Tactiq and GE Healthcare Case Study: GENIE Acquisition Product Development

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Since 1996, Tactiq (www.tactiq.co.uk) has been developing complex embedded software and an outstanding track record in the medical systems industry.


Tactiq plays a leading role in developing and supporting GE Healthcare's most successful nuclear medicine imaging system—the GENIE Acquisition system, with LynuxWorks' LynxOS real-time operating system inside. Tactiq is proud to have GE Healthcare as a major client for over ten years.

Author: Tim Jones, Principle Engineer, Tactiq Ltd.

Nuclear Medicine (NM) imaging has been in use since the 1960s. A radiopharmaceutical injected into, ingested by or inhaled by the patient emits gamma radiation. A sensitive gamma camera detects the radiation emitted from the patient. A computer (operators console) processes this to form and store an image. Computer technology is used to provide image processing, archiving and network features. Real-time computing allows the undertaking of complex scan types that require the precise real-time positioning of the patient with respect to the gamma camera and synchronisation of the image formation to physiological processes.

Nuclear medicine images biological function not anatomical structure. NM images are typically "fuzzy" compared to other imaging procedures but the functional information is quantitative and complementary to other techniques. The most widespread applications are bone, cardiac, lung and renal imaging. Image processing is used to extract data such as the ejection fraction of the heart, lung capacity (both gas and blood flow) and kidney function. Bone imaging is used to locate joint wear, hairline fractures and bone cancer.

GENIE Acquisition
The GENIE Acquisition Operators Console controls the NM scanner system and provides a graphical user interface for operator interaction, including scan set up, image review and network image transfer.

Nuclear Medicine Imaging System
GE Healthcare's "MG" NM system is a very popular variable-geometry, dual-gamma-camera imaging system with approximately 1300 systems installed worldwide.

GE Healthcare is the world leader in the provision of medical imaging products including X-ray, ultrasound, CT, MRI, PET and nuclear medicine. GE Healthcare is an $18bn business.

The Tactiq (formally Atalanta) team are the design architects behind GENIE Acquisition, GE's most successful NM operators console. Tactiq continues to play the lead role in the development of GENIE Acquisition. This document describes key aspects of the development process and the roles played by Tactiq.

GENIE Acquisition

GENIE Acquisition is a system control and imaging application running on the LynxOS® real-time operating system. The hardware platform is an "off-the-shelf" PC. GENIE Acquisition provides gamma image acquisition, sophisticated motion control and an operators interface to nuclear-medicine imaging systems. This enables a technologist to set up and execute a variety of NM scans. Image data can be easily transmitted using DICOM across a hospital network to a variety of destinations including image processing workstations or Picture Archive and Communications Systems (PACS).

GENIE Acquisition's primary functions:

• User interface to set up and execute patient scans
• Scanner gantry calibration and real-time motion control
• Gamma camera data acquisition, image correction and image framing
• Gamma camera control, calibration and image quality assurance
• Image display during acquisition
• Display of previously acquired data for review
• DICOM network functions for sending images to PACS or workstations and fetching patient schedule information

GENIE Acquisition is regarded by many inside and outside GE Healthcare as the "gold standard" for ease of use, reliability and flexibility. Since its introduction in 1996, over 2000 have been shipped with a range of NM systems. In 2003 over 350 GENIE Acquisition systems were shipped from manufacturing in Haifa, Israel.

Tactiq's role in GENIE Acquisition development

The Tactiq team are the architects and core development team behind the highly successful GENIE Acquisition system.

For over 10 years Tactiq's project managers and engineers have lead and worked with engineering teams in the UK, USA, Denmark, India and most recently Israel. Highly developed collaborative engineering skills and experience continue to ensure the smooth execution of GENIE Acquisition projects regardless of the geographic location of GE's engineering teams.

Tactiq continues to play a central role in ongoing development and support, working closely with GE Healthcare's engineers based in Haifa, Israel and with service engineers worldwide.

Product development process

Understanding requirements

Clearly documented product requirements are essential to ensure that all interested parties have a common understanding of the performance, features and cost targets. This stage of the product life cycle offers a low-cost opportunity to make changes that affect product specifications.

Tactiq analysed and documented GENIE Acquisition requirements encompassing:

• Control and calibration of a range of NM scanner gantries
• Control and calibration of a range of NM gamma cameras
• Integration with hospital medical imaging networks
• NM technologists' (operators') needs
• Doctors' needs for study types and image quality
• Service engineers' needs
• Hospital administration needs for scan times, reliability, safety, cost and training times
• GE's needs for marketability, reliability, safety, cost and time to market
• Future enhancements and maintenance

Design

A good design is crucial to ensure that the finished product meets requirements and is flexible enough to accommodate changes that are inevitable during the product lifecycle. The quality of a design has a significant influence on product lifetime and return on investment.

GE Healthcare's target for GENIE Acquisition's production life was for 5 to 10 years. Tactiq applied a wide range of expertise and experience to design a robust framework within which it is easy to add new features and to support a wide range of different gamma cameras and mechanical systems. The result is a product that looks as polished and remains as reliable today as it did 8 years ago. GENIE Acquisition now supports nine different nuclear medicine hardware systems with 95% common software. This is producing substantial benefits in product reliability, speed of development, validation and maintenance.

Object-oriented design techniques are used extensively throughout GENIE Acquisition. MagicDraw™ computer-aided design tools are used for much of requirements capture and OO design.

System and subsystem testing were considered early in the design process. Tools and an environment were created to allow simulated testing as an intrinsic part of GENIE Acquisition development. The ability to perform simulated testing accelerates and simplifies subsystem testing and is a significant factor in producing excellent overall system reliability.

The Tactiq team designed the very successful GENIE Acquisition graphical user interface. User task analysis and focus on customers' needs resulted in a user interface that was ground-breaking in its ease of use. Operator training time for a NM technologist was reduced from one week (previous Starcam™ system) to less than half a day, yet the ability to perform complex scan types was not compromised.

Tactiq developed the embedded database, DICOM networking, real-time image display and acquisition software. From 1997 Tactiq has maintained and enhanced the gantry motion control software and the DSP software that performs real-time gamma event correction.

In 2001 Tactiq re-designed the gamma camera interface electronics to support a pre-existing model of gamma camera, allowing field upgrades of the acquisition computer.

Implementation

GENIE Acquisition is implemented principally in 'C' and 'C++'. The majority of the user interface is implemented in C++ with most of the underlying software written in C.

GENIE Acquisition operates on LynxOS, a fully featured UNIX®-like operating system with a deterministic, hard real-time kernel. The host (LynxOS) software is built, tested and debugged using GNU tools, Make, BASH and CShell. DSP software is developed in assembler and built into downloadable executables using Analog Devices tools. A CVS (source version control) server is used to manage software versions. The flexibility of CVS enables the Tactiq team to work concurrently with engineers around the world on the same software application.

CVS is used as a source version control system. This is core to managing collaborative development work. It is not uncommon for GENIE Acquisition releases to be developed by a team split between the UK and Israel.

Testing and validation

Tactiq has incorporated powerful simulation into GENIE Acquisition. This allows for extensive testing without the need for a complete NM system. An emphasis on early testing improves the quality and reliability of software prior to integration testing.

Simulation allows over 70% of integration to be undertaken without the need for connection to an NM system. Final integration testing, prior to system validation, is normally undertaken at GE's facility in Israel. Remote system access tools allow engineers in the UK to access NM systems in Israel either for test and debug. These tools enable engineers in the UK to use an NM system in Israel while running the user interface on a PC in the UK. It is also possible to access the system via remote login to monitor system status, retrieve error logs and modify configuration parameters. Restrictions on the remote operation of scanner motion ensure safety. In the case of large releases that include significant new features a Tactiq engineer travels to Israel for 1 to 2 weeks to accelerate the integration process. Final validation is undertaken in Israel with support and guidance from the Tactiq team in the UK. Remote access is once again crucial to support the validation process.

Support

Since GENIE Acquisition's introduction in 1997, Tactiq has provided worldwide technical support, primarily through a combination of telephone and remote system access from the UK. Occasionally Tactiq's engineers travel to hospitals around the world, providing engineering representation for GE Healthcare. Breadth of knowledge enables Tactiq to identify and correct problems beyond the remit of the GENIE Acquisition software. A personable demeanour and the rapid correction of faults results in improved customer satisfaction. Tactiq has received much praise from GE Healthcare for its professionalism and effective approach to correcting technical issues while on a customer's site, demonstrating Tactiq's full product lifecycle expertise and commitment to client satisfaction.

Training

Recognised by GE Healthcare as a leader in the development of advanced embedded computer systems, Tactiq is regarded as such a world-class source of knowledge. Tactiq has prepared and presented training material to GE Healthcare personnel in the USA and Israel to communicate a clear understanding of the design and implementation philosophy that is fundamental to GENIE Acquisition's success. This helps ensure that engineers joining the GENIE Acquisition team design and implement software that does not compromise the reliability and maintainability of GENIE Acquisition.

Looking at the bigger picture

An in-depth knowledge of embedded systems technology and nuclear medicine combined with world-class collaborative engineering skills has enabled Tactiq to make many significant contributions to GE Healthcare's nuclear medicine program. Tactiq has identified and researched several opportunities to add key new features or reduce product cost. The most recent of these is currently underway and expected to save GE Healthcare over $1.1m per year. The ROI in the first year alone is estimated at 4:1. Looking at the big picture and focussing on customer needs generates real benefits for Tactiq's clients beyond the rapid development of high-quality products.

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