Editorial

Casimir A. Kulikowski1 Editorial Reinhold Haux2 Editors Medical Imaging Informatics 1 Department of Rutgers - The State University of New Jersey New Brunswick, New Jersey, USA 2 Department of Medical Informatics University of Heidelberg Heidelberg, Germany and University for and Technology Tyrol Innsbruck, Austria

The 2002 Yearbook of Medical multiple underlying biological levels Informatics takes as its theme the topic (cellular, molecular, atomic) leading to of Medical Imaging Informatics. The the definition of structural informatics visual nature of so much critical [5], and the development of a Founda- information in the practice, research, tional Model of Anatomy [6]. Mean- and of medicine and health while, knowledge representations for care would suggest that computer-based integrating multimodal image inter-

imaging and its related fields of graphics pretations [7], methods for modeling and should be central to the elastically deformable anatomical practice of medical informatics. Yet, objects [8], integrated segmentation historically, this has not usually been the and visualization systems [9], knowl- case. The need for technological sub- edge-based methods [10], and model- specialization on the part of imaging driven systems for surgery and educa- researchers and the frequently opposite tion [11] have been gradually helping tendency towards generality of informa- renew connections between imaging and tion systems studied and developed by mainstream informatics work. Encour- informatics researchers may have aging further productive collaborations contributed to an increasing separation between researchers in imaging and between the fields in the period from the informatics was one of our motivations 1970’s to the 1990’s. in the choice of Medical Imaging Infor- matics as the theme for this Yearbook. A trend towards re-convergence, however, began in the early 1990’s as The Yearbook of Medical Infor- important new image , matics is distributed through IMIA’s mapping, registration, and segmentation Member and Corresponding Member issues arose in the context of neuro- Societies worldwide. For the 2002 imaging with the Human Brain Project Yearbook we expect that over 7,000 [1,2], and multimodal, whole body copies will reach the memberships of imaging with the Visible Human Project 45 Member and 8 Corresponding [3,4]. There was early recognition of member societies. The Yearbook’s the need for computer-based knowl- editors are grateful for the contributions edge representations, not only of anato- of distinguished researchers in medical my at the tissue level, but also at the informatics who have prepared five

Yearbook of Medical Informatics 2002 3 Editorial invited review papers, six research approximately 40 years ago. Starting Project initiated at around the same and education papers, and six synopses in the mid-1970’s rapid progress in time led to a very large number of of papers included in the different computer-based imaging research and projects in brain data mapping, registra- disciplinary fields covered. In addition practice came from the increasingly tion and segmentation, all of which we owe a debt of gratitude to the 49 specialized, highly mathematical, bio- made clear the new informatics, reviewers who assisted in the selection physical, and engineering models of biometrics, and computational imaging of papers from the recent refereed different imaging modalities (CT, MRI, challenges inherent in integrating literature. digital angiography, ultrasound, nuclear massive visual datasets of subject- medicine imaging, etc.). Various specific data which needed to be The present Yearbook includes specialties such as radiology, cardiolo- abstracted and summarized into atlases papers selected from the literature for gy, and nuclear medicine distinguished and retrievable maps of the brain. the period April 2000 to March 2001. themselves by concentrating their Possibly as result, there has been a re- The criteria for selection include topic efforts on the technologies most awakened interest of medical informa- significance, representativeness and effective for their own diagnostic and tics researchers in imaging problems, coverage of research in a given subfield, therapeutic goals. Hospital or enter- and the development of what can be subject to appropriately high levels of prise-wide storage and retrieval of large identified as a medical imaging informa- quality in presentation and results. A numbers of patient image studies led to tics subspecialty [13]. This is centered more detailed description of these the development of PACS systems, around the problems of image data quality criteria can be downloaded from but, technological, organizational, and representation and abstraction, where http://www.Yearbook.uni-hd.de/ economic constraints tended to divorce for describing the underlying quality_criteria.pdf. The referees them from novel imaging research, medical knowledge needed to interpret score and rank the papers, and the and they frequently became just another images are now being developed in final selection is made by the editors part of the IT infrastructure for hospitals computationally explicit form [14]. This with the advice of editorial board mem- and clinics. Meanwhile, professional will not only assist in standardization bers from each of the specialty areas. societies and conferences devoted and interoperability, but will be crucial

We expect to publish a description of exclusively to biomedical imaging and in making image data more usable for the quality criteria used in selection in its subdisciplines proliferated. The , decision support, and the medical informatics literature in number of researchers in the main- visual modeling and simulation. the coming year to help provide more stream of medical informatics who general insight on this process [12]. remained professionally active in medi- Fundamental issues in imaging that cal imaging began to shrink, and this are well-known to medical informatics This year’s preface to the Yearbook trend continued until recently. researchers include: standards for „From Digital Anatomy to Virtual image information exchange, commu- Scapels and Image Guided Therapy“ The combination of more advanced nication protocols, underlying computer has been prepared by Nicholas Ayache, and user-friendly medical image data data and knowledge representations, Research Director for the Epidaure bases, coupled with improved 2D and coding, nomenclature and vocabulary Project, Medical Imaging and Robotics 3D reconstruction, visualization and for including imaging information in of INRIA (The French National Institute navigation , is making the electronic medical record, relation for Research in Computer Science and medical imaging results more accessible to computerized guidelines for health Control), Sophia Antipolis, France. to physicians at the point of care. care, information compression, effi- Starting in the early 1990’s the Visible cient indexing of image , Human Project produced a widely security and confidentiality of imaging Imaging Informatics and available reference set of multimodal records, etc. Medical/Health Care images of the whole body. Its wide Informatics:The dissemination has led to much anatomi- There are also many informatics Opportunities and Constraints cally-detailed education software, but challenges that require deeper scientif- of Interdisciplinarity more importantly, it has raised impor- ic, technical, and medical expertise as tant informatics issues of knowledge imaging information becomes more Medical informatics researchers representation, modeling, and informa- integrated and pervasive to the practice have contributed to the development tion retrieval for dealing with large- of medicine. These include: of medical imaging methods and scale repositories of such multimodal · the development of better human- systems since the inception of this field digital image sets. The Human Brain computer interaction models for

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health care that rely not only on the informatics researchers in the develop- D. Fieschi, J. Gouvernet, M. Joubert, increasing power of graphics and ment of working systems for the and G. Soula provide an overview of visualization but also on good psy- practice of health care, and the improve- Research and Development in Health chophysical and ment of education. Informatics at the Faculty of Medicine studies, given the multiresolution of Marseille, while György Kozman of nature of many medical imaging Veszprem University describes how studies, and how this affects per- Review Sections education in medical informatics is ception and interpretation of data; based on an information technology · developing better techniques for As is customary, the 2002 Yearbook curriculum at his university. Yu-Chuan automatic segmentation and includes a number of original review Li presents the Evolving Biomedical registration of medical images in artic les, which focus primarily on this Informatics Program at Taipei Medical 3D as well as 2D; year’s theme. An article by Michael University, and Wendy McPhee writes · data abstraction, summarization, Ackerman on “Visible Human Project: about Education Downunder from the and graphical (iconic) represen- From Data to Knowledge” updates Centre of Medical Informatics at tation involved in atlas construction; the status of this seminal project for Monash University. Finally Edward · representation of biological variabil- the field. “Imaging Informatics and H. Shortliffe describes the changes in ity across repositories of bioimaging the Human Brain Project: The Role of the program in Bio-Medical Informatics data to interpret imaging data across Structure” by Jim Brinkley and at Columbia University, where he has populations, and the linking of Cornelius Rosse, provides a com- recently assumed the chairmanship. phenotype to genotype data; prehensive review of how imaging · improving ways of integrating informatics approaches were essential results from automatic image seg- for the Human Brain Project and the Challenges in Medical mentation with expertly derived development of structural informatics, Informatics manual segmentations and annota- and have led to the development of a tions - and methods for evaluating computer-based foundational model of In this section, three papers can be

the outcomes; anatomical structure. Wieslaw Nowinski found dealing with the future of Medical · developing annotation languages for gives a systematic review of the applica- Informatics. Incoming IMIA President extracting key patient findings found tion of different modeling methods for KC Lun (Singapore) describes within the massive quantity and enhancing neuroimaging results. Two important future tasks of IMIA. Mark great level of detail inherent in papers address other important topics to Musen (Stanford) reports on the medical imaging data; medical informatics: Bonnie Kaplan and outcomes of an IMIA satellite confer- · creating underlying computer-based Nicola T Shaw use evaluation processes ence on this topic. Finally, the result of representations of knowledge to review how people, organizations, a panel discussion on the future impact (ontologies, atlases, etc.) to help and social issues impact medical of information and formalize such communication, informatics concerns; and Gunnar technology on health care, addressed while also preserving the flexibility Klein reviews advances in standards- by clinicians, researchers and industrial needed for capturing novelty and setting activities in the field. representatives, is presented. enabling discovery; · embedding advanced imaging sy- stems in more general health care Education and Research in Guest Editors delivery software and evaluating Medical Informatics their results within health care After the selection of papers to be environments with effective feed- The Yearbook provides an opportu- included in the Yearbook had been back for how to modify nity for highlighting an international accomplished, guest editors were and update the imaging methods in selection of current education, training, asked to write Synopses reviewing the different clinical contexts. and research programs in Medical papers in the different sections. The Informatics. This year Russ B. Altman section on Health and Clinical Man- As researchers in medical imaging describes the program in Biomedical agement was edited by Steven Chu of informatics begin to address these and Computation at Stanford University the University of Auckland; that on other topics, we hope that the 2002 which increasingly introduces Patient Records by Michio Kimura of IMIA Yearbook’s theme will stimulate biomolecular as well as clinical applica- Hamamatsu University, that on Health greater interaction among imaging and tions of informatics. Marius Fieschi, Information Systems by Sedick Isaacs

Yearbook of Medical Informatics 2002 5 Editorial of South Africa, the section on Signal medicine guidelines for care, as well experience has been essential in Processing by Pablo Laguna of as the world-wide concerns for helping chart a course of excellence Zaragoza University, and that on controlling costs in health care and world-wide coverage for the Knowledge Processing and Decision systems, there has been growing Yearbook during this period of rapid Support by Greg Cooper of the research on the impact of informatics change in medical informatics. University of Pittsburgh. Computer- systems on the quality of health care, supported education had as guest editor and its implications for patients and Acknowledgements Jens Dørup of Aarhus University, and health care practitioners. the section on was The editors gratefully acknowledge edited by Ralf Hofestädt of the The 2003 Yearbook will continue its the contributions of the Referees and University of Bielefeld. coverage of all topics in medical infor- Guest Editors. They would also like to matics, including the one newly added thank the writers of the professionally this year, that of bioinformatics, which, critical Review Papers and the IMIA due to its long-term implications for the contributors to the Education and development of molecular medicine Research Section. The Yearbook contains detailed and its methodological connections to information about IMIA, its Member medical informatics, will now become They are most appreciative of the Societies, Working Groups, and Special a permanent section of the Yearbook. considerable skill, time, and effort Interest Groups. Preparation of the devoted by the Managing Editors, general pages describing IMIA activi- especially the Executive Managing ties received considerable assistance Advisory Board Editor Elske Ammenwerth, and by the from Steve Huesing, the Executive Section Managing Editors, Andreas Director. The section on IMIA The Editors wish to thank the Bohne, Klaus Ganser, Petra Knaup, Working Groups and Special Interest members of the Advisory Board for Christoph Maier, Andre Michel, Reiner Groups was greatly aided by their invaluable contributions to the Singer, and Astrid Wolff. A consid- erable amount of the organizational contributions from Nancy Lorenzi. planning of this Yearbook. They are: Marion Ball, Vice-President of Health- support was carried out by the staff at For the first time in this Yearbook, a link, Inc. of Baltimore, MD, Jan H. van the Department of Medical Informatics more detailed report on the activities of Bemmel, Rector of Erasmus University at the University of Heidelberg, where IMIA regions is included with the help Rotterdam, The Netherlands, and Alexa we most especially thank the Editorial of Regional Editors. We would like to McCray, Director of the Lister Hill Assistant, Martina Hutter, without thank Arie Hasman (for EFMI), Sedick Center of the National Library of Medi- whose untiring efforts the Yearbook Isaacs (for Helina), Jochen Moehr and cine, NIH, USA (Figure 1). Their would not have been completed. Charles Safran (for the North American IMIA Member Societies), and Chun Por Wong (for APAMI) for their support.

The IMIA representatives from the individual countries provided the material for their own national societies.

The 2003 IMIA Yearbook

The theme of the 2003 Yearbook will be on the Informatics Foundations of the Quality of Healthcare. With the increasing automation of health care systems, the more widespread intro- duction of electronic patient records, Fig.1. IMIA Yearbook Advisory Board Members (Alexa T. McCray, Jan H. van and the application of evidence-based Bemmel, Marion J. Ball)

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The referees who contributed to the J. Murphy, United Kingdom ciples for anatomical knowledge selection of articles in the 2002 C. Nøhr, Denmark representation: the Digital Anatomist symbolic knowledge base. Journal of the Yearbook of Medical Informatics are: N. Oliveri, Argentina/USA American Medical Informatics C. Quantin, France Association 1998;5(1):17-40. A. Abu-Hanna The Netherlands C. Safran, USA 7. Höhne KH, Pflesser B, Riemer M, H. Åhlfeldt, Sweden G. Schiff, USA Schiemann T, Schubert R, Tiede U. A new R. Beuscart, France B. Seroussi, France representation of knowledge concerning human anatomy and function. Nature A. Bolz, Germany Y. Shahar, Israel Medicine 1995;1(6):506-10. T. Bürkle, Germany M. Stefanelli, Italy 8. Gee JC, Reivich M, Bajcsy R. Elastically J.J. Cimino, USA I.M. Symonds, New Zealand deforming 3D atlas to match anatomical H. Dickhaus, Germany M. van Gils, Finland brain images. J Comput Assist Tomogr 1993;17(2):225-36. J. Dørup, Denmark R. Walton, United Kingdom 9. Robb RA, Hanson DP, The ANALYZE M. Egmont-Petersen, The A. Winter, Germany software system for visualization and Netherlands W. Wolf, Germany analysis in surgery simulation. In Lavalle S, U. Engelmann, Germany T. Yoo, Korea Taylor R, Burdea G. Mosges R, editors. K.-H. Englmeier, Germany J. Zvárová, Czech Republic Computer Integrated Surgery. MIT Press, Cambridge, MA 1995. p. 175-90. G. Eysenbach, Germany 10. Gong L, Kulikowski CA. Composition of M. Fischer, Germany References image analysis processes through object- D. Gamberger, Croatia centered hierarchical planning. IEEE Trans G. Gell, Austria 1. Toga AW. Three Dimensional Pattern Analysis and Machine W.T.F. Goossen, The Netherlands Neuroimaging, Raven Press, NY, 1990. 1995:997-1009. 2. Koslow SH, Huerta MF, editors. 11. Kikinis R, Shenton ME, Iosifescu DV, A.M. Grant, Canada : an overview of the McCarley RW, Saiviroonporn P, Hokama J. Grimson, Ireland Human Brain Project. Mahwah, New HH, et al. A digital brain atlas for surgical L. Hanmer, South Africa Jersey: Lawrence Erlbaum; 1997. planning, model-driven segmentation, and E. Hovenga, Australia 3. National Library of Medicine (U.S.) Board teaching. IEEE Trans. Visualization and of Regents. Electronic imaging: National Computer Graphics 1996;2(3):232-41.

H.K. Huang, USA Institutes of Health. NIH Publication 1990. 12. Ammenwerth E, Wolff AC, Knaup P, R. Jané Campos, Spain p. 90-2197. Skontzki S, van Bemmel JH, McCray AT, M. Kaus, Germany 4. National Library of Medicine (U.S.). Haux R, Kulikowski CA. Quality criteria G. Kozmann, Hungary Proceedings of the Third Visible Human for medical informatics research papers, submitted for publication, 2002. T. Lehmann, Germany Project Conference. Banvard RA, editor. October 5-6, 2000, Bethesda, MD: US 13.Kulikowski CA. Medical imaging N. Maglaveras, Greece Department of Health and Human Services, informatics: challenges of definition and V. Maojo, Spain Public Health Service, National Institutes integration. J Am Med Inform Assoc F. Martin Sánchez, Spain of Health; 2000. 1997;4(3):252-3. W. McPhee, Australia 5. Brinkley JF. Structural informatics and its 14. Mejino JLV, Noy NF, Mussen MA, applications in medicine and biology. Brinkley JF, Rosse C. Representation of A. Merzweiler, Germany Academic Medicine 1991;66(10):589-91. structural relationships in the foundational J. Möhr, Canada 6. Rosse C, Mejino JL, Modayur BR, model of anatomy. IN: Proc. AMIA Fall P. Molholt, USA Jakobovits RM, Hinshaw KP, Brinkley Symp, Washington DC, 2001. p. 973. P.W. Moorman, The Netherlands JF. Motivation and organizational prin-

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