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Medical imaging provides a non-invasive procedure of taking images with a clinical application, using a variety of imaging modalities to provide a specified diagnostic picture of the body. Various modalities are used, such as CT, MRI, PET, Ultrasound & X-Ray.
A critical element in patient care, access to diagnostic images is crucial at all times, especially when demand is unpredictable. Load balancing provides a fast, redundant and scalable architecture for the transfer, storage and retrieval of images.
Failures can be costly to the healthcare system and to patients, so achieving zero downtime is a key consideration. Loadbalancer.org appliances monitor the status of medical imaging storage and applications servers (health checks) and seamlessly directs traffic to the healthy, online or least loaded servers.
A standard imaging deployment combines fast, highly available storage with unrestricted retrieval of images using our ultra-fast Layer 4 Direct Routing (DR) mode of operation. In a large hospital environment, peak image retrieval traffic volumes can be more than 5x the volume of storage traffic. The example outlined here demonstrates the benefits of DR and why our products are so well suited to medical imaging requirements.
|Imaging||Total Images||MB/image||MB/study (RAW)||Number of studies/year||Storage per study type (MB)|
|Cardiology imaging device||22||22.11||486.42||10,000||4,864,200|
|CT – Multi-slice imaging device||400||0.52||208.00||20,000||4,160,000|
|CT – 64-slice imaging device||2000||0.51||1020.00||100,000||100,000,000|
|CT – 128 -slice imaging device||4000||0.51||2040.00||200,000||200,000,000|
|Fluoroscopy imaging device||24||1.96||47.04||50,000||2,352,000|
|Mammography imaging device||4||26.00||104.00||20,000||2,080,000|
|MRI - Magnetic resonance imaging device||400||0.18||72.00||10,000||720,000|
|Ultrasound imaging device||40||0.75||30.00||30,000||900,000|
In this example of 440k studies/year we have a yearly storage requirement of 315TB, which equates to 863GB per day, or a data rate of 1.9GB/s. The below table demonstrates how the retrieval traffic exceeds 11GB/s but, by utilizing DR mode, traffic on the return path bypasses the load balancer directly to the client, meaning there is no packet flow limitation. In practice, this means our entry-level hardware provides reliable image retrieval on a deployment of this size.
|Number of stations||Studies/hour||Study size MB (avg)||Data rate Mbit/s|
|Reporting stations traffic||45||100||1020||10,200|
|Concurrent users traffic||1000||10||30||667|
|CDR PACS users||600||40||60||533|
Supporting up to 500k studies/year, the Enterprise R20 is the chosen solution for medical imaging deployments large and small. For anything greater than 500k studies/year the Enterprise 10G model offers exceptional value for money - and will cope with the most demanding of environments.More Information Free Trial
Below are examples of the systems, standards and protocols that support load balancing:
|PACS||Picture Archiving and Communication System (PACS) provides storage and access to diagnostic images from multiple modalities.|
|VNA||Vendor Neutral Archive (VNA) is an archival system, capable of storing images in a standard format.|
|DICOM||Digital Imaging and Communications in Medicine (DICOM) is a standard for storing and transmitting medical images.|
|HL7||Health Level-7 (HL7) is a set of standards for transfer of data between software applications used in healthcare.|
|XDS||Cross-Enterprise Document Sharing (XDS) is a standard for sharing of patient Electronic Healthcare Records.|
The following tables shows the typical ports/services that are load balanced:
|104||TCP/DICOM||Exchange of images and related information|
|11112||TCP/DICOM||Exchange of images and related information|
|2575||TCP/HL7/MLLP||Communication between healthcare IT systems|
|443||TCP/HTTPS||Client viewer connectivity|
Loadbalancer.org specializes in load balancing healthcare applications and are the only vendor with native support. In order to support such an array of different applications, we use a variety of load balancing methods including Layer 4 DR, Layer 4 NAT and Layer 7 SNAT modes.
You need a vendor who’s experienced in supporting the healthcare industry to the highest standards and who has worked with some of the world's leading medical imaging vendors. We will support you on the way and protect your business not just the load balancer. Our team of application delivery specialists will provide you advice, helping design and simplify your architecture.
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