Clinical-oriented collaboration over the Web during interventional radiology procedures.

Multidisciplinary collaboration is a key requirement in several contemporary interventional radiology procedures (IRPs). We proposed a hybrid system (NetAngio) to enable "on the fly" heterogeneous collaboration to support IRP providing intraoperating essential services, and investigate its feasibility and effectiveness in a referral medical center. We have developed a Web-based, cost-effective structure, able to support real-time mentoring, image manipulation, and education services beyond the boundaries of the single institution and potentially allow sub specialists to participate in opinion and decision making in more complex cases. Supported services based on a Motion Joint Photographic Experts Group (MJPEG) coder/decoder (CODEC) can be easily accessible by authorized collaborators, within a user-friendly interface by using a typical Web-browser. Ten interventional radiologists, two vascular surgeons and two medical physicists participated in 33 "fully collaborative" cases during a 13-month period from January 2004 to February 2005. In addition, fifteen 90-minute open seminars and finally, 75 expert's module activations, and 255 learner's module activations were performed during the evaluation period. Collaborative procedures are able to enhance outcomes performance especially in more complex cases where the simultaneous presence of a remote expert interventionist and a medical physicist or a surgeon is required. Further research is needed to promote integration of additional data sources and services.