Enhancing low-dose CT images in the EHR based on HTML5

The Web Access to Digital Imaging and Communication in Medicine (DICOM) Persistent Objects (WADO) standard specifies a Web-based service for accessing and presenting DICOM persistent objects, such as images and medical imaging reports. This paper analyzes the image transferring mechanism of the WADO service and proposes to extend its abilities by accessing 16-bit images and incorporating a denoising method clinically in demand. In our Electronic Health Record (EHR) implementations, we found that due to severe degradation by quantum noise and artifacts under low dose scan protocols, direct display of low-dose CT (LDCT) images tends not to be clinically desired. We propose to improve LDCT images in web clients of the EHR without downloading anything except HTML codes. We achieved that by using advanced features of the new HTML5 standard. Our implementation is plug-in-less, ensuring to enhance LDCT images anywhere, anytime in any HTML5 compliant EHR client. Evaluation results validated our improvements of the WADO service in enhancing clinical LDCT images.