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Email-P2P Gateway to Distributed Medical Imaging Repositories

For the healthcare professionals the importance of the medical imaging as a diagnostic tool is undeniable. For this reason, industry and research organizations increased significantly their interest in the medical imaging area, trying to deliver solutions for creating, storing, exchanging and displaying medical images. The raise of hardware and software solutions drove the community of vendors to gradually decrease the price of his solutions. As consequence, there was a rise of small imaging centres competing with bigger healthcare institutions. The market offers drives the patients to move across a wide range of healthcare institutions to undergo all the necessary exams. Producing a great amount of medical data dispersed over several institutions. This scenario of isolated islands of images repositories unable of interacting with each other is, in our opinion, propitious to a peer-to-peer (P2P) archive solution. Until now, medical exams (images and studies) have been exchanged through analogue films, media storage devices (CD, DVD, etc), virtual private networks or manual email procedures. This paper describes the Dicoogle P2P system, a distributed PAC system where its users may easily store, search and exchange DICOM files. However, potential peers of the Dicoogle system are usually inside private networks, behind NATs and firewalls, disabling the inter-institutional peer interaction. Therefore, we propose an Email-P2P gateway to Dicoogle that offers a way to exchange DICOM files through these virtual barriers.