia conferencing between distributed sites.

Contained within the MCWS are high-resolution Electronic View Boxes (EVBs) for the display of CT, MRI, or Plain Film images. Also included is a high-resolution video link for the presentation of a view of the consultant, the display of video-taped or live medical images, the display of histopathology images obtained from manual and remote-controlled microscopes, or a choice of other video sources. As a component of this project, a prototype high-speed medical image communication network was implemented, which allowed 155 Mbit/sec multimedia communication between users. The MCWS environment also provided Gateway access to remote/distant sites via high-speed Integrated Services Digital Network (ISDN) Primary Rate Interface (PRI) telephone circuits, at 1.544 Mbit/sec data rates.

Design and fabrication of an ISDN-based Central Communication Hub was completed during FY05, as a replacement for the original fiberoptic-based Central Communication Hub. Software development was initiated to embed the functionality of the TELESYNERGY® environment within the newly implemented ISDN-based Central Communication Hub. Rapidly nearing completion, is the task of converting the TELESYNERGY® WorkStation Software from its original Sun/Solaris workstation environment to the PC/Linux environment.

Results: TELESYNERGY® Systems were implemented at the Belfast City Hospital in Belfast, N.I., U.K., and at the St. Luke's Hospital in Dublin, Republic of Ireland (ROI), during the summer of FY02. A second ROI system was installed at the Trinity College Dublin's School of Radiation Therapy, in Dublin, during February of FY04. Two additional TELESYNERGY® Systems were installed at the Cork University Hospital, in Cork, ROI, and at the University College Hospital Galway, in Galway, ROI, during February and March of FY06. An ISDN-based Central Communication Hub was also installed at the Trinity College Dublin's School of Radiation Therapy, in Dublin, during March of FY06. Current plans call for at least five basic TELESYNERGY®-Lite Systems to be installed at smaller cancer centers throughout the ROI.

Since September 1999, we proposed and planned for the installation of a TELESYNERGY® System within the King Hussein Cancer Center (KHCC), in Amman, Jordan, as part of the NCI-Jordan Cancer Consortium. The installation of this most advanced TELESYNERGY® System, was successfully completed during January of FY04. Another TELESYNERGY® System was installed in the Clinical Center's re-designed 11th floor Telemedicine Clinic during the Summer of FY04.

A total of twelve TELESYNERGY® Systems, currently installed worldwide, are supported by CIT staff. An additional thirteen systems, installed within the U.S. and in Brussels, are supported by NCI staff. These systems have been successfully utilized in support of multidisciplinary team meetings, tumor boards, second opinion consultations, educational programs, and a multitude of other multisite, collaborative conferences.